SARAH: This is At the Core of Care, a podcast where people share their stories about nurses and their creative efforts to better meet the health and healthcare needs of patients, families and communities.
I'm Sarah Hexem Hubbard, Executive Director of the Pennsylvania Action Coalition and the National Nurse-led Care Consortium.
Our special COVID-19 pandemic coverage continues with a look at an innovative nurse-based initiative to build vaccine confidence in California.
We’ll be hearing from nurse practitioner Lizett Leandro.
During the pandemic, she’s been a consultant for the Trust a Nurse, Ask a Nurse program and helped create the initiative’s informational template.
This telehealth platform, which was created by HealthImpact, relies on volunteer nurses to field vaccination questions from community members. Lizett will share what her experience has been like doing this type of public health outreach.
Over the past two decades, Lizett has worked primarily in long-term care with the elderly. She started as a CNA and eventually became a nurse practitioner.
LIZETT: I work for a senior living nonprofit in Southern California. I work as the clinical director of clinical operations and quality. I oversee nursing education policy and procedures and quality improvement for skilled nursing facilities and assisted living communities in southern California.
SARAH: During the first year of the pandemic, Lizett had a baby and returned to her organization to help coordinate vaccinations for senior residents.
LIZETT: The vaccines gave us a lot of hope. I think it allowed for especially the assisted living communities, memory care communities, skilled nursing facilities to have more resident-to-resident interaction, more families involved. More human touch, personal touch. More activities, you know, dining experiences. So that all has helped a lot. We're still not where we want to be, of course; but at least for our organization, you know, we're staying very positive and very hopeful that our vaccine has really helped a lot. I mean, we're very confident in the vaccine. You know, we do have almost 100% vaccination rates with our staff. And most of our residents, we have about 95 plus vaccination rate with our residents as well. So for us, you know, it is looking brighter. But we're not where we want to be yet. And we're in Southern California. So December and January were tough months.
Working with the vaccine rollout in my organization, I quickly realized that we had a lot of vaccine hesitancy. We had a lot of lack of education, lack of resources. And it was mainly because we just didn't have the material. And when I say material, I mean, the correct material from the credible sources on hand. Like the flyers that, for example, the California Department of Public Health put together, the CDC put together. So I started gathering all that material. I started making myself available, as a nurse, to our staff. And when I say staff, I mean all levels, because everyone is really a professional, in my eyes in the nursing home world. From housekeeping. From maintenance. From CNAs to nurses. To nurse managers to administrators. Finance. Everyone was really not 100% with confidence in the vaccine. And it was mainly because of lack of education. And I just started seeing a change when we started providing education. And when I say education, I mean the flyers with the facts. The terms that weren't so medically diverse with all these different medical terms. You know, we started providing more education on what type of vaccine it is. The post side effects, how to manage those. Why you need two doses versus one dose. You know, what was the overall clinical trial, like how many people were part of the clinical trial? And once you started sharing that education, people started being more open to asking the right questions and increasing their confidence and ultimately getting their first dose, and then getting their second dose.
SARAH: By the spring of 2021, Lizett got involved with HealthImpact to help get its Trust a Nurse, Ask a Nurse telehealth platform up and running. This free service is still available and relies on nurses who volunteer to speak with community members through video calls.
LIZETT: My main role has been providing nursing education through a template that I created with flyers, facts, links, everything that has to do with vaccination. And what that entails is really having material from like, for example, the California Department of Public Health. And that means flyers, sites, where people can get vaccinated, links to common questions to common issues about, you know, what if I have this, can I get this? So we get all the material from CDC, or CDPH, which is the California Department of Public Health. And it's really all to provide confidence in the visitor that the material they have access to is online, but sometimes it's hard to access those sites. And we literally send it right to their phone. We first have a video call with them and explain what it is, answer all the questions, and then we follow up with the material just to solidify the patient education.
One of our objectives with the platform was to target Spanish-speaking communities that have low access to care. It could be for various reasons, you know, health literacy or just not having access to care because of overall status in the U.S. or not having health Insurance. So everything that was provided in English for the nurses, was also provided in Spanish. So every flyer was also in Spanish. And this was all data gathered from CDC, CDPH that was either translated or gathered with Spanish speaking flyers.
One of the visitors that I had was bilingual, so being able to provide Spanish material and English material-- it was really invaluable because I spoke to one person, but that conversation actually impacted you know, probably 10, 20 other people. Because I know she was going to take that material to 10, 20 other people.
Most people trust nurses and you’re calling somewhere where you know you're going to have a professional answer your questions. And this is why we offer it to all community members. You can have a community member from a breastfeeding clinic call. You can have a community member from like a local library that is not sure if their child should have the vaccine. So it's from all levels of care and in the whole spectrum of from pediatric to breastfeeding to adult to you know I have X,Y and Z conditions, can I get the vaccine?
SARAH: As part of Lizett’s vaccine confidence outreach, she has fielded a variety of questions. But one of the most asked-about issues has been breastfeeding.
LIZETT: We had a group of lactation consultants call to speak with the nurses and get education. And breastfeeding was a big question for them from their clients. Like their clients were hesitant to breastfeed their baby because they either had COVID or they were not vaccinated yet. Or they were vaccinated and did not want to breastfeed because they were vaccinated. So that we know really spoke to me because being a new mom and I was actually in the middle of breastfeeding myself. So I had done a lot of research on the benefits of breastfeeding along with, you know, what it was to breastfeed with the COVID-19 vaccine and if it had any impact. So being able to share material from facts from the research from CDC, from CDPH. That it was actually encouraged to breastfeed. That it did not affect in any way the child, and it would promote you know, more bonding with the child and the mom. And all the benefits of breastfeeding of course were highlighted. It really spoke to me on how lack of education and access to information is such a big factor in vaccine hesitancy, you know, and how providing this education to the right person can make a difference.
SARAH: While we’ve reached a point where many substantial gains have been made during the pandemic, the virus is still with us. Vaccinated and boosted individuals are still contracting COVID-19 but not severely in most cases.
But there is still a high risk of severe illness and death for unvaccinated adults.
So as we’re about to hear from Lizett, it’s still important to promote vaccine confidence.
LIZETT: It's a tough situation for all of us. But I truly believe we have to empower our health care. Everyone has the power to provide education to patients, to visitors, to friends, to community members. And I know it must be hard to increase a vaccine confidence when you're still seeing people get COVID when they're fully vaccinated and boosted. But one of the things we have to remember and stay very much aware of is that overall we have seen a very successful rollout of the vaccine in preventing severe COVID, preventing deaths. And that to me, you know, is really, the most valuable tools that we can get from the vaccination rollout, you know, is having one more tool to prevent death, to prevent severe COVID. I think, you know, our nursing community or healthcare community, we have to stay grounded to that fact, you know and understand that, yes, COVID is not going anywhere. But the science is also not going anywhere. We are seeing more therapeutics. We are seeing more research and what's working, what's not working. We're seeing more research on the overall strategies to mitigate COVID, infection control. So I would say, you know, stay positive, because yes, COVID is not going anywhere. But science is not going anywhere as well, you know, everyone's still working hard at their finding the right therapeutics and overall research behind vaccines and the tools that we have.
SARAH: Given the work Lizett has done so far with Trust a Nurse, Ask a Nurse, we asked her how she thinks this platform could be applied in the future around other public health issues.
LIZETT: I think this telehealth platform has really opened a lot of ideas and has really made us all think as a tool for many other areas. Like we know the objective is to have a trusted healthcare professional, which is the nurse, be involved in providing that education to the community members. And those community members can range from someone who doesn't speak the language, someone who doesn't have access to care, someone who really just wants to have a candid conversation with a health care professional about any condition. So we realize that COVID-19 is not the only condition that community members have questions about. I mean, we know there are so many other conditions, diseases that are affecting the community, you know, in terms of a public health issue. So we are seeing that this could potentially expand to address other health screenings, other programs, other conditions and there are many other things that are affecting our community not just COVID right now.
SARAH: As for the future of nursing throughout this pandemic, Lizett recognizes the challenges ahead but remains hopeful.
LIZETT: We are experiencing a lot of challenges with staffing burnout, with overall staffing challenges, shortages, and COVID-19 just really brought to light a lot of those issues. And I am positive that this year is going to be a year of change. And I just hope that all my colleagues out there, you know, we stay positive. We stay strong. It's very unfortunate to hear a lot of nurses say they want to get out of nursing.
And I just hope that we all stay strong and that we reconsider those thoughts and we find a way to strategize our stress. We find a way to promote health and wellness within ourselves to stay in the profession because, ultimately, it's really our vocation. You become a nurse when that's your vocation.
CREDITS:
SARAH: Next time on At the Core of Care, we’ll hear from Garrett Chan, the nurse leader behind HealthImpact and more about the organization’s efforts to promote vaccine confidence through nursing.
GARRETT: We are still doing about three or four vaccination events per week, with a focus on doing outreach. Some of our most memorable vaccination events have been in the farm worker community of Sacramento County. Part of the county is very rural. And there's not a lot of access to care. So we have had many different outreach events there. We've also done school-based events. We've also done skilled nursing facility events. So it's really exciting to see all of the different opportunities and getting the vaccine out into the community.
SARAH: Support for our special COVID-19 pandemic coverage comes from the Centers for Disease Control and Prevention.
You can find our most current and past episodes of At the Core of Care wherever you get your podcasts or at paactioncoalition.org.
For more information about related upcoming webinars and where to find COVID-19 resources, log on to nurseledcare.org. And you can stay up to date with us on social media @NurseLedCare.
At the Core of Care is produced by Stephanie Marudas of Kouvenda Media and mixed by Brad Linder.
I'm Sarah Hexem Hubbard of the Pennsylvania Action Coalition. Thanks for joining us.
