As a nurse practitioner for over 13 years, I have cared for and loved numerous patients throughout my career. Never would I have imagined a world where loved ones were hospitalized alone, without a loved one or advocate.
On Thursday, July 2, my dad and brother drove my 70-year-old mother to the hospital due to emergent, excruciating back pain of unknown origin. After checking my mother into the ER, my dad had to leave his wife of 49 years alone because of COVID restrictions; she was nearly immobile and in severe pain. There was no wiggle room, no negotiating or pleading considered — no family caregiver allowed for my mother. My father was devastated. It was like a dump and run, the worst kind of abandonment imaginable. The exact opposite of what we as humans hope to do best: protect the old, weak or sick at all costs. My dad had to put blind faith in our newly COVID-restricted medical system.
After 24 hours in the ER, 18 hours of which included no treatment, my mom’s MRI showed three fractures in her back and cancer in her spine and hip, and she was being admitted to the inpatient oncology unit. My mother delivered the news to me over the phone. My dad was heartbroken. How had we missed the signs of cancer for so long? Why was my mom alone? And why had COVID shut down every patient’s right to have an advocate at their bedside?
It has been the worst kind of horror story. Pandemic hit, the world shut down, and sick loved ones sit alone — and sometimes die alone — in hospitals. Unimaginable.
Once the shock from the cancer diagnosis passed, anger set in. How can we as humans do this to each other? How can one virus have derailed safety measures we fought so hard to ensure for patients?
The only power I had was to work every medical channel, network and brain I could think of to get an advocate for my mom. I called patient advocacy, the charge nurse, the intern caring for her, and all the outpatient physicians I knew who might have a link to the hospital. Every answer for my dad was “no” due to COVID. The only exception they would consider, and this too would have to be cleared by the hospital, was if my mom had only days to survive, and even then, it was only one family member per patient. Flabbergasted, appalled and deeply saddened we had to make the most of what we could do as a family from the outside.
It will take time to truly realize the implications of not having an advocate with my mom. But one immediate, and very likely scenario, was an increased length of hospital stay and adverse events she encountered — possible COVID exposure in the ER, urinary tract infection and delayed testing and diagnosis. According to the British Medical Journal from 2018, adverse medical errors decreased by 38% on several inpatient pediatric settings around the nation after “implementation of a structured verbal and written communication intervention for rounds that emphasized health literacy, family engagement, and bidirectional communication.” Between my mom’s pain, post op recovery from a hip replacement with rod insertion, and an abundance of narcotics, there is no question things were missed, and communication between provider and family suffered.
Time will hopefully heal my mother. But will time heal the emotional trauma she endured in a hospital alone due to the COVID restrictions? What about the trauma of not being with those we love during their greatest time of need? Unfortunately, the rate of hospitalization continues to climb, so we need better policies enacted now to safely get at least one patient advocate in with their loved ones, despite COVID. This can safely be done with testing, masks, waivers and staying for the whole length of admission. If nothing changes, these severe COVID restrictions could cause more harm than good, including a much higher fatality rate for those with and without COVID. Could the fallout from COVID be worse than the disease itself?
Every patient and hospital case is unique and must be handled on an individual basis properly, ethically, and with a strong consideration for the emotional ramifications that could last beyond COVID. Change must happen now before the emotional wounds are too deep for time to heal.
Amy Rump (email@example.com) is a nurse practitioner.