Dr. Bruemmer has been working at the Kateri Memorial Hospital Centre (KMHC) for almost 23 years, and with the COVID-19 pandemic, he’s had to find ways to adapt his practice quite drastically.
“I would say, overall, there are fewer patients, but it’s very unusual from the way we usually practice, you know, standard medical practice,” he told The Eastern Door.
“I mean, you see a patient, there’s always an adage if you’re diagnosing somebody that you really need to lay your hands on them and lay your eyes on them – there’s a kind of therapeutic component to it and also a medical legal component.”
But due to strict protocol in place, that isn’t happening like it used to. Phone consultations make up for roughly 75 percent, according to the good doctor, and it is rare you will see him or his colleagues unless you absolutely need to.
“For patients that have, for instance, abdominal pain or something you just can’t figure out (over the phone), then we bring those patients in and there’s a process for that,” he said.
Blood work is another process the hospital cannot get around from a distance, and so the attending nurse practices social distancing as much as possible in that case, and wears a mask and gloves.
The crisis has kept people away from each other, forced us to wash our hands incessantly, and think long and hard about going places, the lines and potential infection, instead of just jumping in the car and doing whatever we want.
The same goes for the hospital, times 100.
“They (patients) get screened to make sure they don’t have any COVID symptoms and if they’re clear to come in – because we don’t want to contaminate the clinic setting at this point – then they’re treated like a normal exam,” he said.
“Anyone who gets through and might be potentially in contact with someone who is positive, we use what’s called PPE, personal protective equipment so we wear a gown, gloves that come up to the gown as well as a visor and stuff that you would use in this type of circumstance.”
Dr. Bruemmer’s drive is short – eight minutes from the hospital from his home in Montreal West – which undoubtedly makes him a bigger asset if he’s called on more, which he has been since the pandemic hit.
Does he fear getting infected, working in a setting that sees so many sick people, even throughout a pandemic?
“I mean, certainly, but the hospital at the moment is considered a cold site so that means that anyone who has COVID symptoms shouldn’t be coming into the hospital because we don’t want people putting the staff at risk – the doctors, the nurses – and most importantly we don’t want to put the residents at risk,” he said.
“Normally we greet our clients warmly with handshakes and so on, but now there is always a bit of trepidation – you’re treating them more carefully, but we do take precautions to make sure we don’t get sick and so we don’t transmit to anyone else,” said Dr. Bruemmer.
The Nurses’ Station
Laurie Whitebean has been a licensed practical nurse at Kateri Hospital for a little over two years, and has adapted to the new reality, both at home and at work.
“We don’t have our reports in our normal nurses’ station, we do reports in a bigger room so that we are following the social distancing practice that everyone else is,” she said.
“We all wear our masks all day if we are within two metres of the patient. This is for the patient’s protection more than it is for us. After each and every procedure that’s done, we wash our hands with soap and water.
“This is drilled into our heads along with the use of antibacterial lotion. We are designated to one floor/unit and we stay on that particular floor trying to keep any cross-contamination of any sort limited. We also have an observation assessment form that is done daily on each patient regularly along with a vital signs. This is to ensure the patient safety and health,” said Whitebean.
But even with stringent protocol, she knows there is danger.
“Like everybody else, this whole pandemic has everybody worried and on edge and I won’t lie, this is a scary time, it is scary going to work,” she said, “Because every day could be the day that somebody contracts the virus. But, this is my job and this is what I signed up for, to help others.”
Every day she tries to take a small video or pictures for the families that are unable to see each other.
As soon as she gets home, she changes her clothes and takes a shower before interacting with family members. Those clothes are kept separately from everyone else’s and washed on their own.
“Of course everyone’s missing their families. Some of the patients that are more cognitive understand what’s going on and understand that there’s no control over the practices and directives that have been put in place,” she said
“Routine is something that is consistent, needed and followed on a daily basis. We have wonderful activity workers that work closely with the patients, keeping them busy and entertained as much as possible.”
Expressing more of what is happening behind the scenes at the KMHC will help people understand things better, she hopes.
“I hope that this helps and that it brings comfort and eases some individuals’ minds,” said Whitebean. “Kateri is doing their absolute best at keeping your family members safe. If you’re worried or concerned or just need a little bit of comfort knowing that your loved ones are okay, call the nursing station and if we don’t answer your call right away someone will call you back with an update.”
Christine Jacobs is a registered nurse in Short Term Care (STC) at the KMHC.
“I feel a sense of duty, for sure, that I need to be there, but also I worry for my health and the health of my patients,” she said.
“At work, we wear masks, gloves, and we follow guidelines to prevent infection spread like hand hygiene. We have isolation protocols in STC such as wearing gowns, face shields, masks and gloves,” said Jacobs.
Her strict hygiene also extends to the grocery store, where she wears a mask and practices strict hand hygiene “so I don’t bring anything back to KMHC or to my home.”
For most of the patients, she said, “It seems like it’s just another day. They accept the new reality of seeing the same staff day in and day out with no visitors.”
They talk on the phone with their families and they are showered, Jacobs said, “with extra love.”
But some patients in STC are waiting to go home, so the extra time is an added anxiety for them.
“We listen, we talk, we laugh with them and we reassure,” she said. “We do the best we can. It’s like everything we ever learned and were trained for about nursing is being used at this time.
“At home, I isolate myself. I practice physical distancing. I wear a mask for the protection of others,” she said. “I wash my hands constantly. My children and husband have learned to disinfect everything that we bring into this house.
“At work we don’t bring any personal items onto the floor such as bags or outside shoes.”
Keeping the Residents Happy
Timothy Armstrong is that guy, the one who plays guitar, sings and keeps things cool.
As an activity worker, it has been a challenge during the pandemic because things are done so differently now.
“One of the biggest ways that we have been impacted is that the residents are no longer allowed to play bingo because of the close proximity of all the players in the activity room,” he said.
Even group activities like darts are prohibited, he said, because so many players are using the same darts.
“I’m using the dry erase board a lot more these days,” said Armstrong, “doing things like hangman but including a large group of people.”
Armstrong plays a sort of stand-in role for the family they can no longer see, family they dearly miss.
“By far the biggest way that they have been impacted is the fact that they are no longer permitted visits from their family members,” he said. “Each room is equipped with a phone but there are many residents who are not able to use it or need a lot of assistance doing so.
“A generous donation by a community member in the form of several iPads has now made it possible for us to FaceTime with family members,” he said, “A big step forward to helping them deal with the separation.”
Another thing the residents looked forward to, were visits from outside entertainers, according to Armstrong, as well as weekly visits from a therapy dog. All of which has ceased for at least a month now, he said.
“I am not afraid once I get to work because I know we have put all the precautions in place to keep the hospital as sanitized as we possibly can,” said Armstrong. “My biggest concerns are the things that I do on my way to and from. Things like stopping at the grocery store or getting some gas.”
Suzanne Jacobs has kept things clean for the past two years as a housekeeper in the Outpatient Department.
“I wipe down all the high touch areas, such as door handles, light switches, chairs, washrooms, and a complete wipe down of the doctors’ offices every day, including equipment,” she said.
And for those who have seen her work, they know how diligent she is, especially these days.
Handrails are constantly wiped down throughout the day, for example, as are chairs in the waiting rooms and surfaces that could accumulate dirt quite quickly.
“My joy is cleaning and making sure everyone stays safe,” said Jacobs. “I have peace of mind knowing that I do my best every day.”
Being able to take care of the tasks she does, coupled with protocol in place, makes her feel very confident with how the KMHC operates and is kept.
“No, I am not scared. I know that the hospital is clean,” she said. “My co-workers are all amazing and we all have the same passion to protect others.”
There is, however, “always a thought in the back of my head, but I keep positive and don’t stress about it.”
She thinks the COVID-19 pandemic is “insane and unbelievable,” and said she “thought war would come first. It sure opens our eyes to see what matters and makes all the difference in our lives.”
When she leaves the hospital, she continues her diligence in keeping everyone safe. “I’m taking the preparations once I get home from work. My kids are healthy and in good spirits. My therapy is the outdoors and my kids.”
For Dr. Bruemmer, he has been impressed with how Kahnawake and other communities have taken on such a tough challenge.
“For me, the single most amazing thing to see is large populations of people who are not used to being told they can’t go out, who are used to doing what they wished when they wished, to all of a sudden say, ‘we understand, we’re listening and we’re complying.’ That’s quite the remarkable social experiment,” he said.