Behind-the-scenes: virtual clinic team members first line of contact on front line

We are IU Health

May 01, 2020

Before they get a test, before they enter the emergency room or a doctor’s office, many patients are talking to a team member that is part of IU Health’s Virtual Clinic.

By IU Health Senior Journalist T.J. Banes, tfender1@iuhealth.org

He answers question after question. He listens as patients voice their concerns and express their fears over a virus that has seized the world. Some are homebound. Some are healing from other illnesses. Some are listening to news reports and wondering if their cough could be signs of a pandemic.

And at the end of the day, nurse Dustin Craig, ends his last call and returns home to his expectant wife and their 2-year-old son.

Craig is one of several IU Health nurses who could be seen as unsung heroes. They are among the first in a line of healthcare providers tending to the needs of patients. Craig is part of a dedicated team staffing IU Health’s virtual clinic.

When IU Health launched a virtual clinic offering Indiana residents free coronavirus screenings nurses stepped into that role. The 24/7 operation screens patients from their homes eliminating the need for visits to a doctor’s office, urgent care or emergency department.

Through the IU Health Virtual Visit app. patients can access information and gain a peace of mind by talking to healthcare providers. It’s as simple as downloading the app, completing a profile, and allowing access to the personal device’s camera and microphone.

“These RNs and providers are the first line of contact prior to being tested. Even though they aren’t bedside, they should be showcased about the support they provide,” said Kathy Neary, senior analyst IU Health clinical informatics.

So after weeks filled with answering hundreds of video calls how are these unsung heroes coping with challenges of COVID-19?

“I would like to say how impressed I have been with IU Health as an organization in our response to the COVID-19 pandemic. It is clear our leadership took decisive action to prepare to care for not only our patients, but also the community as a whole,” said Craig, who joined IU Health six years ago. He has also worked at IU Health Simon Cancer Center and as a Clinical Analyst in Clinical Information Services.

In the virtual hub he typically works with 20 to 50 nurses.

“The Virtual Hub has been an invaluable resource for our community and team members, and the speed in which actual site and processes were set up and implemented is nothing short of amazing,” said Craig. “The Virtual Hub has allowed RNs across the organization, whom do not typically work in patient care to have an opportunity to assist with large-scale COVID-19 screenings while people remain inside their homes. It also provides a protected environment with the resources and equipment needed for team members to do the virtual screenings while maintaining social distancing. Without the Virtual Hub, I truly believe the emergency departments would have been overwhelmed by people with symptoms of COVID-19 that would have resulted in greater spread of the virus.”

And at the end of the day?

“I think it goes without saying that we are all concerned about our family members, especially those of us who have children and at-risk family members. But I trust that this is all in God’s hands, and so far all I can say is that I have been blessed.”

Nurse Julianne Combs treasures a photo taken the last day she worked bedside with fellow nurse Katelyn Kingsbury. Even though she’s not working bedside today, she sees her work in the hub as the most rewarding during a difficult time.

“We are there for people when they feel ill, vulnerable, and scared to talk them through their symptoms and give them advice and assistance. I have really enjoyed getting to help others in this way. It certainly can be exhausting, but I try to remain positive and upbeat to cope with the mental stress of this job,” said Combs. Married to husband Ryan, she is a mother to two daughters Taylor and Emma.

“My family has been at home since COVID restrictions began, so I generally work at the hub all day and come home to some stir-crazy family members,” said Combs who has worked at IU health for the last five years – in Day Surgery Assessment at IU Health Methodist Hospital and on the Clinical Informatics Team. “We try to maintain some semblance of normalcy and routine at home, which is helpful. I’ve tried to maintain contact with family and friends, so I check-in with different people on my drive home.”

Susan Barney started her nursing career at IU Health in 1991 working in NICU. She also worked in emergency medicine and trauma at IU Health Methodist Hospital.

“This is not the frontline compared to what our counterparts are doing in the hospital, but it is sure does feel like it some days without the risk,” said Barney. “Screening during a pandemic is like something I’ve never done before. You see these people through the video that are scared, frightened and full of anxiety. Some are very sick and you can see it. With others the anxiety has just taken ahold of them. They can see your face and in some cases I have cried with them over how scared they are,” said Barney.

“One father was so fearful that he had give the virus to his daughter that he just had to know. This was a time when there was no community testing. You reassure them that we will get through this, that we will get through this together and that we are here 24/7 so they can call us back. You can see the relief on their faces to just have someone to talk to. I have those faces that will haunt me because I have no idea of the outcome.”

Nurse Deb Vahary sees her role as vital to the care of patients and families facing COVID-19. But she also knows there are family members struggling with other challenges and hardships. She is thankful to be part of their lives.

“I did cry recently with a patient. She had lost her son three weeks prior in a car accident, and while she was not looking for sympathy, it was clear that adding the burden of illness to her grieving process was overwhelming,” said Vahary. “Her biggest concern was to maintain her health so she could continue as sole caregiver to an elderly parent who had other risk factors. As we talked, I shed tears thinking about how difficult it must be to lose a child amid all of this and not even get a break to allow for grieving. I just wanted to reach out and give her a big hug,” said Vahary. “All I could do was to be present and walk through this experience with her. In that moment, I felt so helpless. As her tears came, so did mine.

I keep reminding myself that I need to listen beyond the words in order to provide compassionate care. Having the patient in front of me on video is better than a phone call, because I can see them as a person, not just a voice. It’s easier to be present in the moment and recognize that they are not always expressing the emotional rollercoaster they are on. I so appreciate that our patients trust us enough to share their feelings.”

At the end of the day, Vahary says: “When I get a ‘thanks for being there for us,’ or ‘this information has been so helpful today’ I am so grateful that I can do this kind of work.”

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