Turkeisha Brown, MSN, RN, NE-BC, Patient Services Manager III, leads 70 employees on 6 Bedtower, a designated acute care unit for COVID-19 patients at the UNC Medical Center in Chapel Hill. Through obstacles, trials, and determination, her staff is unified to help fight the deadly SARS-CoV-2 virus.
It’s 4:30 in the afternoon, nurse manager Turkeisha Brown and her staff log on to yet another COVID-19 WebEx meeting, a meeting that is now a part of their daily routine for the staff of 6 Bedtower at UNC Medical Center in Chapel Hill. Nurses currently working 12-hour shifts stand at the door of Brown’s office to listen. Some gather in the conference room. And those at home, preparing for their night shift, join the call, too. The meeting begins with an update on the number of COVID-19 positive patients, new training information, process changes, and the latest information on available personal protective equipment (PPE).
“I started these COVID-19 daily meetings when I learned how rapidly our operations, processes and physician teams were changing, almost on a daily basis, said Turkeisha Brown, MSN, RN, NE-BC, Patient Services Manager III. “During this pandemic, we noticed it was not unusual to work a shift, come back tomorrow, and be doing something completely different than the previous day.”
Before the beginning of the pandemic, 6 Bedtower serviced patients who needed medical care for pulmonary and infectious diseases like pneumonia, asthma, cystic fibrosis; as well as for patients with AIDS, meningitis, and sepsis. Now, 6 Bedtower is the designated unit for all acute care COVID-19 positive patients over 18-years old. For Turkeisha Brown, who manages 70 employees and oversees the care of 31 patients, her job is never done.
“My job as a nurse is to take care of the patients,” she says. “My job as a nurse manager is to take care of the staff, who in turn takes care of the patients. As long as the staff have what they need, then our patients will be serviced well. That is my responsibility.”
And nursing is what she always knew she’d do, even though she never expected what this pandemic has wrought.
A History of Caring
It was in elementary school when Brown, a Durham native, knew what she wanted her career to be.
“I was raised in a family of caretakers. Ever since I was in third grade, I wanted to be a nurse. I felt like it was my calling,” said Brown.
Brown graduated from North Carolina Agricultural and Technical State University with a Bachelor of Science nursing degree, and she received her Masters of Science degree in nursing from East Carolina University. She began her nursing career in 1998 at Duke Hospital, where she worked in the med-surg unit for several years. After accepting the opportunity to become a travel nurse, Brown gained experience providing care to patients in units such as cardiac step-down, telemetry, orthopedics, neurosurgery, urology, and pulmonary/infectious diseases. In 2008, Brown accepted the position as a Clinical Nurse IV at UNC Health, and she was promoted to Nurse Manager of 6 Bedtower in 2010.
“Each day I take into account our staffing to meet the needs of patients and the unit. I listen to staff’s concerns, review emails and safety reports,” she says. “I also work collaboratively with other disciplines and departments to help remove barriers so the staff are better able to care for their patients. There is also a financial management component of my job as well.”
The pandemic, now in its sixth month in North Carolina, has been a demanding time for staff.
“I’m tired, to be quite honest,” she says. “Many times, I have to take my work home because I can’t get it all completed during the work day.”
Arriving to 6 Bedtower to start another day, Brown stops by the front desk to say good morning to her fellow colleagues. After putting her bags in her office, she heads to the high and low-risk zones of the unit to check on the staff working their 12-hour shift.
“A low-risk zone nurse is paired with a high-risk zone nurse,” she says. “These two nurses have a set of five patients. The low-risk nurse is known as the nurse with ‘clean hands.’ He or she is there to assist the high-risk nurse by providing medications, supplies, making phone calls to the pharmacy, paging doctors and care managers, and coordinating other aspects of care such as discharges and home needs.”
High-risk zone nurses are hands-on with the COVID-19 positive patients. They provide treatment, medications, and therapies to the patient. They also coordinate and collaborate with the respiratory therapists and physicians in the high-risk zone. After two hours and the changing in and out of PPE, the two nurses swap roles.
“They put on their gowns, gloves, masks, and face shield before approaching the high-risk zone,” Brown says. “In collaboration with Shared Services, our staff now uses reusable surgical gowns. These reusable gowns are collected to be washed daily, and a new shipment comes in every day.”
After an exhausting 12-hour shift, nurses gather together with those who are coming in to relieve them for a quick safety huddle, which the nurses update each other on new information that developed during their shift. And, to start the new shift with positivity, the group discusses something optimistic that happened at work.
“I’ve heard the nurses say, ‘My patient was finally able to go home today.’ Another nurse would say, ‘I had a patient who was alert enough to FaceTime with their family for the first time since they were admitted,” Brown says.
“But it gets tough mentally and physically,” says Brown as she takes a deep breath. “I can see how my staff is really worn out when they come out of the high-risk zone.”
To help provide support for her staff’s mental health, Brown is working with UNC’s psychiatry department to offer wellness sessions to the staff. She’s also providing mental health check-ins during the COVID-19 daily huddles. Brown hopes this can help her staff address their stress, anxiety, and worry during this unprecedented time. And now, staff have access to a new Heroes Health App.
“Giving the patients their prognosis is not always a good feeling,” Brown says. “That tends to wear on a person who is used to caring for people and making them better. So, taking care of someone that you know might not get better is a heavy load to bear.”
A Full-time, All-the-Time Job
The staff of 6 Bedtower not only spend their days caring for those affected by the SARS-CoV-2 virus, but they also factor in the health and safety of those outside the hospital walls – their families. And this, too, is emotionally draining on staff and Brown herself.
“Some nurses on my staff have to live in the basement because they’re afraid of transmitting this disease to their loved ones,” Brown says, wiping tears from her eyes. “I have staff who have been living in hotels since this pandemic started because they live with family members who have serious risk factors.”
“In the beginning, we saddled up and were ready to take on this disease, but we also anticipated this would be over by now,” she says. “Now, there’s no end in sight.”
Brown, like infectious disease experts at UNC and around the world, wants people to wear masks in public to help limit the spread of COVID-19, as cases and hospitalizations continue to increase in North Carolina.
As a dedicated manager, Turkeisha knows the physical and mental health of her staff is top priority. Her goal each day is to make sure the culture of the unit is positive and uplifting. However, even for her, there are days when even she begins to feel drained.
“What’s been hard for me is managing the stress of the staff,” Brown says, her voice trembling. “I can do the work. I can help them do the work. I can take the necessary precautions to not expose my family. I can do all these things, but it’s my concern for the staff that makes it harder for me.”
“I see them upset. I see them scared. I see them stressed and frustrated because of this disease. It takes a toll.”
Adjusting to this new way of care has not been easy for those who work in the COVID-19 acute care unit. Through teamwork and dedication, the staff has been able to help families reunite with their loved ones who were able to beat and survive the disease. Brown tries to remain optimistic as she reminds her staff to keep moving forward, to keep providing care for those families who need them most.
“I love my staff. I love what we do, but it is hard. We’re tired, but we have a job to do. We have to take care of our patients. And my staff has responded to this challenge.”
Brown smiles, and says, “Sometimes you have to strap on the Nike’s and just do it.”
Turkeisha Brown, MSN, RN, NE-BC, Patient Services Manager III is the lead on the Diabetes Resource Nurse Committee, Cystic Fibrosis Resource Workgroup, Manager Representative of the Medicine Service Quality Council, and Manager Representative of the Pulmonary Arterial Hypertension (PAH) Interprofessional Workgroup.
Written by Brittany Phillips, UNC Health Communications Specialist