Issue link: https://digital.copcomm.com/i/1333042
12 Working Nurse l WorkingNurse.com January 25-February 22, 2021 During the observation period, the pod manager collected the consent forms so the registrars could create a separate online file for each vaccine recipient. The pod manager also gave each patient the vaccination card they will need to bring to get their second dose, explaining how to schedule the next appointment and when it would be due. Patients had been advised to take a photo of both the vaccination card and their consent form, which lists the type of vaccine, lot number and date given. BY THE TIME THE LAST PATIENT had left after their observation period, the next pod of 10 patients had com- pleted their education and taken their places in the cubicles and the nurse had already filled the next 10 syringes from the medication room cooler. It Takes a Village Nurses are used to being in control of the immunization process from begin- ning to end, but this model relied heav- ily on support from ancillary services. For example, we had an EMT on hand in each pod in case of any prob- lems, and an Office of Emergency Services worker collected the obser- vation time slips as each patient left, preventing people from going any- where until they had been observed. There was also an IT specialist in case of glitches with the registration system, and security guards to deal with the few people who tried to enter without an appointment. A doctor was available to answer questions about health issues or aller- gies, but most problems seemed to stem from anxiety. No significant reac- tions occurred. Most people were extremely cooperative, so the process ran smoothly. Thanks to this great support, each nurse could vaccinate a patient in four minutes or less. The Second Shot At present, most patients are still receiving their first injection, but the scheduling system will soon allow for each day's allotment to be divided between people receiving their first doses and people returning for their second shots. All patients are encouraged to schedule their follow-up appointment at the same facility so that they will already be familiar with the process and get the same kind of vaccine. (Since currently only hospitals and county facil- ities are providing COVID-19 vaccines, there really aren't any other options, but that may change.) Patients automatically receive a text message reminding them to schedule their second appointment. Each day, the facility also puts up posters showing the date for the sec- ond dose along with a QR code that patients can scan to make an online appointment. High Stakes As a public health nurse, my usual work involves baby immunization clin- ics for patients whose health insur- ance doesn't include well visits and blood pressure checks on seniors who are already well-supervised by private physicians. By comparison, the COVID-19 vacci- nation clinic had me working at light- ning speed, with much higher stakes. I was hard-pressed to accommodate 80 people in a shift, and we were con- stantly encouraged to work faster. Naturally, patients slow down the process. There are always those with tight sleeves that they push up one inch at a time, asking "Is this high enough?" (Curtains around the cubi- cles offer privacy for anyone needing to remove a shirt entirely.) Larger patients or young men with bulging muscles require a longer needle length. Some people have a difficult time hearing you through the N-95 mask and shield, causing anxiety or requiring instructions to be repeated. Fits and Starts Because vaccine doses are arriving in fits and starts, the health department has very little notice for employee scheduling. All public health workers are advised to check our emails and texts for schedule changes and to be ready. I'm glad we're making inroads on getting our country vaccinated, but going through this process for almost 300 million Americans — twice each! — will be an extraordinary public health accomplishment. WN The COVID-19 vaccination clinic had me working at lightning speed. Still I was hard-pressed to accommodate 80 people in a shift, and we were constantly encouraged to work faster. Observations Christine Contillo, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She writes the Book Club column.