We recently sat down for a conversation with Andrew Donovan, RN. Andrew has served as the Infection Preventionist at St. Joseph Healthcare since 2012. His role has always been important, but his efforts have largely taken place behind the scenes. During the pandemic, Andrew has become a ‘go-to’ for many – always prepared to answer a question quickly yet thoroughly. Around here, he’s almost as famous as Dr. Shah (almost)! We hope you enjoy reading our conversation with Andrew.
What it’s like to be an Infection Preventionist in the time of COVID-19
You’re an infection preventionist, before COVID, I’m not sure most people thought much about the role of an infection preventionist. Can you describe your role and what made you choose this path in nursing?
I came into this role as an infection preventionist by accident really. I grew up here at SJB, first starting as a new grad RN on CPCU in 2008. Due to some health limitations, I moved into Case Management from there and left the organization in early 2012, but came back after 6 months of being away. As cliché as it sounds, I missed the family atmosphere of the Organization (more on family in a bit!). When I considered coming back I took a look at the online job board and noted they needed an infection control nurse. I remembered sitting through orientations and training thinking the role of an infection preventionist might be cool, but little did I know how much this job involved. I was welcomed back to the SJB family in October 2012 as the infection preventionist and I’ve been in this role ever since.
The role of an infection preventionist is unique and often overlooked. The term “infection prevention” is relatively new as the role used to be called “infection control”. As healthcare has evolved, so has the work of the infection preventionist. No longer is it enough to “control” things that cause harm due to infectious agents, but rather society has justly grown to expect that we “prevent” these outcomes from taking place to begin with. We’re all familiar with the Hippocratic oath of, “First, do no harm”. That’s become the expectation from healthcare facilities. No one should leave the healthcare setting feeling worse or having had their lives impacted in a negative way due to an infection simply because they had contact with the healthcare system.
I’m thankful I accidentally found my way to infection prevention as I feel I’ve found my place. Working in this role you’re somewhat on an island. Sure, I’m a part of the Quality department and I work with some of the best professionals around, but my perspective is very focused, and specialized. With that comes a sense of ownership. After some time, I began to see the infection prevention program as a reflection of myself, to the point that it has become a passion to ensure the best, most cutting edge, evidence-based practices are being used to not only keep patients safe, but also my colleagues safe from harm as well. The real impact comes at the bedside, not from me in my office or making rounds in the hospital or outpatient setting. I’m a resource to facilitate safe, infection-free care wherever a patient receives care.
Can you chronicle a typical day in your IP world since COVID began?
In December 2019 I took a leave of absence to tend to some personal health challenges I was experiencing (more on that in an upcoming blog post). As I was recovering at home and watching more TV than is likely healthy, I remember hearing about a novel coronavirus coming out of a place called Wuhan, China.
Since 2014 and the Ebola pandemic in West Africa, I’ve been particularly interested in what takes place with infectious disease outbreaks in other countries. Given how connected we are as a society, one can get on a plane most anywhere at any time so when the coronavirus started making the news, I wanted to learn more. #nerdalert Having worked through the Ebola pandemic, many in the infectious disease circles felt Ebola needed to be taken seriously and facilities needed to prepare, but given the unfortunate fact that Ebola kills its host rather quickly and is spread by contact with blood or body fluids, routine transmission of Ebola outside of healthcare was less likely in the US than say an organism that was spread by respiratory droplets or aerosols.
Throughout my recovery the news started reporting more and more about the novel coronavirus and with each day, I grew more and more eager to get back to work. As Mary, our hospital president, put it when I returned, “I knew you couldn’t miss a good pandemic”. Little did she know… I came back to work on Wednesday, February 5th and my first order of business was to attend a special huddle before the Safety Huddle to discuss, you guessed it, COVID-19.
Since that time, my role as an infection preventionist has changed quite a bit. It was soon after that we initiated incident command. Then came meetings, some multiple times a day, and those in attendance wanted to hear from the IP. This was new in many respects. I work closely with Dr. Michael Coyne and he’s said a few times, perhaps a bit cynically, “No one wants to hear from IP because it’s usually bad news”, and he’s right. How many people cringe seeing me come down the hallway? It’s ok… I get it… I used to wonder about my predecessor, Jessica DeGrasse when she was in this role too. 😊 COVID-19 was bad news too, but in this case, people wanted to know more. How to protect themselves and their loved ones was a common theme, especially early on. Now that we’ve learned what we have about COVID-19, the meetings are a bit less regular, but still just as important. As many can attest to, things continue to change routinely.
My day usually starts by reviewing COVID-19 data from the previous day in addition to the usual indwelling devices data and healthcare associated infection surveillance I do. The federal government requires we report data to them regarding COVID so I’ve tried supporting that, but it’s really been a team effort here at St. Joe’s and has been from the beginning.
From there it all depends on what my calendar looks like and what the day brings. I’ve learned despite my best intentions and plans; a day can go sideways rather quickly so being adaptable is key in the infection prevention role. I may have policies to update, or data to prepare for different meetings, or data to report to the CDC. For me, COVID-19 has become a part of my routine. Personally, I don’t think it’s going to go away anytime soon, especially given the fact we’re less than 3 months away from the official kick off into influenza season 2020 (cue the screams and horror movie music). With that in mind, COVID-19 presents a fascinating challenge. It allows me to grow as a professional and learn more than I might have without COVID-19.
What do you hope people remember about the role of infection prevention post-covid?
Post-COVID, I hope people remember infection prevention and the role of an infection preventionist is here to make sure people working in healthcare can get their jobs done in a safe manner,with as little risk of exposure to infectious diseases as possible. I couldn’t do this job alone. I frequently seek out the opinions of frontline staff before implementing infection prevention measures whenever possible. Such has been the case with COVID-19, certain things have to be in place and little flexibility exists. Take protective eyewear as an example. No one likes wearing them. That’s why they’re always in the backseats of our cars, but it’s a simple measure to keep you safe from a respiratory virus that has had devastating consequences on healthcare personnel.
The public should know that I encourage my coworkers to seek my expertise whenever necessary. If I don’t know the answer to something, then we’ll learn together. I’m always willing to help our team accomplish their job in the safest way possible and help to keep our community safe.
If you could ask the general public to adopt one safety measure right now to continue to slow the spread of covid what would that be and why?
This won’t likely come as a surprise to anyone, but if I could ask the general public to adopt one safety measure right now to slow the spread of COVID-19 it would definitely be to mask up whenever you’re outside your home and unable to maintain social distancing. Masking has taken on a very political, divisive tone in our society and its doesn’t have to.
I can completely understand the frustration of the changing guidelines and recommendations. As mentioned above, it was “Don’t wear a mask because we don’t want you to touch your face”. Then the recommendation became, “Yes, wear a mask, but still don’t touch your face”. Of course, we had the “You can’t wear a bandana as a face covering”. Now we have, “Bandanas are effective against COVID-19”. I TOTALLY get it. It’s like me trying to follow three different stories coming from three different 5-year old’s at the same time #myheadisgoingtoexplode.
The fact remains we are dealing with a novel, meaning new, coronavirus. The experts in the field of infectious disease didn’t know what they didn’t know, but now there’s mounting evidence proving masking has a positive effect on controlling COVID-19. Look at? what happened in Singapore as an example. Do your homework when you read different perspectives, especially on social media. This is a glorious time for scammers and those who like to spread mistruths and social media is an excellent platform to accomplish this!
The experience with COVID-19 has been hard, reallyhard. Since 2017 I’ve been dealing with complications of Crohn’s disease that has kept me sidelined much of the time to the point where just working and taking care of my family took all I had. My wife and I haven’t dared to plan any trips or family outings lasting more than a day because I haven’t felt like I could be depended on. Now that I’m feeling better we have COVID-19 messing things up and limiting what we can do. But I believe if we come together as healthcare professionals and as community members we can help eradicate this pandemic.
We ALL play a critical role in our efforts to keep COVID-19 at bay – in the hospital whether you work in EVS, dietary services, or are a CNA, nurse or provider, you all contribute to the wellbeing of our organization and our community as a whole. Simply wearing a mask when at work and when out in public will go a long way in preventing the spread of COVID. Our future well-being and that of our children depends on it.