Sometime around February/March 2020, the whole of New Zealand (and the World) learned new words; ‘Coronavirus’, and then ‘COVID-19’. We all started to have conversations containing words like ‘bubble’, ‘lock down’, ‘social distancing’ and ’20 second hand washing’. We wondered what to do and how we would feel, survive, and how long this would all take, while stories from overseas consumed us. Then, within days, it happened – New Zealand went into a COVID-19 pandemic response process of 4 Levels. We had a few short days in Level 3 and then a month at Level 4. Our Prime Minister talked alongside Dr Ashley Bloomfield every day and we learned our plan was to go “hard and fast” and beat the curve (not just flatten it).  And of course we were all asked to ‘be kind’.

The caregivers and coordinators at Medcall and Care on Call had their own families and job security to consider, so our continued work was super important in reassuring and guiding our own employees, as well as providing ongoing assistance and support for our clients.  Just before Level 4 was announced, we created a Crisis Management Team comprising of senior management, HR and clinical RN’s. This team meet daily throughout Level 4 with the purpose of providing clear leadership, guidance and support to everyone engaged with us. We digested data, discussed global information and hoped that our Prime Minister and Doctor Bloomfield had it right. We engaged with ACC (through Solora), MOH and Disability networks, and second guessed what we were recommending – we checked, checked and checked again!  

In Level 4 we quickly adopted the philosophy of ‘infection prevention’ to ensure the wellbeing of our clients, staff and team. Once we had this fully at the forefront of our thinking and planning, the rest came naturally. The following points offer a rundown of the key decisions and systems we implemented in Level 4:

Care on Call Services:

• All care staff were contacted to check how they were feeling, and anyone with pre-existing medical conditions, risk factors were supported to stop working.
• Formal communication was uploaded to CareNet (our intranet) for all staff to access and made available to clients 24/7.
• Crisis Management Team details were made available for anyone to contact for advise/support.
• All clients were reviewed and any risk factors entered into their clinical notes.
• Our Nursing team completed daily (or as agreed) health and wellbeing checks with clients.
• Our office team completed daily (or as agreed) checks with staff.
• Care teams were reduced to ensure people needing care received it with as small ‘bubble’ of staff as possible.
• COVID-19 health and wellbeing declarations completed each day for all needing it and this information was clinically reviewed by Nurses in CMT to check no risks or to respond and ensure isolation and follow up where required.

Medcall staff services:

• Caregivers and Nurses were only allowed to work in one facility, completed daily COVID declarations and all working were inducted in the infection control processes for that facility.
• Staff were getting changed in ‘clean’ and ‘dirty’ rooms at facilities, wearing PPE, attending regular meetings and going home straight to the shower without so much as a wave to their families.
• We stopped working with other agencies to ensure our protocols were effective. 

Office team:

• All our office team were set up to work from home.
• We commenced zoom meetings with each set of managers 3 times a week, and each team was asked to stick close to each other, do the right thing, and be kind and tolerant with one another.

As we moved into Level 3, we maintained strict infection prevention priorities and developed a new management plan – this was published for all to access and respond to. We also provided education sessions and the CMT remained available 24/7 for any questions at all. CMT continued to meet daily (only reducing to 3 times a week toward end of Level 3), and sometimes these meetings were super quick and other times we debated, gave virtual hugs and always left with the task at hand!

For Care on Call homecare support services we saw that we had developed such trust with our clients, that most returned to full care throughout Level 3. Our team quietly and professionally got on with providing support without fear, and with absolute clarity about keeping safe and how to respond to any concerns. By this point, some Medcall clients had experienced tragic news with elderly New Zealanders passing away from COVID and clusters associated with a couple of aged care facilities around New Zealand. These were our most vulnerable and the sector responded firmly, clearly and did our best to prevent needless death and sorrow. 

We are incredibly grateful and proud of the way our team members have conducted themselves throughout each level. Everyone has consistently shown warmth, concern, professionalism and care. We also want to acknowledge and express our gratitude to the few team members who provided care to residents tested COVID positive. 

So what did we learn?  We have learned that honesty, transparency, decisiveness and being quick to respond to changes makes this kind of stuff manageable. And we were reminded about the all the qualities of humanity (we always need to be aware and reminded of these).

Thanks for reading, and kia kaha Aotearoa!