Changes COVID-19 Brought to the Nurse Practitioner’s World

BY MICHELE WOJCIECHOWSKI

The pandemic has affected all nurses in all fields. Some NPs weigh in on how COVID-19 has changed their work.

During the pandemic, Alvin Mena Cantero, DNP, FNP-C, MSN, APRN, CEO and health care provider at Alvin Clinica Familiar, Inc. in Houston, Texas, says that he’s seeing more patients each day—anywhere from 65 to 75 patients across a variety of demographics. Up to 85 percent are Latinx, “largely because Spanish speakers prefer providers who speak the same language and can therefore help them to fully understand messages.”

“Many nurse practitioners are overwhelmed with trying to help everyone and their families, and many providers have experienced flashback and burnout episodes,” Cantero, a graduate of Walden University’s DNP and MSN-FNP programs, explains. “Dealing with this pandemic has been like constantly working in an ER setting for most health care providers… I have advised my fellow health care providers/nurses to avoid working too many extra shifts in the hospital because it can aggravate burnout syndrome, which in the worst case may cause them to make a mistake that may cost a patient’s life.”

“Despite the hard work and increased scope of practice in order to fill the gap within primary care in underserved communities, the state of Texas, like many others, has thus far failed to recognize nurse practitioners’ independence in full scope of practice and still mandates them to be overseen by supervising physicians,” he says.

Cantero has been using telehealth regularly. “It has been a great way to prevent overcrowding in my practice, especially because most of the other clinics near my practice shut down during the beginning of the pandemic,” he says. “By using telehealth, I have also been able to educate more of my patients about vaccinations and the importance of early detection and prevention of COVID-19.”

One problem, says Cantero, is that in Texas many NPs have left the state. “Despite the hard work and increased scope of practice in order to fill the gap within primary care in underserved communities, the state of Texas, like many others, has thus far failed to recognize nurse practitioners’ independence in full scope of practice and still mandates them to be overseen by supervising physicians,” he says. “I believe this only lowered the quality of care provided to our communities during this pandemic…Many nurses have moved to other states for this reason, which has aggravated the nursing shortage.”

Meanwhile, Melissa Valdes, APRN, a family nurse practitioner who has been working in the Community Health of South Florida, Inc.’s (CHI) Mobile Medical Van (MMV), which is described as a state-of-the-art health care facility that provides health care in underserved communities such as public housing communities, migrant communities, homeless encampments, day cares, and more. The staff provides health care services, including COVID vaccines as well as COVID testing.

Before COVID-19 hit, Valdes says that they were not using telehealth in the MMV. But then it became a necessity.

Before COVID-19 hit, Valdes says that they were not using telehealth in the MMV. But then it became a necessity. “Some patients don’t feel comfortable coming into our mobile medical van or visiting the CHI health centers because of COVID fears, so we are using telehealth quite a bit more these days,” she says. “We are also being more creative and strategic about how we motivate patients to get vaccinated and spread the word about the good of vaccines to their friends and families. This entails speaking about the vaccine in simple, clear terms, avoiding too much medical terminology, and includes sharing our own experiences with COVID and the vaccine. For example, I often share the story of my 85-yearold grandmother’s experience with COVID who got the disease after being vaccinated, but who was able to recover quickly, largely, we believe, as a result of having been vaccinated.”

Both Valdes and Cantero say that they have become even closer with their patients during the pandemic.

Both Valdes and Cantero say that they have become even closer with their patients during the pandemic. “I also formed closer relationships with patients’ relatives, since in many cases, if a patient contracted COVID-19, their entire family did as well,” says Cantero. “I think a more trusting relationship was built, and I capitalized on this opportunity to educate my community regarding COVID-19 prevention and the importance of vaccination. I also focus on education patients about disease prevention and health care promotion sincere there is a high census of patients suffering from hypertension, diabetes mellitus, and obesity.” “You do get closer with patients during COVID since we tend to share our own experiences with COVID and vaccinations as we get out the message to our patients that the vaccines are effective and safe,” says Valdes. “Many patients identify with these experiences, and sharing stories helps build trust, which is critical to the relationship between health care professionals and patients.”

Cantero hopes that once the pandemic gets under control, health care personnel will get psychological evaluations. “It’s important for health care providers and nurses to keep supporting each other and be humble and kind both toward each other and our patients. It’s very important to be there for your patients, but also for yourself, your wellbeing, and your family.”

Michele Wojciechowski is a national award-winning freelance writer based in Baltimore, Maryland. She loves writing about the nursing field but comes close to fainting when she actually sees blood. She’s also author of the humor book, Next Time I Move, They’ll Carry Me Out in a Box.