2021 Annual Conference

Role of CNS in COVID-19 Pandemic

When COVID-19 presented in the United States in early 2020, healthcare organizations scrambled to take necessary precautions to keep staff and patients safe. Guidance from local health departments and the Centers for Disease Control was somewhat sparse and rapidly evolving in the early stages of the pandemic. The sole clinical nurse specialist (CNS) for a large ambulatory cancer center assumed a unique and multifaceted role in COVID-19, focused on maintaining staff and patient safety by utilizing the most up-to-date guidance and evidence.

Initially, the CNS focused on rapidly training and validating staff on proper application and use of COVID-19 appropriate personal protective equipment (PPE) through hands-on sessions. Quickly, to ensure patient safety, the decision was made to open an oncology specific COVID clinic in a location separate from the cancer center, staffing with a core group of nurses, nurse practitioners (NPs), and medical assistants. The CNS was essential to the day-to-day operations of the clinic including coaching staff on proper care and testing procedures, collaborating with nurses and NPs in coordinating patient care, and advocating for the necessary supplies and equipment.

The oncology COVID clinic was open six days per week for seven weeks from March 30 to May 8. During that time, the clinic tested 356 patients utilizing rapid point-of-care testing. 25 patients tested positive, resulting in a 6.8 percent positivity rate. The CNS was present in the clinic for 75 percent of operating hours and observed 75 percent of instances of staff donning and doffing PPE. For observed instances of gaps in practice, just-in-time corrections were made by the CNS. As a result, zero percent of staff working in the COVID clinic experienced symptoms or tested positive for COVID-19.

COVID-19 came fast and furious, without a playbook. Guidelines were ever-changing; however, the CNS stayed up to date with best practices and was a key communicator of changes in guidelines to the frontline staff. The rapid and proper training of staff and day-to-day clinical support by the clinical nurse specialist allowed for the safe care of patients and protection of staff.