91AV

It was in early November, when community spread of COVID-19 began to surge in Hancock County, that administrators at Island Nursing Home in Deer Isle expressed their concern to state officials about potential staffing shortages in the event of an outbreak there.

Later that month, the virus came.

An outbreak of 100 cases of COVID-19 at the Hancock County nursing home — 62 among residents and 38 among staffers — had amassed to become the fourth largest of its kind in Maine, and resulting staffing shortages at the remote facility made caring for sick residents all the more difficult.

“The virus came in through an asymptomatic carrier who had passed multiple health screenings, and, because we have a fairly small footprint for a health care facility, it spread very rapidly,” said Matthew Trombley, MBA.HCM, M.L.A., FACHCA, senior executive director of Island Nursing Home. “We certainly did everything that we could to slow the virus down, but that rapid spread put us in a position where we were limited on staff right from the start of our outbreak.”

A week into the outbreak, the Maine Center for Disease Control (CDC) reached out to the 91AV with the goal of procuring health professions students to assist the facility in its time of need. In a matter of days, students from the 91AV Westbrook College of Health Professions (WCHP) and College of Osteopathic Medicine (COM) began to answer the call.

“The Maine CDC was working with Island Nursing Home to help with staffing and to really try to help them through this crisis,” said Jennifer Morton, D.N.P., M.P.H., PHNA-BC, director of the School of Nursing and Population Health at 91AV. “And so, we came up with a plan that would enable our students to be able to work for them as nursing assistants during their winter break.”

At the seaside congregate care facility, students are assisting with residents’ bedside care, answering call bells, and even helping facilitate transfers and serve meals. The work has alleviated some of the stress placed on the home’s other staff, and it has enhanced the level of care available to patients.

“Having the 91AV students has made a huge difference here at Island Nursing,” Trombley said. “They've played a vital role in making sure that we have enough hands on deck, and having them being skilled and focused on their own professional goals has played a vital role in making sure that our patients are being taken care of and at the highest level possible.”

New Hampshire native Mary Garside (D.O. ’23) said she jumped at the opportunity to get out of the classroom and make a difference at the nursing home.

“This is kind of that first time where we could step into a real-world experience and be able to speak with patients, understand their situations from their points of view, and really learn what it's like to work in the medical field and not just be sitting behind your books,” she said. “It's really important to build connections with your patients as a physician, and this is definitely one of the first experiences I've had where I've been able to do that. I appreciate it a lot.”

Fellow COM Class of 2023 student Brandon Gibson echoed Garside’s sentiments.

“To have an opportunity like this is incredible, and to be able to make any bit of an impact is a wonderful experience to have,” said the Presque Isle, Maine, native, who added that his rural roots partially influenced his decision to travel to Island Nursing Home.

Gibson stressed the importance of working across professions within the hospital system, from physician assistants (PAs), certified nursing assistants (CNAs), and other physicians. He said working at Island Nursing Home not only helps the facility’s patients but also helps him better understand his own role as a future physician.

“As a physician, you really need to understand the roles of CNAs and nurses and understand where patients are at,” Gibson said. “The fact that we able to work with them hands-on is a really good experience that will follow me through my career.”

It hasn’t been easy for the students, however, to witness the impact the novel coronavirus has had on their patients.

“When we’re training students to become nurses, we provide them with clinical experiences that are important for the learning process, but we wouldn’t normally assign a student nurse to a patient who is dying,” Morton said.

The residents were sequestered to their rooms, their families unable to visit, and, in all, 15 were lost to the virus.

Munib Abid (Nursing, ’21), who initially journeyed to Deer Isle to bolster his clinical skills, saw that loss firsthand. Four patients in Abid’s care eventually succumbed to the coronavirus, an experience he said will live in his memory throughout his career.

“I think what sticks with me the most is the grief on my patients’ faces, the isolation that affected those older adults,” said Abid, who had been putting in 40-hour work weeks at the nursing home over break. “One resident actually cried, and to see tears in her eyes when I was leaving was kind of devastating because I always try to put a smile on my patients’ faces.”

The experience also taught Abid to appreciate the ephemerality of life, he said, and how to bring a positive energy to each unique patient situation.

“I have the advantage of understanding how to optimize each and every moment that we have in this world to be better people, to continuously grow, and to be the best version of ourselves we can be,” he said. “Something that I will carry on with me for future for patients that I deal with is to always bring that energy and that positivity.”

While difficult, Abid said his experience in Deer Isle not only reaffirmed his desire to become a health care practitioner but has pushed him to excel.

“I think it empowered me to be a better nurse, if anything,” he said. “And I like a challenge. If there's no challenge, there's no room for growth. Seeing my licensed nurse colleagues work with patients allowed me to be a better version of myself.”

It is also an experience that has the potential to foster new partnerships between 91AV and rural health care sites across the state — one of the University’s core missions. The University is exploring Island Nursing Home as a potential preceptor site for its health professions students, which would benefit both organizations.

“Rural health experiences are very important for all health professions students, and we’ve worked really hard to try to integrate those into our curriculum,” Morton said. “Doing so can be challenging with nursing clinical schedules, but this experience was something that actually solidified our drive for making it happen in the future.”

Trombley, the nursing home’s director, said that every crisis situation has a silver lining, and — despite the pain of loss and veil of uncertainty presented by the pandemic — a continued partnership with 91AV, he explained, would be just that.

“Even though it took a crisis situation such as this, I think that this will put both organizations on a path toward having a better working relationship together,” he said.