Vaccinating the homebound
For a small team of Hartford HealthCare nurses, it’s a slow but necessary process
Connecticut has become a national leader in vaccine distribution, in part due to its use of mass vaccination sites. But a small team of Hartford Healthcare nurses travels across the state to vaccinate people who are homebound. In their world, a good day means vaccinating 10 people in six hours.
“It’s not that efficient, but the thing is, we are seeing patients who wouldn’t get it any other way.” — Kristen Murphy, regional director of operations for Hartford HealthCare at Home
Mary Blackburn, 90, steered her wheelchair up to her kitchen table and readied for the shot.
“Just a little pinch,” said Natalie O’Connor, a registered nurse and homecare aide supervisor at Hartford Healthcare, injecting her with a dose of the Moderna COVID-19 vaccine at Blackburn’s Rocky Hill home on Friday.
“That’s it? Wonderful!” Blackburn said with a wide smile. “I was expecting a bigger needle. Thank you, thank you, thank you.”
Connecticut has become a nationwide leader in vaccine distribution, in part due to its use of mass vaccination sites, like the one at the former Pratt & Whitney Airfield in East Hartford, which can vaccinate 1,700 people in a single day. Local vaccination clinics have also sprung up across the state, set up in churches, senior housing complexes and high school gymnasiums.
But a slower, quieter effort is also underway, as a small team of Hartford HealthCare nurses travels across the state to vaccinate people who are homebound. In their world, a good day means vaccinating 10 people in six hours.
“It’s not that efficient, but the thing is, we are seeing patients who wouldn’t get it any other way,” said Kristen Murphy, regional director of operations for Hartford HealthCare at Home. “These patients might have to go by ambulance to the doctor. So if we’re not getting it to them, they’re not getting it.”
Blackburn said she was initially hesitant about getting the vaccine, but when she realized it could be brought directly to her home, she agreed.
“If I ever came down with that,
I’d be dead in 24 hours,” she said of COVID-19. “I’m a diabetic, I’ve got pancreatitis and now I’m having a problem with my esophagus. I didn’t want another hurt.”
Reaching the homebound
A refrigerator hums in the corner of an office in Bloomfield, secured with an alarm and plastered with a warning: “Do not unplug, vaccines inside.”
A half-dozen vials of the Moderna COVID-19 vaccine sit inside, waiting to be injected into the arms of homebound patients and their caregivers.
Every morning at 9, a Hartford HealthCare at Homenurse punctures a vial and draws out 10 doses into individual syringes. If the doses are not used by 3 p.m., they will spoil. Two nurses divide the 10 syringes in half and ferry the vaccines to homes across the Hartford region. Each day’s schedule and route is carefully planned.
“The complexity with doing homebound patients is that we have to go out twice,” said Andrea Griffith, vice president of operations for Hartford HealthCare at Home. Nurses must administer a first dose of the COVID-19 vaccine followed by a second dose a few weeks later.
Hartford HealthCare at Home launched its vaccination team in January and inoculated the first homebound patient against COVID-19 in the beginning February. So far, about 150 homebound patients have been vaccinated out of the current pool of 3,500 patients across Connecticut. The people receiving the vaccinations are preexisting patients in the hospital system, receiving home care for conditions like chronic obstructive pulmonary disease (COPD). Most have limited mobility.
“A lot of them have been very isolated for the past year, and now they feel like when they have the second dose, they can start getting out to whatever they did before, their doctor’s appointments, even to church, or their families can visit them comfortably again,” said Murphy, the regional director of operations.
About 75 clinicians have volunteered to administer vaccinations to homebound patients, and Griffith hopes to soon add more, expanding the team’s reach into the central and eastern parts of the state. Griffith foresees the team eventually being able to vaccinate as many as 50 patients per day.
‘Outrageously pleased’
Barbara Foran, 94, did not venture outside much before COVID-19 hit. But the pandemic hovers over her life at home. It’s something Foran, who has severe dementia, does not quite understand, but which she asks about — again and again.
Watching the news on television, she will say, “What is a COVID? Why are people wearing masks?”
A few months ago, realizing that her mother’s health was in decline, Foran’s daughter Sandy Schroll, 72, decided to move from Orlando, Fla., to the house in which she grew up, perched on the top of a hill in Andover. Along with her husband Peter Schroll, 74, Sandy Schroll is now a primary caregiver for her mother.
Foran has l i mited mobility, and it would be extremely challenging to take her to a vaccination clinic, the Schrolls said. But in late February, Foran and her daughter were vaccinated through Hartford HealthCare’s homebound program.
On Thursday, Bridget Kennedy, a clinical team manager for Hartford HealthCare at Home, returned to Foran’s home to vaccinate Peter Schroll. In addition to homebound patients, Hartford Healthcare vaccinates caregivers or spouses, part of an effort to further protect vulnerable patients.
Kennedy arrived carrying an insulated bag with syringes of the Moderna COVID-19 vaccine, medical gloves, a thermometer, alcohol wipes and doses of epinephrine, to counteract any potential reaction to the vaccine.
Sitting around the dining room table, beneath a row of decorative bowls and a copy of the “Desiderata,” Kennedy talked Peter Schroll through the vaccine.
“I can tell you I’m super good at this,” she assured him.
“I’ll definitely let you know,” he replied playfully.
“Keep your arm down and loosen your elbow,” she said, positioning the syringe.
“1, 2, 3.” The needle disappeared.
Peter said he was “outrageously pleased” to receive the shot. Heworks part time, and getting vaccinated gives him a extra sense of security as he helps care for his mother-in-law.
On her way out, Kennedy stopped to greet Foran, who was sitting in an armchair in the living room, with a newspaper in her lap and a cat and dog underfoot.
“I just gave the vaccine to your son-in-law,” Kennedy said.
“Thank you for coming,” Foran said with bright eyes and a chuckle.
Foran does not recognize Sandy or Peter Schroll. She often asks who her daughter’s mother is. But from time to time, Foran will call her daughter on the phone and when Sandy Schroll takes the call in an adjoining room, her mother will recognize her. That is, after all, how they have communicated for many years, when the Schrolls were in Florida.
“She doesn’t realize it’s that same person,” Peter Schroll said. “You take advantage of those brief moments where she’s lucid and she’s good and she laughs and she wants to help you with the dishes. A week or so ago, she was in a really good mood and was very inquisitive and Sandy literally sat with her, holding her hand, staring at her, recounting her life.”