When most of the world closed their doors and shut themselves inside away from COVID, a group of people who had always been the lifeblood of the country found themselves wearing a new label: Essential.
Randy Brinson has spent the past 16 years working as the IT manager for a 650-bed urban hospital in downtown Dallas. As a registered nurse, he approaches his IT work with the consideration of someone who’s stood bedside with patients as well as shoulder-to-shoulder with doctors and administrators. He also happens to be my dad.
I wanted to get his insight on what it took for his hospital to become prepared for rising numbers of cases in Texas as well as his thoughts on the pandemic response as someone who was on the front lines.
Ryan: What was the biggest challenge at the hospital when COVID cases began coming in?
Randy: The perspective I have is a little different because I know how flu viruses work. Knowing this is a type of flu virus, I sort of went through a period where I was thinking through all of the dominos that would start falling while at the same time knowing there were a lot of unknowns. I’m looking at it first not from an IT perspective but from a clinical perspective because I’m a nurse. The first thing that matters is: What are the patients’ needs? Then, what are the needs of the nurses and the doctors who are taking care of the patients. We had to prevent the staff from getting sick.
Once I worked my way through those dominos, I realized I had to get with some clinical people to talk about how we could use technology to facilitate the communication piece of this, both between caregivers and patients but also between patients and their family.
We started by putting iPads in patient rooms and using Duo and FaceTime for physicians and nursing staff to communicate with patients without them having to go into the room. We were going through so much PPE equipment and many times, you just need to talk to the doctor or nurse. Not everything requires hands-on interaction. So we set up a means of using technology to communicate so we didn’t waste PPE.
It’s an ordeal to put on all the PPE that’s necessary to take care of the patient in the room. It’s also an ordeal taking it off. There’s a very specific way to take it off so you don’t expose yourself or other people. By making that technology available, it saved a tremendous amount of wear and tear and time.
Ryan: What was the response from the management side of things to what you were having to do?
Randy: Because we work for a large corporation, we were trying to tell the corporation how they needed to be handling this based on what we were seeing on the ground. They didn’t necessarily agree and those at the corporate level wanted some time to evaluate what was needed. Those of us working in the hospital had already been told by patients, physicians and staff what was needed and we met that need quickly. Once the corporate leaders decided what they wanted to do, we made a few changes but our evaluation in the hospitals was right from the beginning. We were satisfied with what we had done that made sense in the beginning and facilitated patient care and improved overall communication.
Ryan: I guess I’m confused. What did they want you to do instead?
Randy: They wanted to see a unified platform to use to communicate both inside and outside of the hospital. They ended up giving us three options, some of which we were already using. It was serving a huge purpose so we stayed the course. It saved time and it allowed patients to communicate with our staff without risk. One of our hospitals had a patient dying and we used an iPad mini so the patient’s family could FaceTime in from Denver to see his dad before his dad died. It’s one of those situations where we were helping the patient’s family more than anyone and we used technology to accomplish that.
Your mom likes to say I’m a rule follower and I am…unless it’s stupid. I pieced together all the education I’ve had, took the knowledge of what we did know which wasn’t a whole lot, and I applied the technology to try to have a positive impact at bedside.
There were times when someone’s family would be out in the parking lot and you could look out the window at them gathered around the iPad talking to their family member who was in the hospital room above. We were facilitating those connections when there was so much anxiety and fear, helping allay their anxiety to the extent we could. Just to be fair, there were hospital staff who were working at bedside who were using their own personal devices to video conference between patients and families and between physicians and family so the best care could be given.
Ryan: While most people were at home, you were at work. What did you see or learn about the way our system of essential/nonessential works?
Randy: First, when you decide you’re going to be a doctor or a nurse, you have a swearing in ceremony and you know at that point, if the world goes to hell in a handbasket, you get to go with it. A lot of times, we have to help people recover from the disaster and some of my six and seven day weeks at work ended up being that. Being able to facilitate the right technology at the right place, being on the floors to make sure what we had was working. At that point, you become “essential.”
When all this started, no one fully understood what was going on. We just knew people were getting really sick, some were dying, and some were not.
Back in the mid-80’s, I took care of some of the first AIDS patients in Dallas and none of us knew what we were dealing with. We did everything at our disposal to help these people who were coming in deathly sick and dying. No one was making it out alive. So I’m looking at that history and the way we had to do the same thing today. We had to do whatever was at our disposal to help these people even though we didn’t know what we were dealing with.
Ryan: What’s your take on the healthcare response at large?
Randy: When I hear the media or politicians blaming people, I have a difficult time blaming anyone for anything. No one knew what they were dealing with. The people who say someone should’ve done this or shouldn’t have done that, that’s 20/20 hindsight because no one knew. Everyone was doing what they felt was the right thing to do at the time. As I walked the halls of the hospital and sat in endless meetings where people tried to come up with different ways to approach this issue, everyone was working to deal with it as effectively as possible. Whether it was my hospital or a hospital in New York or one in Italy, everyone was doing what they thought was right based on what they knew at the time.
I couldn’t fault anyone then and I still can’t. So when you look at decisions about who was and wasn’t essential, it was all done to protect people. I know being at home created tremendous hardships for many people, however, in the grand scheme of things, I think there are a lot of people who are alive today who wouldn’t be if that differentiation hadn’t been made. There’s no way to statistically put a number on it but I really do think there are hundreds of thousands of people who are alive today because they stayed home.
Ryan: Has yours been a thankless job?
Randy: A little bit. I’ve brought up stuff in meetings I typically wouldn’t say because I felt they needed to know. For example, we’d be at the hospitals on weekend afternoons making sure the staff knew how everything worked. I wouldn’t typically make sure the healthcare system leadership knew that because it sounds like I’m tooting my own horn, but it was important that leadership knew we weren’t sitting in our offices doing nothing. We had to get out and do things that were somewhat risky at that point in time.
The people in the hospital who were the most appreciative of our work and recognized what we were doing were the nurses at bedside. They’d tell us, “I couldn’t wait for y’all to get here,” and “This is wonderful. You don’t know how much time you’ve saved me.” So no, it wasn’t thankless but there also weren’t people standing outside at 7pm beating on pots and pans for us either.
Ryan: During this pandemic, what have you learned about yourself?
Randy: That I’m quite adaptable. Having done this a long time now, I have a certain degree of satisfaction knowing all the different places I’ve worked, all the different experiences I’ve had, have been invaluable during this period of time. I’ve used it all. Whether it was technology in the ICU or bedside or working with administration and having to put my foot down, I was able to use all of those past experiences in this situation that was high stress, fast-paced and critically needed. And frankly, I think I did pretty good.