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Providing care in isolation

How can doctors help a patient feel cared for when they’re not even allowed near the patient?

Doctors, nurses and other healthcare workers are facing immense challenges in caring for patients diagnosed with COVID-19, the highly-contagious respiratory illness caused by the novel coronavirus. The many restrictions that have been put in place are designed to limit the risk of exposure to the virus for those working in the hospital, but they also create new challenges to providing patient care.

For palliative care doctors like Natalie Rodden, these challenges are especially unique. Rodden leads the palliative care team at St. Anthony’s North Health Campus in Westminster, which consists of her, a social worker and a chaplain. In her role, she typically works with patients who are dealing with chronic illness and their family, helping to provide relief from the symptoms for the patient and relief from the stress for the family.

“We say in palliative care that we hope for the best but we prepare for the worst,” Rodden told the Denver Catholic. “We try to help patients and families work through this.”

Coming from the Latin word palliare, which means “to cloak” or “to shield,” palliative care doctors like Rodden are trained in helping to support patients and their families through serious illness, whether it be a chronic diseases such as cancer or other serious conditions such as Alzheimer’s.

Natalie Rodden, left, leads the palliative care team at St. Anthony’s North Health Campus in Westminster. Her job has taken on a new meaning amid the coronavirus pandemic. (Photo provided by Centura Health)

“I spend a lot of time working in the intensive care units, helping families and working with patients who may have a relapse of a disease or a new diagnosis of a serious disease or a traumatic situation happen and helping them cope,” Rodden continued. “We look at the suffering a patient experiences from a physical component, but also the emotional, social and spiritual aspects as well. It’s very holistic, and I think it’s really about promoting the dignity of the person in the midst of a serious illness.”

In the midst of dealing with COVID-19 patients, her job takes on a new meaning. Not only is Rodden unable to connect with the patient on a personal level, because of the restrictions, family members are also unable to visit their loved one in the hospital. A big part of Rodden’s job is to connect with her patients and families on a personal level in face-to-face interactions. Now, virtually all of that connection is done remotely.

“It’s hard because I’m usually at the bedside holding the patient’s hands and looking them in the eye and doing a lot of emotional connection with them, but non-verbally, just seeing where they’re at. That’s immensely challenging over the phone,” Rodden said. “It’s very difficult when you can’t be seeing your loved one every day.”

At a time like this, Rodden relies on her faith in the Lord to get her through the long days. It grounds her in her own humanity and the understanding that ultimately, despite her best efforts as a doctor, God is in control.

“I don’t think that I could do my job very well, if at all, without my faith,” she said. “I think in this disease, I realize so much more my littleness, I realize my lack of control. I think as doctors, we like to feel this semblance of, ‘I know what’s going on. I can figure this out. I can make this better.’ And I don’t know all the time that I can make it better.”

Originally from the Louisville, Kentucky area, Rodden relocated to Colorado in 2016 after accepting her current position with St. Anthony’s. For a palliative care doctor, the timing was quite interesting: As Rodden recalls it, “I took my palliative boards on a Monday, which was the last test of twelve years of school. And then on Tuesday, the next day, physician-assisted suicide became legal [in Colorado].”

When she entered medical school, Rodden was originally interested in becoming an oncologist. It was during her residency rotations at a cancer center, however, that Rodden gained deeper insight into the kinds of suffering people have to endure when dealing with something like a cancer diagnosis, which began to lead her down a different path.

“I think palliative care kind of chose me,” she said. “I realized that so much of patient suffering was beyond just managing with chemotherapy. We were forgetting who the person was behind the cancer diagnosis.”

In addition to helping patients and families better cope with their situation, Rodden also serves as an advocate for the patient and helps to facilitate excellent communication between them and their families.

“Our job hasn’t changed,” Rodden said. “Actually, our job has become a bit busier because there’s a lot of patients coming in who are facing a potentially very serious illness. It’s been a real beautiful time to serve as a palliative care doctor, but it’s hard.”

In keeping with her call as a palliative care doctor, Rodden strives to ensure that each patient is known as more than just a diagnosis and that their inherent dignity remains intact. This is especially important for those who are diagnosed with COVID-19.

“I don’t think that I could do my job very well, if at all, without my faith. I think in this disease, I realize so much more my littleness, I realize my lack of control. I think as doctors, we like to feel this semblance of, ‘I know what’s going on. I can figure this out. I can make this better.’ And I don’t know all the time that I can make it better.”

“We want to know them as a person. And we want the whole staff to know them as a person because this disease has a lot of stigma with it, [as we’ve seen] all around in our community,” she explained. “I want to help the whole hospital remember that this patient is a person.”

For COVID-19 patients in particular, strict isolation has become the norm. Family members are not allowed in the room with their loved one. Sometimes, multiple family members are hospitalized at the same time. The human connection and feeling of being cared for that is so important for people suffering from illness has become limited. Despite these challenges, Rodden and her team do what they can to make the patients and their families feel loved.

“Our team tries to creatively think of ways to love these patients and families in the hospitals,” she said. “Sometimes that’s having the families send in photos or letters or notes, maybe colored drawings by kids.  We post those in the patient’s room for them. We’ve had family members make signs and we’ve helped figure out where they can stand so that they can show them through the window and the family member can see them from there. Any way we can try to create opportunities for connection for families, during this time in particular.”

Due to COVID-19, Rodden has been seeing patients she wouldn’t normally see. The nature of this virus and the fact that it can be dangerous to people of all ages, regardless of health background, makes for a tough reality check in people – Rodden included.

“For a lot of these patients, they are previously healthy. It’s very different than my typical patients I see in palliative care who have had chronic illnesses for many years and are not a stranger to the health care system,” Rodden explained. “For a lot these patients and their family members, their only exposure to hospitals might be through television shows or what the media is portraying right now. They don’t know what it what it means to be connected to a ventilator.”

In this trying and difficult time for our society, doctors have perhaps one of the toughest jobs. However, like many healthcare workers, Rodden knows that she’s right where she’s supposed to be.

“A lot of us are exhausted, but we wouldn’t imagine being anywhere else,” she said. “It’s why we went into health care, is to be like helping at a time like this.”

Aaron Lambert
Aaron is the Managing Editor for the Denver Catholic.
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