ASD Nursing

The Harbinger: The ASD Nurse’s Guide to Navigating COVID-19

Issue #2

Thursday, May 7

Greetings ASD Community,


We hope that you found some useful information in Issue #1 of The Harbinger. We are excited to give you all Issue #2 of the newsletter this week. Also, if you have not had the opportunity, please check out Issue #1 HERE. It is our hope that this information will help to put your mind at ease and give you an organized plan of action when dealing with our new normal. In ASD Nursing, we have been thinking about what the new normal will look like globally and how it will change how we navigate the world. Here are some quotes from our Nurses.

“We definitely will not be as transient as we used to be. It will be harder to travel.”

“People will be wearing masks all the time. Masks will become accessories with outfits.”

“Hand sanitizer and hand hygiene will be more accessible. People will carry it more and there will be more stations set up everywhere for it.”

“Less gathering. It will be a long time before we see a concert, festival, or sporting event.”

“People’s individual comfort level will change. Even when stay at home orders are lifted it will take a while for people to feel comfortable coming outside and being normal.”

What are some ways you all feel our “New Normal” will look? How are you and your family feeling about these changes and how are you preparing for them?

Stay Safe! Stay Healthy!

Click here to learn more about the ASD Nursing Team


Past Harbinger Issues

April 23, 2020


Carmen Jones, RN, BSN

Head Nurse

carmen.jones@asd.edu.qa

Tips to Cope with Stress During the Pandemic

1. Stay safe at home. Maintain a healthy lifestyle including proper sleep, exercise and balanced diet.

2. Maintain social contact with loved ones at home and by phone or emails with friends or relatives. Talking with trusted people helps to relieve stress and confusion during the crisis.

3. Update your knowledge of the crisis from credible and trusted sources like WHO, CDC, MOPH websites. Understanding the real facts about COVID-19 will help to reduce the stress of the outbreak.

4. Limit watching or listening to the news or media coverage on this crisis to once or twice a day as it may upset you and your family.

5. Engage yourself in activities that you enjoy. Practice your creative skills (any arts and crafts) that help you to relax and manage your emotions in this challenging time.

6. Support your children to overcome the situation. Give extra love and care to children will need extra attention during difficult times. Help them with homeschooling, play and relaxation. Explain COVID-19 and precautions in a way that your children can understand. Go to CDC site to get more information on Talking with children on COVID

7. Try to keep regular routines and schedules as much as possible.

8. Do not smoke or use alcohol as a method to get rid of emotions. Seek medical attention or contact a Counselor if you are overwhelmed or concerned.

9. Have a plan of where to go and seek help for physical and mental needs if required.

10. Take care of your mental health. People with preexisting mental health conditions should continue their medications and be aware of the possible worsening of current symptoms and/ or the possibility of new symptoms.

by Prima Vinod

ASD Elementary School Nurse

Grocery Tips and Tricks


For many of us nowadays, the main way we risk exposure to COVID-19 is being around people in a grocery store while we are out to get the necessities needed for our households. Therefore, some tips and tricks about how to safely and quickly navigate the grocery store are useful.

1. Strategically time your trips. It has been noticed that the grocery stores see busier traffic times depending on their location and time of day. For your peace of mind try to go early in the morning if you notice that the traffic is lighter around that time of day. If you go to the store and the number of people looks overwhelming, there is no shame in deciding to shop later or trying a different store with fewer people.

2. Have a list and stick to it. Know what you want to get from the store and have a plan of action when you enter. Try not to stand around texting or looking at your phone. Know what you need where to get it and get out of the store ASAP.

3. Wear a mask. This is a situation where social distancing may not always be achievable. Therefore, it is imperative that masks are worn while in any place where there are many people and you may not be able to remain 6 feet (2 meters) away. Most grocery stores are requiring this worldwide.

4. Gloves are optional. Some supermarkets in Qatar are now requiring gloves to be worn when shopping. Keep in mind that just because you are wearing gloves, DOES NOT mean you or your items are safe from exposure to COVID-19. If gloves are not being changed between each item you touch, cross-contamination is inevitable. Therefore, even if wearing gloves, try not to handle your personal belongings i.e. cell phone, wallet, etc. And most importantly NEVER TOUCH YOUR FACE with or without gloves in public. Remember COVID-19 gains entry to your system through eyes, mouth, or nose and NOT through your skin. See the CDC website on how to correctly remove gloves.

5. Wipe down what you can. Qatar grocers have been making sure that carts (trolleys) and baskets are wiped down before you touch them. However, once you leave the store and return home, wipe down your cell phone, car doors, steering wheel etc., if you really want to prevent COVID-19 from infiltrating your personal space. Be mindful and not excessive when wiping down groceries. Wiping down items such as cereal boxes can ruin the integrity of the packaging and contaminate your food with chemicals. Produce should be washed as you normally wash them. Vinegar can be used as an extra agent to get rid of pathogens on your produce.

The main takeaway is to limit your time in crowds and to do all you can, within reason, to disinfect when you return home. I hope this helps as you navigate the grocery store.

by Carmen Jones, RN

ASD Head Nurse

A Series of Unfortunate Events

On How the Human Body Handles an Invading Virus

"The damage that the human body can survive these days is as awesome as it is horrible. Crushing, burning, bombing, a burst blood vessel in the brain, a ruptured colon, a massive heart attack, rampaging infection. These conditions had once been uniformly fatal."

- Atul Gawande

The human body has been ingeniously schemed to withstand danger or insult originating either within the body itself or externally from the surroundings. Every imbalance or danger perceived by the body is counteracted by a series of events to salvage itself from total destruction. Take for example a simple cough. It is a natural defense mechanism that protects the respiratory tract from inhaling foreign bodies or clearing excessive bronchial secretions. Another exemplification is fever, a mechanism created and sustained for the deliberate purpose of restoring health. The high temperature of a fever speeds up metabolism, inhibits the growth of invading virus or bacteria, literally burns them with heat and accelerate the healing process (Gunther Paulien, 2017). These defense mechanisms are initiated by the body to act as a warning sign that something is wrong and that we need to do something, like resting or taking medicine.

In case of a viral infection like COVID-19, the chain of infection commences with catching the virus from a carrier. The most common is human to human transmission, either by coughing, sneezing, or plain talking; which disperses the virus into the air within 3-6 feet from the source. Studies have shown that it may land on surfaces and can be infectious for a couple of hours depending on the type of material or stays afloat in the air for at least 3 hours; hence, the need for social distancing, wearing of masks and frequent hand hygiene. Once the virus enters the body, it acts like a key to get inside the healthy cells and replicate from these binding sites. It particularly attacks the alveoli, the part of the lungs responsible for effective gas exchange. It uses the host cells as an engine to generate more copies of the virus and release it into our system. In the process of embedding the genetic data of the virus to create copies of viruses, the host cell is damaged. It then sends a signal to the rest of the body systems to respond. The first one to respond is the immune system, starting a chemical inflammatory process to contain the invading virus. At this stage, we may develop a fever to promote the blood vessels to dilate and deliver the needed soldier cells into the site of infection. A number of blood tests may be done to confirm the infection, together with a nasal or oropharyngeal swab. The patient may also present with a dry cough, naturally to get rid of the offending organism.

If for some instance, the immune system is overwhelmed by some factors such as age or a pre-existing medical condition, the alveoli become edematous or fluid-filled and eventually collapse. Some part of the lungs where the battlefield took place, may contain dead viruses and damage cells that may have died during the process. This will be evident in Chest X-rays or CT Scans. The area of the lungs supposedly used for gas exchange is now been challenged, this will manifest as low oxygen saturation and increase work of breathing in trying to compensate for the lost function. The areas with mucus consolidation may trigger productive coughing. The low oxygen level may then tell the heart and circulatory system to work harder and this will present an increase in heart rate. The picture is painted as what we medically have known as pneumonia. When this gets out of control, it will lead to an even uglier phase called Acute Respiratory Distress Syndrome (ARDS). At this stage, the lungs notably may get tired, supplemental oxygen may not be sufficient and a need for mechanical ventilation is essential.

When the inflammation of the lungs spreads into the systemic circulation, it will launch a sequence of events called Systemic Inflammatory Response System (SIRS) that may fuel a septic shock. As fluids leak out into the tissue spaces from the original insult, the overall blood volume depletes, and blood pressure drops. At this time the kidney and the liver will be challenged and potentially crash with an awful display of liver and kidney function tests. The viscous journey to decrease perfusion to major organs embarks. The need for an ICU transfer is inevitable as multi-system organ failure unfolds. It is our hope that the outlining of the pathophysiology of this disease helps to form your awareness of what to do in the case of symptoms as well as why it is so important to practice social distancing and continually wash hands.

by Nemfa Cerbito, RN

ASD MS/HS Nurse

Be Productive While Staying at Home!

The outbreak of COVID-19 affects many countries globally. It has greatly impacted our day-to-day lives. This pandemic crisis has urged people to stay at home. Social distancing, virtual learning, and working from home have become the new normal. As a result, it is not uncommon to experience mixed emotions such as fear, anxiety, or even burn out. But how can we handle these drastic changes?

Deb Levy, a life coach, has six strategies that can help us to get through these challenging times.

  1. Practice Self-Care Habits. We should be physically and mentally fit by eating healthy foods, drinking an adequate amount of water, exercising regularly, taking time to relax and unwind, and getting enough sleep.
  2. Plan Your Day. We can make an organized to-do list on a specific task for a day and jot down our goals. Make a schedule and try to stick to it. It will help us to be as productive at home as we are at work.
  3. Start the Day with a House or Family Meeting. Coordinating with family members regarding your daily schedule when you are working from home will enable you to accomplish your tasks without conflict. If you have children, they should also be apart of the meeting as to the time of their online schooling and breaks.
  4. Create a Workspace. We can make a dedicated workspace at home. It should be accessible to all our needs to complete our daily goals.
  5. Eliminate Distractions. As much as possible, try to limit distractions such as cellphones, gadgets, or other temptations that can disrupt our productivity. You can turn off notifications from social media and messaging apps to avoid disturbance. If with kids, instruct them to keep quiet during your working hours.
  6. Focus on the Positive. We can maintain a positive outlook in these difficult times. If we are anxious about daily headlines about COVID-19, it is okay to limit monitoring of the news. Acknowledging our feelings toward the current situation is understandable. We can develop new skills as we explore the internet. It is also the right time to engage in activities we enjoy.

We all know it is hard to differentiate between our work and personal time while staying at home. To surpass this, we should practice self-care habits, plan our day, start meeting with family, create our dedicated workspace, eliminate distractions, and always focus on the positive. Lastly, staying connected with our family and friends virtually will prevent us from being lonely during this time of uncertainty.

by Laureen Tordecillas

ASD Elementary School Nurse