By Jim Manzardo
It’s holiday time 2020, and all through the world, nary a soul has been spared the weariness, hardship and grief of COVID-19. Yet people everywhere, parents and grandparents especially, are also feeling eternally grateful that this novel virus has been quite merciful to children.
Though pediatric hospitals have cared for many children and adolescents with COVID-19, almost all of them have been sent home directly from emergency departments with minimal symptoms and orders to quarantine. For those who were hospitalized (almost always because of comorbidities) and for their parents, the greatest fear, of course, has been for their survival. Fortunately, very few children and adolescents have died from this virus.
A major source of stress for families has been the visitor restrictions. At the pediatric hospital where I work, early in the pandemic, both parents were allowed to be at bedside. Given the uncertainties, parents usually understood that neither siblings nor any other family or friends could visit.
But some parents were distressed in April when they were informed that only one parent at a time could be at bedside. These restrictions were difficult and felt isolating for more alert patients who wanted both their parents, and for those parents who now only saw each other in passing. Though video calls have definitely helped patients and parents feel more connected to family and friends, the diminished physical presence of these loved ones has still been difficult.
Also, early in the pandemic, volunteers were no longer permitted to enter the hospital. They have always played a vital role in helping kids feel normal, especially through play, the arts, music, humor, and schooling, and in giving parents a break. Their absence has left a big hole.
The remaining hospital staff, though more limited in our direct human contact and wearing PPE, have often been the sole people interacting with our young patients for extended periods of time. Our empathic, compassionate bedside nurses especially, though no substitute for parents, have been extra sensitive and responsive to patients’ and parents’ difficult circumstances and needs. Among those challenging circumstances has been a rise in children and adolescents with mental health issues who need inpatient psychiatric placement. Yet many pediatric psychiatric facilities are full, leaving these youth to wait in general pediatric units not resourced to address their specific needs – an added stress for those units’ staff.
As with chaplains in adult healthcare facilities, more of our spiritual care than usual has been directed to staff. Similar to elsewhere, staff has grown weary of COVID-19’s impact on all aspects of people’s lives. However, as popular culture began speaking of healthcare workers as heroes, many in pediatric healthcare settings felt undeserving of such accolades. Considering our low COVID-19 numbers, some even felt survivors’ guilt, aware of how overwhelmed their friends in the adult healthcare world. Many ICU staff where I work tried to address this internal angst by sending wellness packages to healthcare staff at the nearby adult hospital.
Over time, with more people staying home and socializing less, fewer kids were ending up in the hospital. Those decreasing numbers eventually meant that pediatric hospitals had to furlough and/or lay off workers. Some staff began to worry about the future of their jobs and to wonder if this was the beginning of a new normal. At our institution, everyone from the CEO to frontline staff shared in cutbacks, which gave many a feeling that we were indeed in this together.
Throughout this unprecedented year, I have accompanied many staff and patients’ parents, and held their worries, weariness and fears. Again and again, I have reminded them they are not alone and encouraged self-kindness, and I have seen the pathway open for them to find light in their darkness, to experience a more gentle leading, and to feel a much needed comfort. Maranatha!
Jim Manzardo, BCC, is clinical care coordinator chaplain at Ann & Robert H. Lurie Children’s Hospital in Chicago.