I've Got Your Nose?

Whew. The last few months have felt like a year. We’re opening up more amenities in AB and unsurprisingly, our Covid-19 case numbers are rising. I work in a rehabilitation hospital setting and at the beginning of the pandemic, my department focused on contingency plans for supporting the inpatients in our rehabilitation units (i.e., people working on retaining skills post-stroke or post-brain injury). Our hospital was worried that the nursing staff would be redeployed to support hospitalized Covid-19 patients or would be off sick and that they would need additional care providers. So, we completed online training modules about changing bedding, transferring patients, helping patients use the bathroom, and recording vitals. Then, we completed buddy shifts with nursing and got to do the above in person for half of a shift.

We were trained and ready to go; however, from June-November, I was actually redeployed to “support the pandemic effort” in an entirely different way. Instead of providing comfort care for inpatient units, I performed Covid-19 testing swabs at a Covid-19 assessment centre.

In my province. There are two different kinds of swabs that are used for Covid-19 testing. Nasopharyngeal swabs and throat swabs. For those that don't know, throat swabs are actually within the scope of practice for my regular job. However, in order to perform nasopharyngeal swabs, we received special permission from our college and on-the-job training at the assessment centres.

1. Nasopharyngeal Swab

For this type of Covid-19 test, the swab is inserted into an individual’s nasal cavity and back into the nasopharynx. It sounds gross, but the whole process takes between 5-7 seconds. Click here for more information about nasopharyngeal swabs.

2. Throat Swab

For this type of Covid-19 test, the swab is inserted into an individual's mouth. The side of each tonsil and the back of the throat are swabbed. Unless the person has a particularly active gag reflex, this swab also takes 5-7 seconds to complete. Click here for more information about throat swabs.

In addition to different types of testing, there were two different assessment centre experiences in my city:

1. Walk-In

A gym and an event centre were repurposed as assessment centres. People would schedule appointments online then report to one of the centres to be tested. The walk-in version is a little bit like speed dating (but less/more fun?) Each swabber takes the next person/family in line back to a booth to be swabbed. After everyone has been swabbed, they are free to leave.

This is what it looks like (from a swabber perspective):

Arrive at the assessment centre, change into scrubs. Following proper procedures for hand sanitization, don mask, face shield, gown, and gloves, then wait for instruction regarding the type of swabbing you’ll be performing - either nasopharyngeal or throat. (It changes based on the swab supply that given day).
Wait for appointments to begin. Pick up someone (usually a family of 5 with several young kids) from the appointment line, take them back to your booth.
Assemble swab materials (swab, collection vial, collection baggie and/or tongue depressor depending on the type of swab).
Take their paperwork, ask for personal identifiers (name and date of birth), fill out questions.
Complete throat or nasopharyngeal swab. Put swab in vial and vial in baggie. Patient is free to leave.
Remove gloves. Sanitize hands. Don clean gloves. Clean station (table, chairs, and cabinet for supplies).
Remove gloves. Sanitize hands. Doff gown.Wash hands.
REPEAT approximately 5 times per hour until there is no one left waiting in line. You may or may not end your shift on time.
Change. Go home, shower immediately. Fall asleep on the couch after scarfing down dinner.

2. Drive-Thru

A waste management facility was repurposed as an assessment centre. People drive into the bays and remain in their car for the swab (we swab them through the window). Two lanes of five cars each enter and then each swabber performs tests on their assigned car. If there are kiddos present, parents bring them into the front seat or climb into the backseat to help them stay still (they are not allowed to open their doors while inside the bay in order to reduce the risk of exposure). Once all of the cars have been swabbed, they exit and a new batch is brought in.

This is what it looks like from a swabber perspective:

Arrive at centre. Following proper procedures for hand sanitization, don mask, face shield, gown, and gloves, then wait for instruction regarding the type of swabbing I’ll be performing - either nasopharyngeal or throat. (It changes based on the swab supply that given day). Pick a lane and a car to swab.
Wait for appointments to begin.
Go to the car window. Ask the person’s name and why they are being tested.
Retrieve paperwork from the side table and fill out information.
Return to the car with paperwork. Review personal information to ensure it is correct. Complete throat or nasopharyngeal swab for all occupants. Put swab in vial and vial in baggie. The person is free to leave when the bay doors open.
Leave car and walk to the “dirty” area. Remove gloves. Sanitize hands. Remove gown. Wash hands.
Walk to the “clean” area. Sanitize hands. Don clean gown. Sanitize hands. Don clean gloves and then wait for the next car.
Repeat ad nauseam until there are no more cars in line. You may or may not end your shift on time.
Go home, shower immediately. Fall asleep on the couch after scarfing down dinner.