Only in rural Minnesota will you find a fish house being used in the middle of winter, in the middle of a clinic parking lot, for something far from ice fishing. But desperate times call for desperate, or rather, innovative, measures. Since early fall of 2020, Lakewood Health System has used a parked fish house as a drive-thru COVID-19 testing site in their Staples and Browerville clinic parking lots. Clinic nursing and patient access staff work out of the fish houses, so patients can drive up for their scheduled test and not have to leave their vehicle.
While the fish houses are still being used for COVID testing, since mid-January 2021, the Staples fish house has also been repurposed to distribute the COVID-19 vaccine to essential caregivers and those 65 years of age and above, who are part of the Minnesota Department of Health’s priority list. As of February 4th, Lakewood has had the opportunity to give approximately 950 people their first dose of the COVID vaccine.
Allocation and distribution of the vaccine from the federal and state governments has been slow and disorderly, causing frustration for healthcare facilities as well as patients and community members. In contrast, Lakewood has created a well-planned and facilitated process for distributing whatever allocated vaccine doses we receive. And according to patients and staff alike, it’s working very well.
“This is only the third day we’re giving the vaccine, but the response we’ve been getting from patients is overwhelming!”, said Lakewood clinic lead RN, Amanda Wensmann. “Some people have brought us hand and foot warmers because they think we’re cold when they see us running around outside. They don’t know that seeing them so grateful and happy keeps us all warm,” said clinic LPN, LaManda Nurnberger.
“And the cookies,” chimes in clinic LPN, Jody Yeager. And sure enough, on the counter in the fish house are packages of both store-bought and homemade cookies, given in appreciation of what this clinic team has been doing for patients and the community. Between cars, the fish house team chats and grabs a cookie (or two) as they sing aloud to music and prepare the information packets and supplies for the approximately 150 people they will vaccinate in the next two hours.
In preparation for each vaccination day, patient access staff call patients on Lakewood’s wait list to ask a few questions and schedule their appointment time. The process takes about 10 minutes per patient, and with approximately 300 people to schedule each day, the team is busy. Once the appointments are scheduled, the team prepares a packet for each patient with consent forms and information about the vaccine. (Lakewood has distributed both the Pfizer and Moderna vaccine.)
The day of the vaccinations, all the patient packets, along with vaccine supplies are brought out to the fish house, which accommodates roughly six nursing and patient access team members (and one writer). All are dressed for the Minnesota winter with hats, boots, coats and smiles, the latter of which are hidden beneath their prerequisite masks.
Two Rural Physician Associate Program (RPAP) students in their third year of medical school at the University of Minnesota – Duluth wear bright orange and black insulated jumpsuits along with their winter accessories. Their job during the vaccination process is to help direct cars and answer patient questions.
“We get a lot of questions about the vaccination process, and a few about the vaccine itself, but overall, it feels like the underlying feeling behind everyone’s questions is ‘hope’,” said RPAP students Kaitlyn Anderholm and Cassidy Peterson. “People want to leave their homes once in a while; they want to feel a little safer, and just hug their families. While we can’t tell them exactly when they’ll be able to do any of those things, they’re happy to be getting the vaccine because it’s kind of the next step in the right direction.”
Staff in the fish house keep an eye out the window and when they see cars in line, a patient access member steps out the door and waves them ahead. Once patients arrive in front of the fish house, staff identify them, ask in which arm they’d like the shot, and then return to the fish house for their packet. Next, one of the three LPNs grab the packet, along with the pre-prepped alcohol swab, needle and Band-Aid, and head out the door.
“The driver is Larry and he wants the shot in his left arm. The passenger is Julieann and she wants her shot in the left arm too, so she’s rearranging to get ready for you,” is, with name substitutions, a commonly heard exchange between staff in the fish house. While most patients receive their vaccination without leaving their vehicle, some prefer to get out to remove a coat or just for comfort; the choice is theirs.
While the vaccinations are being done outside, inside, the patients’ vaccine information is being added to their chart in Lakewood’s electronic medical record (EMR) by the lead RN. If anything in the process is missing or needs to be changed, a patient access team member inside the clinic is an instant message or phone call away. They will print whatever is needed and someone from the fish house runs in to grab it. Even the potential issues in the process have a plan.
After receiving their vaccination, patients are told to pull around to a designated parking area and wait 15 minutes before leaving the grounds. If they have any questions or concerns during that time, they’re directed to honk their horn and one of the RPAP students will come over. From start to finish, the process takes about 20 minutes, with the 15-minute waiting period at the end taking the most time. Everything is overseen by emergency medical services (EMS) staff, sitting nearby in an ambulance, should an emergent situation arise.
“We’re excited to be here!” said community members Larry and Juliann Fleisher as they waited their turn in line. One of many common statements heard from patients, along with smiles, waves, and of course, their thanks. “We’re taking care of our community, not just our patients. Our mission is to provide healthcare to everyone, not just those who normally receive care from us,” said Lakewood Director of Clinics and Access, Missy Lindow.
For those 65+ who have not received their vaccination but would like to be added to the wait list, please call 218-894-1515 and choose option #2. As Lakewood is allocated more doses, we will continue to schedule those on the wait list, which sits at about 900 people as of February 2nd and increases daily.
Excitement, thankfulness, and ultimately, hope, are shared by both patients and staff as the vaccination process continues at Lakewood. It’s a bright spot in the midst of the winter cold and gloom, and the nearly year-long pandemic which has hit so many. We don’t know when things will be back to ‘normal’, but until that time comes, Lakewood’s team will happily continue to vaccinate the hopeful.
The January 27th fish house team: (These teams often change day-to-day.)
Amanda Wensmann, clinic lead RN
LaManda Nurnberger, clinic LPN
Jody Yeager, clinic LPN
Sarah Zetah, clinic LPN
Jen Hjelmstad, patient access supervisor
Sara Wing, patient access
Kaitlyn Anderholm, RPAP student
Cassidy Peterson, RPAP student
Donald Brusewitz, EMT
Ashley Goddard, patient access