For our May issue, we chatted with notable Nashvillians about life as they know it. From healthcare workers spending long hours to save lives, to parents finding the difficult balance of working and parenting (and teaching) at home, their stories were both familiar and inspiring.
Bynum, who works in Developmental Medicine at Vanderbilt Children’s Hospital, talked openly about the fears and uncertainty healthcare workers and patients alike face every day, and what it’s like to be a working mom of two right now.
Nashville Lifestyles: What is your profession and what did your working life look like before the COVID-19 pandemic?
Shai Bynum: I am a nurse practitioner in Developmental Medicine at Vanderbilt Children’s Hospital. We are an outpatient clinic made up of doctors, nurse practitioners, psychologists, and behavior analysts serving children ages birth to 21 years with developmental disabilities. I also work in a specialized clinic treating children with Cerebral Palsy. Typically, meaning before COVID-19, my job includes seeing children in the outpatient setting for scheduled clinic visits with occasional in-hospital consults. I also see children for outpatient office visits in Baclofen Pump Clinic. A Baclofen pump is an infusion device and catheter implanted under the skin that delivers a constant, precise dose of medication, baclofen, directly to the intrathecal space or spinal space. Baclofen is a muscle relaxant and antispastic used for the management of severe spasticity, or tight muscles, often seen in Cerebral Palsy.
NL: How has the pandemic impacted what you do?
Bynum: This pandemic has impacted everyone’s daily life in significant ways. Weeks ago, Vanderbilt Children’s Hospital moved all of its outpatient clinics to Telemedicine only, limiting face-to-face visits for only essential medical needs. All of our general development, learning, ADHD, Autism, and muscle impairment visits are done over Zoom through Telehealth. However, the Baclofen pump clinic is considered an “essential clinic” as these children depend on the medication pump and running out of medication can be life-threatening. So, we have continued to see children with baclofen pumps in-person in the hospital during the pandemic.
To say that Telemedicine has been a “learning curve” is a bit of an understatement! The art and science of medicine is mostly a hands-on practice. Learning how to connect with families and patients while diagnosing and treating complex medical issues through a computer screen is not something many clinicians ever learned in school. While remaining socially distant is so crucial in these times, it also has been especially challenging to provide excellent medical care in this way. I hope patients and families remember that most medical providers are no more proficient in technology than the general population (and some of us are much worse!). There is frustration on both sides of the computer screen, and we are all learning this together. But I am also so thankful that we have this incredible opportunity to see patients and keep them safe at the same time, even if the conditions are not optimal.
In addition to Telemedicine from home, I have continued to see patients in person in the Baclofen Pump Clinic at the Children’s Hospital. We see children from all over Tennessee and Kentucky who depend on baclofen and the service we provide at Vanderbilt. Initially, the anxiety of “what do we do?” and “how do we keep everyone safe?” was a huge hurdle. Many of the children seen in the Baclofen Pump Clinic are vulnerable to illness, and they often get much sicker than the general population, so the anxiety of coming into the hospital for an essential need, while potentially exposing themselves to the virus, is unimaginably scary for these families. We have been working longer shifts with staggered appointment visits to ensure limited contact with others and reduce potential exposure to the virus. The extended working hours and schedule management have been very challenging logistically for our staff and our families.
NL: What have been the biggest changes to your job?
Bynum: The changes to our daily lives have been difficult, but even more challenging are that the changes keep coming. Every day there is new information and recommendations. What we did yesterday is different than today. Which, for me, means a lot more time and mental effort goes into my day-to-day work. I may work varying days and different hours each week based on the needs. We have to make specific plans for every possible scenario. What if a patient has tested positive for COVID-19? What if their parents are infected? How can we get them safely in and out of the clinic? What happens if I get sick? I spend more time figuring out new technology, scheduling appointments, and making sure we have adequate equipment to keep ourselves, our staff, and our patients safe. Things that used to be simple, like finding masks, now can take hours. Ensuring we are seeing the patients with the most pressing needs promptly, while also limiting their exposure is a puzzle that sometimes seems impossible to solve.
NL: What has been the hardest part about all of this?
Bynum: For me, the hardest parts are all of the unknowns. In the medical world, we often have answers. And even when we don’t, we have educated guesses. Right now, it feels like we have so little that we “know” for sure. I, like most medical professionals, like being able to fix things, and now, it seems, fixing is impossible. I feel worried, right along with all my patients and families, about getting exposed to COVID-19 and unknowingly passing it onto my vulnerable patients, their families, or to my own family. Most of the time, I know how to be safe, what to do, and how to prevent spreading illness. At this point, I don’t know day-to-day if I will have access to things like masks and gloves.
Then, there are my children at home. With my kids out of school and my husband working from home, I am constantly thinking of them when working long hours in the clinic: Are they are eating lunch? Are they doing schoolwork? Have they played ten hours of video games today, or are they accidentally burning down the house? I know many of our friends and neighbors have beautiful schedules to help keep their children focused, on task, and in a routine during these uncertain times. I sometimes wonder when my children are grown, will they look back on this time and think, “Remember those months we were out of school, never saw our parents, and were basically fending for ourselves?” I sure hope not! Or if they do, they know we were doing our best.
NL: What has given you the most hope in all of this?
Bynum: One thing about this pandemic that I hope becomes part of our new normal is the idea that we are all in this together. Those of us that are healthy stay home to protect the elderly and more vulnerable. We are all learning, and hopefully, teaching the next generation to think of the world as a whole instead of just our small part. We are preserving our resources and sharing what we have with others who can’t get out or are unable to get the things they need. We now have the understanding that even if you are not personally affected, your actions can impact others in a big way. I love that my children are thinking about how their actions and decisions affect the whole world. We are all figuring out to be helpers and caretakers of others, not just ourselves.
I think I most want everyone to know that we are all in this together. We all want it to be over, and we are all hoping that it is soon. Even in healthcare no one as all the answers but keeping children and families safe is our top priority. I hope we can all continue to look at one another with compassion and the understanding that we are all doing our best!
For more stories on how Nashville residents are navigating a new normal during the COVID-19 pandemic, purchase a copy of our May issue on newsstands or at shop.nashvillelifestyles.com.