Alex: Hello, and welcome back to Modern Healthcare is Beyond the Byline. We're here to add some context to our stories to help you better understand the news and how it's reported. My name is Alex Kacik. I'm the hospital operations reporter for Modern Healthcare. Post-acute and staffing reporter, Ginger Christ, and I will be talking about some of her latest work on vaccinations for staff and patients in nursing homes, and how she finds patients to talk to. Welcome, Ginger. Thanks for joining me.
Ginger: Thanks so much for having me.
Alex: Well, Ginger, you've done such a great job of getting the perspective of patients in your stories, and that requires extra work. You have to build rapport. But the end result, you get a such a more relatable and impactful story. It's something that I've tried to do, but I often come up short. But your recent piece on nursing home residents' willingness to get the vaccine has some great anecdotes from Frank, Carol, and M.A. I wanted to start with what you learned when you talked to them.
Ginger: Sure. Yeah. The way I see it is if you're going to write about residents, you need to hear from residents too. We can talk about residents' need to get the vaccine. But unless you actually hear from them, you can't really tell their story. What I tried to do was ... as vaccinations kicked off in long-term care, I was hearing from a lot of different facilities saying, "Do you want to find out more information about what's going on? How we're running these clinics?" I said, "Yes, that all sounds great." And I wrote stories about the clinic starting and what some best practices were. But at the same time, I was also just really wanting to talk to the residents.
Anyway, I just worked through the nursing homes, and asked them if there were any residents who were willing to talk and there were. So, we tried to set up interviews. It was a little complicated, because as everyone knows visitation is closed in nursing homes. I haven't been able to go in and talk with residents like I normally would. All of these calls that I set up with them were set up through FaceTime, and we had to have an aide at the nursing home help them figure it out. In one case, we went through three different platforms before we got it working. Had to talk to an aide on her cell phone. She called my cell phone. We were FaceTiming. It was a whole thing.
But anyway, once we finally got through, it was really nice to see the residents' faces and just hear from them. I wrote about Frank, who is a veteran. He was one of the first at his facility. Actually, at a nursing home near me outside of Cleveland. But anyway, I got to chat with him, and just mid-interview he breaks out in song, and he's looking at a photo of his wife on the wall. You just really get to see their personality, and just help remember that these are people with rich lives. They have a lot of experiences. They've gone to war, in Frank's case. They've had vaccines. Getting a vaccine means maybe something different to them than what we automatically might think. For them, they really saw it as a way to lead, and a way to set an example for the rest of the country and say, "This matters. This is why we're doing it." And just really have their stories told.
Alex: Frank was saying that it's just another shot, right? He's like, "I've had done this before." But we need to collectively pull together to try to mitigate the spread of this, which is hitting facilities he's at so hard. But it sounded pretty optimistic, and a sign of solidarity from the residents' perspective where they're eager as everyone else to try to get life back to normal, and they feel like they're trying to do their part by getting vaccinated. Because you hear about hesitancies with getting the vaccine, but it sounds like the folks you've talked with were willing and ready.
Ginger: Yeah. I mean, I think they all kind of echoed what we've seen across the country, which is that residents are overwhelmingly willing to get the vaccine. We've seen a lot more hesitancy when it comes to staff. They're not quite as at-risk, so maybe it doesn't seem as immediate to them. I've talked to workers too for other stories.
But in the case of residents, you have to think about what their life is like. As M.A. explained, she's like, "You're already cut off from the world in a way when you move into a facility. No matter how much independence you have. What type of long-term care facility it is. There's some kind of divide between you and the life that you had."
So then you have to think about their world just getting smaller and smaller as this pandemic has gone on. They can't see each other. They can't eat together. They don't have that community that they moved into, so they weren't aging alone. For them, this shot is really a sense of freedom in a way to get some of their life back, and kind of try to enjoy these years that they have. From them, they were saying, "Why wouldn't we get the shot? Also, we hope everyone else does too."
Alex: You mentioned Frank. He said that he writes songs and sings them, and you're getting folks to open up to you. I'm wondering how you get there with them. You're trying to connect with them. Sometimes frustratingly over technology it doesn't always work. We're used to doing in-person reporting, and that lends itself to a much different back and forth. How do you get folks ... What's it like interfacing with them through Zoom, or FaceTime, or what have you? And how do you get them to open up?
Ginger: I think I'm benefiting from a bit of experience on their end. Just because the pandemic has forced everyone in long-term care facilities to ... they only can connect with their families through technology. Talking to me was just ... It wasn't really that out of the ordinary for them. A lot of the residents didn't quite have the camera at the right angle. I couldn't really see them. I saw kind of a wall behind them for a while. There certainly were some complications.
Anytime you have to do an interview not in person, it's more difficult. I'm thankful for video because I could still read their expressions mostly when I could see them. But it is still different, because there's more of a barrier to talking to someone and getting to know them. I want to get to know them, and just get an overall sense of who they are as a person, and understand what this vaccine means to them in this case. What their life looks like now, how their life has changed, and really piece all of that together to give a full picture of what this person is going through, and what different policies and things mean, and how they affect them.
Alex: What is your reaction when you hear them share their life experiences, and how they got there, and what they're looking forward to? And how does it shape the story you write? Because I imagine it has a personal impact on you when you're able to connect with someone on a personal level, but also it can change the direction of how we tell stories as well.
Ginger: Yeah. I think that's why I always try to talk to the people who are affected in the story instead of just talking to hospital administrators, or long-term care administrators in this case. The idea to me is to look at a policy, or to look at a story, and think about who it's going to affect and then talk to that person. I think it really lends a lot more to a story when you look at something that might seem black and white, and then you try to add color to it, and try to just fully understand an issue. Because I don't think you can fully tell a story unless you understand the perspectives of everyone involved.
Alex: The way I've gone about it is trying to go through patient advocates, and they'll try to direct me through specific patients who typically are having trouble navigating the system. Whether it's getting the right care, or maybe getting really high bills. But sometimes they'll get cold feet and they'll back out after an interview. Sometimes they get worried that there'll be backlash from someone based on what they say. Just from personal experience, I know it can take extra hours, days sometimes with these stories. It's a luxury when we do get it to come together and hear these patient voices. But it doesn't come overnight.
Ginger: Yeah. It definitely does take a lot of work. I certainly am not able to do this on every story, although I try. But yeah. You have to go through a lot of different sources. Sometimes I'm just reaching out via social media to see if someone's been affected by something, hoping that word of mouth spreads. I'll go through a hospital or a nursing home, and ask them if they have anyone that would be willing to talk. They often will talk to people already, and have a list of people who've signed off to talk to the media. They just do that on their own, or a nursing home small enough that they can go around and figure out who they think might be willing to talk.
It's not always ideal, because then the facility is choosing the person and it's less objective maybe. I try to keep that in mind when I'm talking to people that have been selected by a system. The most trouble comes when it comes to staffing stories. Those are ones where I found out that workers are very cautious about talking to the media, because they've seen the repercussions that play out sometimes when you maybe say something negative about an employer that has a lot of power. In some cases I will talk to them off the record to help them feel comfortable first, and then we'll kind of talk about what it means to go on the record. Because a lot of people aren't even familiar with what that process looks like. You kind of need to explain it to them, let them talk through something, and help them understand the process. There's a bit of media literacy that comes in, too.
Alex: I'm wondering broader thoughts just about what you've seen thus far in terms of the vaccination rollout in skilled nursing homes and other long-term care facilities. I know there are some extra hurdles there in terms of setting out space in some of these facilities to administer the vaccines. Patients need consent. And if there's cognitive issues, I imagine there's some trickiness there. Yeah. And you're trying to minimize re-entry, so you're trying to get it all right upfront. What have you noted about the vaccination efforts in the long-term care facility sector thus far?
Ginger: Most administrators I've spoken with have gone through the federal long-term care partnership. They've been working with CVS and Walgreens, which have a pretty detailed plan of how they're doing these clinics. They kind of do the same thing all across the country at 15,000 nursing homes.
But what I found is that it really varies site by site and what that looks like. These first clinics had a bit of a learning curve as they figured it out, because the FDA emergency use authorization came, and then these clinics were set to start within a week or two in long-term care. But nursing had to get authorization from residents. They had to get all this paperwork signed and filed. And at the same time, set up these clinics and make sure that they would work ... at the same time as they're educating patients on what this means, or residents on what this means, as well as staff.
There were a lot of things that were happening very quickly. And this has only been like a month and a half since the vaccines were even approved. At this point now, we have pretty much ... every long-term care facility has completed the first round of doses for residents, and they're moving into the second. I think what I've been hearing is that a lot of lessons have been learned from this first clinics on how to run things.
I've seen things like one facility creating a fast pass. The administrator likened it to Disney World in saying that staff ... if they were working that day, they could come to the front of the line. One place had timed appointments. And then for residents, at some places they can't leave their rooms. So, they had to go room by room and administer the vaccine. In other places, they were able to set up clinics.
I've noticed a lot of the hesitancy has come in Alzheimer's units or memory care units where it's harder to maybe get authorization from the resident, informed consent. And so places have really been spending a lot of time there. But yeah. There's a lot going on that they're trying to manage at the same time that they're trying to provide this very individualized care. There's been a lot to balance.
Alex: Yeah. We've had a couple of guest appearances from your felines. I don't know if our listeners heard.
Ginger: My cats have been very active during this call. If anyone has heard a meow, then that is them saying, "Please subscribe to Modern Healthcare."
Alex: We'll list them as co-contributors. I'm curious if there's one story you could pick out from a resident that sticks out to you. Is there something that they told you that resonates with you that you think will last in your memory, and just has had a personal effect on you?
Ginger: In Frank's case, he's in his nineties. And he's like, "I've gone through things. I just find a way to look at the bright side of things." I think hearing those lessons from someone like that, it just really helps keep things in perspective for me even personally. And just as a reporter remembering that every story has nuance, so you can't assume that you know the story without talking to people that are involved.
Alex: Well, Ginger, thanks so much for your reporting and for getting those stories out there. It really adds another dimension to all this news that we're getting every day, and puts a face behind all these statistics. Thank you for that, and thank you for sharing your experience with us.
Ginger: Thank you so much.
Alex: All right. Thank you all for listening. We'll have links in the show notes that feature Ginger's reporting, as well as links to subscribe to all of Modern Healthcare's content. We appreciate your support.
