LSA, founded by the Little Sisters of the Assumption, firmly believes in the mission to empower families, children, and elderly by meeting their basic needs for food, healthcare, education and a safe home.  Our Nursing program is one cornerstone of this mission, providing healthcare to vulnerable populations who otherwise wouldn’t have access to the care they need.  The COVID-19 crisis has only amplified the importance of providing quality healthcare and the LSA mission.

Today, we talk to Dr. Brenda Brathwaite, DNP, CNM, and Director of Nursing at LSA about the importance of this program and the community impacts of COVID-19.

For those unfamiliar, can you provide an overview of the Nursing program?
The Nursing program is central to the history of LSA. Nursing is actually the flagship program, which was founded by the Order of The Little Sisters of Assumption, who came to the United States in the final decade of the 19th Century. Over the years, this program has evolved to offer critical services to our community. Today, we are very proud that our Nursing program offers a special focus on families and young children, with a proven track record of improving family health and well-being.

First and foremost, the Nursing program provides much needed prenatal and postpartum community health nursing visits to mothers and infants.  We also provide skilled community health nursing visits in the home to pediatric patients from birth to eighteen years of age. Additionally, we also provide skilled community health visits in the home or assisted living facility, offering nursing care for chronic health conditions, wound care, patient education for recovery and provide services for physical and/or occupational therapy for increased independence. Our services do not conclude with childbirth, but rather, LSA continues to work closely with families to ensure that the young and old alike have the services and tools for lifelong good health.

How has the Nursing Program responded to COVID-19 crisis?
Like many other nursing providers in New York and nationwide, the COVID-19 crisis was a startling reality that the LSA Nursing program has had to adapt to. Personally, while I had dealt with other health crises in NYC over my 39 year nursing career, COVID-19 however, has been quite different. I am now part of the leadership team of LSA during this pandemic. The COVID-19 crisis has challenged us all on a daily basis, but our mission is to keep the nursing program moving forward and serving our community without interruption or sacrifice of quality of care. The priority has been to keep our patients healthy and cared for; while keeping our community health nurses safe. 

To ensure safety of our staff, we have taken a number of precautions, these include: creating modified work schedules, allowing our nurses to work remotely, as well as, to work in the community. Through the generosity of our health partners, we have provided the needed PPE (Personal Protective Equipment) for our nurses to keep them safe. Additionally, via our partners at Memorial Sloan Kettering, we provided training for our nursing staff on appropriately donning and doffing PPE, as well as, providing fit testing of N95 masks to ensure they are sized appropriately for our nurses.
The nurses also completed certification training for nasal swabbing of community health patients for COVID-19, in case there is another surge in NYC. When testing was instituted for hospice, nursing homes and assisted living facilities, we organized testing for the community health nurses with our community health partners at Vista on 5th.  Lastly, our nurses are being tested weekly to ensure the safety of all of our clients.

How has COVID-19 impacted home visits?
The COVID-19 pandemic has necessitated us to modify some of our services to ensure safety. We have converted to modified telehealth services, we have scaled back on home visits for our Maternal Child Health (MCH) patients, Primary Care Providers for our adult wound care clients changed wound care schedules from daily to three times/week to focus on safety for patients and nurses. One nurse is assigned to the community now that the curve has flattened. The other nurse works at an assisted care facility because the patients at our assisted care facility are considered to be high risk. The third nurse works remotely coordinating care for our MIH patients and also for CHHA patients and assisted living patients.

What impacts from COVID-19 do you see on the patients?
Our adult patients have expressed sadness about feeling isolated and lonely. Our adult patients’ children, friends, and extended family were unable to visit them because many adult patients had comorbidities that placed them in the high risk category for visitation during the peak of COVID-19. Our MCH patients were experiencing inability to obtain supplies such as diapers and formula; some of this was due to financial insecurities, as well as, not being able to get to stores during the peak of the pandemic.

Why do you think the COVID-19 pandemic is impacting East Harlem so greatly?  
Unfortunately, telecommuting isn’t an option for many workers in East Harlem because they are classified as essential workers, so it was mandatory that they reported to work at the outset of the pandemic, which led to increased exposure to COVID-19. Many people living in East Harlem live in shared housing arrangements, which also led to increased exposure. There are also health disparities that exist for immigrant populations due to underinsured status which leads to decreased access to preventive health services.

What can we as the community do to help?
LSA can continue to provide the critically-needed services like the Food Pantry, Advocacy, Environmental Health, Parent and Child Development and Nursing. LSA has to continue to remain focused on our mission and to offer the vital support services to our community. Additionally, it is key that we collect good data from all of our programs. By compiling and disseminating this information, in a safe and private way, to our local public officials we can have meaningful conversations around the health disparities that exist for black and brown communities in East Harlem. 

Let’s end on a high note!  What’s your favorite part of working with LSA patients?
As a Certified Nurse Midwife I have been able to appreciate the collaborative links between all sectors of health care delivery. Such links assist in seamless care for patients with health disparities and ensures closing the chasm that sometimes prevents entire populations from experiencing health equity.