Rows upon rows of forest green cots — 530, to be precise — sit empty at the Exposition Center at Wisconsin State Fair Park outside Milwaukee.
God willing, they'll stay that way.
That's because the beds were set up at the new Alternate Care Facility, or ACF, to host low-acuity COVID-19 patients in the event that area hospitals became overstretched. As of the end of May, that hadn't happened, but a stellar team of nurses, physicians, nursing assistants, military personnel and other professionals are ready to spring into action should the need arise.
One of those nurses is Alverno's Annette Ries '19, DNP, MSN Ed, RN, CHSE, assistant professor of nursing in the JoAnn McGrath School of Nursing and Health Professions. As the ACF's co-nursing director, Ries is part of the leadership team that is creating patient care protocols, designing aspects of the facility and overseeing health care staff.
Another important mandate? Helping to reduce the spread of COVID-19, so that the ACF is not needed.
“We are Wisconsin's best insurance policy,” Ries says. “We're working very closely with the community and the military to give our expertise and knowledge about the virus, about protection and about testing.”
BUILDING A FIELD HOSPITAL
The ACF came to be in early April, in response to the quick spread of the coronavirus across Wisconsin. The Federal Emergency Management Agency (FEMA) approved the state's request for assistance, and the facility itself came together in 10 days.
The Exposition Center was chosen for its convenient location near hospitals and freeways. The cavernous 200,000-square-foot space has previously hosted everything from boat shows to the State Fair vendors hawking as-seen-on TV knives and juicers. (Now, a concession stand that once sold brats and nachos is set up as the distribution site for patients' food.)
The conception and construction of such a facility during a pandemic of this scale is a once-in-a lifetime event. That meant Wisconsin's brightest medical minds had to think through every possible need and protocol.
“There was no playbook for this,” says Debra Standridge, the ACF's chief executive.
The facility was constructed jointly by the Army Corps of Engineers, private architects and seven local contractors, boosting the state's economy at a time of historic unemployment.
“A lot of people went to work putting this facility together,” says Tim Richman, the ACF's chief operating officer.
The ACF can accommodate 530 patients, based on an estimate of the need if all area hospitals reached 80 percent surge capacity for COVID-19 patients. Hall A houses 296 beds with the capability for oxygen to be piped into each patient's room. Hall B features 234 beds, and bottled oxygen would be available for patients. Hall C is empty but could be quickly set up for patients in three to five days.
During construction, one of Ries's projects was determining a way to safely funnel nursing and other health care staff in and out of the facility. There is one staff entrance, and after a temperature check, caregivers will enter, don their personal protective equipment (PPE) and make their way to their station. They will use a separate exit to take meals and breaks and to doff, or remove, PPE before going home.
“We want to make sure that we are always following the latest best practices and [Centers for Disease Control and Prevention] guidelines for the safety of our patients and staff. Part of that is limiting the transmission of the virus,” she says. “Our number one priority is keeping the nursing staff safe.”
READY TO LEAD
Ries was appointed nursing director on April 15. She hadn't sought the role; instead, she had planned to volunteer her services as a nurse. Her nursing background and education made her stand out, however, and she was asked to serve as nursing director.
“Of course, I said yes. I was absolutely honored to be working in that capacity,” says Ries, who earned a doctor of nursing practice (DNP) degree from Alverno in December 2019. “My ACF role is absolutely everything that I went to school for. I knew I could do it.”
Before Ries took on the role at the ACF, she had an important discussion with her husband, her 14-year-old son and 20-year-old daughter.
“I said, ‘Mom's a nurse. I can't sit back and go no, no, not me. As a nurse, we have to help. That's our calling. This is what I would like to do, but of course, I won't do it without your full support,'” she recalls. “My family supports me 100 percent.”
Ries, who has been on Alverno's faculty for 11 years, is proud to leverage the power of Alverno's unique ability-based curriculum in her work at the ACF.
“I've used every single one of the 8 Abilities in this new role daily,” she says. “I cannot say enough about the Alverno education. I totally believe in the philosophy of teaching, and that's why I teach here.”
Ries has already incorporated what she has learned from the pandemic and her ACF role into undergraduate classes — she taught four courses this spring — and will include the information in the master's-level courses she will teach this summer.
“My teaching is considering the future of nursing. Who's going to be working in these field hospitals? Nurses whom we've taught,” she says. “Before, we taught emergency preparedness, but nothing in this capacity. No one did. The textbooks didn't cover this. Now, I'm bringing my students pandemic-related case studies and simulations. We're engaging students in these conversations to expand their knowledge.”
While Safer at Home has helped flatten the curve, medical experts have warned that reopening the state in late May could bring a new surge in COVID-19 cases. The next flu season could bring another surge.
“We don't know what this virus has in store,” she says. “Always err on the side of caution. Social distance. Wash your hands. Wear a mask so that you're not spreading the virus when you're out in the community. Limit what you're doing in society so that we don't have to use this place.”
Should the facility need to start accepting patients, Ries and her team will be ready with 24 hours' notice. If the facility goes unused, so much the better. The lessons learned and the protocols documented will keep Wisconsinites and others safe for generations to come.
“We are making a blueprint for how to care for people in crisis situations, whether that's a war or another pandemic,” she says. “If, God forbid, something were to happen, we'll be ready.”
This article appears in the spring/summer 2020 issue ofAlverno Magazine.