Jennifer Clarke, MN, BScN, RN, GNC(C), is the Associate Director of the Support Program for the Autonomy of Seniors (SAPA) at the CIUSSS Centre-Ouest-de-l'Île-de-Montréal. She was interviewed by Gretchen Lydia Keller on April 16, 2021. At that time, she was the Program Coordinator SAPA for Donald Berman Maimonides Geriatric Centre.
Facing the Pandemic in a Milieu de Vie
As site coordinator responsible for one of the Montreal’s large long-term care sites, with 387 residents, Jennifer Clarke had to maintain a positive front for her staff and residents —even through her darkest moments of the pandemic.
Following the first directives for managing COVID-19, her team established a hot zone in the chapel, which fit 12 beds. But a week after their first case was confirmed on April 7th, they had fifteen cases. “I was supporting everybody but in my head I was freaking out,” said Clarke. “That first week was the panic week. I could not allow myself to be negative or to be pessimistic in front of staff or families. But when I was alone, I was scared: for myself, for my colleagues, for the residents.”
The chapel was overloaded so two more hot zones were opened. Then, with staff in short supply, she and her team decided to put all COVID patients on one floor, consolidating staffing resources and improving care. This meant moving residents from their rooms.
“This was one of the most difficult decisions I have ever made," she said. "One of my core values is respecting individuals and their autonomy, but not one resident wanted to move. And because we had to act so quickly, we couldn’t consult them.” She could easily imagine their point of view. “For two months they've been confined to their rooms, which are all they have. Now we're taking away everything that is familiar to them. And those who were able to express themselves said, ‘I would rather get COVID then you take away my things and move me.”
“It reminds me why we’re here: for the residents. They're not just a number or Mr. So-and-So in this room. These are people with lives.”
The gap between residents’ rights versus the greater good weighed heavily. “And some of them got COVID and died anyways,” she said. “But I don't know if I could have made any other choice.” The decision was particularly difficult given Clarke’s deep commitment to her residents. She recalled one of the residents who got COVID and died during the pandemic. “He was the sweetest man ever. He had given me a picture on my birthday two years ago. I have that picture in my bedroom and I look at it every day,” she said. “It reminds me why we’re here: for the residents. They're not just a number or Mr. So-and-So in this room. These are people with lives.”
Overall, many residents died in the first and second waves, and while Clarke expressed both sorrow at these deaths and gratitude that she and her staff were able to support these residents through their last moments, she is unhappy that so many died alone. “I wish I could have advocated more for having families here, but we went with the directive to have no visitors, and I'm not sure that was the best move,” she said. “Maybe it protected people, but maybe it didn't.”
Consistent engagement with her team and her superiors enabled Clarke to cope with the intense emotional stress of leadership. “The decisions I had to make weren't easy, and some went against my values, but I understood why we were doing things,” she said. "But what also struck me in that moment—what I think of a lot—is the closeness I felt with the team and just the bonding experience. That we were all in it together and we were there for each other. That is so important: having other people to rely on and to be there with you."