Six research nurses mirror the pandemic

Natalie, Paola, Chantal, Séverine, Stéphanie and Khadija are in constant contact with the population of Geneva as part of the studies carried out by thePopulation Epidemiology Unit. The six UEP nurses juggle sampling locations, timetables, questionnaires and serologies. Six complementary backgrounds with three watchwords: mobility, flexibility and adaptability. They talk about the specific aspects of their work as research nurses since the start of the pandemic.

" This story has taken us all over the country! Natalie, who specialises in emergency care at the HUG, has been travelling around Geneva on the Health Bus of the Population Epidemiology Unit. But right from the start of the COVID-19 crisis, she had to be inventive. As everywhere else in the hospital, she and her colleagues Chantal and Paola had to adapt to logistical protocols that changed every quarter of an hour. " From one day to the next, we went from a team of 10-12 to 80 people to manage the COVID seroprevalence studies in the Geneva population ," recalls Chantal, who was previously a research nurse in nephrology at the hospital. She joined the trio in February 2020, right in the middle of the pandemic hurricane. Since then, the studies carried out by the Population Epidemiology Unit have multiplied. Natalie recounts that in the few months between the first seroprevalence study and the study of unconfined workers, they had already carried out around 20,000 serological tests.

Making it all up

The team's three cheerful nurses all agree on the stimulating challenge of developing mobile units. "We were requisitioned first and foremost to carry out PCR tests on staff at the time of the first peak in the epidemic, at a time when the protocols drawn up by our colleagues in the scientific unit, project managers, researchers, coordinators, data analysts and administrators were maturing just as urgently". On site, they had to get organised and find solutions. Paola, who has 27 years' experience at the HUG, describes it this way: "When you find yourself decentralised like that, you have to think about all the logistics from A to Z, from visors and gowns to disinfection, right through to imagining the flow of people between the blood collection booths, in areas not designed for a pandemic. In retrospect, what stands out above all is the enthusiasm for meeting a wide variety of people. "We really got to see everyone, even more than we used to on the bus! Their off-road expertise is asserted in this unprecedented daily routine. Their shared enthusiasm for this lesser-known approach to the nursing role is clear to see. " In this highly mobile adventure, we really had the impression of being useful, of taking part in a collective effort by contributing in our own small way to perhaps improving local public policies over the longer term", Chantal points out.

A complementary team

Comprising three carers at the start of the crisis, the team doubled in size from one summer to the next. Séverine, who joined from the hospital sector, has been strengthening the team since July 2020, working on the initial studies. In the autumn, the youngest member of the care team, Stéphanie, was recruited after her first year working in a young adult psychiatry unit. She joins the teams in the effort of writing to and telephoning the participating populations, bringing a nursing sensibility to their recruitment. As the waves and variants progress, the serological monitoring of participants is set to last. Not to mention the fact that other studies are gradually emerging, including Schoolsand then KIDS a year later. Studies on the very young are an integral part of the unit's research. Khadija will be joining the team in summer 2021 because of her experience in paediatrics. " A child is emotionally very intelligent. They either trust you straight away or they never do. But that doesn't necessarily happen verbally. You have to maintain the same level of respect as in a clinic. This is all the more important given that, for the KIDS study, we are currently working on a component involving children with clinical vulnerabilities. Even if their families willingly agree to take part, I always keep in mind the notion of consent, asking myself whether or not it will be possible to take blood after observing any signs of withdrawal or fear that may be too great emanating from the child's behaviour."

" A nurse doesn't just inject people "

Although the procedures remain the same, being a research nurse implies a different vision of care. "It's different on a relational level, it calls on a different intuition. You don't just walk into the room of a patient who is mentally or physically suffering", Séverine points out. They all agree. " Let's just say that here, even if it's hectic at times, you don't have the same approach to work at all. There's not the same emotional charge as with patients," says Khadija. Paola insists that, together, they represent know-how and expertise in the field, over and above the gesture: " We're a bit of a bridge between the field and the teams analysing the biological and informative data that we collect in contact with the participants. In the various sampling areas, it is they who explain the purpose of the studies. Natalie appreciates being able to take the time to do this: " Despite the pace, we take the liberty of talking to people ". " It's also a good time to talk to people. It's not for nothing that the project is called Specchio. The participants hold up a mirror to what's going on in the city as a whole. It gives people the feeling that they're part of something bigger. And we also take a more macro view of health in the canton, a population-based approach ," adds Paola.

An upheaval in practices

The experience of the pandemic has accelerated everything, particularly the digitalisation of epidemiological research and monitoring practices. "We have to adapt to more powerful tools for monitoring population samples. At the time, we were also using, for example, tablets or virtual reality headsets to reassure the very young. We're witnessing a real upheaval in practices", both Paola and Chantal observe. Further afield, working in a scientific environment seems unusual. " One of my colleagues nicknamed me the Swiss Army knife!" laughs Stéphanie, underlining the great strength of the multidisciplinary nature of the UEP teams. "I find the dynamism, cross-disciplinary approach and creativity involved in my work particularly rewarding. There's a lot of co-construction here. This ability to adapt and the experience gained during the crisis will be essential for one of the major changes to come between now and the end of 2022: the takeover and digitalisation of the Health BusThe Health Bus, a flagship study on the risk factors of chronic diseases conducted since 1993 by the Epidemiology Unit, before COVID took centre stage...