Front-line Faces: Bringing a human connection to COVID unit

July 28, 2020
Travis Toelkes poses in the hospital hallway
Travis Toelkes volunteered to work on one of the new COVID units at MUSC Health. Photo provided

Editor’s Note: This is part of a series of profile stories of MUSC Health front-line health care workers who are providing medical care and support to patients with COVID-19.

As an MUSC Health Meduflex nurse, Travis Toelkes is used to “floating” to different units whenever they need nursing help and quickly learning the protocols, procedures and supply systems of that particular unit.

It’s a skill that’s come in handy as he’s helped to organize a COVID-19 unit from scratch. When the number of patients at MUSC Health quickly escalated at the beginning of summer, managers were told on short notice that it was time to implement the hospital’s tiered bed capacity plan.

Toelkes volunteered to work on one of these COVID units and became part of the core staff on a new unit in University Hospital Extension, the old children’s hospital. Along with nurses pulled from across the hospital, he worked to do everything from setting up chairs and monitors in patient rooms to labeling and organizing supplies.

“All those people have really come together and organized the floor,” he said. “I’m proud of that.”

Growing up, Toelkes always knew he wanted to do something in health care, but he wasn’t sure what. He followed a pre-med curriculum in college and did an internship with a chiropractor, but he realized that wasn’t a good fit. After college, he did deep tissue massage for eight years and then led teens on outdoor adventure camps, guiding them through backpacking, rock climbing and whitewater rafting.

When some friends started going into nursing, they told him about all of the career paths open to nurses – that he could work in a hospital, a clinic or a school, or as a flight or travel nurse. Travel nursing appealed to him for the chance to work in new places, and he earned a Bachelor of Science in Nursing through an accelerated program in Montana.

He also met his wife there.

“In the middle of Montana, I met this little surfer girl with a Southern accent,” he recalled.

Her family was anxious for her to return to South Carolina, so he took a job at MUSC Health. After a couple of years here, he did end up doing travel nursing, but he returned again to MUSC Health. Working in the hospital made him realize he wanted to work with people on preventive care. This month, he learned he’s been accepted to a family nurse practitioner program at the University of South Carolina. He hopes eventually to work in a holistic practice that can help people to make healthy choices. In the meantime, he’ll be caring for COVID patients for the foreseeable future.

Toelkes’s unit cares for COVID patients who need hospitalization but aren’t so seriously ill that they require ICU-level care.

a nurse in gloves, gown, hairnet, mask and face shield enters a patient room 
Toelkes prepares to enter a patient room. Photo provided

Many of the patients are Spanish speakers who understand a bit of English but not enough to really follow what doctors are saying. Telephone translation is available, but Toelkes, who speaks fluent conversational Spanish, makes sure to follow up and help put these patients at ease. It makes a huge difference to the patients to have someone walk into the room who can speak their language, he said.

“I really make a concerted effort to offer those language skills to everybody because I know being in the hospital is a scary situation,” he said. “For me personally, that’s the most rewarding – I can help Spanish-speaking patients feel more relaxed and cared for.”

Toelkes also makes sure to facilitate communication between patients and their families. Providing updates to families and setting up video chats has become part of his daily patient routine, and if he hasn’t heard from a family in a few days, he’ll reach out with an update.

Medically speaking, the COVID unit is an interesting place to work. When the pandemic began, the main treatment was breathing assistance, but now, he explained, they have more tools in place, like steroids, the drug remdesivir and convalescent plasma therapy. Toelkes has been able to send some patients home. Others, though, have been transferred to one of the ICU units.

Toelkes realizes that the fast-changing situation – and the constantly evolving public health guidance – has been difficult for the public to keep up with. It’s even been difficult for some health care workers to keep up with, he said. Unfortunately, that’s led to situations in which some in the community dismiss public health guidance outright, saying that experts don’t know what they’re talking about. That’s not true, Toelkes said, but allowed that experts should have stressed from the beginning that they’re learning as they go.

That can be true in the hospital, too, where Toelkes’s unit went from an abandoned children’s unit to a shipshape COVID unit in three weeks.

“We have challenges, but we’re rising to them,” Toelkes said.