July 14, 2020

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Dispatch from the front

Winnipeg ER nurse shares her account of the fight against COVID-19

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She's a veteran nurse at a Winnipeg hospital who has seen her fair share of medical emergencies. But nothing in her past could have prepared her for what's unfolding on health care's front lines amid the coronavirus crisis.

There are stringent new safety protocols. There's an omnipresent fear of the unknown. It's all become part of the new, frightening reality for Manitoba health-care employees — the foot soldiers in this pandemic fight.

The nurse worked back-to-back shifts last weekend at a Winnipeg ER. The woman, who has requested anonymity, shared her first-person account with columnist Dan Lett.

Heightened anxiety:

I was very anxious going into this weekend. I felt like I was going into my first job. I was physically terrified about going into the hospital because of what I was reading and what was going on, and what I perceived was going on. I felt sick, like I was going to pass out. I’m sure my heart rate must have been 140. I don’t think I’ve ever been physically scared in my job and I have seen some violent patients in the emergency over the years.

We have a couple of private Facebook pages where we connect and do shift swaps, things like that. There were a lot of posts there that really had me worried, where people were really concerned about what was going on. When I got there, it wasn’t as horrible as I thought it was going to be. But the buildup to get me there, I was really scared.

A calm before the storm:

At emergency, there wasn’t a larger number of sick people. It feels really good in emergency right now because it’s mostly just the emergencies that we’re seeing, the people who really need to be here. People are staying home and staying safe, and our volume is way, way down from what we normally see. But we're all worried about what's coming.

It feels like we’re in the Twilight Zone and everybody knows it’s coming, but when? That’s what this feels like — the calm before the storm. It’s the fear of what’s coming, and when is it coming, and are we going to be ready when it comes, and do we have enough supplies, and are we going to put ourselves at risk? Or, am I going to bring it home to my kid and is she going to get sick? Am I going to give it to my grocery store clerk who, in turn, is going to give it to every person in the community where I live? The guilt of it all.

Precautions become paramount:

A lot of people are talking about personal protective equipment. They don't know what it's like to wear this stuff all day. My ears hurt from the glasses and the masks. We’ve come up with a couple of things for our masks, just from what we’ve learned from posts by nurses in places like Italy. They have scars on their faces from wearing masks all day long. We learned from them to put buttons on our headgear, up above the ear, so we can hook the masks to the button instead of our ears. That was a trick that a nurse from Italy posted on a page sent to us. A helpful little hint.

Most of us are showering at work before we come home, and changing clothes. Traditionally, I’ve never changed my clothes before coming home from work but I’ve been doing that for about a week and a half now. There's much more we're doing now that's new, like all the steps we have to go through when doffing our PPE.

It feels like we’re in the Twilight Zone and everybody knows it’s coming, but when?

We have a spotter watching us – someone who's clean – to make sure things are taken off appropriately, and making sure we wash our hands between each step. When you come out of a room, you take off your gloves, because they're likely the dirtiest, and then you wash your hands. Then you take off your gown and wash your hands. Then take off your mask and goggles and wash your hands. It’s tough – especially in the winter. When you wash your hands that much they tend to crack, so we have to moisturize often.

We're wearing a surgical skull cap and mask, goggles, a gown and gloves. The gowns have a plastic lining that makes them very protective, but also very hot. And then, underneath all that, you’ve got your uniform on, with all that covering. It gets very hot, very quickly. But we're glad to have the equipment, and a bit concerned about whether we'll have enough.

Worried about protective equipment shortages:

I’ve never before had a fear that I wouldn’t have a mask to put on. Or that maybe I should wear this mask my whole shift because maybe there won’t be one for my next shift if I use too many today. I think we're all thinking that. Before, I would never wear a mask my entire shift. Now, we only take off our protective gear when we go on break. In a 12-hour shift, we get four breaks.

If we turned into a situation like Italy, there might not be enough PPE. I have no idea what kind of stock the health region has. We don’t go to the main storeroom in the hospital to see how many boxes of gloves and boxes of mask they have. They give us a certain amount every day. If we use it up quicker, then they bump up what we get. Our supplies are kept in locked cupboards because they're still going missing.

Entire boxes of gear are going missing from supply rooms... I have no idea what people are thinking because you’re just stealing from yourself in the end.

Before this started, we had isolation carts. When a patient is put in an isolation room, an isolation cart is put near that room. In that cart, there are masks, gloves, gowns, shields, N95 masks. Right now, we can’t stock those carts because people are taking stuff off the carts. So, all the masks are sitting at the main desk and other supplies are locked up in a cupboard. If you need a mask, you have to walk to the desk.

I’m not sure who is doing it. I don't think it’s the single mask that someone might slip in their pocket that we’re concerned about; entire boxes of gear are going missing from supply rooms. I don’t know if people are selling them, I have no idea what people are thinking because you’re just stealing from yourself in the end. It’s cumbersome for everybody. And locking up the supplies makes everyone a little scared. The stories coming out New York City, about how they ran out of this and they ran out of that, and how if we don’t stay home and flatten the curve and wind up in a situation like New York or Italy, we’re going to be in trouble. I think that's mostly where the fear is coming from.

Bracing for what's to come:

The normal stress of our work isn’t there right now because we’re not as busy as we normally are, and moving people and getting stuff — it doesn’t feel like that now. There isn’t as much pressure. There’s still quite a bit of overtime. I’ve picked up a lot of additional shifts over the next two weeks. There’s still an abundance of OT shifts even though there are fewer patients. There just aren’t as many people getting in traffic accidents, or falling and breaking their hips. People are behaving, I guess.

If it gets really bad in hospitals, I’m not sure that we’re going to have enough nurses. It will depend on the acuity of the COVID patients. If there is a large number of critically ill patients coming in quickly, it’s not going to be easy. Initially we were told after March 12, it would take three weeks before we’d see something in the hospital. Speaking to the doctors, they’re expecting it any day now.

We all know that we don’t have an infinite amount of ICU beds and ICU equipment and ICU nurses. I know that within the last year, they’ve cut what we did have. The changes government made to hospitals definitely increased the workloads in the facility where I work. For all of us. For ICU, for dialysis, for medicine. Every unit in my hospital felt those closures and those changes.

I don’t think we’re functioning now like we’re going to once all the changes are made and everything is in place. I think it might all be OK once it all gets done. It just wasn’t done right and now, to have this pandemic in the middle of the changes, is bad.

There was a nurse in Italy who didn’t know she was positive and gave it to a lot of patients. She ended up taking her own life. Everything has changed for all of us with COVID, and it’s scary. In Italy, they have to make decisions not to give someone a tube and a ventilator because they don't have enough to go around. I don't want to do that.

We’re caregivers, we’re not lifetakers. It’s hard to imagine telling someone sorry, we don’t have the equipment for your mom, we can’t help her, she’s going to die today. We shouldn't have to make that kind of decision. I take care of people. I can’t imagine saying that to someone.

dan.lett@freepress.mb.ca

Dan Lett

Dan Lett
Columnist

Born and raised in and around Toronto, Dan Lett came to Winnipeg in 1986, less than a year out of journalism school with a lifelong dream to be a newspaper reporter.

Read full biography

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Updated on Monday, April 6, 2020 at 8:14 PM CDT: Removes opinion tag

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