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How a normal day begins
During a remote interview conducted by the Santara Clinic, she was jokingly asked to confirm that she was actually a real actress, not a hired one, the nurse assured that if she had not read the comments of people in the media after several articles about COVID -19, the problem would have been more than strange.
“But I read in the comments that these are mannequins that were hired by actors to intimidate the public and there are no viruses. Therefore, I confirm that I am genuine and represent our entire team working with COVID-19. How is our normal day? We get to work early in the morning at least half an hour before on-call time starts, because we have to count team members, whether someone is not sick or is not isolated. The numbers are not usually encouraging.
We then review how many patients we have and distribute the publications. Usually, in order not to hurt anyone, because patients of different complexity may be in different positions, we do it by lottery. We have two posts for 6 beds, one for seven beds and one for four beds. Then we go to get dressed, there is a bit of congestion in the room. Finally, a few minutes to seven minutes later, we are all “dressed up” and go into the workplace, “the nurse said.
What does it mean to work four hours in “spacesuits”?
With the highest level of protection, popularly called spacesuits, doctors have to stay at least four hours, and if the procedures take longer, five or more.
“Our work has never been easy, we have always had stressful situations, but now it is even more complicated with security measures. Every movement is complicated, we sweat in these suits, then we cool down, because the accumulated moisture does not disappear anywhere, our underwear gets wet and when we sit quietly writing documents, we feel it. Also, you will generally not remove your respirator to drink or scratch your nose. And certain masks really tickle your nose a lot. I leave to the imagination how we feel when we cannot clean our noses after sucking.
In the past, we also had to wear protective equipment: a disposable bathrobe, apron, mask, gloves, but we did not use all these equipment constantly, but only when we were with the patient. The procedure took up to half an hour, then we were able to remove them. Furthermore, these measures did not cause a greenhouse effect, ”said O. Bartkienė.
Tragically, there is a lack of manpower
The number of procedures for a COVID-19 patient depends on their condition and other factors, but generally must be performed by more than one person. There were situations where only a few nurses were left with seven patients and had to perform six procedures every few hours, each of which required assistance. Those moments imply utter despair.
Even patient treatment, which must be done every 2-3 hours for pressure ulcer prevention, often requires several people, especially if the patient is larger and has a lot of connected equipment. In such cases, 2 to 3 people are needed, and sometimes 6 or more. Special slide boards help move the patient elsewhere, but there are no elevators to flip. It is made by the hands of people.
At the very least, they can turn the patient over, hold his arm, and speak, which is also very important.
“It just came to our attention then. We have to hear how the beds, the equipment are counted, but we are not talking about human resources, and that is disappointing because we really do not have manpower. We try to close the gaps by inviting students from medicine to volunteer and we are very happy when they come, but their skills cannot fully cover our work. But at least they can turn the patient over, hold him by the arm and talk, which is also very important. Next time, we won’t even have time to get close to the patient and comfort them. After all, not everyone is intubated, but they see intubated patients as they have many procedures. We try to protect them with screens, but they understand what is happening.
We often hear that we complain. I don’t think we complain and complain, I don’t hear that from my team. We are only counting the facts. And if it is difficult for us, we say it, we will not say that we enjoy it. We do not collect and we do not need pity, we only need work and social responsibility, because only the amount of work that we will have will depend on the behavior of society ”, assured the interlocutor.
Skeptics are even skeptical in the hospital
The nurse is not hiding: hearing the skeptics say that there is no virus, that the hospitals are empty, makes you angry and frustrated.
“The most disappointing thing is that people are guided by opinions, not facts. And when they try to give them the facts, they hear, “How much can you intimidate us?” It is a closed circle. So I want to ask: do people need information to know what’s going on or do they want to deny the facts and be guided by opinions? But the amount of our work depends on your attitude, your choices, I repeat. We tried to patch the holes formed, but it is difficult to do anything in this situation.
I have asked patients several times how they got infected or believed in the virus before. But when one shook my hand to see if there are still believers, it was the last time I asked. I realized that my human emotions could break through and I can’t let that happen; I have to take care of all patients equally. Therefore, I decided that questioning would not really help me, I will not prove that it was because of such skepticism that they got infected because they did not protect themselves. Yes, everyone has the right to have an opinion, but the saddest thing is that action is followed by action. It is disappointing that those who spread propaganda do not protect themselves and encourage others to do so, therefore the scope of our work is growing, ”O.Bartkienė opened.
Tired and angry
When asked what emotions are on the team, the nurse did not wrap her words in cotton and immediately said that the answer would not make her happy. After mastering the first wave, everyone felt encouraged, working in a special place, as there were many patients who had already recovered, emerged from truly critical situations, and were full of energy and optimism that they could not boast about now.
Now it affects one or another of various exacerbations of health disorders: migraine, fainting, heart rhythm disorders, high blood pressure. After all, it seems that we will still have to work for a long time in such conditions.
“It just came to our attention then. It is caused by fatigue, an excessive number of patients and an insufficient number of staff. Sometimes it seems that we are on the verge of emotional exhaustion. Much depends on the day, the position in which you work, because It is easier to work with lighter patients, but the team is tired, angry, and does not express emotions, their suppression also has a negative effect. I noticed that when we have lunch with colleagues we begin to be quieter because our emotions are bad, we do not want to talk out of our anger and pour it out, we try to stifle everything within us.
Our physical health is also deteriorating and this is very worrying. Working in our department has never been easy, it required a lot of physical preparation, good emotional condition, so our team is definitely not weak neither psychologically nor physically. However, now one or the other has various exacerbations of health disorders: migraine, fainting, heart rhythm disorders, high blood pressure. At the end of the day, it seems that we will still have to work for a long time under these conditions, “said the interlocutor.
According to her, everyone who works in this department is most offended by the public misunderstanding that the virus is not fictional. Therefore, the forecasts for the holidays are not optimistic: when seeing how much anger arises when the public spaces are closed and the gatherings are limited, the nurse does not expect a reduction in morbidity.
Colleagues ask for help
The fact that doctors who care for critically ill patients give their last efforts is not lacking in the staff, and other colleagues also speak out for social purposes. The anesthesiologist-resuscitator Vaidas Vicka, who works in the Resuscitation and Intensive Care Unit II of Clínicas Santara, shared the following request for help:
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“The mood is good and we are ready to work, but! When several nursing assistants can no longer work due to illness, we end up in a pit of understaffing. Therefore, we would like to ask all the students of the Faculty of Medicine (medicine, nursing, physical therapy, etc.) to come and volunteer for RITS II! What we promise is total protection, hard work, heat and sweat on the guards, and a tremendous sense of satisfaction for your contribution to managing the pandemic.
What should be done? To help nurses and doctors, from bringing help to washing hands or just talking to the patient. We need you NOW! We already have gaps in the schedules this Friday, Saturday and Sunday. If my message hung something inside, write to FB Ieva Bartuševičienė and Elija Januškevičiūtė, they coordinate the flow of volunteers. I would lead the training already this Friday. “
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