“My fingers are crossed that we’ve slowed down the spread”: An ICU nurse describes what it’s like to treat Covid cases

I’ve been doing this for a long time. I’ve been a nurse for 20 years and worked in intensive care for 14; right now, I’m at Trillium Health Partners. You have to be a strong person to work in this field. You have to love what you do. We deal with ethical issues that can really bring a person down. For example, when you have a patient in her 80s on a ventilator and there’s a shortage, what do you if a 30-year-old comes in and needs one? Do you kick the 80-year-old off? How do you deal with that? It takes a toll on you.

I was a nursing student during SARS, and I did a couple of shifts on the SARS unit at the time. The atmosphere was nowhere near as fearful as it is now. That virus was more deadly than Covid, in terms of the percentage of patients who died, but it didn’t spread in the community like this virus does, and people weren’t expected to self-isolate. It’s like we were innocent then and now we know better. Nurses are expected to be like the soldiers who are happy to go to war. I have friends who are terrified to work, but they still go. If you refuse to work, you’ll lose your job. But your job could kill you.

I’m on the permanent night shift; normally, I work three 12-hour shifts each week. I come in, get a report from the day nurse, then assess the patient and administer medication at specific times. Usually I’m assigned to one patient, possibly two, but that’s rare. Our protective gear varies depending on the patient—we only use N-95 masks during aerosolizing procedures like intubation or bronchoscopy.

Because the hospital anticipated a huge influx of Covid patients, they’ve brought in nurses from other areas, and we’re working in teams: surgical nurses, for example, who are basically out of work because surgeries are cancelled, have been redeployed to ICU. We buddy up with these nurses from other departments and give them a crash course in how to work with these patients.  At the beginning of one shift, I gave a report to an endoscopy nurse who was terrified. She told me she had never worked in ICU before and was in awe of what we do, specifically running life-support machines. I tried to put her at ease. I said, “Its okay, we’re all here to help each other. If I went where you work, I wouldn’t know what I was doing either.” I probably would’ve crapped myself if I had to work ICU and didn’t know what I was getting into.

So far, we haven’t yet seen the surge in Covid patients that was expected. I’m keeping track of the numbers, and we’re not seeing anything close to what we saw in Italy or New York. My fingers are crossed that the province’s strict social distancing measures have successfully slowed down the spread. I don’t think we’re ever going to stop it completely, not until they make a vaccine, but I think we’ve slowed it down. But obviously nobody wants to be too hopeful because that could lead to recklessness.

The ICUs have opened up extra beds by moving critical patients out into other areas that were previously used during surge times. Basically, we’re trying to make more room for really sick Covid patients, while also protecting other ICU patients. The people who need to be in the ICU are vulnerable, and if they contract Covid, they will definitely suffer. When a Covid patient arrives, they are brought into the ICU like any other patient, but all health care workers wear full PPE. The patient is taken to a room where a nurse attaches ECG leads and other wires to monitor his or her vital signs. Once the patient is settled and the nurse has a report, he or she will do an assessment. Doctors’ orders are reviewed, medications administered, and blood may be taken for testing. For the first few weeks, I didn’t seen a Covid patient leave the ICU. Now, patients are improving, and at least one has been sent home.

The mood in the hospital is very sombre. Most people’s spirits are dampened by fear and uncertainty. When I saw the news coming from Italy, I cried every day, because I knew what they were going through. Everyone at the hospital is terrified of running out of masks and other gear. Now, the hospital is saving used masks and they’re looking into how to clean them so they can be reused. Some nurses are saying they’d never wear a reused mask, while others say they’d rather wear one of those than nothing at all. We sign out masks when we take them so hospital administrators know how many will be needed for the next shift. We’re not desperate like they are in the States, where people at the hospital are wearing garbage bags and bandanas instead of PPE.

After a few shifts wearing a mask, I had an allergic reaction: my eyes were red and swollen, and the skin underneath felt itchy and tight. Last week, I was redeployed to assist the occupational health nurses at Trillium Health Partners in Mississauga to avoid any further damage. I’m now doing eight-hour shifts, Monday to Friday. The transition from nights hasn’t been as hard as I imagined, but there isn’t much for me to do. They’ve rerouted the phone lines because they have other nurses who are working from home. I answered the door a couple of times to let people in. But I can’t go back to work: if you’re anywhere near a patient you need to be wearing a mask. People even wear masks to go shopping. The hospital wants me to try other masks to see if there are ones I’m not allergic to so I can go back to working in the ICU.

Right now, the simple things are getting me through. I have two sons who live with me and they’re in the kitchen right now, cooking. I love seeing them work together and help out around the house. Even the nice weather cheers me up. I have a back porch, so I’m able to go outside and sit and enjoy the sun. The song “What the Worlds Needs Now is Love” came into my head, so I went and listened to it on YouTube. It reminded me of happier times.

—As told to Isabel B. Slone