COVID-19 did not arrive with a set of instructions. Healthcare professionals everywhere have had to quickly adopt new practices and improvise to solve problems they never faced before. Here Holly Gasiecki, BSN, RN, describes how the pandemic has impacted her day-to-day work as she cares for patients in Roswell Park’s Intensive Care Unit (ICU).
What was your day like in the ICU before COVID-19 appeared?
Before COVID-19, each nurse would take care of two critically ill patients. We would constantly be making sure they were going to get their scans, checking all their lab work and adjusting critical medications, sometimes on a minute-by-minute basis. At times we would bounce back and forth between patient rooms very fast to make sure they continued to stabilize.
It was a little bit easier to go back and forth between rooms and get other staff into the patient’s room to help you, because you didn’t have to put on all the personal protective equipment (PPE) before entering. So we’ve had to adapt and be more flexible, because things are always changing. We’re learning how to get into our PPE a little bit faster, and now our nurse-to-patient radio is typically one-on-one, so that has helped significantly.
On a scale of one to 10, how has your stress level changed?
Prior to this, my stress level in the ICU was about a five. As an ICU nurse, you have to be really flexible and adaptable, because things change on a regular basis. But I’d say it’s probably about an eight right now, because you don’t know what your shift is going to be like. COVID-19 is definitely a factor in every nurse’s stress level. Even nurses who’ve been here 15 years haven’t seen anything like this. So we’re all learning together.
The nurses are the ones who have the longest exposure time to any COVID-19 cases, because typically we spend the most amount of time in patient rooms. To minimize wasting PPE, we are in the patient rooms longer. It’s a different kind of nursing care.
But so far, everything’s going pretty well. We are protected, and Infectious Disease experts are constantly on our floor, checking with the nurses and patients to see if there’s anything we feel we need to change or bring to someone’s attention.
When you first became a nurse, did you ever expect you might have to deal with something like a pandemic?
In nursing school you learn about disaster nursing, but it’s something you never expect to actually see. It might have seemed like a far-fetched idea, but now that it’s here, it’s very daunting. We’re learning with the doctors and administrators how to make everything work. It feels like a team approach.
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Can you think of a way that you and your colleagues have worked together to solve a pandemic-related problem?
In the ICU, when you’re in the room with a patient, acute changes can happen rapidly. You might need emergency medications or a lot more supplies, or you might need the doctor immediately. So another nurse on our floor had an idea that in those situations, you could use the call light that the patients use so another nurse could come and see what you need. They can pick up the phone from outside the patient’s room and talk with us without having to put on and take off their PPE. This is essential in emergency situations that have happened.
With the new visitor restriction policy, visitors are no longer allowed on the inpatient floors. How have patients and families responded to this?
I know it’s upsetting for some families, which is completely understandable. Our social worker in the ICU has been reaching out to families, and the doctors have been really good about calling and speaking with families. And in some end-of-life circumstances, we’ve had families who have had to come in.
But overall, people have understood that it’s not just for their loved one — it’s for a lot of other loved ones, and our patients are at higher risk because a lot of them have weakened immune systems.
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How have you and your fellow nurses helped your patients adapt to the situation?
A lot of patients in the ICU are sedated, but when they wake up, we let them know their family’s not here because we can’t have visitation right now due to the pandemic. Other patients who have been awake ask questions, or they might ask us to call and update their families. Recently we have been able to provide patients with electronics to call or video chat with their loved ones. We encourage them to call home if they’re able to, and they do.
We want to make sure no family is left in the dark. I think we’ve done a really good job reaching out to the families and answering their questions. Some family members call more frequently than they would otherwise, because of the visitor restrictions.
What makes all of this worthwhile?
Caring for people. I’m willing to do whatever I can for the best patient outcomes. Our nurses are really invested in our patients’ well-being, and we do the right thing to make sure we’re following all the rules and being their advocates. We feel close to them and want to represent them, and that’s what’s most important.