Frontline nurses buckle under covid stress

“I know it’s very easy to slip up, to make a mistake, and get covid, but some people are putting themselves at risk. They are putting us nurses at risk. For what? Some fun? Because they don’t think this is real? They are tired wearing masks?

“The hospitals are flooded with patients. Flooded! All the beds are filled. And we are short staffed. Right now, I’m fed up of covid and I’m fed up of wearing PPE (personal protective equipment).”

Those were the sentiments of one nurse who has been caring for covid19 patients in the parallel health care system since March 2020.

Saying she was tired, stressed and frustrated, she told Sunday Newsday: “This is the worst I’ve ever seen it. Some of the symptoms are out of the ordinary. People’s oxygen levels are dropping even faster than before. We’ve never seen a spread like this.

"If things continue like this, I don’t think we will be able to maintain the parallel system.”

The scenario is unfolding even as medical professionals are shifting patients out of the hospitals as soon as it is safe for them to leave. The nurse said previously, once someone had covid19 they would stay at the hospital until they were completely recovered. Now, patients are being sent home or to step-down facilities to quarantine when they are ambulatory to make room for critical patients.

The nurses have also been improvising because some supplies are running low. For example, she said there are not enough bedpans, so vomit bags are used for people to urinate. There are also not enough oxygen outlets, so they have to wait for one patient to finish, sanitise it as soon as possible and move another patient to the outlet.

“It’s stressful to watch all these people dying. And then sometimes you get attached to your patient and they start to deteriorate. It takes a toll on you.

"I think the government should just shut down everything completely, because people are not listening and there’s only so much we can do. If they see how people are suffering, then they would understand.”

She also does not believe nurses are being treated fairly. She recalled that last year many new and inexperienced nurses were hired to work in the parallel health care system.

“When there was the lull, I did different courses to better myself so I can handle myself, because I love the profession and I wanted to save lives."

She said in 2020 there were experienced nurses from various regional health authorities in the system but, at the start of 2021, they returned to their previous posts. The new nurses also studied, worked and trained at various RHAs during that time, and returned to the parallel healthcare system with April’s increase in cases.

In addition, several of the staff got infected at some point, leaving them further short-staffed.

She believes if any new nurses are not in the parallel health care system, it is because they do not want to work with covid19 patients, because even those still waiting for their exam results were hired as enrolled nursing assistants.

She said some of the nurses are getting stomach problems and urinary tract infections because they are constantly on the go. They are in full PPE for over six hours, sweating, and sometimes cannot eat or use the washroom because they are so busy and it takes too much time to remove and don the PPE.

Often, those who live far from their place of work do not get enough rest because, by the time they get home after a shift, they only get a few hours' sleep before they have to return to work.

Fortunately, she said, rooms for people on the night shift who live far away have recently been provided so they could rest.

She added that she was not worried about contracting covid19 from a patient, but from some of the staff who are careless about their PPE, or come to work when their relatives are sick. She does not want to give the virus to her child, who has special needs.

She lamented that, under the present conditions, during a pandemic, when nurses are risking their lives and that of their families, they are still on one-year contracts and are given no incentives.

No vacation for nurses

A maternity nurse at one of the country’s general hospitals had similar concerns, as her team often comes in contact with covid19 patients.

She said all the nurses, for the past nine or ten years, have been on temporary continuous contracts so they do not get vacation, double time, shift allowances, minimal benefits, cannot get loans, and get nothing when they retire. Even some permanent nurses get refused their vacations because the healthcare system is so short-staffed at the moment.

The wards also need more staff, especially midwives, and they all deserve some kind of incentive.

They lose family members to covid19 and can provide no physical comfort for fear of infecting others, and they have to pay exorbitant fees for people to care for their children while they are at work.

She said because some pregnant women require emergency surgery, maternity wards have handled deliveries bycovid patients. Anyone going in for a caesarean section is swabbed and covid19 patients, as well as any suspected covid cases, deliver in an isolation room.

There were also cases where women had their babies vaginally and only after the delivery, it was discovered they had the virus.

“When a woman is in labour you can’t tell her not to breathe hard because covid is spread by droplets. So they are breathing in your face, full go, because it’s nearly impossible to be in pain and taking deep breaths with a mask on.

“We understand and we empathise, but it’s really risky. Still, we are on duty, we are willing, we are doing what we have to do as nurses and midwives because it’s something we love. Safe mummy, safe baby is our number one priority.”

She said her maternity ward has enough PPE but not enough staff, so even when they come into unexpected contact with covid19 patients, the team maintains protocols and keep working unless they have symptoms.

“It’s not just nurses. It’s doctors, attendants, cleaners. We are all part of the team and we give our time and energy because we’re committed to this thing and covid isn’t going anywhere.”

When she discovers she has come into contact with a positive patient unknowingly, she separates herself from her husband and children for at least a week. She said the separation is always difficult but her latest and most difficult was when she had to be apart from her children, mother and mother-in-law this Mother’s Day.

In addition, nurses often have to deal with members of the public who are hostile or do not comply with the staff’s instructions.

“I think the government is doing a good job in providing information to the public regarding the vaccines and wearing masks and so on. The problem is the public. Our primary concern is getting you out of the hospital healthy, so stay at your bedside, wear your mask properly. The nurses are not the enemy. You need to work with us.”

She said there are usually three staff members to 25 patients. These three have to clean the patients, give them medication, counsel them and try to keep them in a positive mindset, as well as co-ordinate tests and other incidentals.

She explained that because of added restrictions due to the pandemic, people of religious persuasions are no longer allowed to visit wards to pray with and encourage patients, so nurses often fill in for them.

“I think the public believes we are robots. Yes, our clients are our priority, but they need to be empathetic as well. We are also struggling. We are not okay. But we are doing the best that we can do.

“Nurses need to be better compensated. Give us that respect, that appreciation for these people who are on the frontline, separating themselves from their families.”