I had the chance to sit down with my mother Evelyn and talk about one of the most prevalent issues up to date being COVID-19, and how she handles facing it everyday as a ICU nurse. My mom was able to give her insight on COVID-19 while dealing with it in the hospital, certain precautions she had to take for the people around her, what a work day is like dealing with people put in near-death experiences, and advice to be as safe as possible. My mom’s background as a nurse is a registered bachelor intensive care unit nurse who experiences and works in a critical care setting, working at the Legacy Meridian Park hospital intensive care unit in Tualatin. She has worked there for over 9 years, and is still going strong!

When did you find out COVID-19 started becoming dangerous and could severely affect all of us the way it does now? 

“April 2020. As a nurse there is more work, and more infection control related protocols, and overall even more precautions on how to take care of the patients to prevent a spread of infection. This includes wearing additional gear rather than our usual ones.” Some of these certain protocols and precautions include extra hand hygiene, gloves at all times, and gowns. According to https://richmonddental.net/library/the-importance-of-infection-prevention-and-control-ipc/#:~:text=But%20Why%20is%20IPC%20So,patients%2C%20but%20your%20staff%20too. IPC (Infection, Prevention, and Control) is very important. The act of following proper IPC will likely reduce the chances of any health complications. 

 “Generally as well, we’re spending more time when it comes to the patient’s care.” The relationship between a nurse and the patient is necessary, and there should be a strong bond between the two. It can just be the little things done for the patient easily making a difference in their lives. It is especially remembered for nurses to always give empathy and the greatest care possible towards the patients, which can form a solid relationship. 

“As a parent I felt scared about my kids exposure to the covid infection and the uncertainty of a cure and prognosis, especially when it comes to treatment and survival.” Prognosis is a medical term determining the likeliness or a possible development of a certain disease. This includes if any warning signs or symptoms can either improve, worsen, or remain consistent. Over a span of time, the expectations and results can turn out unpredictable. 

“As a daughter having elderly parents I always have that fear of them catching the virus, knowing the rate of survival is very low of elderly. At the same time my exposure to my elderly parents are crucial because of the possible transmissions from me as a carrier, so choosing to spend less interaction with them is the best action to take as much as I want to see them regularly.” According to https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html#:~:text=Among%20adults%2C%20the%20risk,they%20may%20even%20die. Age is a huge risk factor with the cases of COVID-19. With the adult age range, the risk level for a severe illness from COVID-19 perpetually increases with age. This makes the elderly at the highest absolute risk. The severe illness can strike them so intensely that they may require immediate hospitalization, intensive unit care, or a ventilator to help with their breathing. Afterwards, possibilities of death at that age, and with that circumstance, are high. 

“Interacting with my immediate family members after work became difficult too, thinking I can be an asymptomatic carrier not knowing too much about the virus at the time makes you wonder that transmission is so easy, as it can be through all ways of coughing and touching.” I asked my mom what an ‘asymptomatic carrier’ was and she said it is a “person that became infected, but they show no signs or symptoms. These carriers are unaffected by the virus, but the carriers can transmit it to others easily, and or develop the symptoms later during their disease.”

What was your knowledge to COVID-19 prior to the outrage of case spikes? 

“It had to be beforehand in February, we were told about the virus while working in the intensive care unit.” The Intensive Care Unit, also known as the ‘ICU’ is the part of the hospital where my mom has been working for the past 20+ years. After asking my mom what exactly is the ICU, she replied with “it is known to be a more intense area in the hospital, treating people with intensive treatments in the unit, and critical care. It is a unit that provides intensive medicine too.” Continuing on with her knowledge prior to the case spikes, she states “I thought it was just very similar to a regular flu not knowing the severity of the situation. I thought it would just generally affect the elderly.” 

What was the experience of the first week in lockdown in March 2020 like for you?

“The ICU unit was very intense due to the intubation, (the placement of a plastic tube into the patient’s trachea, creating an open air tunnel, which will allow certain medicines to come through the body.) of many patients experiencing respiratory distress. Lots of people were admitted with pneumonia and no visitors or family members were allowed to visit, making the general environment a very tense and sad place. There were family members crying over the phone, increasing the Facetime calls for families. The emotions were at an all time high in the hospital.”  

After weeks of changes due to COVID-19, what was the population like in the hospital?

“Initially, I thought the elderly were going to be affected the most, but all populations of all ages ranging from 20, 30, 40 year olds and higher were being admitted as patients. Of all those ages, at times there were some congregations of races of people. There was a week where there were a lot of Russians coming from the same area of Silverton. Another moment was when there were a lot of Hispanics from the same area of Hillsboro and Forest Grove.” While this was an interesting observation of the types of ethnicities being involved, I wondered if background, race, or culture had any direct relation to COVID-19. When researching, I came across https://www.mayoclinic.org/coronavirus-who-is-at-risk/art-20483301 There was a mention that when it comes to the people with increased risks of COVID-19 symptoms, the risk of developing symptoms are generally just “increased in people who are older and also in any age range of people who have serious health problems. These problems include heart/lung conditions, weak immune systems, obesity, and or diabetes.

What were some new adjustments you had to make? 

“The clothing changes. Before work we put on our covid scrubs rather than our regular personal scrubs. When done with work we remove our covid scrubs and change to our clothes to get home. Most of us take a shower from the hospital before getting home, if not most nurses remove clothes before they enter the house, including the footwear. This is taking consideration that we won’t bring covid home when accidental exposure to covid patients will usually be tested for a covid swab right after, immediately. Unlike now, we don’t get tested unless we have symptoms right after.”

What is your work day like as an ICU nurse caretaking for people with COVID-19? 

“First we start with a huddle, briefly talking about our nursing assignments. Then we get reports from the nurses from the outgoing shift which are events that happened during the previous shift, like test results, lab results, and procedures. We proceed to the patients by wearing “PPE” first, which stands for Proper Protective Equipment. This also includes “PPAR” which is positive pressure air resistance, which is a special kind of equipment that we wear over our head battery as an operating tool, preventing any bacteria pathogens to enter onto us. Next is, protecting people from any fluid coming in contact to our clothing and body, usage of gloves to protect our hands from touching directly anything in the patient’s room. We use covers and hair caps then we go to the isolation room and then go into our patient assignment introducing ourselves. We are telling our patient’s plan for the day, and the preparation of patients if any procedures have to be done. 

If a patient is intubated or on a ventilator usually they are sedated under anesthesia medication to calm them down. When asking my mom what it means to be ‘sedated under anesthesia medication’, she replied with “it is the medication given to a patient through an IV, making the patient experience a drowsy and extra calm state.” 

“Most of them are also chemically paralyzed, because we use paralytics (muscle relaxing medication), to paralyze them. Some of them get nutrition through tube feeding. At one point when lungs are compromised some patients are put into the prone position, which means having them lay on their stomach to improve their lung heart function. We monitor these patients carefully for any changes in their vital signs, especially their respiratory status. After that report information we find out the tests done on the patients, and state it back to the doctors, who carry out their orders afterwards. We make sure to check our patients chart electronically for laboratory results via x-ray results, and other tests results. We answer calls since visation is not allowed from the family, and we set up FaceTime and zoom calls between the patients and the families. We continue the day according to the day the patients need to progress. Then the next shift arrives and you give another report to the next shift incoming.”

What are your overall opinions and thoughts on COVID-19 now? 

“It is a very contagious disease that is a step higher than a flu in terms of how fast the transmission is. The difference of coronavirus than the flu is that in the hospital now, compared to months prior, I see a lot more of all ages involved compared to the flu, which I see more on the elderlys. The chances of being critical are accelerated. I initially thought at first you had to have an already existing disease comorbidity, like diabetes, cancer, and or kidney problems, but I’ve seen covid attack healthy people too, of all ages.” This was an interesting statement that defies previous knowledge I had found out online, while researching people that can get affected. In terms of the hospital where my mom works, these were just her observations, which were surprisingly different. 

As a ICU nurse, what is your advice to all people to be safe, and to not get COVID-19?

“Practice good hand washing, and wearing masks. Wearing masks at all times, even a face shield if necessary, avoid crowds, and become isolated if tested positive, make sure to quarantine when exposed, and get a covid test if symptomatic (showing any symptoms, signs of disease/injury, an example could be a simple cough.) It is most important to get the COVID-19 vaccinations. It takes 2 shots for them to work and takes 2-3 weeks after the second shot to get the immunity. It is supposed to give us 94-95% immunity once the second shot is obtained.” 

When we think of nurses, we think of the many duties they attain all for the community. They are immensely caring towards the patients, they communicate with doctors, research medicine, and check the vital signs at all times. Nurses play such a vital role in all medical related events and fields, and have a vast majority of job options. It was quite the experience to interview my mom as she is a big inspiration to me, since I plan on becoming a nurse just like her and devoting my time to helping all ranges of people. I was able to come to the consensus that ICU nurses monitor patients on the daily, study the illnesses and medicines, assist the patients with all types of their needs, and they respond to emergencies as organized and as quick as possible. 

Are you possibly interested in becoming a nurse, and learning about what the best parts of the job are? Then, you can visit https://www.cosmopolitan.com/career/a47143/the-best-things-about-being-a-nurse/ You can also go to your local hospital, clinic, or nursing care facility to see if they offer any programs or internships if interested in becoming a nurse. Nurses help many families cope with the illness being dealt with, and educate people to learn how to live with it and become better from this point forward. In many ways, they help continue life.