Fear, frustration, compassion and shame: What nurses are dealing with during the pandemic
Nurses share stories of arduous work that is emotionally draining, a risk to their health
(WARNING: This story contains graphic descriptions that may disturb or offend some readers.)
There are close to 450,000 nurses in Canada. Some work in hospitals, some in long-term care homes, some are privately hired, but they all share one commonality. Since the beginning of COVID-19, they have been on the front lines of an international pandemic that has taken more than 1.4 million lives worldwide, including 12,000 in this country.
The work they've done has been arduous and a risk to their personal safety and health, but they have persevered. The National talked to three nurses in three different provinces about their experiences, and these are their stories.
Clarice Shen, Toronto
Clarice Shen, 25, is an acute care nurse at Toronto's Sunnybrook Health Sciences Centre. In January, just a year out of nursing school, she was caring for a patient who was exhibiting symptoms of a virus that didn't even have a name yet.
He turned out to be the first patient to test positive with COVID-19 in Canada.
"There was a lot of uncertainty, but as a team, we kind of came together and supported ourselves," Shen said.
When it became clear the hospital needed to expand the intensive care unit, Shen volunteered to work in the ICU to support the staff there. She's been on 12-hour shifts in the ICU ever since.
A number of the things she has experienced when dealing with COVID-19 patients were new to her.
"From a nursing standpoint, the fact that a lot of patients with the virus get sick really, really fast — they can present to the hospital with very mild symptoms, and they can progress very, very quickly to the point where mechanical ventilation is needed — I was really taken aback. Because it is really traumatic to be put on a ventilator," Shen said.
In her time in the ICU, Shen has helped care for dozens of COVID-19 patients and says most people don't realize how hard it is to be intubated.
"I was caring for a patient on a ventilator and he had this thing where his body just on and off twitched, where his teeth would bite down on the ventilator. And his teeth were actually coming out, like, he bit off part of his tongue and his teeth were coming out, and there was blood everywhere," Shen said.
I never imagined that I'd be in a position to tell someone 'you can't visit your loved one in the hospital.'- Clarice Shen
As hospital rules changed, Shen has had to tell the families of seriously ill patients that they could no longer visit, or that they must cut visits short. She says she's tried to address the frustration she deals with daily by maintaining compassion.
"I never imagined that I'd be in a position to tell someone 'you can't visit your loved one in the hospital,'" Shen said.
"I try to help them understand what it is that we're trying to do … helping them feel that I'm on their side, even though the situation might be really challenging."
And Shen has held the hands of many patients in the ICU while they passed. Too many times, she says, a patient's condition has worsened and they've succumbed to COVID-19 so quickly that their families couldn't get there in time.
One recent instance sticks in her mind, when she was at the bedside of a woman who died before her two daughters could get to the hospital. Shen was covering a break for the nurse who was the patient's primary care provider, so she didn't know the patient very well.
"All I could really tell her is that I loved the colour of her nails, and that her hair was beautiful, and that her daughters loved her. So I eventually just told her over and over again that her daughters wished that they could be here," Shen said.
"It's important she didn't feel alone. I mean, it's an honour and a privilege that I can be there for patients in their final moments."
As cases reach record highs in Toronto and the city finds itself in a second lockdown, Shen says she wishes people could see what she sees in one shift in the ICU. She thinks it would scare them as much as it does her, and help keep them vigilant against contracting or spreading the virus.
"You know, last week you had two COVID patients in the hospital. And this week you have 15, and two waiting in the ER, and you have no beds in the ICU. And then you're trying to get people out of the ICU who would benefit, potentially, from a few more days of staying there, because you need that bed. So, that is scary for me," Shen said.
Meaghan Thumath, Vancouver
Meaghan Thumath is a registered nurse who wears many hats.
She works with homeless and marginalized communities in Vancouver's notorious downtown East side. She also teaches nursing, does clinical research, and participates in international deployments with The World Health Organization that have included work on Ebola and other outbreaks overseas.
Since the outbreak of COVID-19, Thumath has been harnessing her experience to care for patients in Vancouver who are largely without other options.
"Sometimes that can look like a homeless camp. Sometimes it's a single-room occupancy building that's owned by a private owner. Sometimes it's a homeless shelter, and sometimes it's a supported-housing facility," Thumath said. "We find people where they are."
I think if you can treat people with dignity, and be trauma-informed and understand sometimes people might be scared, generally people are extremely grateful.- Meaghan Thumath
Thumath's patients are often dealing with many more issues than just possible exposure to COVID-19.
"So we are seeing a sort of twinning of the overdose crisis as well as COVID-19. And then on top of that, people are still struggling with HIV, and Hepatitis C, and other infections," Thumath said.
She points out that asking homeless people to self-isolate or quarantine when they are exposed to COVID-19 presents added challenges that most Canadians with a place to live can't begin to understand.
Part of her job is also training shelter workers in best practices for when people with symptoms show up on their doorsteps.
Thumath says she does the work, and takes the personal risks associated with it, because of how rewarding it is.
"It's a huge honour, because people are so grateful for your help. I think if you can treat people with dignity, and be trauma-informed and understand sometimes people might be scared, generally people are extremely grateful," she said.
The personal risks she takes are significant. Thumath recently returned from a trip with the World Health Organization to South Africa, assisting with the pandemic response there.
She was also part of the team that helped repatriate people from Wuhan, China, to Canadian Forces Base Trenton in the spring this year. It was on that assignment that Thumath contracted the virus herself.
She says that experience helps her better understand what her patients are facing.
The toll her work has had on her family is something that weighs on her as well. Thumath is married and has two children. She writes goodbye letters to them every time she is deployed somewhere in case she doesn't return.
"I'm grateful to my husband for being supportive, but it does weigh on me," she says. "That's the hardest thing — a drawer full of letters to them just in case I don't come back."
Shaye Fleming, Calgary
Shaye Fleming has been off work since September. That's when the 29-year-old caught COVID-19 while on a regular shift as a cardiac nurse at Calgary's Foothills Medical Centre.
"It's been over two months now, and I'm just starting to feel a little bit back to normal," she said.
"I still get quite short of breath, and this isn't like me, you know? I usually can run, walk, like, usually I'm quite active."
The ongoing impact of the virus has left Fleming frustrated, and feeling another emotion she says she wasn't expecting.
"I've been experiencing a lot of anxiety with it as well. When you're young you think you'll be fine, and I was one of those people that wasn't worried about getting it. And so the fact that it has been a prolonged recovery period, and I'm lacking a lot of that stamina that I once had, yeah, it's been hard for sure," she said.
Fleming has tried to return to work twice, but was unable to both times. Her symptoms have continued to be too debilitating.
... That shame of not being able to go back to work when I felt like I should have been OK, that makes you feel pretty shameful as well.- Shaye Fleming
She hopes to try again this week. Not being able to go back to work has only added to her stress, she said.
"I haven't been able to be there, and be a support for my co-workers and my colleagues," Fleming said. "So, you know, that shame of not being able to go back to work when I felt like I should have been OK, that makes you feel pretty shameful as well."
As cases spike in Alberta and around the country, Fleming says she hopes people heed social distancing requirements and listen to public health officials. But she adds that regardless of how people approach the pandemic, nurses will always be there to care for them if they fall ill, even though providing that care means a risk to their own health.
"We will care for your loved ones and for you, regardless of what you believe in and what you value at the moment during this pandemic," she said. "Nurses will always be there for you."
ABOUT THE AUTHOR
With files from David Common