Unparalleled Nurse
All Images courtesy of Heather
We asked people to give their honest and personal accounts of life in the time of Corona. Over the coming weeks, we will bring you their different takes on this challenging and unparalleled time.
HEATHER - CALIFORNIA - MAY 2020
Heather, give us a little bit of background, where do you live, what's your profession, why did you choose it, and how long have you been in it?
I am an Emergency Physician and have been so for the past 15 years in San Jose, California. I am originally from here but spent time in New Orleans and Chicago for my medical training before settling back in my hometown. I am of Arab-Italian American descent, a product of an immigrant family. I'm happily married to a Mexican-American man. Love to travel, play golf, and spend time with my friends and family. I grew up in Emergency Medicine; my mother was an ER nurse for 40 years. I even got to work beside her in the ER when I returned home for about six years before she retired, which was a real treat to be able to work alongside my mother whom I have admired all these years. I always knew I wanted to go into medicine, but during medical school, I decided on Emergency Medicine because I liked the critical aspect of patient's illnesses and that I had to know something about everything. The ability to save someone's life is a true honour, and one I do not take for granted.
Where were you and what were your first thoughts as the pandemic began to take hold and eventually disrupt life as we know it?
I had been watching it unfold in China when news first broke at the beginning of the year. Having dealt with SARS and MERS in the past decade, I was worried about the aggressiveness of the virus. When details from China finally started to be exposed for the true nature of its contagiousness and mortality and living in the Bay Area of California with such common ties to China in the Silicon Valley, I knew it was a matter of time before we saw it in our county. Initially, my reaction is always "do not panic" …as an emergency physician, panic is not in my nature. I take care of people with infectious diseases every day, so I know there are ways to control contamination. However, it became quite clear early on; this was completely unknown, and it was extremely hard to handle compared to its predecessors, because of two main issues: 1) extremely contagious and 2) asymptomatic spread. It is hard to identify the enemy when the enemy doesn't even know it is an enemy yet.
How has the virus affected you and your industry in general?
Initially, things were chaotic. Medical professionals are still people, and people get scared. I saw colleagues refusing to come to the ER to take care of critically ill patients in their speciality, out of fear of catching the virus. Many of my colleagues are middle-aged men - and initially, they were in the bullseye. We had to assume that virus was transmitted in every way possible - and plan accordingly. Our hands were tied because we were not given the tools for testing or the necessary equipment to protect ourselves. A lot was because of lack of preparedness. There is no money in planning ahead in a for-profit medical system. Also, the federal government, in its infinite wisdom, refused to listen to the warning signs early on, which has led to the US having the highest number of cases in the world. Initially, all hospitals were chaos. People were flooding in with COVID. Extremely ill, having to put people on ventilators left and right. We were facing an unknown monster and trying our best to tame it, but not always knowing what to do.
Then, thankfully, our governor put our state in lockdown. Slowly, the chaos diminished. People still came in sick, but we could handle the volume. Then, a peculiar thing happened - everyone feared coming to the hospital. So our volumes dropped by more than 50%. Now, we were all waiting for patients because other emergencies don't just disappear. But they didn't come. People were terrified.
They saw videos of NYC and thought if they went to the hospital, they would surely die. Sadly, many who should have come for the heart attacks and strokes didn't come. They paid the price with their morbidity and mortality. Our income dropped, they shortened our shifts, our nursing staff cut by 50%. Now, people are starting to come back to the ER, and once again, we are left without the resources we need to care for the patients (the nurses this time) because, in for-profit medicine, hospitals mainly care about the bottom line. I have started doing Telemedicine, both as a way to help more people in a new way and make up for lost wages, but also to decrease my personal risk by seeing patients remotely.
What have been the most difficult challenges for your business / your working life, and how did you approach them?
Work-life is just about making sure we can care for our patients and stay safe. Donning and doffing the PPE (Personal Protection Equipment) is so labour-intensive, and the hurdles your mind has to go through during the day to ensure you are not missing any possible patient with any chance of having COVID, takes it toll. There is also the frustration of not having adequate testing, which makes diagnosing the disease harder, not to mention being able to mitigate public risk. We still don't have the ability to test patients that we want at one of the hospitals I work at because we do not have "enough" tests. It makes you feel so impotent. Worries about the future, future income, how will the medical landscapes look? Will our pay cuts be permanent, or will things slowly return to normal? The unknown is hard for everyone. Also, knowing that we will be back on this merry go round next winter, in "cold and flu" and COVID season. So you hope for a reprieve during the summer, so you have the strength to do it all again this winter until we get a vaccine.
The newest difficulty has been all of the wing nut conspiracy theorists that my friends and family come at me with. On the one hand, I am open to all information; however, as a scientist, I know how to determine if the information is credible and reliable. People are looking for a narrative that supports their internal desires and bias. Nobody likes change. Nobody likes having to stay at home and be away from friends and loved ones, to not be able to play, laugh, dance, worship, celebrate milestones. However, this is when the vulnerable fall into the traps of those who are self-promoting or genuinely insane. They spout dangerous ideas. I honestly have to turn off social media because I cannot believe that people whom I have known for my whole life might believe these things. That belief is like a direct slap in the face to the profession I have sacrificed years of my life for….to care for those same people. People want to believe something "bigger" than just a virus can disrupt their lives so much. They think that it must include the sinister acts of man, a master plan to dominate our freedoms by malicious Shakespearean characters. But nature is capable of the most intense destruction than any man can dream up - and viruses are the henchmen.
“But nature is capable of the most intense destruction, more than any man can dream up - and viruses are the henchmen.”
What are your top 3 tips or suggestions for your fellow professionals when it comes to maintaining motivation?
Motivation in medicine comes from within. For many of us, it is a calling. The Bureaucracy weighs us all down. But we have been fighting that for decades. Making sure we take time outside of work to be with family and rest and do things that fill up our cups. That makes work easier.
Have you adopted different working practices that have changed your perspective on how things can be achieved, has technology played a part in this, how?
Yes, I now do Telemedicine visits with patients over a couple of different platforms. I can FaceTime a patient, interview them and order tests as well as treatments remotely from my own home. It is exceedingly helpful and convenient for the patient as well. I see a lot of primary care and some urgent care issues that can be handled this way going forward.
“I am hoping that physicians can use this time to rise up and take back medicine from the bean counters.”
What do you think the future holds for your industry?
More Telemedicine for primary care, for sure. I am hoping that physicians can use this time to rise up and take back medicine from the bean counters. Focus for us has been on patient care, and we rose to the challenge in the world’s time of need. I am hoping we can use this as a springboard to battle the money-making institutions like for-profit health care, insurance companies, and pharmaceutical companies to fight for our patients and us. Probably overly optimistic, but you have to start somewhere.
What have been your hardest personal challenges?
Personally, living in constant fear that I will bring something home to hurt my family. The third person to die of the illness was our next-door neighbour. He contracted COVID at the end of February at a conference and passed away on St Patrick's day. He was 50 yo, married, father of 3 young children. It shook us to our core, and especially my husband, who is the same age and had many other similarities.
When it first started, I had an exposure that was "high risk" …the patient didn't initially have symptoms of COVID, and we were not using PPE on everyone yet upfront. As soon as I saw the patient, I knew they had it, and I knew that while I had taken suitable precautions, it was not full PPE. I immediately called my husband from work and told him to go to a hotel for the next five days. I had to make sure I didn't develop symptoms. Living in a hotel is not a long term solution, and he eventually came back when the governor made the ‘shelter in place’ order.
We have not slept in the same bed since March 12. Initially, we didn't sit in the same room, and I bleach wiped anything I touched immediately. As cases have decreased, so has the hazard level. We will hug when I have had a stretch of days off, but that is about it. I have not embraced my parents since March 12, and they are elderly (albeit healthy), I cannot take the risk. I visit them weekly, mainly sitting outside, 10 feet apart.
“I miss being able to put a comforting hand on a patient’s shoulder, the little things like that. ”
What coping mechanisms have you adopted to help you through this crisis?
A lot more FaceTime calls! I've been using online group video meetings to see friends. Having colleagues (who I work side by side with) over for some socially distanced outdoor cocktail hours. We all have the same bugs, and we need to have an outlet for our mental health. Incorporating more exercise and cooking at home (something we rarely did before) has also been amazing for our health, and we intend to continue, especially as restaurants are not likely to open any time soon.
How has your perspective changed on life since the pandemic began?
Can't say a whole lot, because I have always had a different perspective than most because of what I do. It is interesting to see others start to value their health and their loved ones more. I have always known that life is fragile and can be gone in an instant. That became a little more real to people initially.
What have you missed during the lockdown and what's the one thing you can't live without?
I have missed spending time with friends and loved ones, and especially human touch. I miss hugs and holding hands and just being near people. I know I cannot live without it, as it refills my soul. Being able to put a comforting hand on a patient's shoulder, the little things like that. So, I find ways to work around it. Throwing a blanket over my husband and giving him a hug….the first time we did that after not touching for nearly two months, I literally cried a sigh of relief.
What are your hopes for the future professionally and personally?
Professionally, I hope we, as physicians, can take back some of our profession from the current powers that be in the American system. It needs to be patient-centred, and also protect those of us who do the hard work.
Personally, I just want my family healthy. A refocus on our health as a family means exercise, cooking at home, and mental health is a priority when we had let it slip in the past.
The whole team before the pandemic.