Previous Challenge Entry (Level 4 – Masters)
Topic: PROTECT (04/16/20)
TITLE: Let It Be Enough
By Leah Nichols
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The people on the steps of the capitol building - they're afraid. Afraid for their livelihoods, whether they can feed their families, whether they can trust their government. They don't fear the unseen enemy, because they don't have to face the risk of death every day.
My patient lies prone, his mouth crowded with the endotracheal tube, eyes taped shut. I press hard against the negative pressure door, hoping that I remembered everything I need for my check. We've moved the IV pumps outside the rooms to reduce the need to enter for every medication change, but standards of care still require hourly physical examinations. It's pretty much for documentation purposes; not much changes from hour to hour. If this man lives, we won't necessarily know what all we did that helped.
I move through my tasks quickly. A bead of sweat forms on my brow and slips down, then another. I pray they don't wet the upper edges of my mask. It's the same mask I've had for the last week, kept in a paper bag when I'm not wearing it to reduce any damage from moisture. It's also the only real protection I have from the virus.
A tap on the glass door draws my attention. It's the charge nurse, with a small whiteboard sign: "You need anything?"
I shake my head and give her a thumbs up. There's a small whiteboard in the room with me, too; we had adopted this system of communication from the example of another intensive care unit, and it has proven helpful in case something is forgotten or a need is discovered in the course of examination.
I'm almost done checking and repositioning as best I can alone. In another case, we might seek out another person to help, but limited supplies mean we have to do as much as we can with one pair of gloves and a gown. Maybe we'll eventually get washable, reusable gowns, but for now, it's just the paper ones that barely cover the surgical scrubs I've borrowed so that I don't have to wear contaminated clothing home to my family.
The hospital just announced that they've secured temporary housing for us in a local hotel when we work three or more shifts in a row, so I have a major decision to make. Do I risk carrying the virus home, or do I isolate from the little people who make my life worth living? Do I protect them, or my own sanity?
The psychological cost to all the changes we've made in the last six weeks isn't considered by the people at home or protesting at the capitol. We're all slowing breaking down here, from the fear of a surge that hasn't yet happened, or the dread that one day we'll come to work and we won't have the personal protective equipment we need, or the sheer exhaustion over watching patients struggle to breathe and being powerless to help. On my days off, all I can do is sleep. I don't have the energy for anything else.
Tasks complete, I strip the gown and gloves off into the trash by the door, then grab a squirt of sanitizer produced by the local distillery to quickly rub in before pulling the door open. I still have to don another pair of gloves to wipe my face shield clean and remove the outer isolation mask which covers my precious N95 mask. Daily corporate emails assert that our healthcare system is doing "everything they can" to provide for our needs, but our only real concern is whether it'll last. When they keep changing the rules to fit the stockpile of supplies, it doesn't exactly inspire confidence.
I just wish those people on the steps, shouting for everything to go back to normal, could see what I see. I wish they knew all that I had to do in an attempt to protect myself, my coworkers, and my family. And I especially wish they felt the uncertainty that comes with not knowing if it's sufficient, and the worry that I might be the one lying prone in two weeks, risking the life of another healthcare worker just doing their best to save me.
I only have a few minutes to chart before checking my other patient. Every hour, twelve times a day, as the supply slowly dwindles down.
God, please, let it be enough.
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