Noemina is a graduate of the University of Hertfordshire, UK, where she majored in healthcare. She has been working in her field since 2012. The journal excerpt she sent us reflects her week-long experience at the epicentre of the new coronavirus battle in the intensive care unit, where serious cases are admitted.
From what is known so far globally, only 10-15% of patients infected with the new coronavirus will be in need of intensive care, the rest developing mild or moderate forms of the disease. The testimony of Noemina Lăiu Cosma, however, joins voices drawing attention to the fact that, despite a lower statistical risk, young people can develop serious forms of the disease generated by the new coronavirus.
Thursday, March 19, 2020
It’s Thursday afternoon in the day surgery department, where I work as a nurse. Every day between 8:30 and 20:30 the task list includes cases related to several specialisations: E.N.T., urology, gynaecology, ophthalmology, orthopaedics, general medicine.
I work in a complex with 6 operating rooms and a resuscitation unit that has 24 beds, where about 40-50 patients are operated on daily, most of whom are discharged because the complex is closed overnight. Outpatients are transferred to other surgical departments that also work at night.
The answer is short: we are in a state of emergency and we will work in wartime conditions!
I’m shift lead. My colleagues ask me if I have any information from the hospital management about the measures that will be taken regarding the possible cases infected with COVID-19. I think it is very likely that they will close the department and send us to help in larger hospitals which will be overwhelmed by patients infected with this virus.
My suspicions are confirmed when we are urgently called to be informed about the measures taken. We go into the treatment room where the manager and the head of the hospital are waiting for us: starting tomorrow, all the operations scheduled in this hospital are cancelled, and the medical staff in this unit will work in intensive care in the neighbouring city.
Nurses who work in intensive care take a year in preparation for this specialty. I ask how it is possible for us to go when we have no idea or experience in intensive care—equipment, treatment. The answer is short: we are in a state of emergency and we will work in wartime conditions!
A moment of peace settles in after the managers leave the room. I look at my colleagues: they differ in age, family, number of children; some have medical problems, others are alone because their families are abroad. Their gaze turns into a wave of questions and fears that I have no answer for. I tell those experiencing medical problems to call the Health Department for medical professionals and request a medical certificate in order to be protected in areas with COVID-19.
Friday, March 20, 2020
Today, four of us are sent to the intensive care unit (ICU) in the neighbouring city for training. None of us knows how this unit looks or works. We are presented with some ventilation devices. We receive instruction on how to use the different branches to access the artery vein for the proper monitoring of the patient, on how to use pumps for different infusions to keep the patient sedated, fully anesthetized, with artificial feeding, hydration, cardiac monitoring, etc. We are instructed on the infusions’ formulas and what the numbers on the monitors represent: the volume and pressure of the oxygen input, etc.
We are taken to an isolation room, with COVID-19 patients, to observe in practice the theory that has just been explained to us. I am amazed to find that the patients in this room are young, 41 and 47 years old. The 41-year old patient is intubated and connected to all possible devices. I search the medical record looking for this patient’s chronic illness, but I find that she was a healthy person before contracting the virus. I look at how she is lying on the ICU bed—face down, to maximize her lung expansion to receive more oxygen. I’m her age…
On my way home, I vow to warn my family, relatives and friends, to explain to them the vital importance of prevention and isolation measures, even in the case of young people. In the news I have not yet heard of young and healthy patients infected with COVID-19 and in such a serious condition.
Monday – Friday, March 23-27, 2020
As we begin a week full of uncertainties, we collect signatures from our colleagues for a petition requesting our management to provide the necessary protective equipment in the COVID-19 area, where we were told that they do not have enough masks. Towards the evening I am informed that starting tomorrow, together with 5 other colleagues out of 24, I will be sent for an indefinite time to zone 1 COVID-19, with all the necessary protective equipment.
I am glad that the nurses with medical problems were exempted from these areas. I feel that God is with us, even though anxiety continues to haunt me while I wait impatiently for the weeks ahead. On my commute from home to work and from work to home, I pray for courage, to be strong for these lonely patients, and for my family.
As a new day begins, we change and put on other lines of protective equipment. A colleague leaves the isolation ward and snatches the protective equipment, bursting into tears in the hallway.
I walk towards the entrance to the COVID-19 isolation room. A nurse guides each of us to the bed of a patient to be handed over to us and to be introduced to the ICU specialist in charge of our team today. A warm voice, muffled by the protective mask, explains to me from A to Z: medication, care, machine settings for the patient in front of me, who is in a critical condition, surrounded by an anaesthesiologist, a radiologist, a bronchologist. I am told that three hours ago he was awake, he was talking, although he had difficulties breathing hard, but that his situation had suddenly deteriorated. While reading his chart I find out that he is 40 years old and the only chronic problem he had before becoming infected with COVID-19 was asthma. I’m thinking of the danger my husband might be in if I were to bring this virus home. He had childhood asthma.
Involuntarily I take his hand and whisper: “You are not alone, I am here, we are constantly here!”
We try to lift the intubated patient a little so we can scan his lungs with an X-ray plate. The temperature in my protection outfit rises well above 40 degrees Celsius. The goggles are covered in steam. I am thinking about how there are still 10 hours left until the end of my shift and I already feel breathless in this suit.
But I look with real admiration at the nurses in the unit, equipped with these same “force” costumes. They are turning into thousands of arms to serve their patients who are fighting between life and death, and I feel my heart swell with gratitude. The voice of the bronchologist brings my attention back to the patient I serve. I imagine how lonely and anxious this patient must feel, especially since family access to his room is not possible. An anaesthetist once told me that hearing is the last sense that dies. Involuntarily I take his hand and whisper: “You are not alone, I am here, we are constantly here!”
Suddenly, the same message of encouragement floods my mind and heart in an instant. Everything around it slows down, and a long-awaited calm invades me. Yes, Heavenly Father, Your whisper has eased the storm. I am safe in Your hands, with all my fears and worries. In this place, we are Your hands that are holding the hands of these lonely souls, who need a whisper of relief.
We are told that we will reach the peak of this epidemic within the next weeks. With maximum pressure on the hospital, medical staff, patients and their families, I do not know how we will endure and overcome this crisis. We do not know how many of our colleagues will see each other at the end of this nightmare. But I know one thing: we are not alone in this. You, Lord, are fighting for us and we are grateful to You.