In ISOLATION: care transcending intangible barriers

Counting days, or months I would say, soon after the brave decision to enter blind in this invisible warfare, so much learning and realizations has transpired. From the woes of our patient due to the torment of isolation to the mental agony of waiting for the swab results to the separation anxiety of both parties after a week’s worth of care, these are the common sequence of events we encounter. For me, the physical run down is just the momentary woe but the separation from my patients being cared for and treated as an extended family is far more taxing, at times, we shed a tear upon expression of our gratitude and wishes of speedy recovery. Think of something caring for your grandmother, uncle, or older cousin, and you have to leave them inside isolation after a considerable amount of time.

Donning Level 4 PPEs before entering the dreaded isolation ward.

PRIOR TRANSFER IN

There is this lingering apprehension whenever a call from the emergency unit on making isolation room reservations, hoping that cases would be benign or mild, as critical cases demands more effort, consuming more of available and remaining physical energy. Seeing patients being wheeled inside our unit with multiple contraptions and that incessant bubbling aquapack connected to the aerating tube, to the airway, additionally, the alarm sounds of the portable cardiac monitor sends a cocktail of thoughts, thrill and drive. I do not have yet, as of writing, solid ICU training, but with me is an angel in disguise, a senior nurse who is willing to transfer her skills and knowledge, despite being swamped inside. From the 7 months under her supervision, it is memorable, pleasant and warm. (Intangible Barrier: Apprehension)

THE CARE

I never thought off being at bedside care prior the commence of the COVID-19 pandemic, enjoying the immense open hours and free riding work schedule. But upon posting this article, already have been in touch with patients from varying lifestyles and localities – from the powerful to the commoners, from the timid to the cheeky ones to the coercive ones. Talk about real plethora of personalities locked in your unit. Getting their trust is the initial objective to get through the barrier and to be able to deliver the quality health care, together with the patients. (Intangible barrier: Distrust)

From experience, the isolation unit or ward is quite the most dreaded part of the hospital taking if to consider the patient’s perspective. Collectively, the isolation could have wreak havoc on their sanity. But I have encountered transient patients with cancer but still have this immense positive aura. I drew strength from them. Imagine when you shall stay in almost complete solitude with limited human interactions, and when at times, their physician’s rounds would be limited to phone calls and via intercom. Pity to the senile one’s who had hardship operating technology, thus, disconnected to their significant others. With the wards jam-packed, carers do not have anymore much time to spend longer with them since other patients are waiting too. (Intangible barrier: Technology)

As the summer has already placed its stronghold upon this archipelago, we also can feel its brunt. Regardless if they or know, I start to perspire the minute I zipped closed my PPE, and that goes on until I doff it out safely. Almost everything on me is wet, drenched from my perspiration. It is an added burden but seeing a patient smile and simply say thank you eases way the agony. (Intangible barrier: exhaustion and dehydration)

The fear of contracting the virus really endures. (Intangible Barrier: Constant Fear)

EMERGENT

Dwindling heart rates, unruly ECG tracings, massive desaturations – few of the many signs that patients are in need of emergency actions. Everyone has to jump into action, but, an added time to don PPEs to protect ourselves. There is no other way, but we have to. Most often, we are met with a cloaked body, succumbing to the wrath of the virus. Usually, there is a pinch inside the chest after we zip closed double cadaver bags after days looking after the patient, after the code. (Intangible Barrier: time spent to don PPE)

SEPARATION

In our institution where we work for a week, there are times when we get attached to patients and relatives. From varying temperaments, being with them seems like having an extended family member. When the last nurse rounds ends of the week, parting with patients sometimes would brings us to tears. From a seven grueling day of duty, we need to rest and recover. Regardless still, at certain moments, we miss our dear patients. That is a fact.

The moment we have discharged patients and when we need to discard these infusion sets

REALITY

COVID-19 is real. There are still individuals who deny this fact, until such time that they will be able to experience themselves first hand. Continue to practice the prescribed minimum health standards to protect yourself, your loved ones and others. With the new variants dominating already the increasing statistics, be wary and be paranoid. Act as if you have the virus. This too shall come to pass. Though, normalization is not yet on hand, but there will be always a blinding light at the end of the sheer dark tunnel.

KUDOS TO ALL FRONT LINERS! Your sacrifice is worth it!

in all BLUE PPE