STO­RIES BY KEVON FELMINE

kevon.felmine@guardian.co.tt

While most peo­ple who con­tract COVID-19 sur­vive, there are pa­tients ly­ing on beds with tubes stuck down their throats to trans­fer oxy­gen to their lungs at In­ten­sive Care Units (ICU) across the par­al­lel health­care sys­tem.

How­ev­er, ac­cord­ing to one team lead at the Cou­va Hos­pi­tal and Mu­ti-Train­ing Fa­cil­i­ty, Josette Bethel-Smith, ICU nurs­es are now be­ing trau­ma­tised by the loss of their pa­tients af­ter fight­ing hard to save their lives.

In a mov­ing sto­ry at the Min­istry of Health’s COVID-19 up­date yes­ter­day, Bethel-Smith said peo­ple would nev­er un­der­stand what goes on in an ICU un­less they are there.

She said ICU pa­tients range from chil­dren and the el­der­ly who re­quire con­stant mon­i­tor­ing, a cock­tail of med­ica­tion and oxy­gen sup­port. And while some may look like they are re­cov­er­ing, their health can change with­out warn­ing, re­sult­ing in doc­tors ask­ing their rel­a­tives to make life-al­ter­ing de­ci­sions on their be­half. 

The ICU at the Cou­va Hos­pi­tal housed 22 pa­tients but re­cent­ly in­creased its ca­pac­i­ty for an ad­di­tion­al 19.

To the rel­a­tives of their pa­tients, Bethel-Smith said nurs­es em­pathise with the de­ci­sions they face when their loved ones are crit­i­cal­ly ill. How­ev­er, she asked them to un­der­stand that nurs­es are do­ing their best. She said nurs­es do every­thing for their pa­tients, in­clud­ing giv­ing baths and feed­ing them.

But she said there are al­so times when nurs­es en­sure that crit­i­cal­ly ill pa­tients get their phone calls to their loved ones and un­for­tu­nate­ly, some of those calls are their last.

“At this time, be­ing a reg­is­tered nurse in a pan­dem­ic has be­come ex­treme­ly over­whelm­ing. I par­tic­u­lar­ly feel it for the nurs­es who start­ed their ca­reers dur­ing this pan­dem­ic. We are go­ing to be sad. Some, if not all, are al­ready trau­ma­tised. We have seen so much death, and we know there is go­ing to be more.”

She said the deaths are even hard­er when nurs­es lose their col­leagues, fam­i­ly and friends. With 1,709 peo­ple hav­ing died of COVID-19-re­lat­ed con­di­tions to date, she said ICU nurs­es are not giv­ing up.

Bethel-Smith said a day in the ICU is phys­i­cal­ly and emo­tion­al­ly ex­haust­ing for nurs­es. Of­ten­times, she said they are un­able to eat, drink or use the bath­room. They spend be­tween six to 12 hours in per­son­al pro­tec­tive gear to re­spond quick­ly to their pa­tients. 

Not­ing, the emo­tion­al and phys­i­cal toll it is tak­ing on she and her col­leagues, Bethel-Smith said, “We, too, have fam­i­lies. Some of us have chil­dren at home do­ing on­line school­ing, and we are not there to guide them. On our days off, we sleep and re­group to do it all over again.”

Bethel-Smith said she thinks about her pa­tients on her days off, won­der­ing if they would still be there when she re­turns.

She re­called car­ing for a 26-year-old pa­tient who asked if he could video call his rel­a­tive?

“Sure you can. How else would they see you? It is the on­ly form of com­mu­ni­ca­tion you all have right now,” she said in re­sponse to the pa­tient, who was re­ceiv­ing oxy­gen ther­a­py.

As she left that day, he wore a non-breather mask, al­ter­nat­ing with Con­tin­u­ous Pos­i­tive Air­way Pres­sure ther­a­py.

“He was do­ing well. He was one pa­tient that I was cer­tain would be able to leave ICU and re­turn to his fam­i­ly,” she said. 

But fate would be cru­el, as his con­di­tion wors­ened. Doc­tors had to in­tu­bate him for me­chan­i­cal ven­ti­la­tion and a few days lat­er, he died.

“I felt that be­cause I told him to talk to them (fam­i­ly) all you want be­cause not many peo­ple get to do that.”

While the North Cen­tral Re­gion­al Health Au­thor­i­ty pro­vides men­tal health as­sis­tance for staff, Bethel-Smith said nurs­es were tired, and it feels like there is no end to the trau­mat­ic pan­dem­ic. She said they would ap­pre­ci­ate it if peo­ple took the COVID-19 vac­cines so their work­load could de­crease a bit.

“To my sweet T&T, there is no cure for COVID, and we are ex­haust­ed. We need you to take per­son­al re­spon­si­bil­i­ty. You do not want to end up in the ICU. COVID-19 is heart-wrench­ing, and it is de­stroy­ing fam­i­lies. I urge you to pro­tect your­self, pro­tect your fam­i­ly, pro­tect your com­mu­ni­ty and let us end this pan­dem­ic for good. Do not de­lay; get vac­ci­nat­ed to­day.”

How­ev­er, she says nurs­es are not giv­ing up.

“To all of my col­leagues, you all are amaz­ing and nev­er for­get that. I know it is a lot, but we are strong, and we are re­silient. So to you, I say thank you for your ser­vice.”