Team Nursing- My COVID Diary Entry

The days ran together. It was Eat, Sleep, Covid, Repeat. I remember seeing terrified Med-Surg and Tele nurses showing up on the unit about a week after I arrived. We were not full yet, but the bell curve was showing a surge that we would barely manage. They decided to introduce team nursing.

Some of the young nurses were excited to get a crash course in Critical Care as most new grads do not get hired to big ICUs due to lack of experience. Now was their chance. Then there were the seasoned, comfortable Med-Surg nurses who manage 5 patients with finesse and skill, but panic with a systolic less than 90. They were afraid to even touch patients. Let alone give them meds, prone them and manage all the lines and tubes.

Mary had been a nurse for 24 years. She and I were to be partners today. As we took our assignment she attempted to write down a report then stopped midway. Knowing well she did not have enough knowledge to grasp the technical ICU report, lab value analysis and questions I was asking.

She stood paralyzed outside of the ICU door, staring at a patient on over 12 drips, intubated, proned on their stomach, tubes and lines and dialysis running. I gave her a reassuring pat on the shoulder and said, “Mary It’s ok! We are gonna have a good night.” I think I knew I was lying. But I hoped it would be true.

When it was time to do our first assessment, she was shaking as we donned our PPE. She kept asking if her seal looked like it was working, touching her nose, molding the thin wire to her face. Taking deep breaths and blowing them out, feeling for any air leaking.? She then began telling me about her elderly mom, with tears in her eyes.

Mary’s mom had been a nurse and worked in the same hospital. She said she was proud to be a nurse, but really terrified to go home at night. She had considered getting a hotel, but for how long? How long would this last??

I took a deep breath, and paused for a moment. I said, ”Actually Mary I could really use a runner. Just stand at the door, grab the meds that are ordered.? I will write on a paper towel and hold it up for you to get what I need, ok? Umm, ask the secretary to help you find everything in our supply room. ”

She first started to argue, “Oh no! I didn’t mean to let you go in alone! I was just…”

“Mary,” I said, “It’s ok, I couldn't take care of 5 or 6 patients if I tried. We all have our skill set. And your mom needs you as healthy as possible.”?

I turned to open the door and waited for her to back up. The tears in her eyes dissipated as she took a few steps back and gave me an encouraging nod.?

90 mins later I exited the room, sweating. She said, “Melissa, take a break! I can listen out for a minute. I looked up labs for you and info like you asked. This patient is only 35. I thought the news was saying they are elderly. “

“He is very young. We are starting to think it could be any age Mary. I am going to go take a break for a few minutes ok?” She nodded confidently and posted up next to the monitor with a forced look of courage, even though she wouldn’t really know what to do if a single drip ran dry. I walked to the center of the nurses station, and stood there. Knowing damn well I couldn’t take a break because my other two patients were just as sick. Plus I couldn’t leave Mary in case something did happen. But I smiled as I watched the central monitor and took a drink. She deserved her moment of courage in the storm.?

Three codes and a few deaths later, the shift ended. As we left the unit, Mary thanked me for teaching her a ton. I looked at her shocked. “Thank me? I felt like I was re arranging deck furniture on the Titanic all night. I couldn’t have survived without you helping me get everything before I even knew I needed it. Take care of your mom!”

Weeks later I received a transfer from Mary’s floor. Her entire Med-surg/Telemetry floor was transferred into a covid ICU because all of our critical care units were full. ICU nurses had been floating down there for weeks. She gave me the most intricate and complex report. I was so impressed.

?I said, “OK Mary! I see you!”?

She laughed, “ Thank you for getting my feet wet. You taught me so much.”?

I asked about her mom.

?“She got Covid and passed away a few weeks ago.” she said, ” I was going to take time off, but it’s not like we can have a funeral or anything. I know she’s at peace with my dad. Now, every patient I take care of I hope we can save in honor of her.”?

Mary’s courage in the storm was incredible. She is just one of the many nurses that sacrificed their families to stay in the fight. Mom’s left their kids and stayed with friends. Dad’s slept in the garage in winter. Coming back to work, shift after shift focused. Facing the biggest challenges of their careers with a brave face.

Team nursing allowed Mary to elevate her practice and gave us Critical Care nurses, a life preserver in the turbulent ocean. Covid has proven that there is a place for team nursing throughout high census and heavy patient acuity areas in the hospital post pandemic.?