Across sa国际传媒, people are working in health care amid a global pandemic. Many cheer them from their balconies and porches each night at 7 p.m. Often in his daily briefings, sa国际传媒 Health Minister Adrian Dix takes a moment to thank them, not just the physicians and nurses, but all the allied health-care workers 鈥� those who work in seniors care homes, care aids and janitors.
Here, you鈥檒l meet a handful of those workers at Royal Jubilee Hospital and hear about their first brushes with the virus. Some common themes emerge from their stories. In the early days, they would worry about bringing COVID-19 home to their families. Some self-isolated; some couldn鈥檛 bear that. Many have found the transition to wearing protective equipment all day difficult and feel the pain of patients who can鈥檛 have visitors. Mostly, says the head of the emergency and critical-care departments for Island Health, these workers have carried on 鈥渉umbly鈥� and 鈥渂ravely鈥� and put their patients before their fears.
Royal Jubilee is one of two COVID-19 designated hospitals on Vancouver Island (the other is in Nanaimo). It has three critical-care units: the intensive care unit, with 11 beds for patients typically needing multiple organ support, and two others, with eight beds each, for coronary care.
There are two negative-pressure rooms in the ICU for procedures that cause the COVID-19 virus to become airborne 鈥� intubations, for instance. In this room, air can circulate, but doesn鈥檛 leave the room. On the side is an anteroom where health-care workers 鈥渄on鈥� and 鈥渄off鈥� their personal protective equipment in an ordered fashion. An ICU nurse called the 鈥渟heriff鈥� watches to ensure it鈥檚 done correctly and to stop anyone who might run into the room.
All of those interviewed, given a chance to say what鈥檚 on their minds, thanked Islanders for the team effort, acknowledging that new cases of COVID-19 cases are falling and the health-care system remains robust because of everyone鈥檚 sacrifices. If they have a common request, it鈥檚 that as restrictions ease in the coming weeks and months, Islanders hold the line.
It鈥檚 hard to keep your cool even with safety protocols
Kelly Phillips, 28
鈥� Critical-care registered nurse
鈥� In job 5 years
鈥� Engaged to respiratory therapist Evan Janzen
Kelly Phillips鈥� voice cracks with emotion as she talks about being at the bedside of a frightened young adult with COVID-19.
鈥淵oung healthy people, they鈥檙e really scared,鈥� says the critical-care nurse. 鈥淏eing able to be there to comfort them and get them through this illness has been a total privilege.鈥�
鈥淭hey have kids and they have a lot to lose, and so being with them and holding their hand while, you know, wearing all your personal protective equipment, is a pretty cool moment.鈥�
Like her colleagues, Phillips struggles with the need to get to patients quickly, while putting on and taking off personal protective equipment in the right order to prevent contagion.
Because each ICU nurse is typically assigned one patient, she says, 鈥渨e are very protective of our patient.鈥�
鈥淚f alarms are going off, we are very quick to respond, and having that delay is emotionally taxing sometimes because you just want to get in there,鈥� Phillips says. 鈥淭here are many times you want to put yourself aside and you just want to go in that room and calm your patient and reassure them and stop that beep or change that bag or whatever you need to do, but you have to keep that in the back of your mind that you have to be safe.
鈥淥ur unit has adopted an attitude of 鈥榣et鈥檚 slow things down, let鈥檚 not panic, we鈥檙e going to be safe, we鈥檙e going to be honest and we鈥檙e going to be very attentive to each other.鈥� 鈥�
It鈥檚 not easy.
Even with all the safety protocols, unintentional exposure can happen.
Phillips cites a personal example: While she was moving a patient, a ventilator detached, causing 鈥渁 massive amount of exposure.鈥�
In those times, care providers become hyper-aware of their contacts and the incubation period for the virus 鈥� an infected person will typically develop symptoms within five days to 11 days, but it can be as long as 14 days before someone knows they are sick.
鈥淚t鈥檚 very stressful and you can feel responsible for everyone around you, as well as your own well-being,鈥� she says.
Phillips considers herself lucky that her fianc茅, respiratory therapist Evan Janzen, works in the same ICU and understands 鈥渢he emotional roller-coaster鈥� of working in a pandemic.
鈥淲e鈥檝e both been in very close contact with multiple COVID patients, so we鈥檙e coming home together with the same amount of exposure.鈥�
For now, they are isolating, and can鈥檛 visit Janzen鈥檚 sick father.
The couple鈥檚 summer wedding has also been postponed because of the pandemic.
鈥淲e joke about getting married in the ICU together,鈥� Phillips says.
For paramedic, it鈥檚 a time of changing practices
Nic Hume, 37
鈥� Paramedic based in Victoria
鈥� In job 8 years
鈥� Partner Anna Stefek, 30, paramedic
Every time paramedic Nic Hume puts on his mask and gets out of his ambulance, he has to assume that the patient he is helping is infected with COVID-19.
For every call, he has to wear a mask, a face shield and gloves, regardless of whether there are any COVID concerns, he says.
鈥淭here鈥檚 been so much change in the way we handle everything in the last few months,鈥� Hume says. 鈥淓verything has slowed down and become very detail-oriented, especially around personal protective equipment.鈥�
Each work day, Hume wakes before dawn and drives to Victoria from Sooke to start work by 6 a.m. For the next 12 hours, he doesn鈥檛 know when, or where he鈥檒l go 鈥� just like in his former job as a newspaper photographer.
In the early days, it was stressful because there was so little known globally about the virus, he says.
The first suspected COVID-19 call was 鈥渦nnerving.鈥� Since then, he鈥檚 changed many practices. Work clothes stay at work and he receives a fresh uniform daily.
A self-described 鈥渘erd,鈥� Hume says he was studying the disease early on, and by late February or early March, he had already said goodbye for now to his 96-year-old dad, columnist Jim Hume.
鈥淭here鈥檚 a very real chance I won鈥檛 see him until mid-summer, and at the age of 96, a lot can happen in those months. He鈥檚 in great shape. He still writes his blog every week 鈥� but.鈥�
Nic Hume, who lives in Sooke with his partner, who is also a paramedic, says it鈥檚 never crossed their minds not to go into work because of the risk of infection.
鈥淭his is what we do. 鈥� This is a particularly unprecedented event in our lifetime, but this is what we signed up for.鈥�
Having said that, the shifts under the shadow of COVID-19 seem longer and harder. Twelve hours in personal protective equipment 鈥� a mask, face shield and gloves 鈥� and the strict regimen of putting it on and taking it off is exhausting, he says.
鈥淚 feel significantly more tired now than I would have a few months ago, and I personally attribute that to being constantly vigilant about cross-contamination, being constantly vigilant about personal protective equipment.鈥�
If there鈥檚 a bright side to the pandemic, it鈥檚 seeing people rise in the face of adversity and show kindness 鈥� food delivered to the front lines, drive-by cheers and drumming at the hospital, chalk art thanking all those in health care.
鈥淚t鈥檚 humbling.鈥�
ER physician drills down for possible second wave
Dr. Matthew Carere, 36
鈥� Emergency-room doctor
鈥� Married, two children, ages 5 and 3
Emergency-room physician Matt Carere has been inspired by the rapid response to COVID-19 in Victoria, where simulations and preparations continue for a possible second wave.
At Royal Jubilee and Victoria General, he says, no stone has been left unturned.
鈥淚t鈥檚 crazy what鈥檚 happening here. Physical walls are being built on a daily basis. We鈥檝e cordoned off areas. We鈥檙e inserting negative-pressure rooms. We鈥檙e changing the entire geography of hospitals, just to be ready for this.鈥�
Carere says how rapidly the hospitals adapted made the pandemic feel real very quickly.
鈥淲hen people are critically ill now and they鈥檙e coming into the emergency and if we don鈥檛 know their COVID status, we鈥檙e pretty much treating them as if they are likely to have COVID,鈥� says Carere.
鈥淚t just adds one more layer, one more decision to an already very stressful situation.鈥�
Previously, for example, an asthmatic child would be given medicine that would be humidified, but that procedure would aerosolize the virus, turning droplets into a far-reaching mist, 鈥渟o we can鈥檛 ask a nurse to start that in the middle of the emergency room.鈥�
Now, staff must don full personal protective equipment and put the child in a negative-pressure room. It鈥檚 the same for cardiac or kidney patients 鈥� the logistics are challenging.
Simulation drills could include an infant with breathing problems, a six-year-old with a seizure, patients with major traumas 鈥� all positive for COVID-19. 鈥淲e鈥檙e preparing for all those eventualities.鈥�
In the beginning, doctors were looking for coughs and fevers, then runny noses, headaches and muscle aches.
鈥淭hen it was vomiting and diarrhea,鈥� Carere says. 鈥淵ou put those things together and basically anyone that comes into the emergency department has one of those things.鈥�
Calming and connecting with ER patients is also tougher in a gown and mask. 鈥淐ertainly with our pediatric patients, when they come in, you pull your mask down really quick and say: 鈥榯his is my face鈥� to normalize the experience.
With reduced traffic in the emergency department as a result of the pandemic, he says, the level of care for sick patients is 鈥渜uite excellent. Now we鈥檙e seeing heart attacks very fast. We see traumas right away.鈥�
Carere says people who work in critical and emergent care tend to be risk-tolerant, but COVID-19 has caused everyone to change their ways. Many physicians shower at work so as not to bring contaminants home. 鈥淥ne doctor installed a shower outside of his house.鈥�
Carere says he鈥檚 indebted to Vancouver Islanders for staying home and decreasing the patient volume.
鈥淲e have a low caseload on the Island, but if we had the pre-COVID volume in our hospital going on while we were trying to change everything and get ready, it just wouldn鈥檛 be possible. We wouldn鈥檛 be ready.鈥�
Personal protective gear a blessing and a curse
Shannon McGregor-Brown, 43
鈥� Critical-care registered nurse
鈥� In job 11 years
鈥� Married with a five-year-old son
The personal protective equipment that every critical-care nurse depends on for safety is one of the most frustrating aspects of dealing with the pandemic, says Shannon McGregor-Brown.
鈥淚 think that鈥檚 probably the most stressful part, sometimes, is not being able to get to your patient in the time that you want to solve the problem that you know you can solve.鈥�
Care providers can track their patients鈥� vital signs from a central monitor at the main desk in the intensive care unit and via patients鈥� bedside monitors that can be seen through glass walls and doors. They can see whether blood pressure is dropping, or if sedation medication is running low or ventilator requirements change.
But before they can get to a patient, they have to stop and put on protective equipment.
It鈥檚 both a blessing and a curse to those in emergency and critical care, especially with COVID-19 patients, because of how rapidly they get sick, said McGregor-Brown. 鈥淭hey come in and we intubate them if their oxygen requirements are tipping and then we ventilate them, and sometimes it just cascades so quickly.鈥�
They might need a renal-dialysis machine to filter their blood of toxins. Antibodies can cause an inflammatory response and there is a possibility of blood clots. There can also be cardiac issues.
鈥淪o there鈥檚 all these physiological changes that can happen over a period of time 鈥� sometimes it鈥檚 a few hours and sometimes it鈥檚 over the course of days 鈥� and some days you think they鈥檙e getting better and then they take another turn.
鈥淪uddenly their pressure is dropping and 鈥� you鈥檙e trying to maybe run dialysis and make sure that their kidneys are going to pull through in the end of this 鈥� You can鈥檛 keep their blood pressure up 鈥� it鈥檚 a cascade of events.鈥�
Not knowing how this virus is going to respond in any one person鈥檚 body is the thing that keeps her up at night.
鈥淚t鈥檚 a crapshoot,鈥� she says.
In March, McGregor-Brown had to call a family in Saskatchewan and suggest they drive out to see a patient immediately. 鈥淭his person was declining rapidly and it broke my heart. They鈥檙e saying to me: 鈥業 don鈥檛 know when I come there, am
I coming to see my brother alive and to say hello, or am I coming there to collect his body and take him away?鈥�
McGregor-Brown didn鈥檛 know, either. 鈥淲e take things literally hour by hour, if not minute by minute, when they鈥檙e critically ill here, and you just try to support that family to the utmost.鈥�
McGregor-Brown鈥檚 husband, Michael Brown, who works in finance, is working at home during the quarantine. She considered self-isolating, but couldn鈥檛 bear two or more months away from her five-year-old son. She exercises extreme caution about hygiene.
She likens COVID-19 to a monster in a dark room. 鈥淸At first] we hadn鈥檛 turned the lights on yet to see what the monster is, but now that we鈥檝e seen it and worked with it, I feel more confident when I go home.鈥�
From feeling strange to feeling appreciated
Toni Barkanyi, 40
鈥� Royal Jubilee housekeeper for 9 years
鈥� Married, two daughters, ages 22 and 17
After the intubation of a COVID-19 patient 鈥� where a tube is inserted through the mouth into the airway, sending aerosolized particles into the negative-pressure room 鈥� the specialists leave and housekeeper Toni Barkanyi moves in to wipe the room clean and remove the hazardous waste.
In the intensive care unit, she鈥檚 responsible for cleaning the entire area, including patient rooms 鈥� washing the linens, removing the garbage, mopping the floors and wiping down all 鈥渢ouch鈥� areas.
鈥淚 have to make sure the space is safe,鈥� she said.
In the early days of the pandemic, when she hadn鈥檛 yet received instruction from her union on protocols, she followed nurses and doctors in the ICU, listening in on their huddles on how to stay safe. She made sure a nurse watched her don and doff her personal protective equipment, both for her sake and that of patients.
Barkanyi worried about bringing the virus home to her husband and children, but felt a responsibility to do her job as part of a team.
鈥淚 felt that they are also my patients,鈥� Barkanyi says. 鈥淚 clean like I鈥檓 cleaning for my family. I can鈥檛 think of any other way to do it.鈥�
On the hardest days, she had multiple daily cleans on multiple COVID-19 rooms.
鈥淚t鈥檚 a long process and it is quite draining, putting on and taking off your personal protective equipment and making sure everything is right, perfect. And then going into the next room and the same routine.鈥�
It took weeks for her to become accustomed to the new protocols and confident that she could keep herself and others safe.
In the early weeks, Barkanyi thought the 7 p.m. cheers for health-care workers had nothing to do with her.
鈥淚t was a little strange for me, because I thought this is just for doctors and nurses, you know. Then eventually, over the course of that time, I started hearing more about the behind-the-scenes workers, housekeeping, the instrument cleaners, everybody else. And then
I started feeling really appreciated.鈥�
In a COVID-19 patient鈥檚 room, there may only be a doctor, respiratory therapist and a nurse, but before and afterwards, there鈥檚 a cleaner.
鈥淚鈥檓 proud to be a part of that.鈥�
Supportive team helps her cope with pressure
Shaelyn Allen, 29
鈥� Critical-care registered nurse
鈥� In job five years
鈥� Married
Shaelyn Allen says trying to keep COVID-19 patients and their families connected is tough.
鈥淭he hardest thing for me is having the families not be able to come in and visit their loved ones when they are so sick,鈥� Allen says. 鈥淲ith nursing, it鈥檚 a holistic approach. We don鈥檛 just nurse the patient 鈥� we nurse the family as well.鈥�
Allen says her own family 鈥� along with colleagues and a phenomenal interdisciplinary team and great leadership 鈥� helps her get through when the anxiety of the COVID-19 crisis mounts.
鈥淜nowing you work with such an incredible supportive team has really helped.鈥�
While being quick-thinking and fast-acting in a medical emergency is the 鈥渂read and butter鈥� of those working in the ICU, Allen says slow and methodical is key in the pandemic.
鈥淵our first instinct is to run into the room when something鈥檚 wrong. But now we have to step back and we have to make sure we鈥檙e protecting ourselves and we鈥檙e doing the right things in the right order,鈥� she says, noting different personal protective equipment is required for different procedures.
鈥淪o knowing instantly which PPE to put on and getting into the room to do your job is quite stressful, to be honest, and it鈥檚 been a bit of a challenge and a learning curve, but I feel like we鈥檝e learned pretty quick on the job as to what needs to be done and making sure we鈥檙e protecting ourselves.鈥�
Allen was hoping to start a family this year, but she and her husband have put that on hold for now, 鈥渏ust for safety.鈥�
Much is still unknown about COVID-19, says Allen, which can lead to a feeling of helplessness and lack of control. 鈥淵ou don鈥檛 really know what you鈥檙e going into 鈥� when you enter the patient鈥檚 room.鈥�
A patient who seems to be recovering can 鈥渢urn, like almost instantly,鈥� she says, adding she鈥檚 only had one 鈥渂ad breakdown,鈥� after her first COVID-19 patient.
鈥淚t was just the pressure,鈥� she says. 鈥淭his is like something completely new 鈥� you don鈥檛 exactly know what you鈥檙e looking for. You don鈥檛 exactly know what to expect. The treatment is different, too, and because there鈥檚 no cure and there鈥檚 no straight-up treatment, you鈥檙e just kind of doing symptom management.鈥�
On tough days, she says, she powers through remembering who she is doing it all for: her patients and the community.
鈥淲e hear that they鈥檙e cheering for us all the time. We really appreciate the support of the community. We couldn鈥檛 do it without them.鈥�
Boxes of gear in her office protect patients and staff
Carrie Homuth, 49
鈥� Manager, adult intensive care units, 23 years
鈥� Royal Jubilee Hospital and Victoria General Hospital
鈥� Married with two grown children
Carrie Homuth shares her office with boxes of personal protective equipment.
In the early days of the pandemic, she was tasked with planning for the intensive-care units of Vancouver Island鈥檚 two main hospitals, which felt like being at war, she says.
If she was to protect patients, she had to first protect staff. At first, it was not clear how much gear they had or how much they could attain in a global pandemic. 鈥淢y office got turned into a warehouse,鈥� says Homuth. Back-up equipment was stockpiled and kept under lock and key.
With the boxes under her nose, her department knew exactly how much they had for how many staff, patients and procedures. 鈥淭hat gave us a sense of control and took away a lot of fear,鈥� she says.
Planning went into overdrive in March. How would the hospitals treat 100 patients requiring intensive-care services? How would they get enough personal protective equipment?
鈥淭he pressure was on us to prepare as much as we could,鈥� Homuth says.
Rallying the troops meant being able to ensure they would be safe coming to work. Staff were being asked to potentially care for hundreds or even thousands of sick and dying.
鈥淚t was stressful,鈥� Homuth says. 鈥淎t that time, it seemed like every day was a gift to get a little more preparation done and now it鈥檚 a gift that the worst hasn鈥檛 happened.鈥�
As the daily number of new COVID-19 cases on Vancouver Island wanes, Homuth says officials are continuing to plan for a potential second wave in the late fall, combined with influenza season.
鈥淚t鈥檚 a constant tension between planning for what is unimaginable and dealing with what鈥檚 in front of you,鈥� says Homuth, who had taken only five days off over seven weeks.
鈥淪leep isn鈥檛 really happening anymore. I think as much as you step away from work physically, emotionally and mentally, it still plays in your mind 24/7.鈥�
Homuth says she鈥檚 either in her office, car or house, oblivious of the outside world.
The pandemic has forced the postponement of her son鈥檚 wedding, planned for Merridale cidery this summer.
鈥淭hat鈥檚 a little sad.鈥�
Worried about patients, and spreading the virus
Leigh Walters, 51
鈥� Respiratory therapist
鈥� Royal Jubilee Hospital
鈥� On the job 18 years
鈥� Married, two sons 12, 14
When a Code Blue is called over a hospital intercom, 鈥渢hings are really bad,鈥� says respiratory therapist Leigh Walters.
It鈥檚 typically an impending cardiac or respiratory arrest. In her younger days, she would have felt an adrenaline rush. It鈥檚 different now: 鈥淎t this point in my life, I always think: That鈥檚 awful.鈥�
Walters has enough experience intubating and extubating patients, giving CPR and assessing people unable to breathe that she doesn鈥檛 need that adrenaline to power through.
Those first few weeks intubating COVID-19 patients were 鈥渋ncredibly stressful,鈥� she says, as no one knew enough about the disease. After performing an intubation, she鈥檇 worry about spreading the virus.
鈥淚 was anxious. That anxiety and those early days of doing those intubations was something that I found very challenging.鈥�
She didn鈥檛 realize the toll it was taking until she found herself waking at 3 a.m. after bad dreams.
Although she took every precaution not to bring the virus home, she soon made the decision with her wife and her two children to self-isolate. 鈥淢y kids are young and my wife, I was concerned about her.鈥�
One of the things that sets COVID-19 apart is how quickly a patient can deteriorate, she says. 鈥淲e need to act really quickly, in a very controlled manner.
鈥淲e鈥檙e shutting things down, we鈥檙e putting on negative pressure, we鈥檙e all getting into our gear and we鈥檙e doing things with a very specific process that鈥檚 developed to ensure that we are safe, that our patients are safe, and that the rest of the emergency department is safe.
It鈥檚 hard, she says: As with other health-care workers, her impulse is 鈥渏ust to go. That鈥檚 the nature of respiratory therapy. We just go and we do.鈥�
Walters says she is grateful to live on an island where people have taken the measures needed to keep infection rates low. And she鈥檚 a fan of the woman at the helm in this pandemic: 鈥淒r. Henry 鈥� she is my source of truth.鈥�
The threat of a surge or another, bigger wave rarely leaves her mind.
Her worst fear is that a work colleague will become infected. But she says no one will walk away unaffected by the pandemic.
鈥淚 think for all health-care workers, this will leave a little bit of a mark.鈥�
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