War on COVID-19: Nurses return to battlefield

CEBU, Philippines —  At the COVID-19 ward of a private hospital in Lapu-Lapu City in Cebu, there is paranoia daily: patients are being rushed to the ICU or intubation room; they're grimacing in pain, struggling to breathe, or losing hope by the day.

Rox, a 26-year-old nurse, never imagined this would be the scene that would greet her in her return to the ward.

Three years ago, when she realized that being a volunteer nurse couldn’t feed her family, she had professed to calling nursing quits to pursue better opportunities.

Yet there she is, back to the familiar hospital smell, except that this time, the ward is busier and the atmosphere more anxious.

The situation is no different at the COVID ward of a private hospital in Cebu City, where Hannah (not her real name), 29, works.

“Every day we have admissions. Patients line up outside the ER (emergency room), waiting to be transferred to the wards. Private wards never get empty. Never would a day pass without a patient intubated,” she said.

Over at the medical surgical ward of the same hospital, another new face has replaced a couple of nurses who had resigned.

Thirty-year-old Phoebe (also not her real name) was building a career in the clinical process outsourcing industry for a few years until the coronavirus forced her company to shut down.

Though detailed at the surgical ward, Phoebe is often whisked off from her regular assignment to join others in the COVID area. There, she is assigned a minimum of seven patients per shift, two or three of whom would normally need intubation.

Rox, Hannah, and Phoebe are among the many licensed nurses who have chosen to return to the fold, so to speak, when others have decided to hang their scrub suits for good, either out of fear of contracting the virus or because the daily turmoil that goes with the job is too big a burden to bear.

Challenges

Three weeks ago, the Philippine Nurses Association in Cebu reported over a hundred nurses contemplating on quitting work or going on unauthorized absences. Their reasons? Fear of the unknown, the perennial issue of undercompensation, and the understaffing in hospitals that has left lean workforces quenching the monstrous demand.

Their renewed gusto aside, the situation on the ground remains far from perfect for Rox, Hannah, and Phoebe.

Rox revealed that in her hospital, the ideal setup prescribed by the World Health Organization is not being observed. Most personal protective equipment, for instance, are “recycled.” Medical practitioners are given masks but not the ideal N95, whose supply runs low.

“So we use three layers of masks or we buy our own respirators out of our salaries,” Rox said.

“We also can’t drink or eat during shifts because of the risk, so we wait after we go home to do that,” she added.

From where Phoebe works, one’s personal burnout can easily affect the others on the team.

“Hospital staff are not sometimes treating us, DOH nurses, nicely. Although a lot of them are really helpful and kind, especially to some nurses with less to zero hospital experience like me, there are some who give us a stern look when we make minor mistakes,” she said.

According to Phoebe, this spite is rooted in the imbalance between the compensation of those nurses fielded by the DOH and those by the hospital itself.

“Some would bat their eyes when we ask for help. Mamundak og charts in front of you. Some of them would jokingly say, ‘mas dako bitaw mo’g hazard pay kaysa namo’ when we have more assigned critical/infected patients compared to the other staff, as if telling us that we should be more exposed to these patients para sulit ang sweldo sa DOH namo,” she said.

When Phoebe heard accounts from other DOH nurses how staff nurses are supposedly ill-treating them in their assigned areas, she was heartbroken.

They get yelled at, she says. Even get blamed over things they didn’t do.  Some of them pass their workload to DOH nurses, as if making them feel they should work more since they get paid more.

“I understand that the nurses in the hospitals where we are deployed are not paid enough and might be frustrated with the current situation. (But) we are all exposed to the same risk every day, have almost equal workload, equal stress yet we get paid more. I myself would also be upset if I were in their place,” Phoebe said.

“However, I just wish they won’t project their frustrations at us because it’s not our fault if they’re (not) well compensated by the hospital. We want them to understand that we are in their hospital to augment the needs because the number of cases is increasing every day, and a lot of health workers are now sick,” she added.

“We want them to understand that we are their allies, not their competitors, not their enemy,” she lamented.

Hannah, for her part, admitted she is groping with her new job, this being her first time to practice the profession since passing the board exam.

Just like Phoebe, she applied through the DOH.

“I am not familiar with the machines and tubings attached to my patient/s. I am not familiar with the brand and generic names of the medications. The training that we had was very shallow, and there was no proper endorsement when we were fully assigned to the station ward,” she said.

But every day is a learning process for her.

“I feel that I am not in the position to question, but I always ask the staff nurses the things that are new to me. I would ask for assistance and let them do it first, then I'll follow. I research the medications through the web. We can't wait for someone to teach us what to do. We have to be proactive in asking questions so we can learn the things that we don't know,” Hannah said.

Their Call

Whenever a patient gets pulled out from the ward to the intubation room, Rox understands it would be an uphill battle for the patient from there on. All she could do at times is stand still in a corner in a moment of prayer.

True, some patients are losing hope and are very hard to convince that having COVID-19 is not a death sentence. But Rox said there are others who keep fighting the good fight.

“So I am here, for the people who need us. For the families who pray for us. To my fellow nurses, let’s give our best until we need to pause, but please don’t stop,” Rox said.

To the government, Phoebe said the health care team does not need praises or tributes but “more actions and less words.”

She said Filipino nurses, especially those working in private hospitals, need the government’s attention in terms of proper compensation.

After all, nurses are humans too, she said.

“They get hungry, exhausted, and burnt out. They’re not robots that can work more than 40 hours a week and could still function like they had 10 hours of sleep,” Phoebe said.

“Nurses, just like their patients, need to eat healthy foods and take supplements. But how can they achieve that kind of lifestyle when their monthly salary can barely make it until the next pay day?” she added.  JMO (FREEMAN)