Episode 3: The nurse worried for her peers on the front lines

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Courtesy photo. (Photo illustration by Natasha Vicens/PublicSource)

Courtesy photo. (Photo illustration by Natasha Vicens/PublicSource)

In our lifetime, there has not been a more scary time to be a nurse. On this episode, we’re hearing from a Pittsburgh-based nurse who is not on the front lines but has a lot of insight into the experiences nurses face. Theresa Brown teaches nursing at the University of Pittsburgh and also authored two books about the profession that pull back the curtain on the experiences nurses face in their daily work.

JOURDAN HICKS: In our lifetime, there hasn't been a more scary time to be a nurse. On TikTok, Instagram, Whatsapp, nurses are sharing what it's like for them right now.

CLIP: Hi, guys. My name's Ali and I'm an ER nurse. I got to work the other day and was handed this packet of papers. My managers told us that it would be in our best interest to fill it out. It is our advanced directives and living wills. I'm only twenty-three years old, so this weighed pretty heavy on me. But it is something I, unfortunately, have to think about being on the front lines.

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CLIP: It feels like we're in a war and like we're soldiers in a war. We're being sent out without camouflage, without Kevlar. It's like we have no defenses against this. And they're giving us very little. You know, I don't know who's to blame for this. It's so much bigger than just the hospital.

CLIP: My name is Shannon Burnell and I am a 27-year-old registered nurse from Seattle, Washington. I've been feeling a lot more anxious lately because I really don't want to go to work. Like it's bringing me to tears, just hearing all these stories and reading all these like all the information.

JOURDAN HICKS: But many nurses in Pittsburgh can't tell their stories. Big health care giants, Allegheny Health Network and UPMC, control the majority stake of the health care market in western Pennsylvania and have long had their employees trained to not talk directly to the media.

For example, a recent memo from UPMC emphasized their policy bearing rank and file employees from talking with reporters, noting that, "questions from media should be directed to UPMC media relations." Employees said they could be disciplined if they were identified in the press.

I'm Jourdan Hicks, community correspondent for PublicSource. On this podcast, we're sharing voices from our community to track the effects of the pandemic in southwestern Pennsylvania. On this episode, we're hearing from a nurse who is not on the frontlines, but has a lot of insight into the experiences that nurses face.

THERESA BROWN: “I really want people to understand the dedication that keeps healthcare workers going to work and not just nurses and doctors, but the administrators who answer the phones on the floors, the cleaning people, the dietary people dropping off meals, you know, all these people have to keep doing their work for the hospital to keep running. And they really deserve so much credit.”

JOURDAN HICKS: Theresa Brown has been a nurse for 10 years. She's also a columnist and author of two books about nursing that pull back the curtain on the experiences that nurses face in their daily work. She also teaches nursing at Pitt. Two and a half years ago, Theresa was diagnosed with breast cancer. Because she's still recovering from the effects of the treatment, she's not able to join the frontlines during the crisis, but she's using her voice to amplify the particular challenges nurses are facing during the Coronavirus crisis.

We'll hear Theresa's story in just a moment.

FUNDRAISING CLIP: Hi. I'm Mila Sanina, the executive director of Public Source. In this unprecedented time in the middle of a pandemic, our reporters have been bringing you the stories from the Pittsburgh region, from talking to local nurses and small business owners to understanding why data on race matters when we look at how at COVID-19 is affecting different communities. If you like what we are doing, please consider supporting us. PublicSource is an independent nonprofit newsroom. You can support local journalism and storytelling by going to a publicsource.org/donate. Thank you.

THERESA BROWN: My name is Theresa Brown. I'm a nurse. My real passion is with clinical nursing, bedside nursing. For the past year, I've actually been teaching clinicals at the University of Pittsburgh. I've been a nurse for about 10 years now.

The challenges that nurses are facing have to do with how physically close we get with the patients. Yes, doctors are at risk, but it's actually nurses who spend much more time with the patient and tend to be physically closer to the patient. The people at highest risk are the doctors during the intubation because you put in a breathing tube and if there's virus there, it can cause it to aerosolized -- to go out in a stream. And that's very dangerous for everyone in the room. So no question that is risky. But nurses do twelve-hour shifts. If you think of ICU nurses having two patients, that's the usual, so for twelve hours, they're with those patients. Suppose the patient is what they call 'bucking the vent,' sort of fighting against the vent physically, even if they're unconscious. So the nurse has to adjust the breathing tube; the nurse might have to be checking the ventilator settings; the nurse might have to try and physically hold the patient down until someone else can do whatever needs to be done to calm them.

Also, patients are so going to the bathroom, they need to be cleaned up. So then the nurse is in there doing that. They might need other medications administered. And part of what we find so fulfilling about our job is being with patients. And now, the longer you spend in a room, the more at risk you're putting yourself. So I imagine there are many, many, many nurses who feel this incredible moral conflict around, 'I want to be there for my patient, want to offer them comfort. And yet it's dangerous for me to do that.'

CLIP: So today was the first day that I've worked since our unit was designated the second COVID-19 ICU at my hospital.

THERESA BROWN: The image that's haunting me the most was a nurse from Michigan who posted a video on Twitter about her day and her shift and what it was like.

CLIP: I have no idea what the fuck just happened for the past 13 hours. Honestly, guys, it felt like I was working in a war zone. Completely isolated from my team members. Limited resources, limited supplies, limited responses from physicians, because they're just as overwhelmed as we are dealing with a ton of other stuff. So basically, I just spent the last 13 hours like treating two critically ill COVID patients basically by myself. This is my new normal through the next however many months that it takes for this virus to die down. I'm already breaking. So for fuck sake people, please take this seriously.

THERESA BROWN: I can't put it behind me. I wonder how many other nurses feel that way. I have this fear that our hospitals are just going to turn in into houses of plague. And I really, really, really hope that I'm wrong, but I'm a bit terrified of that...that there just won't be enough well people to take care of the sick. And that's because so many of the sick will be the people whose job is to take care of those with COVID.

I think people have read about how they don't have enough personal protective equipment (PPE) and they don't have enough masks. They don't have the right kind of masks. I've read things from nurses being told to go to work unless they have symptoms of COVID. But one thing we've learned is that it tends to be asymptomatic patients (patients who don't look sick and don't feel sick) who are transmitting the disease more than people who actually have symptoms. So if health care workers are being told, 'unless you have symptoms, you need to be at work,' they are going to be there spreading the disease. And it's scary. It's very, very scary.

A lot of nurses have been given gag orders. So they're not supposed to be talking on social media or to journalists about the fact that they don't have enough protective equipment or what their working conditions are like. I'm part of a group that started a forum on WikiWisdom trying to get frontline nurses to share their stories with us. And we're seeing despair.

CLIP: “I'm a nurse in New York City and our current PPE situation is dismal. We are showing up. We're taking care of our patients. We're doing the best we can with minimal supplies. I am pleading with President Trump to unleash the Defense Protection Act. Our lives and our patients' lives depend on it.”

CLIP: “We get one N95 mask a day, and one face shield the day to reuse. When we take them off. We came in this paper bag right here. They were never meant to be used this way.”

Also seeing pride.

CLIP: “I signed up to help people. Nurses, doctors, everybody that works in health care right now, we've signed up to help people because that's what we want to do. We want to help each other. We want to help people. But we didn't sign up for a suicide mission. And that's what this feels like. And every single health care worker death is preventable.”

THERESA BROWN: Nurses feel like it's never been more important to be a nurse and feel good about the work that they're doing or trying to do even in these difficult circumstances. And it's probably that pairing that has come out the most--that people are really scared and also incredibly committed. And I hope the public knows that. I hope people know what that feels like to go to work thinking, wow, I could get this disease that's killing people and yet I'm still going.

This podcast was produced by Andy Kubis and edited by Mila Sanina and Halle Stockton. If you have a story you'd like to share, get in touch with us. You can text a voice memo to 412-432-9669. Or email it to jourdan@publicsource.org.

Also, we'd like to ask for your support. PublicSource is an independent nonprofit newsroom in Pittsburgh. Please support local journalism and storytelling by going to publicsource.org/donate.

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