To Filipino nurses, the hospital ward for coronavirus patients is a dangerous second home.
Cebu City -- Fay, one of many regulars called to the COVID-19 ward, works for five days straight – a total of 120 hours in a week. After that, she has to quarantine herself in the hospital for 5 to 14 days before she can go home to see her father and sick mother.
Another nurse, Ric, hasn’t seen his family since he was assigned to the triage area. He fears for their safety and stays in the hospital to protect them.
Within the white walls of the hospital, Fay and Ric grapple with the realities of frontlining.
They settle into new routines, managing teams and shortages in challenging conditions. They assist sensitive patients and face discrimination inside and out. They stress, they cry, they pray, they laugh to cope. They miss their families dearly and they want to go home.
These are the stories of our medical ‘heroes’ told as realistically as possible.
A new normal
Working 435 miles away from the capital city and the first coronavirus case in the country, Fay said, “Dako kaayo ang kabag-ohan… Nagubot ang tanan,” (There were really big changes… Everything was a mess.)
In just one snap, routines were changed, schedules were mangled limbs, the shortage of staff and facilities grew all the more evident, seminars and trainings suddenly needed conducting, and emergency meetings were called in the backdrop of a global health pandemic.
“Ngano ni sugal man mi sa amo mga kaugalingon?” (Why are we gambling our lives away?) Ric voiced that the institution was never ready for the scenario. Even after the SARS and H1N1 outbreaks, there was no contingency plan, no proper area for isolation, while people outside believed otherwise.
Fay cited mañana habit as one reason for the lack of preparations. Mañana habit is a negative Filipino trait of doing things later rather than sooner. As team leaders, Fay, Ric, and others had to come up with concrete plans against the pandemic and in spite of the instantaneity of it all, they slowly organized.
“Every day is really a challenge for us,” Ric admitted. On normal days, he likes to party but sacrificed that to answer his duties as a nurse, and was left in shock as everything was new. They now have to work for days on end without a break. Patients kept trickling into the hospital. Seven ambulances lined up in a row with a slew of patients needing assessment – only five nurses and a doctor were on the field.
Ric and his team bore the brunt of the first surge of patients, but he is grateful that changes are being made and mistakes are corrected.
As of April 20, 2020, there are over 6,000 confirmed COVID-19 cases in the Philippines.
Out of stock
There is a global demand for personal protective equipment (PPEs) and medical supplies, leading to a supply deficit resulting to the infection of 252 health workers with 17 doctors dead in the Philippines alone. Manpower is challenged while patients come in a steady stream. If nurses don’t have the materials they need for patient care, they run the risk of falling ill.
For Fay, there were only 50 PPEs when their first patient arrived. 6 to 8 PPEs are consumed on a normal day – more if the patient is in critical condition. Management had to call for donations and nurses were pushed to improvise, sewing umbrella cloth as PPEs. Other PPEs were flimsy and had to be fixed over and over again. Nurses even had to buy their own hand soap.
With stress and frustration in his tone, Ric said this is another problem he has to face as team leader. They have to strain and compromise to preserve supplies, as well as their health.
The hospital has a “1 is to 1” protocol, meaning one PPE is to one patient to avoid cross-contamination. Nurses had to change in and out of hot, heavy PPEs frequently. Once, they were at the brink of breaking protocol due to the shortage.
To save time and minimize supply use, Ric’s team strategized delivering food and medication to patients in bulk instead of an on-call basis. They also made arrangements with able patients to pick up their food that the staff leaves in a nearby spot.
There remains to be a dwindling supply of equipment. As the curve is yet to be flattened and cases rise with no end in sight, health workers need all the help they can get.
In their care
Due to prolonged isolation and absence of a cure, patients are agitated, scared, and overwhelmed. It is a nurse’s one duty out of many to care for them, even if patients do have a tendency to lash out because of the stress they are in.
Tagged as persons under investigation (PUIs), a couple with their baby arrived in a hospital in anger. The family was made to wait, walk through long corridors and three glass doors, and even then, nurses still had to hurriedly wear PPEs – they were notified late.
Hysterical, the father complained about the slow response and hurled insults, saying they looked like “astronauts” in their suits. He expressed hurt because the nurses never smile, but the masks covered their faces. The parents ran out of milk for the baby, but they weren’t allowed to leave as PUIs. “Di man mi virus, ma’am, ngano di man mi ninyo pagawson?” (We’re not the virus, ma’am, why won’t you let us go outside?)
Fay patiently spoke to the crying parents to explain the situation. In turn, she listened. She found that to get here, the family travelled for nine hours and were coldly discriminated by other travellers all while their baby was turning blue and sickly. She could see that the pandemic was affecting them all the same and extended understanding, offering milk for the baby.
Ric says there are patients who ask for hot water, tea, and even curtains for their room. Although exhausting, he accommodates these demands because he places himself in the shoes of the patients – quarantined in a foreign room for 14 days with only strangers in scrubs as company. It’s understandable that patients want a form of familiarity or ordinariness.
Despite this, Ric admits with a weary voice that he does feel as though they are a hotel sometimes and they are sweating in their PPEs to serve.
Hearts within PPEs
With eyes trained on our own safety, we often forget that the people beneath scrubs are human too. Patients are not the only ones in need of care. Nurses often have to assess their physical and mental health too – a feat that proves difficult given the job.
At the end of his first shift in the COVID-19 ward, Ric asked his team members to give him time to cry, even if just for 15 minutes. He was exhausted and overwhelmed too, he said with a crack in his voice. Yet, he has to put up a brave front and perform his duties well for his members and patients.
Stuck in a rock and a hard place, Ric absorbs and adjusts to different personalities under pressure while communicating with doctors having contrasting views. Reconciling these differences is added burden, but necessary as a team.
He often calls his mother for encouragement and consolation to cope. Most of all, Ric and his six team members find solace in each other, “We are not just a team… we are family.”
Fay also does her best to lead and boost the morale of her team. She prepares and orients them before starting a gruelling five days of work. She would say: don’t let the work overwhelm you, let’s just follow protocol, and get through this together.
She divides tasks properly to prevent burnout and created a distributed schedule so that all the members could rest. They laugh and pray together. They are all they have for five days, after all.
Fear of heroes
Our health workers are often praised as heroes, but at the same time, people fear them.
Fay often walks to and from the hospital because public vehicles ignore her on the streets. Many assume all health workers are infected. Even a medical technician was forced out of her boarding house when she herself had no contact with the COVID-19 unit.
Even the institution discriminates.
Out on an errand, another health worker returned to the hospital in tears, “Nasakitan ko ma’am. Nalain ko sa atong mga kauban ma’am kay mura man ko naay virus. I feel discriminated sa mga tao outside. Ang nakalain pa gyud kay ang akong mga kauban… naa daw ko’y line na dapat agihan” (It pains me, ma’am. Our colleagues really hurt me ma’am, they think I have the virus. I feel discriminated by people outside, but the worst thing is that my own colleagues discriminate… they say I have to stay away from them.)
Even after following quarantine protocols, Fay came across her colleagues and received similar comments, “Nag uno man kaw diri? Ayaw pag gupot sa ako!” (What are you doing here? Don’t touch me!)
She didn’t think she’d receive unfair treatment from the very people she works with. Almost in tears, she said these encounters hurt her the most.
To avoid discrimination, all she could advise her team members was to avoid posting photos in social media.
Even until now, discrimination remains to be a problem that frontliners face every day.
Long way home
Home is often out of reach to health workers. The pandemic compels them to work for almost a month.
Health workers with families settle for the occasional never-enough phone calls.
Fay herself misses her parents who she cannot even see when she is in the house – she only goes out of her room when her parents are asleep. Before she leaves, she buys them weeks’ worth of canned goods, rice, and maintenance medicine for her mother recently diagnosed with high blood.
Akin to how her parents were when she was younger, it is her turn to leave bills on the countertop and reprimand her parents, now senior citizens, for working the store – they were concerned about money.
“I don’t know if makauli pa ako,” (I don’t know if I can still go home.) Ric expressed. He realized the importance of family during these trying times and regret not spending more time with them in the past. Whenever he called them, he couldn’t even vent out his problems. He didn’t want them to worry about him any more than they already do.
For Ric, Fay, and many others who toil for days in the hospital, their motivation to work lies not just in service, but in family. They do not want the situation to worsen to the point that their families would be caught in the medical chaos, nor do they want to see their parents, children, and spouses as patients. Health workers leave home for us to stay home.
Ric sends a plea to everyone reading this story, “Please stay at home kasi dili sayon as frontliners, dili sayon ang amo mga gipang agian” (Please stay at home. What we’re experiencing as frontliners is not easy at all.)
As one can see, there is more humanity in these stories than heroics.
“Everything is hero, hero, hero lang gyud pero they don’t know kung unsa najod ang reality na nahitabo sa amo sa sulod.” (All we hear is hero, hero, hero but they don’t know about the realities happening inside the hospital.)
As one can see, there is more humanity in these stories than heroics.
The reality is this: these are nurses under pressure, clinging to prayers, with hearts underneath their improvised PPEs.
These are nurses who feel, who fear, who do their best, who fall short, who grow tired, who feel stress, who cry, who laugh, who hurt, who miss, who want to go home – humans all the same.