Dallas Buse is an ICU nurse at U of L Health Mary & Elizabeth Hospital. This interview has been edited for length and clarity.
How have things changed?
“One nurse I work with has been staying in my apartment on an air mattress because she lives in Elizabethtown and has a daughter. And we’ve all been working 50 or more hours a week just to help fill in the gap. So our family lives are changed a lot. … But as a unit and a team of nurses, we are becoming a lot closer.”
“If you’re at home on your day off just sitting around, all you do is think about your co-workers and your patients because you feel like you’re abandoning them if you’re not there helping. You know how stressful the situation is.”
Are you surprised by how intense this has been?
“I remember whenever we got our first potential COVID patient, I was actually the nurse who was assigned to that person. That patient was our very first one in the hospital. We put him in a negative air-pressure room. The whole hospital team was so focused on this patient, making sure we were doing all of the right things, having all of the right PPE. It was this big ordeal. But now the COVID-ICU is full. We went from being so focused on that one patient who ended up not even having COVID, to now where every room is filled with people who we know are positive. It’s just crazy how fast it escalated.”
What goes through your mind when you see people protesting that everything should open up again?
“I wish I could take all of the protesters and bring them into our ICU and have them just observe for an hour. Just take it all in and listen to the phone calls of the family members who can’t be there with their loved one in the hospital, who they’re really worried about. And look at the nurses who are working themselves to death, and the doctors and the (certified nursing assistants), and how sick the patients actually are, and how young some of them are. You can see something on the news and think, Oh, it’s just the media blowing it out of proportion. You know, this isn’t even that bad. We need things opened back up. But they don’t realize how bad it can actually be and how bad it is. Our ICU is already full or almost full every day.”
So if I came in to your unit, what would I see? What’s going to be different from any other ICU?
“There will be no family members, no friends. You would see IVs pumps outside of all the patients’ rooms — which that’s been really different. Obviously we’ve been trying to eliminate our exposure to COVID, so instead of having the IV pole inside the patient’s room, we’ve had to run extension tubing from all the way under the patient’s door and outside into the hallway. That way we can just, if the pump’s beeping for something that we don’t necessarily have to go into the patient’s room for, we can just fix it from outside the room. You would see boxes outside of all of the patients’ rooms that have gowns, gloves, masks. You would see a lot of bleach wipes sitting out for sanitation. You would see all the nurses who are usually in royal blue scrubs and no surgical caps or anything, now we are all in the surgical scrubs with caps on our heads and glasses and masks. Yeah, it’s just a whole different atmosphere.”
“The patients in the ICU on a ventilator with COVID-19 are definitely some of the sickest patients I’ve ever taken care of. I had a very young patient, and we got to FaceTime the mother. And I was thinking, this is awesome that she can see him, but he is intubated, and she’s going to see all these cords and wires and monitors coming from him, and she’s probably going to freak out, thinking, Oh my gosh! I need to be there!”
Has the way you’re caring for the sickest patients changed?
“We have been proning a lot of our patients, which means to put them on their stomach. And we never did that before this started. So there is a more physical labor involved with caring for these sickest patients. A lot of times it takes six or more people to prone a ventilated patient, so that takes a lot of time away from the other patients. Because all the nurses and the respiratory therapist are all in that one patient’s room focusing on turning one patient. That’s the major change in caring for them.”
How does this affect you?
“One day I went in and I had this patient who was younger than me (Dallas turns 23 in June) on the ventilator, positive for COVID, and he was like the celebrity of our unit because he was so young and so sick. I was assigned to him for the day. I was like, There is no way I should be taking care of him. There’s more nurses here that have more experience than me! But then you just have to snap out of that and say, This is what I trained for. This is what I’m here for. They have no one besides you. And if you were that person, what kind of nurse would you want at your bedside? So, for the 12 hours I’m there, I’m super focused, non-emotional, getting the job done, doing what my patients need me to do for them. And then at the end of the day I can cry, I can be emotional, I can call my friends and my mom and just bawl on the phone to them — whatever I need to do.
“I actually was off work for a while — I had to get tested for COVID because I started having some (gastrointestinal) symptoms. I was negative, thankfully. But when I went back to work, the patient that I had been caring for who was so young, he was doing better and was off the ventilator and was moved to out of the ICU. ... He told me he just got off the phone to his mom, and he was not in any pain. He was feeling good. And the last time I had seen him … I didn’t know if he was going to live. And now, to see him up and talking and joking with me and thanking me — I have been able to cope with all of this a lot better after that. … It gave me a new sense of hope that what we were doing here is not a waste of time.”
Do you have the protective equipment you need?
“We do. We are having to reuse our N-95 masks. We have paper bags that we put our N-95s in at the end of the shift. And then we put a face shield over top of our N-95 to prevent cross contamination. And we just started reusing gowns — before we were able to put on a gown we could throw away every time you were out of a patient’s room. Now we have one gown per patient per nurse, and it stays right outside the room so you can put it on when you walk in. And then, the face shield that you use over the N-95s, we have a little station outside of each patient room and we come out and sanitize our face shields. And there’s a hook outside the room where we put our gowns every time.”
How is this going to change you?
“I think it’s going to raise awareness of how easy it is for our life to change out of nowhere, how easily everything can just be taken away from you. I don’t know how much that will change society, but I’m hoping it changes us for the better and helps us be more kind to each other and more respectful of each other and more understanding of what others are going through mentally, financially, physically. So hopefully we come out of this with — I know we’re going to have a better unit in the hospital — but hopefully a better society, too.”
Photo by Mickie Winters.
