Nurses in ICU providing critical care and connection to COVID-19 patients

Medical Watch
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CHICAGO — Nurses from all over the hospital are being redirected to ICUs to help care for COVID-19 patients, and many are finding they’re providing a critical service they never trained for.

As of Wednesday, there were 51 COVID-19 patients in Northwestern Medicine’s ICU.

Paula Dunskis is an advanced practice nurse in cardiology with a background in critical care.

“You see them fighting for their lives,” she said. “They are very, very ill. They are intubated. They are on a ventilator. They are sedated.”

They are also alone — no family or friends at their bedside. That’s where Dunskis and fellow nurses Margaret Hefferon and Terry Strzelczyk try to make difference.

“When all of this started happening, I just felt the anxiety and fear building up inside of me, like I know there is something more that I can be doing,” Hefferon said.

Hefferon usually works in orthopedics but the nurse practitioner did not want to sit on the sidelines during the crisis.

“I have ICU background,” Hefferon said. “It’s been eight years since I worked in an ICU but I’m ready to jump back in and ready to do anything I can.”

“The transition going back into the ICU — your skills come back pretty quickly,” Dunskis said. “But this is a whole different ballgame and very uncharted territory and it is somewhat taxing.”

They’ve had years of intense training, but right now, a phone call to their patients’ family members is their most powerful tool.

“They don’t understand anything about what is going on. All they hear all day long is what is going on in the news,” Dunskis said. “They hear the president, they hear the governor, they hear the CDC. And I’ve had some family members in their head they think they are going to lose their loved ones. They think their loved ones are going to pass away. … When I get on the phone with them, they are very scared. Some of them are in tears and I kind of walk them through. Sometimes I’m on the phone with them for quite a while and I just listen. And then when they are ready, I try not to overload them. … They get to know me. They get to know my voice. As soon as I say, ‘Hi how are you?’ They already know my name and they feel better. And I can tell in their voice that they feel better.”

Part of their role is education and helping families understand the medical care they can’t see in action.

“Something we’re doing in the ICU is putting patients on their stomach,” Strzelczyk said. “It’s called proning position because it allows them to try to recruit more cells of the lungs to help with ventilation. … When you say to them ‘We’re going to prone your family member,’ they really don’t know what that means. But when you explain to them about turning them on their stomach and what it means … I had a family member say ‘Oh did he get tummy time?’ And I said, ‘Yes he did. He got tummy time and he did really well with it.’”

But face-to-face connection is still critical, even in virtual form.

“When the patients are on the ventilator and not able to communicate, many families do like to see them and talk to them and pray with them,” Strzelczyk said. “And so the bedside nurses will bring an iPad into the room and allow the family to spend some time with their family as they can. …And you really don’t know what a patient can hear or not hear even though they are sedated. So hearing their loved ones voices so I think that is beneficial to both.”

We are fighting and we do care and that is why we are here. And as rewarding as it is to talk to families and give that kind of care, it is hard at the end of the day. And we are just pushing forward to give every patient a fighting chance.

It is a remarkable calling to take care of both physical and mental needs of patients and their families.

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