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Tales of COVID: Felicia Nemick, ICU Charge Nurse

Unbearable sadness for patients, unbounded pride in Temple response.

July 01, 2020

Back in the beginning of March, in the earliest days of the COVID crisis in Philadelphia, Felicia Nemick, 37, a charge nurse in the medical intensive care unit at Temple University Hospital, had an “unexpected exposure” to a COVID-19 patient.

“The patient had shown no symptoms,” Nemick said, “and her positive diagnosis caught everyone off guard.”

Nemick went home to South Philadelphia to quarantine with her two young children, ages 3 and 5. It was the three of them, all alone.

Terrifying thoughts raced through her mind all week. What would her children do without their mother? What if she got her children sick?

“That was the scariest week of my life,” she said

She did not get sick, and after two negative COVID tests, she went back to work.

Her first day back, in mid March, they assigned her to be charge nurse in the new COVID-19 ICU setup in the hospital’s Boyer Building.

“I was pulled in because they were short and I was placed in charge,” she said. “What a way to bring me back.”

Here’s the thing:

“I realized very quickly this is where I had to stay,” she said, “and I never went back."

“The teamwork, the ambition, the organization of the nurses there,” she continued, “was exactly why I do what I do. Every single person steps up beyond belief. No questions asked. Everyone was just ready. We were making due with minimal supplies in a setting that wasn’t really set up for what it was. We make things happen out of the blue. We `MacGyver’ things.” That’s what we’re best at.

She also noted that nurses volunteered in the 60-bed COVID ICU from across the hospital, from the post-anesthesia care unit, from interventional radiology, from the operating rooms and gastroenterology.

“The group that is there is getting it done in such a beautiful way,” she said.  “I work with an amazing team that is making something from nothing almost.”

Nemick is more confident, less fearful of getting sick herself, having been exposed before, having better equipment now, and knowing what she’s walking into.

Masks do remain a concern, she said. All nurses are wearing KN-95 masks that come from China, she said, and these masks aren’t as tight or as substantial as the traditional N-95 masks, but those are in short supply.

“We’ve been anxiously waiting for that change,” Nemick said.

In her decade as an ICU nurse at Temple, she has seen her share of suffering and sadness. But nothing can compare to the last month, she said.

One example:

“We had a very young gentleman in his 30s on full life support, multiple medications,” she said.  “He was not doing well despite every effort. We had to call his mother to ask for her wishes for him. As we were having that discussion his blood pressure was dropping. And we cut the conversation short, so she could talk to him directly instead. We switched it to FaceTime, so she could see him and say her goodbyes to her son."

Her son died that evening.

“Next day she was in our emergency room with COVID as well,” Nemick added. “It’s the saddest thing. “

Too often patients are dying alone, loved ones saying goodbye remotely, with nurses holdng the phone. “We hear a lot of `I love yous screaming from the phone,” Nemick said.

She also said, “We’re seeing a lot of families in the ICU. We just paired an elderly husband and wife in the same room. We’ve had brothers in the same room.”

Nemick also noted that as the hospital tries to limit staff exposure to COVID patients in the ICU, nurses are picking up many more responsibilities.

“We had a nurse plumbing the toilet,” she said. “Emptying our own trash, changing our own sharps containers.” She said many ICU rooms have machines that are intended to create negative pressure, with tubes carrying the air out the window. But when those tubes become disconnected, COVID air gets blown into the room instead of out, and nurses have had to do the repairs. “We have to put the tube back on with duct tape,” Nemick said.

She feels almost unbearable sadness for the patients and families, but also almost unbounded pride in Temple’s response.

“Such a positive experience in such a disaster,” she said. “It makes me feel good.”

When she goes home now, at the end of her long days, she is beyond careful.

“My kids are used to not touching mommy when I first come home,” she said, “but now I take about ten more precautions. They understand. `It takes quite some time before you see Mommy.’ “

Michael Vitez, winner of the 1997 Pulitzer Prize for Explanatory Journalism at The Philadelphia Inquirer, is the director of narrative medicine at the Lewis Katz School of Medicine at Temple University.