Tales of COVID: Rosie Orr, ICU Nurse
So exhausted she limped to her car
Rosie Orr, a cardiac ICU nurse, worked so hard, so long on Easter Sunday caring for COVID-19 patients, lifting them, turning them, comforting them, comforting their loved ones on the phone, that she limped to her car after her shift ended.
“Now we’re the jack of all trades,” she said. “We’re doing everything. Nurses solely are turning patients. Getting our own EKGs. . . We empty the trash too. “
In a perfect world, each nurse would have just one COVID-19 ICU patient, two at the most, because they are so sick, but now Orr and her ICU colleagues at Temple University Hospital care for three COVID-19 ICU patients each. And often, because space is so tight, all three patients will be in the same room.
And whereas before, a nurse would have an aide to help lift and turn the patient, nobody else other than nurses and doctors are allowed in the COVID-19 ICU rooms, she said.
While the physical demands are immense, the emotional ones may be even greater.
“In the last couple months I’ve had more crying family on the phone then in my previous 5 and a half years of nursing,” Orr said. “I don’t know which side is worse to be on -- the patient who is all alone or the patient’s family who is completely helpless. They can’t even hold their hand.
In speaking with families, she said, “you try to be as realistic as possible, and let them know that you understand that the situation is awful. And let them know that they’re not overreacting, and that they have a right to be upset. I’ve had family members who are crying and still thanking me for what I’m doing and I’ve had family members completely berate me and act like its my fault that I’m doing this terrible thing separating them from their loved ones.”
She said she is torn. “It’s really hard,” she said, “to fight your natural instinct to be bedside and do everything you can for a patient, to hold their hand and to provide that emotional support, but you’re also trying to protect yourself and knowing limited exposure is the safest thing to do.”
Orr said when the pandemic began, nursing leaders asked for volunteers to staff the COVID units, but not enough nurses volunteered -- not for lack of commitment, Orr said, but for fear of insufficient PPE. So all ICU nurses at Temple now rotate through the COVID floors in the Boyer building.So Orr said she spends one shift in Boyer in the COVID ICU, and then two or three shifts back on Rock with her normal ICU patients.
She is so proud of her colleagues, their effort and commitment. Like her peers, she says she will work no matter what. She feels a loyalty to her patients and to her fellow nurses. But she wants equipment that will keep her safe. “I will work under any circumstance I have to no matter how chaotic or emotionally exhausting,” she said, “but I just want to be protected.”
Her biggest concern is the masks. She said Temple, like so many hospitals around the country and world right now, with supplies so limited, doesn’t have enough N-95 masks for nurses. The hospital provides KN-95, which are approved by the CDC. But they just don’t feel secure enough for her and many of her peers.
“I put it on and I feel my breath go up and down my neck, into my eyes,” she said. “And patients are coughing or being intubated.”
Orr has a friend who works in hazardous waste and she got N-95 masks from him. She wears it so tight that “it hurts for the first three hours, and then you can’t even feel it.”
She said the volume and severity of illness from COVID-19 is heartbreaking. She had one patient Easter Sunday who crashed and had to be intubated and his father had died of COVID a week earlier.
While some of her colleagues have developed symptoms, “I feel fine,” she says, “and I’m not too afraid to get it because I can’t be thinking like that. That fear would be paralyzing.”
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. Michael.firstname.lastname@example.org