The last few months, in the depths of the pandemic, I have been extremely quiet about my role as a COVID-19 front-line respiratory therapist. I was concerned that people would be uncomfortable around me given my close proximity to the plague. “Do you work directly with COVID patients?” they might ask while cautiously retreating backwards tightening their masks.
I am caught between feeling proud of my work with virus patients and feeling like I am the virus itself. I reclaim my dignity as I respond, “Yes, I am a respiratory therapist, and it is my job to be there for these patients.” I don’t get to choose which patients I take care of — COVID or not, they are my patients and I am a very vital part in keeping them alive. Why shouldn’t I be proud of that?
Although respiratory therapists have their busy, intense and overwhelming season during winters when respiratory illnesses are at their highest, even those paled in comparison to the emotional and mental strain I experienced while working during this pandemic.
What follows is a description of a typical day during COVID.
Walking into work, I take a few big deep breaths. I know it’s going to be an emotionally draining and hectic day. I pick up my assignment. I’m in the COVID-19 unit again for the third day in a row. I rush to pick up all my personal protective equipment — a pair of specific COVID-unit scrubs, full face mask and head and shoe coverings. I’m ready.
I march to the wards. Although I have been working here for a time, everything looks unfamiliar. The rooms are veiled with ominous signs and hazard warnings. “Enhanced Respiratory Precautions,” the signs read. Intravenous line poles running between the patient and a point outside their door are held up so as to not touch the floor. Continuous oxygen saturation monitors are outside every doorway.
To an oblivious visitor it might appear like a movie set from the frontlines in World War II, but for me it is real, dangerous, urgent and critical. At any other time I would fear to cross this barrier, but today it is my job — I have no choice but to rush to the patients like a soldier running into battle. Taking a deep breath, I start my rounds.
To limit exposure for safety reasons, only one RT is allowed in a room at any given time. If there is a code, an emergency intubation or a procedure typically requiring at least two RTs, it must now be performed by one. There is limited support, backup or aids, which compounds the stress and strain of the COVID environment enormously. I feel alone behind enemy lines.
I don’t get a chance to sit or let my face breathe without a mask. I run between my patients’ rooms trying to keep their oxygen saturations above normal. I help them breathe. I put them on any respiratory device I can think of. I prepare the patients and tools for intubation. I make them comfortable on the vent.
I am the one they see at the head of the bed right before they fall asleep, as I reassure them that they are being cared for, their family has been notified and everything will be OK.
My job does not stop there. I am alone on the difficult journey with them. I manage their ventilator, take charge of their airway and sometimes am the one to turn it off as I whisper in their ear, “What an incredible fight you just fought.”
I entered the health care field to help people, but never did I imagine that I would be thrown into the frontlines of battle against an aggressive, invisible and deadly enemy. Had I known about the pandemic and its impact when I chose this profession, would my decision have been the same? I am ambivalent. But I am also grateful, fortunate, honored and proud. I am a better person and a better professional for it.
Although there is sustained emotional and physical exhaustion, bleeding from constant hand scrubbing, dried skin from extended mask wearing, and fear of bringing the virus home, it is a small price to pay for the personal life lessons and growth that the experience afforded me.
I learned how to adapt and adjust in rapid response to fast-changing situations and events. Being at the frontlines during the pandemic and experiencing the exigency of my role as a respiratory therapist, I learned that the profession I chose is the sine qua non of who I am.
My respiratory team and I learned resourcefulness when there were no resources. We devised new and creative ways to minimize contact and proximity to COVID patients by arranging for all patients’ monitoring systems to display in hallways outside the rooms.
And collaboration was key. The nursing department rallied tirelessly to help with breathing treatments, airway suctioning and attending to ventilator alarms when other respiratory responsibilities became too overwhelming for us to manage. There was a sense of unity flowing through the patient care units.
The 17th-century English author John Donne famously said, “No man is an island.” That was once just a quaint platitude to me. As I learned about and experienced supreme team reliance and co-worker trust, those words became deeply embedded in my new philosophy. We are not a collection of isolated islands, rather we are a mighty continent, and I hope to encourage and inspire young men and women to choose the noble and rewarding profession of respiratory therapy. JN
Esther Lapin is a registered respiratory therapist at Honor Health Osborn Medical Center. She lives in Scottsdale and is a member of Ahavas Torah.