https://drive.google.com/file/d/1fhBacyKEaiSnfObzpHr0QpJXSefhCKyP/view?usp=sharing
STEPHANIE SHINN
NICU NURSE AT CHILDRENS HOSPITAL WASHINGTON D.C
Mafine: So, how are you today?
Stephanie: I’m good! How are you!
Mafine: I’m good. So, your upbringing. We have to start from the beginning, beginning, beginning.
Stephanie: Okay!
Mafine: What got you interested in healthcare or what started your career?
Stephanie: In healthcare?
Mafine: Yea.
Stephanie: History or my healthcare journey?
Mafine: Yea.
Stephanie: Um, so both my parents are nurses. They came to this country on a work visa for nurses. Um, and, all growing up I thought I was going to be a doctor. I was like “I’m going to go to medical school”. I didn’t want to be a nurse. Um, and, when I was in high school as a senior, I got pregnant at 18 and I ended up – my mom was like saying that I could still go to medical school. She was like you might need to take a little bit of a different path, and because she was a nurse, um, she said that, um, I could use my nursing – I could be a nurse, use my nursing degree as a bachelors, as my pre-reqs to go to medical school. So, she said that it’ll be better for me to provide for my child if I had a career that make a living for the both of us and then still go to medical school. So, I ended up going to medical school – to nursing school and when I started doing the clinicals for nursing school I realized how much – I was really lucky in the sense that I got to experience so many different types of nursing. Um, and I chose my clinical experiences to also be exposed to different types of nursing. Um, I had only been exposed to nursing from my parents and both of them had specialties. I knew I didn’t want to be just a general nurse. Um, and they both had specialties, my dad was an OR nurse and my mom was an emergency room nurse and she worked in a very busy trauma center. Um, and so, I always picked my clinical sights – my clinical experiences like what those specialties could be. Like when we went to — when we did our labor and delivery clinicals I wanted to be in a very busy labor and delivery unit. I didn’t – I wanted to get the most out of my clinical experience to see what type of nurse I would like to be. So, and I realize that I wanted to specialize, and then also too when I was closer to graduating, I knew I’d wanted to branch out into pediatrics. Um, I had some bad experiences with adult nursing early on in my – in nursing school so I had almost quit. Actually, quit nursing school. I almost did it. But then my mom was like, oh, you know you, you might be better suited to do pediatrics. She said, you can get through anything. And she was like, maybe you should do pediatrics when you’re done. And so, when I was, like, my beginning of my senior year, I decided to, like, really hone in on what type of pediatric nursing. So even in a sub — the subclinical part of general nursing, there’s also pediatrics, and then even with pediatrics, there’s even more subclinical specialties in a neonatal intensive care and when I was done my summer internship, I had decided that I think that that’s what I really wanted to do. I really wanted to take care of just sick babies, and that’s how — and when I graduated, I applied to a high level NICU so that I could specialize to be a neonatal nurse.
Mafine: So, what was the bad experience like? What –
Stephanie: Bad experiences in nursing school for me was that I found that adults are way mean. They’re like, um. Um, in a lot of problems with adults and in health care is that a lot of times adults are not the best at taking care of themselves. And it’s not to say that I didn’t, for some reason, a lot of my patients in nursing school were very difficult, and it was just I got really frustrated with them, because a lot of it is convincing them that they need to take get better care of themselves. And with children, they don’t do it to themselves. You know, a lot of times the children, it’s something has been done to them, or something they were born with, is what causes their whatever, their whatever they’re going through so and had a lot more empathy for them. Yeah, you know, they’re smaller, much easier, much easier to exactly feel cuter.
Mafine: Okay, so we’ll transition to like COVID and the pandemic. So 2021, especially somebody that — especially somebody who you know works in a hospital, in healthcare, what were like your initial thoughts and feelings when the pandemic was like starting?
Stephanie: So, like I said, I work in a very busy, high level neonatal intensive care. And as with everything, we were starting to hear these, like it was just kind of rumblings, especially like in February, of starting the like, the end of January, February, we were starting to hear about, like, there’s this one, let me, let me Back up a little bit. So January, starting in November, all the way to like March is normally what’s called RSV season, RSV and flu season. And RSV for babies is really, is really important that we try to keep kids babies, especially try not to get them exposed. RSV is, technically, is technically, like the cold. It’s a cold virus. But for some babies, babies are very susceptible to it, and it’s, you know, for me and you, for adults, getting the common cold is okay. We might take some medicine for a little while, but sometimes for babies, it can, like, really, put them out. A lot of them, if they get sick with RSV, then they end up on ventilators, and, you know, kind of sick. And the progression with the diagnosis of RSV is that they get worse before they get better. And only time and taking care of their circumstances is what takes care of that. And so in February, when we were starting to have increased RSV, we were starting to hear out of like the National Institutes of Health and from other parts of the country were, they were talking about this virulent, like cold virus. And they were like, for some reason, we were like, getting it. We were being told, like, in little bit of spurts, like they were telling us that we had to start being way more vigilant about staying clean. We were starting to see like RSV on the uptick, and they were those, those kids would — were sicker longer than they typically would be sick. And so, when they were starting to hear about when adults, when they were — everything for children and pediatrics and babies follows the adult streams of like with like– illness. So like. So when we were starting to see like, there’s people getting sick with cold and flus and they’re dying, they start to get worried about how it’s going to affect children. So in February of 2020, we were starting to see this, like, Hey, there’s this weird cold virus in adults that they’re just going really quick. And how, like, it started to be, like, slow. They’re like, Oh, the admissions for — to ICUs in adult world is with this weird virus is, um, up ticking. Then they were starting to, starting to get worried about it. So, then they were seeing that also too. Usually when you’re taking, when you get diagnosed with RSV, a lot of times it looks like the cold — it’s a cold virus. So, we were thinking, you know, hey, what’s going on? And when they started testing it, and they were calling it something else, we were getting really worried. Because typically, every flu season it’s the same virus, but then there’s like, little things that are different about it. That’s why you get a flu shot. It’s not the same flu shot that you got last year. It’s a it’s a flu shot that’s modified, modified differently from the one last year. But typically, your flu shot isn’t even for the one that they had last year. It’s just that there’s so many hundreds of strains of flu that they take the data from the previous year. So, then we were hearing that they were like, Oh, this doesn’t typically look like a normal flu. And so, when they started being able to test for COVID, they had to develop a whole new test. And so that they were saying that even that they couldn’t give you the very typical flu shot, because this was looking different. The COVID 19 was different. So, then we were, they were like, Oh, we got to make again — in our hospital, at least, they were like, it was, like, all of a sudden blast, like every other day of like, Hey, anybody exhibiting symptoms, you got to make them wear a mask. We got to put out more hand sanitizer. We got to make sure that everybody’s washing their hands. They weren’t letting parents in if they even, like, sneezed or, you know, if anybody we thought was sick, we were telling them to stay home, and we were — they were also telling us, like, immunocompromised patients were being shuttled off to different units so that they can make sure that they were being really clean. But in our unit, like I said, we weren’t seeing it as much because I think that initially we were being very, very like, up to date, and we were being super cautious, yeah, for my unit.
Mafine: With all the blasts and things that were coming out, like, was it like rapid, or was it like spaced out?
Stephanie: Spaced out, it would be like, daily we would get like, a different thing. They would tell us — They would tell us specifically to we were they were telling us specifically, like, every day, this is what we have to do, this is what we’re hearing. And they were telling us to — they were like, make sure you read your emails, because it’s changing every day. And they were telling you to, you know, keep making sure you if you’re if you’re exhibiting any symptoms, or if anybody in your family has, let your let your charge nurse know. And then they would come and talk to us and what they started doing like, because I remember it was March 13, when, when they, when they went into lockdown, right? It was a Friday. It was the 13th. It was in March. I remember that. And they were saying how they that’s when they started putting before we would get to work, we would have to go into this app, and they would they would like, are you exhibiting these symptoms? Check this box, and if we had answered any of those questions ‘yes’, they would stop us, and then they would ask us. We would have to take our temperature through the before they would even let us on the unit. So, every shift we were being tested, we had to take our temperature right before. And it started out with the charges doing the temperature, and then they let us in. And then it started being where they got those, those temporal scanners, when they’d be like, Oh, your — your temperature is this, and blah, blah, blah. And then they let us go. But in the early days, the email blast, the blast for like, daily, and then it got to be every shift, like every 12 hours, because our shifts are 12 hours that we would be getting different information. And that was like that for early part of it. And then then it kind of got into a groove. But the groove didn’t happen till like three months in, like after, it was, like the summer time, like after we shut down. Yeah, after the shutdown. But yeah, and even when we shut down, I remember them saying that like they were telling us to make sure we had our ID badges on us, because any healthcare worker could be driving around, but they were like telling people, you know, don’t leave your houses, don’t be driving around. All the grocery stores are closed. So, I remember in the early days when they shut it down, they told everybody, every hospital employee, um, if you were an essential worker that carry your ID badge, because that’s the only way you’re going to get in the hospital. So, and then that’s when they were also telling, like, the EVS workers, they, I think the first week, they’re telling the, the janitors and the environmental services people like, don’t come. And I remember we had to empty our trash, and we were the ones like taking care of those things, and then they were only letting bits of people into the hospital. And then when they called everybody back to the hospital, that was but then, like I said, life had changed. And then everybody had to take their temperature, everybody had to log their stuff, like their temperature, their symptoms, and especially in the first month or two when we were in the lockdown. So, yeah. Like, the early warnings were, like, daily, yeah. And then it got to be and then when the heights of it, and then we would get we would have to have a debrief in the beginning of the shift. Of like, these are the how many new cases, and this is how many patients you know who is testing positive. And then also in those early days too, is like, there was just so much confusion as to, like, how we were going to proceed forward. It was like, Oh, if you got a temperature and you got a cough, Oh, yeah. And, and since we didn’t have a test initially, they were like, putting all those people in one side of the unit, and we were keeping everybody out. We used to be able to have, we had a more lenient visitor policy, especially in our in my unit, it was like, pretty lenient. And then after that, it got really, like strict, they were only allowing one parent at a time, the other parent couldn’t even be in the hospital. Like they would have to literally drop off a mom who just delivered, and she’d have to get walked upstairs, or she’d have to walk upstairs by herself, like in the elevator. So it was, like, really, really hard for initially. And you know, in my unit, most of the moms are just had a baby, so they can’t even leave their labor and delivery units to come over for our sick babies. So, a lot of times, the dads weren’t allowed to come, and it was just a mess for a long time.
Mafine: So like, in the beginning of the pandemic, where you said there was, like the consistent, like text blast and a lot of like confusion, emotionally, like, what was coming up for you, or like your co-workers?
Stephanie: Me specifically, the emotional toll was, like, just the confusion. Then I’m a touchy-feely person, I’m social, and it was really hard because, like, you had to stay six feet away from everybody. And it was really hard because, like, I said, like, being a person that needs to hug my friends and everything, even my co-workers, and I’m with them a lot, so it was really hard. It was confusion and kind of sadness of just like, not being able to, like, really talk to people. I’m also, like, a sub group in my unit where I don’t take care of babies. Every day, I go and pick up babies from different hospitals to bring them back. You know, because our unit is such a high specialty, babies who are sick in other labor and delivery units and other hospitals, they need to come to us for surgeries, for if they’re, if they, if they come out, really sick, so for special procedures and stuff. So what I was seeing a lot was, like, parents who didn’t want to be separated from their babies because, like, especially the mothers who were extremely like, you know, emotional at that time, because they just delivered a baby, and then having to take their babies away, it was like, super sad, yeah, and you know, like to have to tell a mom, like, hey, you need to, you need to make sure you you have two negative COVID tests before you can even come back to see your baby. And your baby was whisked away from you right after you deliver them, and you didn’t even get to see them nor touch them or kiss them or anything. And we’re taking them to a whole nother hospital. It was sad, and you’d find these moms who are extremely angry or extremely sad, and then these dads who are like, confused, or even there was some point where their dads weren’t even being weren’t even being able to be there with their — their significant others to give them even comfort. And there were some dads who were like, you know, I can’t even be there the hospital with my wife. Right? And then they’re taking my baby away, and then they tell me, I can’t even go see my baby in the hospital, and I haven’t been able to see my wife. I mean, it was extremely hard. I mean, you know, like, and I said, like, looking at those emails every day, it’s just like, something’s confusing. I’m like, Oh, I thought we we were doing this. And they’re like, Nope, that’s done, you know. So it was just a very confusing time. It’s frustrating. And then also, too, not only in that, when the height was happening and so many people were getting sick, there was like, because people didn’t, didn’t want to, they didn’t want to part with their family members. We were finding the fact that there were a lot more moms delivering at home because they didn’t want to be separated from their family. So, we were finding that they would come at the last minute, and sometimes to the detriment of their babies.
Mafine: What were like, some things that you wouldn’t like — what do you mean, detriment?
Stephanie: Um, so there’s like, if a baby has difficulty at delivery, like, a respiratory problem or not having like, sometimes they, what we call is, like, coming out depressed. So, like, for whatever reason, like, some babies might be born too early, right? And we were having a lot, an increased incidence of moms who are like, they’re going to deliver a preterm baby. And if you were in a hospital, you have this entire set of staff that can take care of them. Like to put a breathing tube in to give them medications and everything else. But these moms were so scared about being alone, like their babies, who wouldn’t see their babies that, you know falsely, they would be like thinking to themselves, like, I want to deliver my baby at home so I can see them, I can be with them. And then there was like, this such fear of, first of all, health care. It started to be like, fear of going to the hospital, because a lot of people were thinking, if I go in the hospital, I’m gonna get sick with COVID, I’m gonna die. Yeah. And so we were even having moms doing that. They were like, I’m not gonna have to go to the hospital and, you know, I can deliver this baby at home.
Mafine: Wow.
Stephanie: And that’s what we were hearing. So like, that. There’s some of these babies that would come out depressed, even full-term babies. Like, if there’s any kind of like, um, you would think that women have been delivering babies for millennia, you know, and you would think that this happens every day, but there’s a lot more babies that are born with respiratory distress or depressed for whatever reason, like a little infection in the mom can be really, really fatal to a baby that’s coming out. So, we were having parents that were just like so scared to part with their — their children, that they wouldn’t even come to the hospital because their fear was that I would not be able to see their baby. So, we were having a lot of babies that, if just a little bit of help with delivery could have saved them, that a lot of their babies could been saved. They — we could provide the care for them that just a little bit of help could help them survive. Yeah, and then they weren’t surviving because the moms waited so long and and then I get that because it was out of fear. It was really out of fear.
Mafine: You know, parents who are mothers that decided to go to hospitals. Did you notice any other like specific behaviors from the parents, like regarding just keeping their kids safe within the hospital?
Stephanie: It sometimes came to be a joke. You know, there’d be like this, if a nurse just cleared her throat, they’d be like, are you sick? And I’m like, No, I’m just clearing my throat. It’s really dry, yeah, you know, under this mask, it’s super dry. In a lot of fear, just like, just irrational fear, even with people who you know, who technically you know, would be pretty smart and stuff like that, they just don’t seem to — they just became irrationally fearful. And it took a lot of convincing. Took a lot of convincing to, you know, took a lot of convincing them that, hey, we’re gonna be okay, yeah, and so it got to be, you know, we need to have a lot more patience with these parents, and a lot more like. There’s a lot of more explaining and trying to have to like, to like, there’s a lot of like, having to talk them off their ledges a little bit, yeah, which also too for us to the repetitive for me, sometimes, like, I it’s easy for me to get annoyed because I’m like this. I just told you that, right? You know, please, please listen and that it’ll be okay and we will take care of it.
Mafine: So, do you feel that okay — well, I’m gonna get back to that. But what you said that there was fear. Like, what were they afraid of? Specifically?
Stephanie: They were afraid of catching COVID themselves, themselves. They were afraid of anybody infecting their babies. There was also nurses who were just so afraid of catching it themselves, or, you know, healthcare people, not just nurses specifically, but healthcare workers, of like, getting it themselves and then bringing it home to their families. So, yeah, just the that fear, especially before the before the vaccine came out. Before the vaccine came out, it was like a there were some people, since there was a lockdown, they’d send their children away. They would send their kids to go live with their parents, their elderly parents or letting them live with other families because they were exposed every day to COVID, you know?
Mafine: I know you said that, like your approach, like dealing with parents, kind of changed a little bit, like, more patience. Like, what else do you think changed in your approach with dealing with parents? Or were there just, like, some similarities between, like, what you would always do?
Stephanie: There was always the similarity I, I, I, I think that because of my experience of being a young mom, like when, when I had my kids young, when I had my oldest young, I remember — always my feeling of like, not wanting to be talked down to. So, in my career, I’ve always felt that with parents, like I’m not going to talk down to them, like I might know a lot more clinically, like I might know a lot more about health care and stuff like that, but I wasn’t going to use so many technical terms in order to try to convince them, because then a lot of times they end up tuning you out. And I think I’ve always been able to, like, explain it in such a way that the normal person that is not a healthcare person can understand, but what ended up during the time of COVID was just like not talking down to them, but also just the patience, the patience of telling, and also, too with learning, having to learn new things and having to keep up on, like how scientific, like institutions like the National Institutes of Health, for you know, even the American Nurses Association, even like the American Medical Association on all their suggestions, like keeping it all like, this is, this is what’s coming out and or even just being able to say, like, we really don’t know, yeah, we don’t know what’s going to happen. We don’t know if you know, we don’t know what’s happening every day, but we’re just telling you that it’s every day that we’re getting new information.
Mafine: But do you think that your approach to caring for children, like specifically with immunocompromised patients, has that changed during the pandemic, or?
Stephanie: Um, a little bit I think that we’re a lot more vigilant now. I’m not going to say that we were negligent. I think that because of knowing how COVID was transmitted. I think that we became a lot more vigilant. Things that we used to take for granted, we became more vigilant, and not that we were like not taking care of it in the way that we’re supposed to. I think that we thought of it more intentionally and, and like when they were coming out with systems in order to prevent the spread of COVID, you have to think of it from like, Okay, you have to start from A. Once you finish A, you have to do B. You can’t go from A to C without having done B. I think that was that has changed. I, um, like, really thinking in the order of how you do things, because it really did help prevent the spread. Um, and, like I said, like, just, just being way more vigilant and thinking about things intentionally.
Mafine: Yeah.
Stephanie: Yea
Mafine: Were there like, just what were like, some of the daily challenges that you faced while caring for immunocompromised children?
Stephanie: Um, keeping up with just like, while the recommendations were that in like, also to again, with, also with, with the fact that we were that there were so many patients and then there was a lot of people who left the healthcare field during that time so dealing with, like not having enough staff to help. And that was, that was the challenge of it like, and then just making sure that we’re doing the best that we can without getting tired. And then there was also to like, like, when a patient would get sick, not to our fault or anything, like, you’d be like, it’s like the guilt of being like, Oh my God, you know, they have it, and how did they get it? You know, did I do – was I doing the best I could to make sure that we weren’t spreading it around? And, you know, like I said, like when they were, when these kids were — and it wasn’t just our unit, like I dealt with babies, and there was a time when they just didn’t have enough beds, even for adult patients. So, there was a it became like a not just for our hospital. It ended up being like for the district and for the state of Maryland that they would lose – they wouldn’t have enough beds to take care of of adults. And so, because all the ICUs would be full of these patients, they were running out of, they were running out of, they were running out of ventilators and stuff like that, we were ending up having to take like patients that were over 21 years old into our hospital, and then just like so then we were taking older babies, like my unit is from birth until, like, six months old. The pediatric intensive care they take from six, six months to 18 years old. And so we were, like, I said, we were getting these daily blasts, email blasts and texts, and they were talking about how we were going to might have to start taking in adult patients. So, we would start taking in 21 to 25 – like 18 to 25 year old patients into our unit because adult hospitals didn’t have enough beds. So, I remember, because the pediatric intensive care was getting full, we would start have to start taking eight months old in our unit, nine months old, up to a year old in our unit, because the pediatric intensive care was getting so full of patients with COVID that we were taking non – we were taking non babies, Like technically over six months old into our unit because the other ICUs were full. So, um, taking care of those patients got to be, like, really hard, because now we’re taking care of patients that we’re not used to taking care of, and also taking the sheer amount in number. Like, I felt like there was a time when we were taking in patients in our unit, and I felt like we’re just putting them anywhere, you know, we would put them at the charge nurse desk, and that’s not where a baby belongs. And, you know, like, because we were just running out of space. So, yeah.
Mafine: What were like — what’s the difference between caring for, like, older babies versus?
Stephanie: They have different needs. You know, I’m not used to taking a taking care of a patient that has teeth. So, you know, like when they’re teething, you’re just like, Oh, my God, I don’t know what to do with this. Or we’re taking care of patients that’s up to a year old, and you’re like, this is not my normal patient population. This is, I mean, not that I don’t know how to take care of a baby, but it’s the fact that an older baby has different needs, like they have different nutritional needs, they have different vital sign changes, a newborn baby versus a six-month-old, and even from a six-month-old to a one-year-old. So pediatric ICU nurses have better care because they’ve been trained and taught and more immersed than that patient population versus my patient population, because I take care of preemies all the way up to six-months-old.
Mafine: Okay, so I remember earlier you said that, um, like dads weren’t like parents weren’t able to come in. You know, visitor policies and stuff changed. But did you notice like, um, parents or like families kind of adapting, or like changing? In their support system to be more like compatible with all of the new precautions that the hospitals taste like. Did you notice like, maybe more of an attachment to like hospital workers because they didn’t have access to their family members or anything like that?
Stephanie: I think so. Because, you know, like I said, most parents want to do the best for their babies, right? They want to do best for their children. So, because the only people that they could see would be a nurse, or, you know, anybody who works in the hospital, that, yeah, it would be, it’d be weird, like some of the people would get attached to an EVs work like an environmental worker, because they thought they get to see them every day, and they can’t see their mother, their grandparents, can’t come to the hospital and see them. And I also did see a like, a lot of reliance on technology in order for parents to feel together. So, we started using the interpreter iPads, so we started using them, not just for the interpreter — for the interpreter part of them, but the iPads would be in most of the kids rooms, so that they can see their family like, you know, they use a lot of face time. In that time, too, during COVID, we had developed this program where parents could see their baby via a camera that was always trained on the baby’s face. So even when they went home, they could just see their baby’s face, because a lot of times it’s the fear of the unknown. Yeah, I can’t see my baby. I don’t know what’s going on, but if we gave them access to the camera that just watched them doing, like, just watching their little sleeping face, that it made them, the parents, more less fearful of like, what’s not what’s going on and then we would have parents be like, Oh, the camera kind of slipped a little bit, Can you move into the face? And you’re like, oh, yeah, it’s not really trained on their face. So, there was, like, a lot more reliance on technology. We also realized that there was an uptick in times the parents would be calling and they want to be on the phone with their baby’s nurse, like, the entire time, you’re just like, this is not, this is not feasible. So, we there were, like, times when we’d have to, like, let parents know, like, Hey, these are the times when we’re doing our vital signs and doing, you know, because it’s every like, three hours that we have, minimally, have to change a baby’s diaper. So, you know, we can’t just, you know, let them be in a dirty diaper the entire day. So ,it’s like scripted times, like, 3pm, 6pm, 12pm that we’re doing vital signs and changing diapers and stuff. And so, a lot of times, like, the parents just want to be in the phone with you. So you’re just kind of like, Hey, we gotta, we actually do a part of our jobs. I know you want to talk to us, because we’re the only ones next to your baby and but yeah, it would be those things. And, like I said, like reliance on people who just are –
Mafine: Frequent.
Stephanie: Yeah, just frequent and stuff like that.
Mafine: Did you ever just get annoyed or just fed up at a certain point? Like, like, I get it, but, you know –
Stephanie: Yes, but you of course, you can’t say that. You know, like, I picked this patient population because, because 90% of the time it’s a happy thing, right? You know, like, and this is a, this is a time that supposed to be joyful for these families, but, yeah, like, the burnout, like, especially, like, after it had gone on for like, more than a year
Mafine: Yeah,
Stephanie: You just kind of like, I was just like, I would love to work from home, you know what I mean? Like, there was, like, just, we never stopped, like, you know how, like, the world shut down. And people going to school, you know, via zoom, and people got to do their to work from home and stuff like that. Healthcare workers couldn’t do that. We still had to trudge along. Yeah, we still had to do, you know, do home school, Zoom school with our kids. And we also still had to keep on going to work like we never stopped. And, you know, so that was the time that you get -started getting fed up, and then, and then, like, like, I said, like a baby being newly born, it’s supposed to be a joyful time. And then just people start getting angry — what do you mean? I can’t come to the hospital. Well, you had a temperature of like, two degrees higher than normal, no, you can’t come here. And then they’re like, then we got, like, families that are angry, well, I have a COVID test, or I can’t afford to go COVID tests, and I’m not doing COVID tests. I’m not going to get the vaccine. Well, you’re not going to be able to see your baby. So, it made a lot of people irate, yeah, you know. And like, I said, like, like, that time when the vaccines were come rolling out again, there was a bunch of people who are like, I’m not getting that. How do I know? And I get it? And we basically had to, like, force people. We were like, if you don’t get the vaccine, or if you, if you come up here with the temperature, we’re gonna have security escort you out, and it can either get physical, or you can come up here and abide by the rules. And that was the time when I started getting like, just being like, I just want this over with, and you can make this easier, or it can be harder. And like, I said that that entire time was – for the time when it was starting to get really politicized, and I think that that’s what got me, like, frustrated with the whole thing.
Mafine: I’m wondering if, like, the hospital ever did anything to, like, reduce burnout, because you’re saying, like, Y’all just we’re just trudging along. Y’all could never, was it just never –
Stephanie: Um, I think they did, but they were just kind of like, there was a there was a time when so many like organizations were trying to help out. There was like a time for like, a period of three months where Call Your Mother Deli was giving us breakfast sandwiches almost every day, like at least Monday through Friday was like bagel sandwiches every day. It was kind of cool. And pizza was like feeding the healthcare workers every day for Monday through Friday, the organization itself. You know, it would be like, kind of empty platitudes of like, “Oh, you guys, you know, thank you. Thank you for all you that you do, and blah, blah, blah, but it wasn’t really anything to – I don’t I actually, you know, like, sometimes, I mean, it’s not that I want to blame them, But I think that they just didn’t know what to do. They didn’t know what to do. I mean, other than, like, try to hire nurses, but then, like, the other thing is too, like, hiring what’s called traveler nurses is that they get hired at a high rate. They get paid at a higher rate than we do, than staff nurses do, because they’re basically coming in to help us. And I think that that was what kind of like pissed people off more, because you’re like, oh, you can’t even pay staff nurses better pay, but you can bring in these basically scab workers in here to work for much higher pay. But I think that their point of view is that these traveling nurses, we don’t have to pay their benefits, right? And I think that the staff nurses are like, Oh, you can pay us that. But I think that sometimes people lose sight of that, not that I’m on the side of management, but like I said, things become political during these times, and at my hospital, where we’re in the union, we’re in a nurse’s union, and what a lot of times, some people, they forget I’m like this. Well, you know, you do realize that the hospital also pays their benefits, pays into our retirement, and those traveling nurses, they don’t do that. Those nurses get paid higher because they have to put that into they have to pay their own benefits. They have to pay their own retirements back. So, it feels like we’re just taking on these people, but in technically, in reality, like, depending on how long you’ve been working for an organization, we get paid really well. I get paid pretty well. Would I like to get paid more? Yes.
Mafine: Who wouldn’t?
Stephanie: Who wouldn’t? Exactly. But I think that, I think that the organization tried, you know, and who doesn’t love babies and children, you know, like working for a children’s hospital, I think was the difference with between us at Children’s and like an adult hospital, like I felt like —
Mafine: Was a little bit more, like, peaceful in a way that you could just you could sink into the babies and escape?
Stephanie: Yes, and then everybody’s like, Oh my God, you know, thank you for all you do, all those babies and you know. And I just want to be like, Yeah, but you know, you should also treat those other nurses who work in adult health hospitals taking care of people, and the burnout could have been worse because I saw how other hospitals were – what was happening in other hospitals, and I was like, Oh, I would never want to work there. You know what I mean? I think it’s bad at Children’s, but oh, that’s even worse. So I think that that’s where I felt it. But, you know yeah.
Mafine: So, with like the pandemic being crazily politicized and a lot of like, vaccine skepticism and stuff like that. Like, did you notice any of that in the parents? Or would they like question certain procedures or certain things that you guys would do during the pandemic?
Stephanie: Yes. Um, so again, that’s all that’s also the thing about where we work, where we are. I think that this geographical location, DC, with being the seat of power, and it’s a highly political area, working in the city, working in the city, is pretty unique, also to our hospital and specifically my team like, because I go by ambulance and helicopter to go pick up babies from so many, like, so many places out outside of the region, so like, predominantly, like, lower socioeconomic areas, Let’s say like more in the country areas like Southern Maryland, Calvert County, southern Virginia, there’s, there is a mindset. There’s a mindset of, like, distrust of government, distrust of – distrust of people, like, of science and, like, I said, like, um, it was just interesting. Like, some of the Southern hospitals, like in Southern Virginia and Southern Maryland, they’re like, they’re not thinking — the thinking of like, oh, that doesn’t happen here. I was like, What do you mean? What do you mean that this is not COVID? Oh, you know, um, was interesting, because I’m just kind of like, What do you mean? We’re sitting here telling you that this is COVID, and you don’t want to believe that just because of – you think to this, that this is fake, this is not really COVID. And COVID in certain people, was different. There’s different symptoms. There’s varying wide levels of symptoms, and they’re like, oh, that only happens to diabetics. Oh, that only happens to brown people. It can’t happen to me, and that’s what we got into. So those people who who didn’t think it could happen to me, then they’re like, I’m not getting that vaccine. How do I know? And you know from from a long time ago, some certain vaccines people said cause autism in their children. So, they’re like, I’m not getting that. They’re gonna make my child autistic and but we didn’t know. And that’s where kind of, and like, I said, like, I would go to Washington Hospital Center or go to cities — hospitals that are more into in the city and it would be a different thought process, it’s like, everybody’s gonna get, everybody’s gonna get, I’m gonna vaccinate, vaccinate my dog. I’m gonna, you know, everybody’s gonna get the vaccine. This is, this is gonna work for us, and stuff like that. So there’s like, extreme political, like, polar opposites of, like, thought. Like, I could go to a hospital in Southern Maryland and then go to a hospital and closer to the city, and those people could be like, almost like, the same demographic, but the thought, the thought process is so different, yeah, which would be strange to me and I also thought that there was like the ones who denied it only sought to people that were like them, you know what I mean. And then there were just people who were just ignorant in general. So yeah.
Mafine: I think that this is a good segue. Um, so, okay I need to think of a question. Okay, you said that like there would be similar demographics of people, but with different thought. And I think that, you know, that kind of corresponds with the Black Lives Matter movement. So as, like a healthcare worker, were there, like, any connections between, like, the issues that the BLM Movement highlighted, and you know, the experience of the healthcare experiences of just what was happening in the hospital and like, the families and stuff. Like, were there any like, did you notice like, I don’t know if that’s a good question, but no, if you understand what I’m saying –
Stephanie: Did I see a correlation between the Black Lives Matter and the denials of COVID?
Mafine: Kind of like: What was happening at work in the hospital – did it really like correspond with a lot of the issues that the BLM movement was kind of bringing up?
Stephanie: Yes. I think so. I think in certain cases, I think that, and I think individual situations by itself didn’t seem like there was a difference, but when you collected all the situations, that’s when it started to — that’s when you started to string it together that you’re like, “oh yeah, that’s exactly why”. I think that COVID actually put more of a spotlight on how people of different demographics were taken care of. How it’s been — how they’re taken care of even prior to COVID. So also to growing up and living in PG County, that we’ve always been a historically — historically black County. It did — you did see how COVID was treated amongst black and Hispanic community versus Caucasian communities, and it only got more apparent when it comes to when it came to COVID. I definitely had experienced and had heard how different people were being treated so like and during COVID — PG, County also had one of the highest rates — of infection rates and also to have also those people not also getting the health care that they needed. A lot of people were told to stay home like, even if they were like, I can’t breathe, I can’t — you know, they were being told, “don’t come here, don’t come to the hospital”. Whereas in other counties they were like they were they were not telling them to stay home. They were telling them to, you know, get yourself taken care of. So, so I did — I did find that it just only made it more apparent how — and you know, this is, this is historical, too. You know, like the Black Lives Matter, just meant that, again, black and brown people were not being taken care of as they are in other counties, especially in other counties, like, if it was a comparison between PG County and Anne Arundel County, the amount of people getting, getting beds were more people of Caucasian, you know, black people were dying at a at a higher rate. And then they started saying, like, oh yeah, people with diabetes and heart –cardiovascular disease, yeah. But those are also, historically, um, communities that have a higher instance of diabetes and in cardiovascular problems because of education and the resources to take care of that if, if black people were given more resources to take care of their diabetes and given more education on how to take care of the diabetes and their cardiovascular — their hypertension problems, then maybe we wouldn’t have — it wouldn’t always be that the people who are more affected by it are black and brown people. If we took care of their health care needs even before, before they got sick, then we wouldn’t have a higher incidence of diabetes in this community, because they would, they would know what foods is, is, is bad for diabetics, or what, what foods are not good for, you know, if you have hypertension. Then those wouldn’t be such an inbred part of their society and their cultures. If we knew that you don’t have to have diabetes. There isn’t a difference between cultural, cultural lines that that mean that black people are higher incidence of diabetes. It’s not it’s actually not true. It’s because they don’t have the — they don’t have the education that’s told to them, like, Hey, don’t eat that much salt, don’t eat sugary things. But what are those? You know, you should eat more vegetables and everything else, and don’t put so much salt in it where you know, if you told them that, that you can probably not have diabetes in your family. You can combat that, you know, then you wouldn’t be getting sick. You know what I mean? So, I definitely do think that is a correlation between COVID and Black Lives Matter. But I also feel that this goes back 100 years. It goes back 100 years. It goes back 50 years, pre dating COVID. I think that the health care, the health care disparities, is because of generations of not taking care of people with low socioeconomic and or black and brown people. But it only put it to light. It just cast a huge spotlight on it and target on it. And that was some at some point, gonna come to a head, and it did, you know, I’m pretty much betting you that, like, 100 years ago, when they were comparing COVID to the Spanish flu, that probably the people that were dying — black and brown people are people who are super poor, yeah, and that’s what happens.
Mafine: I feel like it gives like a whole new meaning to Black Lives Matter. Because I think, like during that time, people were really talking about just police brutality, and I think like, the pandemic couldn’t have happened at like or the rise of the movement couldn’t have happened at a more perfect time, because it does highlight, like, all the health inequities and things like that. So my final question is, has your perspective as a nurse evolved or changed, like, particularly about like health equity or race, or even just like being a part of a community and taking care of your community like in what ways have you changed or evolved?
Stephanie: I definitely think it’s changed, because I feel having seen such, um, having seen how different it is — the treatment of, you know, like black and brown communities, prior, you know, prior to COVID, that it just like I said, like I feel that I can’t not not say anything. You know what I mean? I think that when — so, for example, when I find when things happen. Okay, so this is, like, kind of a personal story. It just like literally happened to me, like two weeks ago. This baby was born. He was 11 days old, so a newborn baby, um, born to Hispanic parents who don’t speak any English, um, had gone to an emergency room locally and they – the doctor who called to ask for us to pick up this baby, um — and mind you, it’s not just white, like, white physicians or white healthcare workers who are treating black and brown families badly. It’s almost, like, kind of inbred in certain people. So, this doctor who called our unit to ask for us to pick up this baby never really relayed accurately how sick this baby was, right? So, didn’t say it and when, when the doctor calls for the referral for us to come get the babies, I usually will call back and I want to talk to a nurse, because it’s usually the nurses who — the nurses who are taking care of the patient. I get a more accurate picture. I get a bit better, a more accurate story from the nurses, not the not necessarily from the doctors. And so, when I talked to the nurse, you know, I was expecting certain things for her to say, you know, based on, based on what the diagnosis was, right, the doctors make the diagnosis, the nurses just relay the information and stuff like that. So, when I was, when I was listening to the story, the nurse sounded on the phone like, um, sounded scared. There were certain words or certain things that she was relaying to me that I was like, “Oh, this kid is has got to be sicker than what the doctor said”. And then the nurse was trying really hard not to say, like, “I’m really scared”, right? But there were certain things that she was saying. There were certain vital signs she was relating to me that I was like, “Oh, this kid is really sick”, you know? But that’s just also based on years of me knowing what to hear and what to pick out, the information to pick out. And so, I made the decision to try to get there faster, that I was going to go by helicopter. Whatever happened, I was not able to go by helicopter, but we head out lights and sirens by ambulance to get there. And I did tell them. I said, please start out the helicopter, because I will need it to come back. So, when I get there, and like I said, like with the doctor being a doctor, from the way that I found this patient, by the way, I found this baby, this baby didn’t just start looking like that. What he said, it didn’t — it didn’t just happen in an hour. It didn’t just happen in two hours. It didn’t happen in six hours. This baby’s been suffering for a minute. And the thing is, with babies and in their bodies, what happens with them is that they will compensate and compensate and compensate until they can’t anymore. And it’s an immediate thing. But there are signs all along the way when they’re compensating that will tell you we don’t have much time, and because the doctor didn’t relay it to our doctor and didn’t call for a while, I already knew that we were way far behind the eight ball with this baby, but then also too, what the doctor was saying about the parents, “Well, we don’t. I mean, this baby was fine, was born at this and they say this, but, you know, they don’t speak any English”, and it was just very apparent by the time I actually set my eyes on this baby that the reason why this baby was ignored is because they didn’t think of these of this family as being: A. smart enough to know that there was something wrong with their baby. They brought their baby in saying, “Something’s wrong with our baby”. But you didn’t feel the need, because, based on what they look like, and for the fact that they didn’t speak English, that you needed to hurry up and do something now. They kind of like went so slow about it, right? So when I got there, this baby was what we call going impending code. This is like — this baby is — is going to do something where we’re so far down, being down that we might not get him back. So, when I got there, I had to do emergency things like emergency procedures to try to get him back. I knew his blood pressure was super low. I knew that his last little breaths, the ones that he’s taking on his own, are probably one of his lasts, that I would need to intubate him, put him on a ventilator, put a tube in his throat to help him breathe. I need to give him all this medication to preserve and conserve any little bit of energy that he has. And I’m probably going to have to give him medication that keeps his blood pressure up, to keep his oxygenation up, and to basically save him.
Mafine: Yeah.
Stephanie: Um, and he was just like, like that. So immediately, as I’m doing all these things, and they’re pretty automatic for me, but as I’m thinking about it, and also, too, when we got there, this man is so extremely misogynistic that, um, some of the procedures that I do, that I’ve been trained to do, are technically what doctors do, but I’ve been taught, in my role as a transport nurse to know how to do them, to give life saving measures, right? But everything that I do is also under the supervision of a doctor. Even though the doctor’s not with me this, it’s under the supervision because they know I’ve been trained to know how to do this. So anyway, when we got there, this doctor is so misogynistic that he’s telling me that he’s not going to let me do those life saving measures because he’s going to do it. And he said he just wanted my supplies and my medications. The problem with that is also too that I’m in charge. If something happens to those medications that you’re giving, I’m responsible for them. I’m not going to let you use them. I’m not going to let you use them. I’m not going to let you use my supplies, because I don’t know that you know how to use them. That’s besides the point. But it just goes to the whole sense of you didn’t want to do anything for this baby because you already took the stance that they don’t really know what they’re talking about. These parents are too stupid. You made it feel like you made them feel like they didn’t know what they were doing, and you also didn’t provide the care in a timely fashion to preserve the little bits of this what this infant needs. And I definitely think that if you want to take it back to when the time that patient rolled into your emergency room, that there’s just a whole line of events that you’ve neglected this family for whatever bias you have. And that’s not the first time that’s happened to me. That’s not the first time I’ve happened to come upon a patient that’s been neglected, and almost always it’s black or brown patients. So, how that’s changed for me is that I’m not afraid anymore to say it out loud. So, I did what I needed to do for the baby. In my heart of hearts, I didn’t think that that patient was going to pass, but from the time I took started caring for that patient, started doing all those emergency procedures, from the time I’d started, it was like at four o’clock in the morning, he was gone. He had died by 9:30. So, in the five hours I had known him, I had done so many things, and they tried to keep him, you know, they tried to bring his blood pressure up, they tried to keep his oxygenation up. But by the time I got back to the hospital, I thought he was gonna be okay, but he didn’t. And I firmly believe, like I said in my heart of hearts, is that people ignoring this family and not taking it seriously. You know, dragging their feet in taking care of him and knowing whether they should have done more for him is what caused his demise. But, I definitely think that it started with the fact that these — that they looked at them and didn’t think that they were serious. They looked at this family and didn’t think they were serious. So, I think that in my practice now, it has changed that I have no problem calling it out. I have no problem saying that this baby was neglected, whatever reason. I think he’s neglected. I think it has nothing to do with the fact that this family didn’t know what they were doing. I think it definitely is that they looked at them and said, “Oh”, you know they didn’t care enough, because if you gave just one more ounce of caring, this patient wouldn’t be dead. So, I definitely think that that’s what’s changed for me and then, and just like, also to, like, some of my co-workers, like, I’ve, I’ve had to tell them, like, Listen, don’t treat them this way because, because you have some sort of bias against them. Yeah, you know, don’t look at them like that. Look at this patient as if this is your child, this is your niece, nephew, grandchild, you know what I mean? Take treat them like you’re they’re your family, because then you would know that this isn’t right. So, and that has been something that has definitely changed over time. I think that and has kind of sped up for me during these last five years.
Mafine: Yeah.
Stephanie: So, I think that, uh, yeah, that’s how it’s changed for me.
Mafine: It’s good that, you know, you’ve evolved in that way, and I hope that many more healthcare workers evolve in similar ways.
Stephanie: Thank you.
Mafine: And thank you so much.
Stephanie: Of course, no problem.
Recent Comments