Friday, May 1, 2020

Raymond Nurse Anesthetist and Windham RN share experiences on the COVID-19 front line

Melinda Zimmer-Rankin at work in the
ICU at New York Presbyterian Hospital
By Lorraine Glowczak

Although no one gets to escape the challenges we face these days - nurses, doctors, and other health care employees are experiencing a new level of stress, tension and exhaustion as they care for COVID-19 patients.

Raymond Nurse Anesthetist Melinda Zimmer-Rankin is currently working at New York–Presbyterian Hospital in New York City and Windham Registered Nurse Deb Akerley works in the ICU COVID-19 unit at Maine Medical Center in Portland. Both medical professionals took time out of their 12-hour workdays to share their stories because they believe what they have to say will help provide education on the seriousness of the coronavirus that puts our lives and businesses at a stand-still – and permanently ends life for many others.

Akerley has worked as a Registered Nurse for nine years, beginning her career as a Certified Nurses Aid for three years. Both positions, a total of 12 years, were at Maine Med’s Intensive Care Unit. 

Although she states she is good, for the most part, at compartmentalizing the emotional toll that goes with being an ICU Nurse, she admits these last two months have challenged her usual level of energy. “I have realized that by the third 12-hour day, I need a break,” she said. good news is the number of COVID-19 patients at Maine Med have remained lower than what the facility and medical staff have prepared for. However, every life is important, and one COVID-19 death is one too many. “By the time people reach the ICU, they are in a very serious condition and must be put on breathing machines,” Akerley explained. “They are usually intubated for two to three weeks and from there, they move onto intermediate care, often requiring various forms of physical, respiratory and occupational therapy – for quite some time.”

Akerley explained that the COVID-19 virus has been a revolving door of learning experiences. “When we discovered that the virus attacked the respiratory system, it wasn’t long until we then discovered it was also compromising other organs and it’s possible that people will eventually develop blood clots due to their lack of mobility from lying in bed so long (despite working with Physical and Occupational Therapists and being turned in bed every two hours)”.

Most of the individuals who are under Akerley’s care have deficient immune systems. Although there are a few young patients who are currently struggling in the ICU, most are over 60 years of age. And, unfortunately, Akeley has witnessed those who have lost their battle against COVID-19.

Deb Akerley at home on one of her days off. She
stated that she feels lucky to have co-workers
who feel like family.
To maintain a sense of calm in such circumstances, Akerley has a support system among her team members. “I am fortunate that my co-workers and I have worked with each other for quite some time and they have become a family to me. We are there for each other – we vent, we cry, we laugh, we eat all the wonderful food donated to the hospital by area restaurants – and we even check in with each other when we aren’t working.”

But perhaps one of the greatest challenges Akerley faces is not while she is working at the hospital. “I haven’t hugged my parents or have had dinner with them, for over two months.” Her father is 84 and her mother is 76.

When asked her perspective of the current COVID-19 situation and prevention, she hopes that people do not stop social distancing. “I hope people do not think that everything is fine. It is far from it and we need to take this virus seriously.”

She does feel fortunate that we live in a state that is not too populated and most likely will not see a peak in aggressive cases if people continue to social distance.

The very populated New York City, on the other hand, has seen more aggressive cases than one could have ever imaged. “Over 12,900 people have died in New York City as of April 28th and over 160,000 confirmed cases. This does not include those who have not been confirmed due to limited testing. “stated Zimmer-Rankin.

The good news is the numbers and admissions are slowly receding but it’s still overwhelming and there are still very sick people who are trying to survive. “There are still 100s, and 100s and 100s and 100s of people surviving on ventilators in New York,” she said. “It still feels like I am in a war-zone”.

Zimmer-Rankin who works full-time in the operating room at York Hospital in Maine, recently took a leave of absence without pay. Since elective and non-essential surgeries are being temporarily discontinued due fear of COVID-19, and work was not available at the hospital - she felt compelled to continue working. “I could have stayed at home and got paid but I am aware of what the financial backlash for the hospital will be once this is over, so I began looking to see where I could be best utilized in New York City.” applied for a nursing position at a traveling nurse organization and was hired immediately, along with 70 other nurses from around the U.S., at Winthrop University Hospital on Long Island, NY. “I would have loved to stay at home but since I already have a studio apartment in New York, I just believed it was something I was called and should do.” Long Island was considered the “hot spot” for COVID-19.

Her beginning experiences on the coronavirus frontline were difficult and taxing, to say the least. The first three days were spent in virtual training. Training, she said, that was inadequate and did not prepare the nurses for beside orientation such as computer access and where needed medical items were stored within the hospital.  

“My assignment was in the COVID positive unit,” Zimmer-Rankin began. “I oversaw 16 patients that were in a conference room converted in an intensive care unit. All patients were intubated and in serious condition. One of my first patients, a man in his early 40s, was the first person I checked in on. I checked all his vitals and they were fine - and he was following commands appropriately. Within an hour, I was doing CPR. He passed away a half hour after that.”

In addition to the stress associated with losing a patient 1 and ½ hours after starting her first shift, other challenges included not being about to sit down during her 12 hour shift, having only a few minutes for lunch and rarely having time for restroom breaks. “What the h… was I thinking,” she wrote on her personal Facebook page three days after her assignment.

Feeling she needed more of a supportive environment, she accepted another job offer from the same organization – this time as a Nurse Practitioner at New York–Presbyterian Hospital. This hospital was closer to her studio apartment, requiring less travel time.

Although still stressful and traumatic for all medical staff, Zimmer-Rankin states that she received more adequate training at the well-known research hospital and now works with the same medical team, often caring for the same patients for three days in a row, all of which makes the job less nerve-wracking. Additionally, the tasks now required of her are much more manageable. “My responsibilities are to assess the patients, look to see if there's been changes within the last 24 hours, manage the vents, the drips, put orders in for everything and make consultations.”

But even in the midst of this harrowing crisis, Zimmer-Rankin has experienced some charming moments within the past six weeks. She recalls the day not long after she began working at New York Presbyterian, she decided to walk home from work. “Rite-Aid had placed flowers outside their doors, and they were free to anyone who needed something to lift them up. I chose the most beautiful orchid because orchid flowers tend to keep their bloom for a long time,” she said. That orchid now sits on her kitchen counter in NYC to remind her that beauty still exists in the world.

Zimmer-Rankin also has her very own, dedicated NYC Uber driver to take her to work in the mornings. “I could easily walk to work, but I like to arrive early – at least by 6 a.m., to study my patients and go over all the charts before my shift begins,” she explained. “My Uber driver speaks little English, but we manage to communicate. He told me that he needs gloves and facemasks to give to his passengers who climb in for a ride and do not wear any protective gear.”

She continued, “He has a young family and wants to keep them safe – while at the same time, making the money they desperately need. We’ve made an arrangement that if he picks me up at the same time every day, I will reach out to my friends who make masks and provide him with those. Only once he was late, and that was because he was wiping down his vehicle from the last drop off. It’s been a perfect passenger/Uber Driver relationship. Last week, I was able to give him six homemade masks. 

So, he only charges me $10 rather than the normal $30 ride that only takes about five minutes.”
And then, of course, there is the food. “There is plenty of food being donated from fabulous restaurants to hospital staff so, needless to say, I'm eating well.”

Although Zimmer-Rankin is still compelled to help others, she admits she is not a savior. “My expectations are that I'm not going to save everyone, but I’m here to provide care in the best compassionate way I am capable. That’s all I can do.”

As for her perception on social distancing measures, she encourages people to self-isolate as much as possible. “Continue to wear a mask and avoid public places where there are large crowds,” she said. “If and when things do open up, continue to use caution and wear a mask – especially for those who have autoimmune disorders, diabetes, asthma, COPD or any other chronic health conditions.  I also encourage people to listen to the advice of Dr. Shah of the Maine CDC.”

Thank you, Melinda Zimmer-Rankin and Deb Akerley, for taking the time to share your experiences, stories and thoughts with our readers.

This article is dedicated to all medical staff and other essential employees, who risk their own lives, to care for the lives of others.

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