Reflections from South Africa

I feel depressed, oppressed, exhausted and with a questionable state of mind; these are ways of describing what I have become during this pandemic. I won’t lie and say I have not thought about quitting. I won’t say I have passion and love for this job at this moment. I won’t say I don’t regret enrolling for a nursing course. I will say this about COVID-19, Corona virus, is driving me crazy.

Nursing is for the strong and when I say strong, I mean emotional, mental and of course physical strength. I mean I wake up every morning to find someone dead. I work in intensive care and death is something you can’t avoid. I have seen people die; I have seen people who are ready to be discharged die; I have declared people dead. Does this mean I am immune to the emotions I feel every time I wrap up a dead baby? Does this mean I am used to it? I won’t say yes but all that it means is that I can tolerate it better.

This global enemy we are battling with has taken our freedom, our family members, acquaintances and most important our sanity. I go to work every morning knowing that there is a possibility I might be a vector of this monstrous virus. I know there is a possibility that one of my colleagues might be sick, that I might lose a friend.

Comfort is non- existent when I’m at work. Wearing the PPE throughout the day is probably the most difficult thing to do at work, 12 hours of discomfort is not a joke.
I watch as people around me test positive, I watch as they get sick, it makes me question my career choice. My career is tough and now that there is an obstacle, I feel as though a piece of me is taken away, I feel as though I am losing myself in the midst of this pandemic.
Nursing is a calling, it’s a sacrifice and it’s a curse in disguise.

My experience of COVID-19 in the Paediatric Intensive Care Unit (PICU) was that the disease spread was like wildfire. What posed an even bigger challenge is that we were about to engage in warfare with an invisible enemy. The epidemiology was unknown and very much under rigorous studies from the patterns and trends that were observed from China and other countries that were hit by the Virus first.

When COVID-19 entered the South African shores, we were assured that we were ready, and all systems are in place to combat the spread. The readiness came to test immediately into the second month when the scale and the speed of COVID-19 spread rose to high numbers. There was a sudden shortage of PPE and surgical masks. This brought fear and uncertainty. Our nurse’s pledge of service was put to the test, one needed to take a division; to continue to serve without proper protection and stand a risk to contract the disease or quit. In the midst of conflict, we heard reports that our colleagues died in other hospitals. Some of our staff members lost their loved ones at home. The reality hit home because their pain became our pain.

Our PICU got an outbreak of COVID-19. Suddenly 5 members tested positive. This meant that the unit was going to be depleted with a further 6 members of staff who were direct contacts and needed to be quarantined at home for 7 days. During the outbreak, the unit saw a great level of teamwork and dedication. At night, the staff operated with skeleton human resources and really performed beyond expectation amid the fear and uncertainty.
I was in the group that tested positive. In isolation, 14 days felt like 10 years. Not knowing how the virus will spread in the body was nerve-racking along with looking at the news, seeing the death rates rising and at the same time not being 100% sure what was going to happen in the end. When I checked my kids at home, they told me they were all okay. There was nobody to talk to. One relied on video calls to chat with relatives and colleagues at work. We prayed tirelessly, drank lemon juice and ate oranges like they were coming out of fashion.

The COVID-19 outbreak in the unit brought solidarity. The colleagues that remain in the ward took care of us in isolation in many ways; they called to encourage us and to make sure that whatever we needed, was provided for. Even in their exhaustion from being overworked, they encouraged one another to soldier on.

The communication was good relating to the notification of the positive results and what needed to be done. After isolation started, there was no more communication from Human Resource, Infection control or Health and Safety departments. We needed a working committee/ team to constantly check if we were okay in isolation. The team that really looked after us were our Unit manager and colleagues in the PICU. As much as we have acquired ample knowledge about COVID-19, there is still a lot to be learnt about the disease. With all the positive statistics especially relating to recoveries, it becomes easier to look after the patients with COVID-19 provided the correct PPE is provided.

In the first instance, I was afraid of being contaminated by COVID-19 but once I started nursing a patient who was COVID-19 positive it came to my mind that I should comply with all the necessary guidance, for me to remain negative and continue to take care of the patient. At this stage, the patient relies on the nurse because this is the only person the patient can see especially when patient is in isolation with no visits from relatives.
The second reason I chose to comply with all the guidance was to protect my family from not being contaminated especially when I know that I have a diabetic husband. It was a big dilemma because I cannot choose my family and abandon my patient. So, as a nurse you just need to adjust, you cannot choose one and sacrifice the other. It was a very big responsibility.

Another experience I had was my patient was young and did not present any symptoms of COVID-19. The patient was asymptomatic but kept in intensive care because of her cardiac condition. The patient condition never deteriorated for us to use all the devices like ventilation, high flow or nasal cannula oxygen therapy. As a team, we were ready for any changes in condition of the patient.

My experience during COVID-19 as an overwhelming and heart-breaking experience, especially losing one of our colleagues was traumatizing.

The experience I had related to having COVID-19. I started with painful shoulders and I thought it may be might be stress or the medication I was taking for hypertension was not effective. After a week or 2, I started coughing, I had no appetite and I did not know what was happening to me. I thought it was minor flu.

As I was working night duty, I went to the kitchen to grab something to eat. It was 2400 hours. We were busy at work and it was difficult for me as I could not eat. I started feeling dizzy and then I went to casualty to consult the medical and nursing staff. I told the nurse that I had loss of appetite and painful shoulders. The nurse told me I must be isolated. Then they phoned the laboratory sister for me to get a swab for COVID-19. I was asked who I stay with, and was told that I must be isolated, asked whether I wanted to quarantine at home, or I should be taken to where nurses quarantine. I told the sister at casualty, I would rather isolate at home. They told me since they took my details, that I would get the result the same day.

I phoned my sister to fetch my kids before I got home. I drove home after consulting the staff, still waiting for results. I quarantined alone at home the same day I tested. I got the results around 7pm and I had tested positive for COVID-19. I did not know what to do and I informed my family the following day. My mother bought medication for me from the doctor.

It was a difficult moment. I did not know what to do. I have been alone and depressed, but I had to be strong for my kids since I am the only breadwinner. I was always tired; I did not have energy. I was also having diarrhoea and coughing. I managed my COVID-19 experience by quarantining and taking medication, exercise and steaming with mint oil. I also drank lemon water and honey ginger. I ate warm food and took warm fluids. Afterwards, I developed ulcers. At times, both my ears became blocked, but I have overcome that now. The fear I had was to leave my kids. I would wake up at night and pray since I knew how dangerous COVID-19 was. The whole country was affected but I thank God I survived. As a nurse it was not safe at all.

I have always loved being a neonatal nurse. It made me feel special because I look after “ANGELS”. The risk of COVID-19 infection from babies is said to be less but we still have to interact with parents who come from home to visit and breast feed their babies. Now that is where the panic set in, because some of the parents would test positive to COVID-19 after interacting with them – making nurses contacts.

Some of my colleagues tested positive and had to quarantine for 14 days leading to staff shortage. Much as I love my job, I kept asking myself why I chose a job that put my life at risk. I live alone and made sure that I didn’t visit my elderly mom; my kids were also not allowed to visit me. My only consolation was coming to work so that I had people who were in my shoes to talk to. There was so much uncertainty about tomorrow.
Some of the nurses were admitted to intensive care and were not doing well. I prayed daily that we did not lose any of them to COVID-19 as this was going to be more devastating- by God’s grace they all survived. I lived in fear, depression gradually sinking in. Watching the world statistics on COVID-19 deaths made it even more scary. I thank God that I did not lose any of my close family members to COVID-19 – though I lost a friend and couldn’t even attend her funeral. The impact of COVID-19 has been devastating and I feel I still have after effects of COVID-19 and require counselling.

My experience during the COVID-19 period as a nurse working in a specialized unit with newborn babies was not too scary, because I don’t believe I can get it from those babies due to their low immature immune system.
I was more worried about life outside the hospital. I was cautious of my environment and the strict limitation to my social life. I was mindful of the need for 100% hygiene standards and my health in general to make sure I did not transport this virus to the babies in neonatal care and to my family. Ways of life really changed but it’s worth it, to stay alive and healthy.
Most of our pregnant mothers were screened before delivery and those not screened were isolated. If they needed to come to neonatal unit, they could not do so until their baby’s test swab was negative; that was the routine along with the PPE worn during the nursing care.

When this pandemic started in our country as an intensive care nurse, I was very stressed, devastated and scared that I was at risk of getting the virus; I am on the frontline as an essential worker. At the same time, also thinking of the poor neonates as their immune is compromised. I also thought how, if it affects me, I might die, as much as I might protect myself and adhere to the rules of COVID-19.
I still felt that I was not safe enough. As it went, I always read about it and started to understand it more and made sure that I got all the information that I needed to stay safe. The only thing to do during these times was to adhere to the following rules:

  1. Washing hands as often as I can.
  2. Always have my mask on.
  3. As a nurse, always wear PPE.
  4. Always practice social distancing.
  5. Sanitise equipment as required to be safe from the virus.

    As this pandemic hit us, I thought that it was the end of the world, I was scared for my family especially my child and my mom. So, I was praying so hard for God to protect me and my family and everyone out there on the frontline.