For me, it doesn’t really feel real that it is Christmas time. My body is still quite full of anxiety over the state of our government, the state of public health, my children’s mental and social health, the questions that remain unanswered about the near and distant future. I feel fortunate to have built in avenues of reliable and supported information, the ability to have stable housing and income, a spouse who always works from home, and lots of technology and knowledge to help my kids through distance learning; just to name of few things I am thankful for. I still live with an endemic level of anxiety and concern for our world.
The weight of this year has been hitting me a little harder in the last few weeks, probably as things have slowed down a bit for me.
My experience on the front line:
I set out two biohazard bags and two clean gloves. Then I tied on a scrub cap. Next I removed a clean disposable gown which I placed over my head, threaded my thumbs through and tied around my waist. Then a pair of clean gloves that slip over the gown at my wrists. I removed my regular surgical mask that I wear all day, and placed my plastic disposable container, with my N95 mask suspended in it, over my mouth and nose. I pull the lower strap up over the container and then my head down to my neck, then the second strap. I cover the container and set it aside. I pinch the metal strap over my nose and breath in and out deeply and slowly, testing the seal. I place my goggles that I wear in every room on next. I test the seal again. I adjust the metal strip when my goggles fog a little. Test a few more times until I am satisfied that the fit is right and the seal is solid. Finally I place the strap of my plastic face shield over my head.
This process has already taken me nearly ten minutes. I’m thinking through every step carefully. I don’t want to screw this up. One error at this moment brings this thing home. It puts my family at risk. I’m not thinking about myself in this moment, I am totally thinking about my kids.
I am hot as I walk into the room. The family on the other side of the door is pleasant. They look tired, like all the moms and dads I see. She has a mask sitting just below her nose covering her mouth and chin. Her baby is swaddled and laying on her lap in the bed. His mask covers most of his face. A bushy beard breaks around the edges on the sides and bottom.
I wonder what they think of me as I introduce myself and explain my business in their room. What would I think if someone walked into my room looking as I do now? They are happy to have me there, they have a lot of questions. The baby is completely asleep. I’m relieved in one sense, I will not have to spend a prolonged period of time within six inches of this mother’s face, but I might have to don everything again and come back. My mind sighs. I start describing the expected feeding behaviors of their baby, and the mom interrupts me to share that her baby is special and already exceeding all of these expectations. Of course she is. I spend about 45 minutes talking and answering questions. My face is sweaty. The shield, or maybe the goggles, or both, are starting to fog up.. my mind focuses on that for a second and I think it’s time for me to get out.
As I finally exit the room, I can’t seem to pull hard enough to break the tie of the gown. I curse in my head as I struggle to pull in the right place. I take a breath and slow down, careful to wrap the gown into itself so as not to shake around any droplets. I get one hand out, then with some effort, the other. I mindfully place the ball gently in the waste bin at the door. As I exit, I hit the sanitizer bottle squirting a huge glop into my hands. It takes a bit for the sanitizer to dry enough that I can put on the clean gloves I had laid out before I went in. As it dried, I thought about the order of doffing what was left. Once my gloves were on, I grabbed a new cavie wipe from the bottle and carefully remove the face shield so as not to touch the mask or my cap. I clean the shield and place it in my paper bag. Next I do the same with my goggles. Then I uncover my plastic Glad-wear. I place it over my face. I reach back for the lower strap and bring it up over my head and around the entire container. Then I repeat with the second strap. I place the cover on and press it tightly to seal. Months ago I drilled three holes into the container for ventilation to allow anything in it to dry. I’m grateful today that I prepared this so long ago. Finally I remove my cap with one hand, while holding the bio bag in the other. I am careful to try not to touch the sides or the edges. I compress the bag a little to let out some air and seal it as well as I can with one hand. I take off the gloves, sanitize and put on clean gloves again. This time I open the second bio bag and invert it, pulling it right side out with the other bag cleverly contained with in. I seal it, doff gloves, and sanitize again.
Its been about 90 minutes since I started, but I think I did a good job. I grab a new surgical mask that I will wear the rest of the day. I store my PPE and place the bio hazard bags in my bag to take home to wash. Disposable hats (bouffon caps) are on low supply so the hospital doesn’t recommend using them for routine care of COVID positive patient.
I sent Jon a text to have my house robe waiting for me when I get home. Its our code for “I’m somehow interacting with someone who is or is suspected of being COVID positive”. He places my house robe in the laundry room that connects our garage to the house. When I pull in the garage, he opens the door. I step in and use the heal of my shoe to close the door. He opens the washer. I give him my phone, lunch box, drinking cup which he will wash right away. I strip down and everything goes in the washer, including the scrub cap that I remove carefully from the bags, avoiding touching the contaminated insides. I put on the robe and make my way to the shower. I scrub and douse in soap and water. My robe and towels go into the washer next, and everything is washed immediately on sanitize. I leave my shoes there for several days when possible.
I don’t get to know if these measures are enough to keep us safe, but the routine is the best chance we have to keep COVID at work. I want so desperately to protect my family, that I take the time to think through it, to plan my moves with intention. This patient experienced only mild symptoms, but many on our unit have been quite ill. A few are lucky to have made it. COVID is devastating to pregnant women. Most of them who have been so ill, also delivered prematurely. This has turned out to be somewhat protective for me as a lactation consultant. When they deliver prematurely, I don’t end up needing to spend time at their bedside, I can provide education on the phone and through bedside staff. Still, it’s heartbreaking to watch this play out on the sidelines. I am grateful for the vaccine that is now being administered to the most at risk of our ranks. I don’t know when my number will come up, nor when my family will be able to receive it. I don’t love that it had to be rushed, nor that long term effects can’t be studied. I don’t love having to be one of the first to get it, but I will get it, and I will take these unknowns. Because the alternative is to let this virus continue to ravage the world. When healthy people get vaccinated, it protects the most vulnerable among us.
May 2021 bring us all peace and humility once again.
