Nurses' Stories Pathways to Nursing Caregiving in a Crisis

1 THE OREGONIAN SUNDAY, MAY 17, 2020

Year of the Nurse

Advance Local illustration, Andrea Levy INSIDE Caregiving in a crisis Pathways to nursing Nurses’ stories

In this pandemic, nurses are balancing a commitment Nursing careers are projected to increase 12% in the Caregivers share their most inspiring, heartbreaking to care with a lack of protective gear and fears about the next 10 years. Multiple approaches aim to address the and unforgettable moments of joy, sorrow, loss and safety of themselves and their loved ones. Page 2 shortage of nurses in the immediate future. Page 6 redemption from the front lines of health care. Page 10 2 SUNDAY, MAY 17, 2020 THE OREGONIAN Year of the Nurse

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Our nurses are at the heart of all we do.

Providence nurses are extraordinary even during ordinary times. In these challenging days, they have soared.

With grateful hearts, we honor our nurses for their dedication, their excellence and their kind compassion in supporting patients and families, and for saving lives.

We celebrate them every day, as they serve and support our 164-year Mission of care.

During these past weeks, our nurses and all of our caregivers have also been blessed by support from our communities. From donated PPE and meals to simple chalked messages on sidewalks, your kindness has lifted us up.

To all our nurses, we are immensely grateful. Thank you.

Providence.org/oregon #ProvidenceHeroes

O9586134-01 4 SUNDAY, MAY 17, 2020 THE OREGONIAN

Nurses: A calling to save lives

FROM PAGE 2 dent nurses, since most experienced nurses Our Nurses were away at war. The nurses were mostly “I never thought I’d be fighting for my life single as well because a student had to leave are True Heroes at my job,” said 57-year-old Sheryl Mount, nursing school or a hospital job when she got who volunteered to return to the intensive married, Keeling said. care unit because she knew she’d be assigned That meant they were treating contagious there once the wave of COVID-19 cases hit diseases unburdened by any fear of infect- at Bonaventure her South Jersey community. “Everyone is ing their own children, unlike today’s nurses scared to death.” grappling with COVID-19. Nor did those ear- By mid-April, more than 9,000 health lier nurses have to deal with home-schooling Senior Living care workers had contracted COVID-19, their children after their shifts ended. according to a report by the U.S. Centers for But that’s Jessica Collum’s schedule. Disease Control and Prevention. The aver- She works three overnight shifts a week in age age of those testing positive for the virus the emergency department of Ocean Med- was 42; the bulk of the 27 reported deaths ical Center along the New Jersey coastline, occurred among workers older than 65. returning home at dawn. “I’ve never been so scared to be a nurse — When she gets home from her shift, she and so proud to be a nurse,” Mount said. strips off her uniform in her garage, steps Every day, when you wake up, you Adding to the stress are shifting COVID carefully along a series of bathmats placed do it with the sole purpose of being treatment protocols that mean nurses can’t in a connecting hallway, then jumps into the practice their profession the way they always shower. She washes her blonde hair so rigor- there for our seniors. did, or even the way they were trained. They ously she jokes she now looks like “that guy have to limit their interactions with their from Van Halen.” Being a nurse is a rewarding experience at patients, and some safety protocols have Normally she’d see her three boys off to abruptly changed. They have always dis- school and her husband off to his construc- Bonaventure Senior Living. Our nurses are the carded surgical masks after leaving each tion job, then get five or six hours of sleep. central pulse of our communities, keeping our patient’s room; now they’re being told to Schools are closed, however, so she spends wear the same one all day. big parts of her day overseeing online les- residents safe, healthy, and happy. Being a part of Jennifer Tinn, an ICU nurse at Rob- sons for her 7-year-old while keeping her ert Wood Johnson University Hospital in 4-year-old twins occupied. She survives on our team will help you grow your profession and Somerset, New Jersey, describes herself as brief catnaps. dedication in ways you never thought possible. a “Type A” who would normally pop into a She takes only a reference book on medi- patient’s room as often as she could, even if cation and a pen and scissors with her into Nurses in senior living communities are true heroes. just to straighten out the sheets. the hospital, leaving her coat in the car. Now, she has been told to “bundle” her She’s wary of sharing keyboards and desk tasks so she completes them all in a single phones with her co-workers. Wearing a mask You are a nurse, the heartbeat visit. Patient IV poles have been outfitted and gown for her 12-hour shift often causes of care, and you are our hero. with extra-long tubes so they can be rolled her to overheat. She frets, unable to decide into the hall and adjusted there. if she’s just too hot or actually developing a She sits on the safe side of a glass parti- fever. The possibility she might be coming tion, monitoring her intubated and eerily down with COVID-19 herself has triggered silent patients but unable to soothe them. panic attacks, she said. On one recent day, On many of her 12-hour shifts, she’ll arrange five nurses went home with fevers. a FaceTime call to relatives so they can Simmons, of Oregon, strips in the garage glimpse their sedated loved one or watch the as well, then makes sure to sanitize anything chaplain praying over them. she has touched, including her car keys and “You can’t reach out to touch their hand. cellphone. She doesn’t even remove her con- You can’t talk to them,” says Mount, the vet- tacts until after she’s showered. eran South Jersey nurse. “They can’t really While nurses are going to extraordinary see your face or your expression. You can’t lengths to prevent exposing their families to stay in their room for very long. It tears away the virus, the looming danger is evident not at your insides.” only to them, but to their loved ones. That kind of nursing takes its toll. “I constantly hear, ‘This is not what I Tinn, 27, said she drives to each shift con- signed up to do,’ ” said Mount, the veteran sumed by dread that never lifts. nurse of nearly 40 years. “Husbands are “There’s just this emotional aura, or vibe, pushing back: ‘This is not what our family that is just emotionally heavy. I don’t usually needs. You’re being exposed to something go to work feeling anxious or feeling worried. that could kill us all.’ ” But this is a type of anxiety I’ve never had, Planning for and around that fear is on the because I don’t know what the day is going to To Do list of MaryPat Carhart, vice president bring for these patients, who are so, so sick,” of clinical services for a Syracuse-based com- she said. pany that operates 13 skilled nursing facilities Just as COVID-19 patients appear to be in upstate New York. improving, the virus can throw a sucker Since February, she’s kept a little note- punch that causes their vital signs to plunge. book on her bedside table to jot down issues The medical term is “decompensating.” The that need addressing, no matter what time of hospital lingo is “crumping.” night they occur to her. “I’m sleeping late, which isn’t like me. I The current pandemic reminds her of her think it’s just emotionally exhausting,” she early years in nursing, when treating AIDS said. “I go home and all I think about are patients was fraught with concerns about If you love working with seniors and would my patients. I think about them even in my the unknown. dreams.” “It’s just human nature. People are going like to join an awesome and supportive “You cry, then you get better, then you go to be afraid. They’re going to be paralyzed,” back to work, then out of nowhere you cry she said. “But that’s my goal: to eliminate team, call or go online to apply: again,” said Simmons. the paralysis.” Nurses have a long, proud history of com- “They’ve chosen this, and this is their call- bating contagious disease, whether polio, ing,” she said of her nurses. “But their biggest AIDS, or the 1918 Spanish flu, said Arlene fear is taking it home to their families. So we (503) 566-5715 Keeling of the University of Virginia School have to make sure that if we get COVID in one of Nursing and editor of the Nursing His- of our facilities, they’ll be OK.” BonaventureSenior.com/careers tory Review. In both the AIDS and polio epi- That means rigorous safeguards, plenty demics, nurses worked before effective treat- of safety equipment, back-up plans for the ments were available and while the means back-up plans, and training, training, train- of transmission were still unclear, she said. ing. “This is what we do in health care — but Traveling nurses often took care of polio really on steroids,” she said. “But this is what patients on the assumption they’d already we do.” Senior Living acquired immunity. “I’m not sure they knew exactly how it Kathleen O’Brien is a freelance writer in ™ Discover Retirement Perfected was transmitted either, so maybe they didn’t northern New Jersey and a former columnist know what to be afraid of,” she said. and health care reporter for The Star-Ledger Retirement • Assisted Living • Memory Care During the 1918-19 Spanish flu pandemic, and nj.com. She can be reached at

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O9565876-01 6 SUNDAY, MAY 17, 2020 THE OREGONIAN Year of the Nurse Paths to nursing Multiple approaches address the shortage of nurses in the immediate future and beyond Lee Ann Moyer Special to Advance Local

As the coronavirus spotlights nurses and Employment Faculty shortages are a primary factor, to be vigilant about credit carryover between other health care workers, a new generation projections for due to the average age of faculty holding doc- institutions, but they often can offer more is deciding whether to enter the field. With registered nurses toral degrees (it takes many years of clinical cost-effective access to advanced degrees. several pathways to becoming an RN and expertise and education to gain the expe- Grants, scholarships and loan forgive- multiple opportunities for advancement rience to teach others), anticipated retire- ness programs can also help practicing RNs within the profession, nursing has been ments over the next decade, and lower com- advance their education, especially if they an attractive job choice for those hoping to pensation for nurse educators in comparison are interested in working with underserved launch a new or (often) second career. with their clinical counterparts. In 2017, the communities or in primary care. One question is how the pandemic might average nurse practitioner earned $106,000, Nancy Casey is a nurse practitioner who change that. Another is how rapidly the versus $78,575 for the average assistant pro- has tried out a variety of settings in her profession can evolve to provide wider, fessor of nursing. 22-year career. “Nursing is the only profes- smoother pathways to career advancement, In 2018, the AACN reported a 3.7% enroll- sion that I know of where you can take it so and who will want to take advantage of ment increase in entry-level baccalaureate many directions,” said Casey, who was an them. programs in nursing. However, this increase ICU nurse before returning to school to pur- Even before the outbreak, industry will not meet the anticipated national sue a full-scholarship master’s program as experts predicted an increase of up to 15 need. And those estimates did not take into part of a professional nurse traineeship. percent in demand for registered nurses by account the fallout that many nurses sense “You can do something for a few years, 2026, making nursing a top-rated profession on the horizon from the COVID-19 crisis. and then switch,” she said. “There’s a lot of for job growth and job security. The Health Lisa Bertreaux of Beaverton is a mother of flexibility out there.” Resources and Services Administration has two who recently applied to BSN programs Casey now works in primary care and projected that more than 1 million registered and is waiting to hear back from admissions runs her own practice with a focus on teen nurses will reach retirement age within the % departments. She says she won’t be deterred health. next 10-15 years. 12 by the pandemic. In an effort to make doctoral programs Admission to nursing programs is cut- “How nurses are feeling right now, as far more available to specialized nurses and throat, however, and there are not enough as not having enough protective supplies, nurse researchers, nursing educators since qualified nurse educators in schools and uni- Projected increase in I can’t even imagine what that’s like,” she the mid-1990s have been creating programs versities to meet demand. And, as the health employment for registered said, “But, it’s not going to put me off from that allow graduates of BSN programs to care industry grapples with the fallout from nurses, compared to a 5% wanting to continue. People are going to go fast-track directly to doctoral degrees. the coronavirus, many fear more practicing average increase for through a lot, and it might make some peo- One of the primary goals of these pro- nurses will leave the field, exacerbating an all occupations ple think, ‘Oh, I don’t want to get into that, grams is to address the nursing faculty already-worrisome nationwide shortage. I am not protected there.’ But I feel like the shortage by condensing doctoral studies need for nurses will still be there, and I want to four or five years versus eight or more in TRADITIONAL NURSING PROGRAMS to be a part of it.” other fields. These programs offer doctor Nursing careers typically follow one of 3,059,800 Nursing organizations have also rallied of philosophy or doctor of nursing practice three pathways. to make full baccalaureate programs avail- (DNP) degrees, depending on the university The first is a hospital-based, hands-on Nursing employment, 2018 able at the community college level, creating and the program focus. diploma program, which does not provide a another cost-effective way to bring more RNs Online education for advanced nursing standard nursing degree upon graduation. into the field. This is a smaller representation degrees also has grown explosively. Many This approach is gradually being phased out of baccalaureate programs, with less than programs allow for partial or full-time on- in favor of the two more academically oriented 3,431,300 half of states endorsing this approach, but it line coursework, though most require pathways, both of which lead to graduates is growing rapidly in an attempt to meet the in-person clinical rotations. becoming a licensed registered nurse, or RN. Projected nursing increased demand for nurses overall. A second route is through an associate employment, 2028 THE UNKNOWN: NURSE BURNOUT degree in nursing, or ADN. More than 600 NURSING DEGREES FOR GRADUATES FROM THE CORONAVIRUS PANDEMIC programs nationally offer it, typically at Source: U.S. Bureau of Labor FROM OTHER FIELD A difficult and ever-changing landscape is community colleges. It leads graduates to Statistics, Employment Many turn to nursing as a second career. also affecting nursing in as-yet-to-be-deter- gain clinical competence and the ability to Projections program The profession has worked hard to make that mined ways. Nurses working with COVID- practice as a licensed RN. It is generally seen easier for those who have completed a bache- 19 patients are being pushed to the limits. as a more economical way to join the RN lor’s degree in disciplines other than nursing. Other nurses, who may have worked in out- workforce. Accelerated baccalaureate programs patient clinics or on elective surgeries, have Rachael Clark is a surgery recovery nurse are available for those who qualify. These seen their hours drastically reduced or elim- who pursued her associate’s degree 12 years intense programs are 11-18 months in length inated. ago. “For convenience, because my son was and are generally full-time. They are among Nurses’ safety has simmered as an issue little, I did the ADN program and became a the areas of greatest growth in nursing edu- in some places and boiled over in others. A registered nurse that way,” she said, “There cation, with more than 200 programs avail- lack of masks and other personal protective is a huge push, overall, for every RN to have able in the United States. There are also equipment, or PPE, caused New York state’s a bachelor of science in nursing, or BSN, entry-level master of science programs (gen- nursing union to file suit. Some California instead of an associate’s, and for a while they erally lasting around 28-36 months) that nurses said they would not work until they made it seem like it would be difficult to get allow those with undergraduate degrees in received proper gear. a job unless you ultimately ended up with a other domains to prepare for specialty nurs- “I think there is going to be a mass exo- BSN. However, there has been such a need ing roles, as well as teaching or research dus, absolutely,” said Marla Moore, RN, who for nurses for so long that they never fully positions. was a critical care nurse for years and now enforced that.” helps nurses process work-related stress and The third career pathway runs through ADVANCED DEGREES FOR trauma. “I think you’re going to see a dip BSN programs at four-year colleges and uni- PRACTICING RNS down in nursing overall in the short-term. versities. There are more than 600 BSN pro- Among those who have completed a nurs- But I do think this is an opportunity for grams across the United States. For many ing program and are interested in further- reform, that ultimately this will make nurs- nursing organizations, it is the preferred way ing their educations, either at the master’s ing better. of bringing newcomers into the profession. or doctoral level, graduates of BSN pro- “We are the sacrificial generation; we will Acceptance rates are low, though, and grams are four times more likely to con- be the ones that the industry learns its les- competition is at an all-time high. tinue onward. However, new opportunities sons from.” Last year, according to the American have also emerged in the past two decades to Association of Colleges of Nursing, nursing allow for diploma or ADN nurses to complete Lee Ann Moyer is a freelance writer in Port- schools turned away more than 75,000 qual- RN to master of science in nursing (MSN) land and the owner of the Portland Mom Col- ified applicants due to site, staff and budget programs. lective. She can be reached at leeann@port- limitations. Students interested in these programs need landmomcollective.com. 6 SUNDAY, MAY 17, 2020 THE OREGONIAN Year of the Nurse Paths to nursing Multiple approaches address the shortage of nurses in the immediate future and beyond Lee Ann Moyer Special to Advance Local

From college to the front lines, new nurses face their fears

Kathleen O’Brien Special to Advance Local

Imagine being dropped into a war zone having learned how to deploy a parachute only from an online video. That’s roughly the situation facing nursing students whose ﬁnal semester was abruptly cut short by the coronavirus pandemic. Few have trained with COVID-19 patients. In fact, the pandemic caused nursing schools to cancel ﬁnal-term clinical rotations. But they’re graduating into a marketplace desperate for fresh troops, with many state governments now allowing them to practice before they are formally licensed. And some will soon be dealing with the coronavirus.

ARE THEY READY? THEY HAVE TO BE. Heather Schmidt, a senior at the University of Massa- chusetts Amherst School of Nursing, was enjoying the challenges of her final internship in the ICU of Brigham and Women’s Hospital in Boston when it was canceled in late February. Just as she had discovered the field she loved, she had to switch to online case studies. The hospital had its first COVID-19 case in an adjoining unit, so she got a taste of what was on the horizon. Surgical masks were already being rationed to just one per 12-hour shift. In Michigan, Grand Rapids resident Cierra Buist was about to graduate from the University of Michigan School of Nursing, with the intention of going into pediatric critical care, when the virus upended her plans. Since her state also changed the rules so recent graduates can work before they’ve formally passed their board exams, she expects to be on the job soon. Isabella DeCarlo completed just four 12-hours shifts of her preceptorship, or internship, before the rug was pulled out from underneath her. While she feels her four years at the University of Alabama Capstone College of Nursing have prepared her for entering her profession, she admits a little part of her wishes she had been able to complete that final clinical experience. “It would help boost that confidence, and make me feel like a real nurse,” she said. “You have to remind yourself that we are equipped. No one has failed the (licensing) test.” Classmate Leah White said she, too, has heard others talk of missing that final bit of instruction that would make them feel they were sufficiently trained to plunge into a chaotic workplace. Beginning nursing students can often be a bit star- ry-eyed about the profession, intending to specialize in pediatrics or obstetrics, said Arlene Keeling, of the Univer- sity of Virginia School of Nursing and the author of several books on the history of nursing. Their career plans don’t usually factor in a pandemic. When she was teaching first-year students earlier this year, before in-class lectures were halted, she made a point of having her students follow the news out of China. “They kept saying, ‘Whoa, nobody ever told us this was a part of nursing,’ ” she said. “They were a bit shocked.”

HOW WILL THE CLASS OF 2020 REACT TO COVID-19? “I expect we’ll see two waves: Some will want to become a nurse as soon as possible to get in the action, and the others will say, ‘This is not what I want to have in my life,’ ” she said. Buist, of Grand Rapids, is firmly in that first category. “I’ll answer to wherever they need help,” she said. And what is the reaction of friends and family, now that the headlines trumpet the danger they’ll face? White said she’s heard mostly praise — which she attributes to the public’s general appreciation of nurses. “The thing I’ve heard is thank-yous for going into a profession like this,” she said. Schmidt said her parents have expressed concern now that she’ll soon be working in a hospital. “The first thing my family said was ‘Oh, we thought we wouldn’t have to worry about you for a bit longer.’ ” Her parents have always been protective, she said, and she’s always leaned into adventure. She’s gone on medical mission trips to Nicaragua and Haiti. If she’s needed to treat patients with COVID-19, she’s ready to take that risk.

Kathleen O’Brien is a freelance writer in northern New Jer- sey and a former columnist and health care reporter for The Star-Ledger and nj.com. She can be reached at ksobksob@ gmail.com. 8 SUNDAY, MAY 17, 2020 THE OREGONIAN SPONSOR CONTENT PRODUCED BY OREGONIAN MEDIA GROUP’S ADVERTISING DEPARTMENT Year of the Nurse: Local Health Plan Regence Thanks Its Frontline Heroes ARTICLE SPONSORED BY ensure their needs are met, and offer social REGENCE BLUECROSS BLUESHIELD OF support resources,” Lindberg says. “Some OREGON members need help arranging for food or other resources, while others are experi- Now more than ever, Americans recog- encing a tremendous amount of anxiety. nize the bravery and dedication of health Our nurses assist with that as well.” care workers as the COVID-19 pandem- In addition, some members with chronic ic wears on. Perhaps none more than the conditions, who should be receiving rou- nurses at hospitals, clinics, and long-term tine preventative and condition-specific care facilities who are keeping diagnosed care, are also losing access to resources patients comfortable and connected to they regularly need. In response, Regence their families. nurses are helping to arrange alternative However, many might be surprised to types of care, such as telemedicine visits know of the efforts of another group of or in-home services with appropriate social nurses – those who work for health insur- distancing protocols, to make sure every- ance companies. Regence BlueCross Blue- one is properly cared for. Shield of Oregon, an insurer serving more A Display of Gratitude than 935,000 members, has more than 200 Regence would not be able to serve its nurses who play a crucial role in health care member care for both the short- and long- reassurance, assess the problem, and coor- members without its nurses, especially – not just during the pandemic, but at all term. dinate care with a provider. with the increased demand for services times. “Nurses touch every part of the care Recognizing Their Efforts thanks to COVID-19. From Lindberg’s per- “Nurses are the backbone of health care – process for our members,” Lindberg says. Many members in insurance care man- spective, their selflessness and call to ser- not everyone knows that,” says Julie Lind- “Their medical training, clinical process agement programs have underlying health vice, healing, and caring goes beyond their berg, vice president of Clinical Services training, and experience with direct service conditions and other complications that put job description and truly shows why all at Regence. “Our clients with health care make them perfect for the role they play.” them at higher risk for COVID-19. Nurses serving on the frontlines of health care are needs or who have spent time in hospitals, When authorizing medical procedures, who work for health insurers are currently being hailed as heroes. though, can absolutely attest that nurses nurses are at the forefront of making de- strengthening their efforts to protect these “Our nurses recognize that health care is are critical to everything we do.” cisions around appropriate and medically vulnerable members by providing frequent so much more than procedures and med- The Role of Health Insurance Nurses necessary care. With the help of nurses, in- information about the virus. They are com- ications,” Lindberg says. “It’s also about The services Regence provides wouldn’t surance companies also provide care man- municating things like how to prevent in- compassion, empathy, and understanding. be possible without its nurses. Many nurses agement to members with complex needs fection, symptoms to watch for, and what to Our nurses are unsung heroes in so many who work for health insurance companies and multiple chronic conditions. They are do if members think they’re infected. ways.” have experience working directly with pa- even an essential component of administra- “Our nurses are reaching out to diagnosed To find out more about how Regence is tients in hospitals and nursing facilities, tion and customer service. When a member members, as well as those who think they supporting its members during COVID-19, preparing them to manage and coordinate calls with a health concern, nurses provide might have COVID-19, to answer questions, visit regence.com.

STAND TOGETHER, OREGON

Since the onset of this public health crisis, the Oregon Food Bank has put over 1 million pounds of food in the hands of Oregon families in need. We’re proud to be part of this shared effort to help our communities stay safe and healthy—and emerge stronger. Join us.

NEWS.REGENCE.COM O9587384-03 THE OREGONIAN SUNDAY, MAY 17, 2020 9

YOU’VE ALWAYS BEEN HEROES. NOW EVERYONE KNOWS WHY.

It's the Year of the Nurse. Your courage and compassion shine every moment of every day. From all the nurses on the front lines to our own nurses supporting members during this challenging time, thanks for everything you do.

O9587384-02 10 SUNDAY, MAY 17, 2020 THE OREGONIAN

Caregivers share their most unforgettable moments of joy, sorrow, loss and redemption Nurses’ stories

KYLA, RN, PORTLAND EMILY MATTHEWS, RN, JEREMY JOHNSON, CRNA, PORTLAND I entered the nursing profession for job ELLINGTON, CONNECTICUT I am a certified registered nurse anesthetist, or CRNA. I security and because of my interest in sci- I became a nurse because of my innate find many people know very little about this profession. I ence. I wound up developing a strong sense drive to help people. The best part of my job have been a registered nurse for approximately 22 years. of empathy and compassion. I love work- comes when I know that I made a difference After six to eight years working in high-acuity intensive ing with people and supporting others in for a patient that no one else could have made. care units, I applied to a nurse anesthesia program. Since their most vulnerable moments. I didn’t know when I became a nurse 2005, I have been administering anesthesia in an operat- I used to work on a medical unit in the that most people are not grateful or appre- ing room setting. Much of what we do requires a checklist hospital. A patient had been admitted for ciative of how hard we work to take care of mentality, for the sake of the patient’s safety. I never really an infection, but he also had severe lung them. I didn’t expect to be verbally abused break away from that. But I do try to interweave some disease. He was a bit cold and unfriendly by patients on a fairly regular basis. I didn’t moments of humanity. I don’t feel like a do a great job of when you first met him, and he gave you expect for management to knowingly and that honestly. I spend a good percentage of my time work- the sense that he wanted to be left alone purposefully have us work short-staffed in ing in pediatric anesthesia. I have just a moment prior to in between care. He was beginning to cre- the name of productivity to the detriment of induction of anesthesia that I am able to whisper some- ate a reputation for himself as “that rude patient safety. thing quietly to a patient. patient.” In my first year as a nurse, I was car- “Every moment Today as I prepared to intubate a newly diagnosed I was his assigned nurse. One day, I tried ing for a lady with chronic lung disease COVID-positive patient, I said something very routine. to strike up a conversation about his family who had chosen to enter hospice care. She matters Something I’ve said countless times before. I smiled and and his life outside the hospital. He told me had the option of doing home hospice, but said, “I’ll see you on the other side.” that he had a wife and was on a lung-trans- she chose to stay in the hospital to be with intensely, in I will be returning to the hospital tomorrow, where I plant waiting list in Seattle. And he was try- “her friends.” I knew she was a Christian, suspect to find that the patient I intubated remains on ing to convince his wife to leave him so she because she had been in the hospital for a terms of both the ventilator. I wager that her course will take several could find a healthier partner to be with, few weeks and we had the time to talk about weeks. She’s likely to remain heavily sedated. I hope my because he thought she deserved more. it. One night, I was busily fussing around checklists and words were not the last words she hears. So many work- We had been taught that a nurse is her room and humming as I worked. As I ing moments are clouded and wrought with mundane never supposed to cry in front of a patient. was cleaning her up and giving her IV med- humanity.” tasks. Hospitals can seem like medical assembly lines. But I started crying anyway, and he teared up ication, I started singing “Jesus Loves Me.” we work with people. Every moment matters intensely, in himself. Later, he thanked me for talking A very short time later, my aide came to tell terms of both checklists and humanity. I know that to be and crying with him. He taught me that me she thought the lady had passed, and true regardless of the ending of my patient’s story. everyone, no matter how they appear, has she had. I had the honor that night of sing- a story. ing a patient into heaven.

LESLIE MULLEN, RN, CANTON, OHIO SARAH KERN, EMERGENCY ROOM I became a nurse for the very clichéd NURSE, BAY CITY, MICHIGAN reason of wanting to help people. So many I became a nurse because I was getting patients have touched my heart, and I will too old to work EMS anymore. EMS is a never forget them. The challenges we face “young kids sport” and after doing it for 15 every day are overshadowed by the good we years I needed something diﬀerent. do and the changes we make. Watching a [What leaves a big impression?] There patient who was on a ventilator and uncon- isn’t one answer for this, it’s happened Kari Goldstein, R.N. scious walk out of the hospital on their own many times. It’s when you hold someone’s Kerr Children’s Mental Health Services is the most rewarding feeling I have ever hand as they pass away, comforting family felt — knowing I helped that happen. as they lose a family member, the joy and With coronavirus, we’re often the only comfort of a family when things are better human beings our patients can interact than they seem. Being an ER nurse, we see with. One of my patients, who I’d worked it all. Every time there is a good outcome with for several shifts, was having a good you’re happy and when there is a bad out- morning and was very alert. I asked him if come you take a deep breath and do it again. he wanted me to call his wife. I held a cellphone to his ear for 30 minutes so he could SUPERHEROES WEAR MASKS hear his wife’s voice. JULIE BALDEH, DIRECTOR Happy National Nurses Week! He was a suspected coronavirus patient, OF HEALTH AND WELLNESS, never tested. I was very concerned about ALLENTOWN, PENNSYLVANIA Thank you for all you do! the lack of proper protective gear. I have My mother is a nurse and as a child I three young girls and bringing this home use to go with her to read mail and pass ice to them and to my husband does worry water to residents. The joy I get from know- me. But that didn’t keep me from doing my ing someone trusts me with their life, and job. Watching tears stream down his face being worthy of that trust, is better than made me realize that what I do is beyond any amount of money I could ever make. just a paycheck. I impact lives. I am a nurse and have been since 2010. On the ﬁrst day at my current job, I had to save AlbertinaKerr.org a resident from choking. That moment stays “So many patients have with me. It reminded me that in one split second your whole life can change. I was very touched my heart.” blessed to have had good training. O9599072-01 THE OREGONIAN SUNDAY, MAY 17, 2020 11

ISABELLE M. PISANI, RN, PORTLAND J.R. MCLAIN, RN, PORTLAND My reasoning for being a nurse is always evolving. I received this message from a patient’s family Doing something meaningful. Problem solving and that reaffirmed why I go in day after day to wit- taking care of patients. Building valuable connec- ness suffering. tions. Providing comfort. Doing work that matters. “You don’t know me, but I know your face. I Giving back to my community has always been a have thought about you, and talked about you moral value of mine. Being able to do this on a larger regularly for the last three years. scale is highly rewarding. “In August of 2016, my family brought my dad Sometimes, it’s the little things that make a big to the Portland Providence ER. He wasn’t feeling impression. I work at Randall Children’s Hospital. well and because he had surgery at Providence Recently, I admitted a 9-year-old girl who was in a a month prior, we wanted to have him checked motor vehicle accident. She sustained a couple injuries, out there. He went to CT feeling much better, one of the serious ones being a broken leg. When the but when he came back to his room, he suddenly ER tech wheeled her stretcher into her room, I greeted coded. As my mom, my brother, and I stood and her like I do all my patients “Hi I’m Isabelle, I’ll be your watched the organized chaos of the code blue ... I TANYA, RN, HARRISBURG, nurse until the morning!” The little girl’s brain, fogged “Your actions was absolutely certain that my dad was going to PENNSYLVANIA with fear, trauma and exhaustion, looked at me, smiled, be OK and that any minute he’d wake up and start I became a nurse to help those in need. and said, “That’s so cool, my middle name is Isabelle!” that night breathing again. I’ve always had a strong desire to give myself Such a simple gesture, and such a beautiful impact, “You were on his chest, doing compressions to others when they are unable to do so providing ease and comfort during a scary time. inspired me to and you looked me straight in the eye as I sobbed themselves in a time of sickness and despair. by the door. It was in that moment, where I saw Nursing has made me recognize that both fulfill my dream. the sadness in your eyes, that I realized my dad life and death are equally precious. SCOTT FINE, EMT, OREGON wasn’t going to make it. I could see both your pain Generally, patients should not be left I changed careers after breaking both arms while And through and your strength in that moment. It’s a vision on breathing tubes for more than two volunteering at Search and Rescue but kept my EMT that is seared into my memory. weeks. The family has to decide whether License so that I could continue to serve. my pain, I “For nine months or so, I saw your face when I to remove the tube and see how the patient Volunteer Medical Team with Team Rubicon closed my eyes. Always the same ... strong, but sad. does without mechanical ventilation, deployed to the Santa Clara Convention Center for found purpose. I struggled with the trauma of losing my dad in or have a tracheostomy performed and establishing the first Federal Respite Center (FRC). such an unexpected and traumatic way. Healing remain on the respirator. [The center allows people suffering from COVID-19, I graduated was slow, but I was comforted knowing, and seeing We had an elderly patient whose chances but not requiring hospitalization, to isolate them- firsthand, that you guys did everything you could of full recovery were slim to none. Her fam- selves while recuperating.] The team deployed nursing school to save him. ily decided to take her off life support. They together for 28 days working 24/7, 12-hour shifts, “Your actions that night inspired me to fulfill said their goodbyes before we removed the some with no days off and only returning to the in December and my dream. And through my pain, I found purpose. breathing tube, and then they left. I believe hotel to isolate and return. As the EMT on the team, I graduated nursing school in December, and I am they thought she would pass as soon as the I worked alongside doctors and nurses from all over I am working working as an RN at PeaceHealth in Vancouver. life support was removed, but that does not the country, including two local nurses, Dennis and “All of this to say ... your simple act of eye con- always happen immediately. Paul, from El Camino Hospital. The compassion and as an RN at tact, and your expression of empathy, has stuck After the respiratory therapist removed dedication of this team was amazing. with me all these years. When I saw your pic- the breathing tube she was in obvious dis- The real heroes that stood out to us were the PeaceHealth in ture pop up in my Facebook, it brought me peace, tress, so I maximized her morphine and patients that elected to stay at the FRC for a 14-day not pain. I don’t expect you to remember me, or held her hand and told her that her family isolation while they recovered. Their decision to stay Vancouver.” my dad. And I am not expecting or wanting a had been in to see her, that they loved her, was one of pure courage. They made this choice as response from you. I just simply wanted to tell and that I was there for her. She passed to not endanger their family or the general public. From a message you that I am thankful you’re a nurse! I am thank- after probably 20 minutes. These true heroes stayed in a large open facility with McClain received from ful you were there that night. And I am sorry for strangers from all walks of life. a patient’s family what you witness on a daily basis.”

GOOD {TIMES} COME TO THOSE WHO {LEAD THE WAY}

Touchmark would like to whole-heartedly thank all of the nurses on our Bend and Portland teams for all that they do for us and the residents who live in our community.

Bend: Kristine Ruud, RN; Justyn Coronado, RN; Kathryn Banks, RN; Katea Bejanu, RN; and Christine Granath, RN Portland: Darby Cronin, RN; Francis Delﬁno, LPN; Gina Mclemore, RN; Meagan Mook, LPN; and Rebecca Tronsgard, RN THE LIFE AWAITS

FULL-SERVICE RETIREMENT COMMUNITIES:

1. ·PORTLAND, OREGON 2. ·BEND, OREGON TOUCHMARK.COM/TIMES O9599035-01 12 SUNDAY, MAY 17, 2020 THE OREGONIAN

Above and beyond

That’s what you’ve done during the COVID-19 crisis. You’ve gone above and beyond.

Working incredibly hard amid a pandemic, you have helped keep our people, our patients, our community and our world safe.

All the while, showing care and concern for your patients and your colleagues in these emotionally trying times.

We appreciate and recognize your amazing eﬀorts. And we are grateful to have such an extraordinary medical community.

Our legacy is yours.

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