An Inside Look On the Frontlines

Seven nurses taking care of COVID-19 patients reflect on their journey into the medical field and what they want others to know about the pandemic

4:40 PM

Author | Jordyn Imhoff

Nurse 4 Sam
Sam Ziemba, a Michigan Medicine emergency department nurse. Photo courtesy of Cecile Hollinshead.

In this time of fear and uncertainty, nurses rise to the challenge. They care for the sickest patients, every day for weeks, sacrificing living at home with their families and risking their health to comfort them.

Here are a few of their stories.

Sam Ziemba

"I was hired in June 2016 to work in the emergency department at Michigan Medicine. I like my role because I get to care for people on some of their worst days -- I'm an advocate for them when they can't advocate for themselves. I take a lot of pride in that. It's hard to describe in words what made me want to be a nurse because it was just something that felt right to me. After being a visitor to family members in the hospital many times, I saw having a good nurse really makes a difference in the patient's outcome.

The emergency department is organized chaos most of the time. There's usually a variety of patients with different, sometimes very complex, issues waiting to see us. Our team has to be flexible. When we started getting COVID-19 patients, I would look to senior nurses to see how they were reacting to everything. When they were anxious or weren't sure yet what our new routines or practices would look like, I became nervous too. It was hard for any of us to be confident because there was little known about the best way to tackle this illness.

As the pandemic evolved, our team's response became stronger. From administrators to environmental services and clerical staff, we came together to help each other out, which increased morale. This outbreak truly magnified how much we rely on each other in my department, and reminded me that no matter how scary it can be, we'd get through it together. There are difficult days though. I'm reassuring patients they'll survive this and comforting patients that may not, while still caring for other emergency visits.

I've been strict about staying at home when I'm off work. I miss my family but two of my parents are immunocompromised. My sister-in-law also recently had a baby that I want to meet, but keeping distance is important because COVID-19 is serious. I wouldn't want to accidentally expose any of them to the virus.

It's disheartening when you drive home after a long shift and see people playing at a park or having a get-together with friends. I think it's easier for them to go out because they don't see the patients' faces in their mind. They don't see their oxygen drop quickly, after doing fine, now scared and without their family to comfort them. I hope everyone will be responsible, and trust us, about staying home."

Katy Maly

Katy Maly, a surgical intensive care unit nurse, with fellow colleague Mark Warren. Photo courtesy of Maly.

"I've been a nurse at Michigan Medicine since 1998, with 20 of those years spent in the surgical intensive care unit. I'm a senior nurse taking care of patients that require advanced care, whether they need continuous dialysis or are on extracorporeal membrane oxygenation, which is when an artificial lung provides oxygenated blood and an external mechanical pump delivers that blood to the rest of your body. This treatment can help the sickest of the sick, especially those with respiratory failure, which we've seen throughout this pandemic.

We've never had so many patients on ECMO simultaneously before. Patients in the SICU require extensive one-on-one care, and it's stressful, to say the least.

Extra care must be given in protecting ourselves, with gowning, gloving and wearing masks or PAPR hoods each time before going into a room. Then, there's a precise removal of these items before exiting. It's a process that's needed and necessary, but adds extra anxiety. And sometimes, we need to get into the room quickly because the patient needs immediate attention.

Unfortunately, the H1N1 pandemic seemed like a practice run for what we're seeing now. The SICU team is amazing and when something like this happens a strong team is needed. As a unit we came together back after H1N1 and learned so much which helped us get ready for this pandemic.

I went into nursing because when I was in art school, I was also taking care of my mom when she was home on hospice and during that time, I felt I was giving her some peace and dignity in her final weeks. I didn't have any heroic ideas when I decided to go to nursing school, I just felt that if I could offer someone else that peace and dignity going through whatever they're going through, then I succeeded."

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Peter Andreolli

Photo provided courtesy of Peter Andreolli.

"I've been at Michigan Medicine since December 2019 as a nurse on Floor 7. I actually graduated with a degree in engineering, but after a year in the field I realized I wasn't happy. Nursing had always been in the back of my mind, so I went back to school and I haven't looked back since. I went into this field because I love helping people. I know everyone says that, but it's true.

This means you don't turn back in a pandemic either. I have a lot of different fears, though. This is unlike anything I've experienced in my career so far. I'm scared for my patients and their families. They're often all alone and the only people they have physical contact with is with one of us, in our whole protective get-up.

SEE ALSO: Keeping Our Patients Safe During COVID-19

I have so much empathy for the family members. They'll call us every day for updates on loved ones, and when they aren't on the phone with one of us, they're waiting by the phone all day waiting for an update. They don't know if they'll receive good or bad news, and that takes an emotional toll on you.

When I come home after work, I worry about my own family as well. I do my part by ensuring all my clothes are immediately washed and personal items are wiped down, as my wife opens the doors for me. But you can never be too careful. I play different roles in this pandemic, as a health care provider, husband and father. My kids, who are 5 and 3, have only seen their grandparents through FaceTime and ask me every day when they'll be able to see their friends and grandparents again. But I don't have that answer.

You don't always actively think about how important family and friends are, but during this pandemic it's something I'm constantly thinking about. I look forwarding to spending time with them in person again. If I could tell people one thing about this whole experience, I would say to call the people you care about to tell them you love them. Our patients and their families can't always do that. Keep up with your personal relationships and practice self-care whenever you can."

Maria Damron

From left to right: Stephanie Knight, pediatric intensive care unit nurse with regional infectious containment unit nurse, Maria Damron. Photo provided by Damron.

"I have been at Michigan Medicine since 2006 and most recently have volunteered to work in the regional infectious containment unit. I've been there since mid-March. 

There's an immediate sense of humility in how fragile our lives are when taking care of patients who can rapidly decompensate. Often times feelings of frustration and fear are present knowing that patients in an ICU require meticulous care and higher needs when their status begins to decline, which is quite often. But the number of patients exceeds the number of ICU nurses available. Patients that should only have one-on-one nursing are now doubled.

However, underneath the challenging circumstances there is hope, optimism and perseverance among every caregiver that enters the walls of Michigan Medicine. The experience has been humbling knowing that multi-disciplined providers and individuals have come together to give these patients' every available resource to fight this disease. I'm honored to serve in this profession and every day I'm humbled to stand shoulder to shoulder with my colleagues who are brilliant. Every day I get to come in and learn from the best of the best. 

During this time of uncertainty, being outside as much as possible and finding comfort in nature and the solitude of sunsets or sunrises is a constant reminder of peace and how I think about ways to serve others."

Angie Yee

Photo provided by Angie Yee, a critical care medicine and regional infectious containment unit nurse.

"I've been at U-M for eight years in a few different roles. Currently, I'm a faculty member at the School of Nursing and a staff nurse in the critical care medicine unit. I recently transferred there from another unit, and had only been working off orientation for a month when the pandemic began. Needless to say, I've learned a lot since then.

I felt uncertain at first. I didn't know what to expect, and hoped my eight years of nursing experience would help me get through this. At the same time, I wanted to do everything I could to help COVID-19 patients. That's why I volunteered to work in the RICU, on top of the critical care medicine unit. I love helping people. I remember in second grade, my teacher told me I should be a nurse because I was always helping other kids in the class. So, since I was seven-years-old, I had a goal to be a nurse.

As a new ICU nurse now, I was nervous but the support I received from my colleagues helped immensely. The kindness, encouragement and camaraderie continues to be vital in getting through this uneasy period of time.

Before the pandemic began, my parents lived with me. But once my unit started seeing more COVID-19 patients, I was worried I would bring the virus home, so my sister and I decided to have my parents stay at her house. I miss seeing my family, and realize I took for granted simple family moments like having dinner together or going shopping with my niece.

I've been taking care of myself by watching a lot of Netflix, keeping in touch with my friends, journaling and talking with my therapist. Although we're seeing a downward trend in COVID-19 cases in Michigan, we're not out of the woods yet and it's vital we continue practicing social distancing and wearing masks in public spaces to prevent a second wave.

I can't wait to hug my mom, have a play date with my niece and go out to eat with friends again when this is all over, in due time. A massage at a spa is definitely on my to-do list, too!"

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Dani Heaton

Photo provided courtesy of Dani Heaton.

"I've been a nurse in our pulmonary and general medicine unit for almost three years. My family is full of health care workers at U-M and from a young age I have always wanted to work here. When I was a kid, I loved coming to work with my dad and walking around the hospital. When I obtained my nursing degree in Tennessee, I was quick to apply here and happy to be home when my current unit offered me a position.

When we started getting COVID-19 patients, I wish I could say I immediately charged into the opportunity without hesitation. That first week was filled with a range of emotions. Going through this with my colleagues on my unit though made it a little easier. They're always there with a kind word to be shared or a sense of humor that made working in stressful conditions bearable.

SEE ALSO: Seeking Medical Care During COVID-19

Caring for patients going through his long, harrowing battle has come with emotional challenges too. We are the only in-person interactions they get, and with all of the personal protective equipment even that is limited. We've faced new challenges and have had to be innovative with how patients can communicate with their families, even if it's just for a few minutes.

I recently read an article written by a critical care doctor in New York City that recounted his interactions with a patient that became sick and recovered. He went back to visit this former patient once they came out of the intensive care unit and the patient immediately recognized him, stating "I remember your eyes!". Because of everything we wear in the hospital while caring for these patients, all they can see of us is our eyes. I think about this story a lot when I'm at work and I hope my patients are always met with kind and compassionate eyes.

Once we find a new normal post-virus, I can't wait to travel again. My husband and I have a lot of family in Tennessee and British Columbia. We miss them so much and I can't wait to hug them again. As silly as it sounds, I also miss going out to eat! I can't wait to sit on a patio of a restaurant in Ann Arbor, having a drink and watching people walk by on the sidewalk.

If there was anything I wish I could say to our community, it would be to continue to take care of each other. For now, stay home, stay safe, be kind to one another and when this is all over, we'll all celebrate together."

Zuleika Esterline

Photo provided courtesy of Zuleika Esterline.

"As an immigrant from Panama, my first priority coming to this country was to learn the language. After studying English at Boise State University, my husband and I moved to Michigan in 2002. I started working in a nursing home as a certified nursing assistant and realized, after observing the excellent care nurses provided, I wanted to be a nurse too. I graduated from nursing school in 2006 and have been at Michigan Medicine since then.

Working in the RICU has been one of the most rewarding, and unfortunately, saddest professional experiences I have yet lived through. On many days, from one end of the unit to another, there is a group of people tirelessly running (actually running) from one crisis to another like a symphony in a synchronized occurrence.

First, the code blue or staff assist light goes off and all available staff run towards the room in crisis, fetching the crash car, line car and respiratory car. Nurses and techs gather any extra supply that could be needed, like saline flushes, lab specimen tubes, labels and more. It's always been like this. You have to be prepared for the next imminent crisis.

In the middle of providing hygiene care to my patient one night, I remember looking out a window and hearing helicopters come and go. I remember looking at my patient and realizing I was all she had that night: she was my responsibility. It was my nursing duty, but also my human obligation to care for her, talk to her, hold her hand and let her know that she was not alone. Now, the sound of a chopper isn't the same for me. The sound increases my heart rate, wakes me up at home and alerts me when I'm at work.

My heart aches for my children and grandchildren I don't get to see, but I understand my mission is to help others through this pandemic and that sacrifices come with this profession. To all the environmentalists, techs, nurses, doctors, mid and higher-level practitioners, security officers, managers and supervisors: thank you for all that you do to make our arduous hours manageable, facilitating skillful and compassionate patient care whenever and wherever possible.

God help us all through this pandemic, and that starts with helping each other."

More Articles About: Health Management Covid-19 Community Health Emergency & Trauma Care Lungs and Breathing Mental Health infectious disease
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