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Behind the scenes with an ICU nurse

Workplaces 12 May 2020
Rear view of nurse and doctor running in hospital corridor 1

As a super-fit triathlete, Stacey De Bono is known for her mental toughness and resilience. Yet the biggest test this young woman faces is not the gruelling training for the next ironman competition, but her job.

Stacey is an intensive care nurse at the Alfred Hospital in Melbourne, a frontline worker in our defence against COVID-19. It is a demanding job in the best of times, but in the uncertain and challenging days of a pandemic, even more so.

“In the 11 years I have worked as an intensive care nurse, I have cried maybe two or three times,” she explains. “I have cried a lot more than that in the past few weeks because I have been working in a very stressful environment.”

Stacie icu nurse 1

Living with fear of infection has become a way of life for this 31 year-old from the regional Victorian town of Moe. Stacey works three 12-hour shifts a week and has to mentally steel herself before each one.

“I try very hard to go in there thinking, ‘I am a nurse today. I cannot worry about myself.’ I would not be able to enter the intensive care unit [ICU] if I worried about contracting the virus.”

The hospital does its best to protect staff. The process of donning personal protective equipment (PPE) before entering ICU is exacting. Stacey dresses in hospital scrubs, then a protective gown to shield her from aerosol or droplets. “You sweat profusely in it because it doesn’t breathe,” she explains. “Your body heat is trapped inside so your scrubs are drenched.”

She wears an N95 mask, tightly fitted to protect her, but which can cause face soreness and a loss of taste for up to four hours after it is removed. She also wears goggles, two pairs of gloves, and a shield that can cause headaches if fitted too tightly.

To enhance safety, the hospital places staff to act as PPE monitors outside the patients’ cubicles. The monitors ensure the nurses’ protective clothing stays in place, and recall nurses if they are seen touching their faces or masks. In that event, nurses must ‘doff’, which means leaving the cubicle to go through the entire gowning process again.

The monitors are also present after a shift when the nurses go through the meticulously careful process of removing their protective gear.

The work with patients is intense and intimate. “We have to brush the teeth of a ventilated patient to stop them getting pneumonia,” says Stacey. “We do that twice a day and we also swab their mouths every two hours.”

If the hospital is unable to get a patient’s full screening history on their admission to ICU, they are placed in a sealed-off COVID area until a test, repeated after six hours, establishes if they are positive or not. If they test negative, they are moved back into the general ICU.

The toll on nurses is taxing, physically and emotionally. The have three 30-minute breaks to eat and hydrate during the 12-hour shift.

For Stacey, relief comes in the form of her tough training. For each of her three weekly shifts, she runs a 24km round trip from home to work, but that is really just a warm-up. She trains seven times a week, a mixture of running, swimming and cycling.

Her sights are on competing in the Epic 5 in Hawaii next year, which is five ironman triathlons in five days. Each day of the challenge she must swim 3.8km, cycle 180km, and run 42.2km. Her work during this pandemic is, in its own way, preparing her for this challenge of a lifetime.

“I guess nursing has been the best job to prep for it,” she says. “It has it all – sleep deprivation, the ability to push on and not stop, dehydration, and being able to control your bladder.”