The number of cases in the Sverdlovsk region is growing, the figure is approaching four thousand. Medical institutions are treating patients with COVID-19, hospitals are filling up, and doctors are working to the limit. More than 500 students of the Ural State Medical University work in hospitals. They are employed in medical organizations as junior and paramedical staff.
One of these students is Vladislav Larionov. He is a sixth year student of the General medicine faculty, a ward male nurse of the intensive care unit No. 4 of the 40th hospital. It is considered to be a guideline in the treatment of coronavirus in Yekaterinburg, and all severe patients are taken there. Vlad told us how he got to work in the hospital, how he met the first patient with COVID-19 and how it feels to work in the red zone.
“How did I get here?”
I decided at school that I would be a doctor, I was attracted by the natural sciences, and they were easy for me. I entered the medical university at the General medicine faculty, I have not yet decided on a specialization. From the first year in the summer we practice in the hospitals, we begin with the position of junior medical staff. After the fifth year, I decided to gain medical experience, to see medicine from the inside, and not just in textbooks. In addition, I wanted to have some money in addition to the scholarship. I believe that a good doctor should start at the bottom of the ladder. A year ago, I came to the personnel department of the 40th hospital, and they immediately hired me. I passed the probationary period and work as a nurse in the fourth resuscitation of the infectious building.
A year ago, everything was unusual, I was even a little confused, because the work of a nurse is the care of patients, monitoring their condition, in the intensive care unit this is the main thing. I need to give injections, droppers, injections, before coming to the hospital I knew about this only in theory, but here straight away without more ado. But they replaced me with experienced nurses, and they quickly taught everything. Before starting work with coronavirus infection, we were instructed, the rules were explained, and the hospital began to prepare personal protective equipment. I was just at that shift when the first patient with COVID was brought. We did not know what kind of illness it was, so it was a little scary. There were questions in my head: how long did this infection come to us? What contagion is it, is it dangerous for me? But in reality, everything was not so scary. The ambulance announced the arrival of the first patient in advance, and we were ready: we put on PPE, prepared tubes for taking tests, equipment.
Then there was no thought that all this would last so long. I stood and thought: how did I get here? How did I encounter especially dangerous infections?
At the stage of training at the university, I did not expect that I would work in infectious resuscitation, also in an epidemic. The feeling can be compared with the fact that you came to a new city and you want to look around, to understand what the life is here. I experienced a sense of novelty. For several months of work, this has become a routine, everything is familiar and understandable. Unless now we pay special attention to personal hygiene and personal protective equipment, you need to clean everything well.
One day out of duty in the red zone
I start the shift at 08:00 and work until 08:00 the next day. First of all, I wash my hands and put on a surgical scrub. The main principle is to go on duty well-fed. The manager told us: “Before you work, you need to eat; the infection does not stick to a well-fed person.”
Before duty, nurses give a brief report of the patients who are in our unit, on average it is 10-12 people, each in a boxed ward. In the non-clean area, someone is always from the doctors, and they need to find out all the details about the condition of the people.
Then I open the packaging with the new PPE and fully dress. At first, it took about 10-15 minutes, because it was difficult to remember what order to put on; moreover, all the ties and locks had to be carefully checked. Now I can do it in five minutes. Duty begins with filling out patient records. For each, you need to fill out a personal card, enter all the manipulations and drugs that I am going to introduce, and also indicate his current indicators (temperature, oxygen content in the blood, and others). Patients who are on mechanical ventilation need to administer therapeutic nutrition through a probe, this is also our responsibility. It enters the body through dispensers during the day, if the food runs out, we top it up.
During the day, we monitor the condition of all patients in our unit; look at the indicators of the ventilator, if a person is connected. To such patients, we must carry out the sanitation of the bronchial tree, saying more simply, we eliminate the accumulation of mucus on the affected bronchi, because a person temporarily cannot do it himself.
Another task is the writing of medical documentation, that is, in addition to cards, we have various nursing journals (sterilization, pre-sterilization treatment), and they need to be kept. This proves that we have sterile material, that everything is processed, and that we didn’t just get it dirty from somewhere. There are special indicators for checking.
In the non-clean zone, we work for four hours, and then we take turns because it is impossible to stay there longer. PPE lose their function, something may get wet from moist air, something will become dirty, and the suit must already be changed. These four hours you can always relax. You can calmly eat, if possible, and even sleep. Because being there all the time is very difficult. Natural need and hunger will still make you leave.
Getting used to pathogen suits was not easy. We are used to masks and respirators, because we have always worked in them. A respirator was worn if a patient with tuberculosis came to us.
But at first it was impossible to be hot in this suit, after four hours you were all wet through. Now I’m used to it.
In the non-clean zone, we can’t remove anything, but this does not interfere with communication, we just have to speak louder. And if you need to contact a doctor from a clean area, we use radio-sets, very convenient.
At the end of the shift, from 5-6AM, we must prepare patients for the next attendants. Patients should be completely changed all dressings, glued patches that hold the probe or tube. Everything should be clean, we wash all the patients and replace linen, this is also our responsibility, and the orderlies help us. We are doing this in order to make the next shift of doctors more pleasant to work with.
About attitude to patients
All patients come to us in serious condition due to the specifics of the department, and we treat everyone equally well. In the recovery of the patient, his mood plays a huge role. Of course, we must also carefully monitor the patient’s condition, carry out all procedures on time, but if you take two patients in the same condition, the one who wants it will be cured faster, even if it sounds a little banal. It even happened that a severe patient responded to treatment much faster than a moderate patient. This applies not only to patients with coronavirus, I am talking about everyone. Some patients, getting on the ventilator, immediately go down, react negatively, do not want to do anything.
And someone writes to us on paper: “Well, when will I be cured? I’m not going to be sick for a long time. ” For such, the heart fills with joy.
At the same time, I treat all patients the same way, I have no favorites.
When we did everything, but the person died, I feel sad, but I try not to let myself through, because in the intensive care unit some patients still die, if everything is taken to heart, it will be psychologically difficult.
Source: городской портал E1.Ru