"We broadcast things, if we can," said Luke. "We tell the patient whether they are awake or not, when we change them, when we are dripping or separating the ventilator". He adopts the cheerful, everyday tone he uses: “‘ Oh, your wife called, she’s worried about you. You will need to improve very soon. "
Phone calls from family members can be practical, to help staff provide the most effective care: telling them that the father or wife hates needles, for example, so that nurses can keep this in mind when drawing blood.
But it may involve delivering the most important message of all: that they love them. This is always passed on, he said. “Whenever we call someone, we reiterate [to the patient], "We got another call from your partner or your kids. They are missing you. I hope they see you soon, so you have to hold on." "
Messages can also travel the other way. If a patient's condition seems more hopeful, a staff member usually informs them that they will tell the wife or child that they have attended.
Even the smallest steps in treatment make all the difference for the team, he said – "when someone can shake your hand, when someone can answer you". And if the condition of a patient with COVID-19 improves markedly, it elevates the entire department.
"It's the most insane kind of feeling for everyone in the ward," said Luke. "It is news all night – all week – that this patient will be able to leave. It is something to appreciate."
He remembers a particular patient who was being prepared for discharge. “The entire ward was on fire. It was a palpable emotion. Every time their stats went up to a higher level and we could reduce oxygen, everyone thought, & # 39; It will happen! & # 39; ”He made a note of what the first person said when he left the ICU. "They were able to speak," he said, "Thank you."
But the reason for so much emotion, at that moment in late April, was simple. "We haven't let a single person out for weeks."
The proportion of patients improving and leaving the ICU is now increasing, he said. But every day, death remains the reality. Luke, like the whole team, goes into work after taking care of a patient for many days, sometimes weeks, and receives news from a colleague: "They didn't make it".
COVID-19's unpredictable trajectory means that sometimes it can happen very quickly, even after showing signs of recovery – but in any case, they do everything possible. "For most people, we keep going, even if the signs indicate that they are not doing well, because people can survive," he said.
Without intending to talk about the effect of all this on doctors, Luke began to describe what life has been like for him and his colleagues since March. He talked about the physical demands in the ICU, mainly for nurses, health assistants and junior employees.
“Changes are difficult,” he said, “you have to use this [hazmat] suit, you’re hot, you’re trying to hold someone or move something. "They wear protective clothing, he explained, because they have run out of surgical clothing. Some patients with COVID-19 are on kidney dialysis and need to change their bedding regularly." So you are desperately changing all sheets, but at the same time your gloves are soaked with sweat they fall and you’re trying to keep the display.
Nurses, in particular, support the weight physically, he said, with hours followed by masks, glasses, double gloves and visors, "drenched in sweat", doing "the best they can" and trying to help themselves. His sheer practical skills amazed him. At first, while trying to wash and transform a patient and make sure the lines and tubes didn't come loose, a very experienced nurse intervened.
"She just took something from me and did the most incredible maneuver of washing and holding the patient and said, 'You need to hold this and you need to try as hard as you can!'" Luke obeyed as quickly as possible when the nurse turned to him again. "She said, 'You need to realize that this is wartime nursing now'."