Dossier: COVID-19

Exhausted, but optimistic

When corona patients wake up from a coma, they’re often scared and overwhelmed. Regula Rigort works in the intensive care unit at the Kantonsspital Graubünden and, for the last few weeks, has sought to instil confidence in patients, relatives and colleagues alike.

Text: Katharina Rilling; street art: the rebel bear; photo: Colin D. / Unsplash

Imagine waking up totally disoriented, not knowing where you are and what’s happened. You wonder why there’s no one around when you really need them. Your partner’s not there, nor your daughter or brother. Just people covered from head to toe in protective clothing. Is it possible for them to smile given the circumstances? “I find it really hard wearing a mask and goggles when a patient wakes up from an artificial coma,” says Regula, who is currently working as a nurse in the intensive care unit at the Kantonsspital Graubünden. “We’re totally unrecognisable. This causes extra confusion and doesn’t help the patients.”

Regula has a lot of experience in looking after seriously ill people. She worked in an intensive care unit (ICU) at Zurich University Hospital for 20 years. But she’s never experienced anything like the coronavirus and the way it affects patients, hospitals and relatives. As the healthcare sector was preparing for the worst-case scenario a few weeks ago, Regula, now head of department and services at the Kantonsspital Graubünden, was recruited to work in the hospital’s intensive care unit. “All those who’d had training in intensive care were asked to work in the ICU,” recalls Regula. “I was really impressed at how quickly the hospitals got organised.” Her area of expertise includes hospital hygiene: “We were able to provide a lot of advice. The aim was to make sure that everyone felt safe in the new situation.” In her normal everyday life, one not affected by the coronavirus, Regula is responsible for organising various departments, such as nutrition, social services or speech therapy. And, despite shifts in the intensive care unit, this work has to go on.

Meanwhile, the number of reported cases has plateaued. “Luckily we never reached crisis point. We always had a handle on the situation, even when we had many patients with the virus,” said Regula with relief.

Exhausting work

Coat, face mask, goggles and gloves: On starting their shift, the nursing staff have to dress for their work in the isolation rooms, pandemic ward or the “corona ICU”. Once a nurse enters the room, they don’t leave again for some time, with helpers providing medicines and materials from outside. Now the patients are monitored, examined and looked after, materials and equipment are checked, and laboratory and blood values are analysed.

Every so often, the nurses have to perform a really tiring procedure: turning COVID-19 patients from their back on to their stomach. As the face-down position has proven successful for treatment, the patient usually remains in this position for 16 hours. Four people help to turn them over, with the right positioning taking about half an hour per patient.

It quickly gets hot under the protective clothing and the glasses press down on the bridge of the nose. “An extremely high level of nursing care is required, because patients are so fragile due to the lung failure,” explains Regula. And compared to other patients who have had a heart attack or a stroke for example, COVID-19 patients stay on the ward for a very long time, on average around three to four weeks.

High morale

Although the last few weeks have been stressful, explains Regula, there have also been nice moments: “When a patient whose case looked hopeless suddenly makes a recovery.” Or when previous patients send thank you letters and photos when they’re back home. “It’s great to see people back in their everyday lives, far away from the hospital bed. What I find really hard is the situation with relatives who are banned from visiting by the authorities due to the risk of infection.” Relatives are not allowed on the ward, they can’t sit with their loved ones. They are only allowed in to say goodbye when there is no hope that a patient will recover. “As a result, we’re having to find individual solutions and spend more time looking after the relatives, too. On request, we send photos of the patient with our own smartphones or make contact via FaceTime.” One thing that’s really hard is to organise a fixed medical contact for the relatives. “And this is extremely important, particularly at a time like this, in order to provide them with some stability.”

Regula likes to switch off and run her worries away. Getting out of her uniform, leaving the sterile hospital environment, pulling on trainers and getting outdoors is one of Regula’s key corona survival strategies. “I’ve noticed how the work on the COVID-19 ward is really draining both physically and emotionally. I’m tired a lot of the time. Exhausted.”

However, Regula knows that she’ll regain her energy – and is confident she’d be able to cope even if a second wave of illness were to strike. The only thing she’s worried about is forgetting, because then everything will just go back to the way it was before. We will have learned nothing.