Pictured above from left to right: Amy Salata, Ana DeCarlo, Amanda (Mandy) Lieske

This blog was originally posted in 2020. Some information may be out of date. For the latest updates on vaccines, testing, screening, visitor policy and post-COVID support, visit EEHealth.org/coronavirus.

This Q&A features the following Edward-Elmhurst Health nurses who have been caring for patients with COVID-19 since the pandemic began in March 2020:

• Amy Salata, RN, CV (Cardiovascular) 3W/3SW, Elmhurst Hospital
• Ana DeCarlo, RN, Pulmonary Medicine, Edward Hospital
• Amanda (Mandy) Lieske, RN, Team Leader, 5^th Floor Medical, Elmhurst Hospital

The interviews with DeCarlo and Lieske were included in "Local nurses share the unique challenges of dealing with COVID-19," a story in the August 2020 issue of West Suburban Living Magazine.

Q: What specific background do you have that resulted in you being chosen to care for patients with COVID-19?

• DeCarlo: I work on a pulmonary medicine unit. Our unit specifically sees pulmonary patients on a regular basis. We specialize in patients with pneumonia, COPD, asthma and other respiratory diseases.

• Lieske: On the medical unit, we care for patients with a variety of respiratory illnesses and viruses. I have experience with telemetry and a lot of these patients have also had coexisting cardiac issues. I was able to use my experience as a nurse and critical thinking skills to anticipate potential deterioration of the patient and [was] able to intervene as the situation presented itself.

Q: What were the unique challenges posed for you as a nurse treating patients with COVID-19?

• Salata: The challenge with this virus in the beginning was not having a full understanding as a healthcare worker how to treat patients. There was limited treatment for these patients which made it difficult for nurses. Patients would quickly deteriorate on the units and require intubation or transfer to the ICU. There was a fear of contracting the virus, but in the end, it didn’t matter because we had a job to do and that was to take care of patients.
  
  
• DeCarlo: COVID was new for everyone. There was so much unknown territory we had to navigate. There was a huge learning curve for everyone. We had to learn new treatments and adapt to new medications and changes in treatment as research evolved. Every day we continue learning and adapting our care for these patients as we know more. We have worked closely with our physicians to work through this pandemic together. With the new challenge of COVID, there is also new stress. Learning how to manage that stress was a challenge as well.

• Lieske: The hardest part was patients being isolated from their family members especially in end-of-life situations. We were able to utilize available technology to allow patients to interact with family members while hospitalized.

Q: How did the hospital staff pull together on such short notice and in such an uncertain environment to provide the facilities and care needed?

• Salata: The hospital did a fantastic job pulling together. We are lucky to have such great leadership that starts at the top from Pam Dunley and Jean Lydon to our amazing director, Amy Wright. We had extra staff available from different locations and plenty of supplies available from many donations for PPE. We had so much food donated from so many different companies it was amazing. We all felt so blessed and cared for.
  
  
• DeCarlo: Facilities worked to convert rooms to negative pressure rooms for our safety. They found ways to acquire masks and gowns so we never ran out. [The] hospital gave us extra staff and resources as we learned how to care for these patients. We had nurses and PCTs from every department come help our unit care for COVID patients.  Advanced practice nurses were specifically designated to our unit as a resource for our patients. The teamwork we have on our unit is amazing. My co-workers can always help me get through a difficult day.

• Lieske: We were provided with excellent leadership who always informed us of the current situation as the pandemic progressed. All members of the inpatient team worked together to provide a support system for each other as well as create a healing environment for the patients. We found positivity in celebrating each success in the patients plan of care. We developed a process of gathering team members to applaud the patient as they were discharged off the unit.

Q: What health and safety concerns did you have for yourself (and for family or co-workers) in treating patients with COVID-19 — especially early when little was known about the virus?

• Salata: In the beginning, as with most, I was concerned with bringing this virus home to my family but this faded over time. I made sure to use appropriate PPE and washed my hands. I was also very careful when going to stores, as well wearing a mask and using hand sanitizer.
  
  
• DeCarlo: I think everyone shared the same feelings when COVID first reached our hospital. Everyone was scared to become infected, but mostly scared to bring it home to their families. There was so much unknown. As nurses, we spend a significant amount of time in our patient's room — potentially exposing ourselves. Many of us didn't see our parents or other close family members for a long time for fear of potentially infecting them. We continue to be diligent about our PPE and handwashing, not just at work, but all the time, in order to protect ourselves and others.

• Lieske: The biggest fear was transmitting the virus to my children and family. Little was known early about the method of transmission, so I took safety precautions to ensure that I was protecting them from exposure.

Q: Any specific case, patient or experience that made your efforts particularly gratifying?

• Salata: Yes! One patient in general, I was trying to decrease her oxygen level from 4 liters to room air so she could be discharged home. Mind you I was working four days in a row, so I had several days to work with my patients. On day two, I was able to decrease the oxygen to 2 liters, but while ambulatory, the patient would cough and become very short of breath and her oxygen level would decrease to 87%. She was very tight in her chest. I advocated for her to have a device called an incentive spirometer and called the doctor for an order. In the beginning of this pandemic, it was known that the incentive spirometer was ineffective with COVID patients, but I wanted to find out myself. The respiratory therapist came to the nurse station with the device and proceeded into the patient’s room to teach the patient how to use it. The patient used the device over the next day and, amazingly, was off all oxygen and felt better to go home. Her husband was excited to have her back home.
  
  
• DeCarlo: Our COVID patients aren't allowed visitors. This was so difficult for many of our patients. Doors aren't allowed to be open, they can't leave their rooms. If they turn on the TV, everything was about COVID. They felt alone with a disease that nobody knew anything about. They were scared and felt like they were alone. Every staff member that entered their room was donned in full PPE and almost unrecognizable. Sitting with those patients for a few minutes just to talk to them was the most human interaction many have had in weeks. Some hadn't seen or talked to their families in weeks. We helped coordinate FaceTime calls with patients and family members using iPads our unit had. Our patients were so grateful. They shared tears, frustration, anger, fear, and even laughs with us. But the most gratifying thing for us as nurses is to watch our patients recover and leave the hospital.

• Lieske: There was a patient that I multiple times. Every day, he would hear people being clapped out and asked, “I wonder if today will be my day?” Finally, it was his day of discharge and I decided to make it extra special by playing Queen’s "We Are the Champions" for him as he was clapped out and wheeled down the hall. He was so grateful and celebrated his discharge with such excitement. Moments like that were what shined a light through such a difficult time.

Q: Anything you'd like to add about your experiences as a nurse during the COVID-19 pandemic that wasn't touched on in the previous questions?

• Salata: I am currently back in school completing a certificate for family nurse practitioner and taking epidemiology and find it all very interesting as a nurse and student. We are going through something very new to all of us and hope to get past this very soon.
  
  
• DeCarlo: This virus is very real. As a nurse working closely with these patients, I see a different perspective than others in the community. I encourage others to wear their masks so we can all protect each other from this virus.

• Lieske: I have been a nurse for many years and been faced with many challenges in my career. To me, nothing compares to the COVID pandemic. The uncertainty of the virus, including how it affected each individual differently and how quickly it progressed, was one of the most difficult challenges of my career.

At Edward-Elmhurst Health, your safety and well-being are our top priority. When you visit us, you will find consistent safety measures in place. Learn more about our Safety Commitment.

For updates on our planning and response efforts as we work to stop the spread of COVID-19, please check EEHealth.org/coronavirus.