Words of The Irreplaceable: Swedish Hospital ICU Nurses Speak

Two Swedish Hospital ICU nurses take us inside the visitor-less ICU, tell us how they're attempting to cope, and let the community know how it can support them.

words by Ari Robin McKenna

portraits by Jovelle Tamayo

ICU nurses are part of a human network of dozens of essential hospital workers whose jobs in normal times interlock to catch people who fall seriously ill, and for weeks now each of these vital links has been strained by the additional weight of caring for patients in the throes of COVID-19. Their collective load-bearing is ongoing, and the weeks ahead will be marked by uncertainty and concerns for their own safety.

For hospital workers at Swedish's system of hospitals and health centers in King County, the additional grit required of them comes during a prolonged period of instability that began almost a year ago, when contract negotiations stalled with Swedish's parent company, Providence Health & Services—who operates over fifty hospitals in the Pacific Northwest. Hospital workers complained about gaps in patient safety and inadequate staffing, and the dispute ramped up just two months ago, with a strike that lasted three days.

When they returned to their places of work, Swedish Hospital workers found that Providence, a Catholic nonprofit based in Renton, had blocked them from reentering with dozens of armed, tactical security guards wearing body cams, and had temporarily replaced them (for up to five days) with a legion of highly-paid travelling nurses and other roving hospital workers.

It doesn't seem like much of a stretch to say that their behemoth employer was sending a pair of pointed messages to Swedish Hospital workers about how easily they could be replaced, and reminding them just who owned the hospital building in which patients receive their care.

In a mission statement laced with biblical quotes, Providence lists one of their five, core values as "Dignity," after the following quote from Matthew 4.2.4: "All people have been created in the image of God."

It also doesn't seem like much of a stretch to say that Providence Health & Services is not quite as generous as Matthew when it comes to doling out dignity. Two months after the labor dispute, and in the midst a global pandemic, Providence owners were clearly wrong about any of Swedish Hospitals' workers being replaceable.

Case in point: the nurses working to save COVID-19 patients from untimely death in the ICU.

Brooke Johnston, 27 – RN at Swedish ICU, First Hill, lives in Kirkland

"It's already a high-stress environment, which we're all used to. We know that's what we signed up for being in ICU. We're used to, you know…doing like fast interventions and multitasking…trying to keep things flowing in a way that helps the patients get better. We're there for family members; we're working as a team together. And that's just normal day-to-day…But with COVID 19, you're adding the emotional side of seeing these people suffering—alone—and you know that their likelihood of dying is high once they've made it to ICU. And so, whenever they saw their families last was like…the last time.

So I know some coworkers have tried to FaceTime with families, but it adds that emotional component of being…you're like the last ones for them. And it's just really hard to deal with. And then adding on the stress and anxiety of feeling protected yourself…We just like constantly are questioning in the back of our minds: 'Are we protected? Did it seep in through my mask? Did it seep into my eyes over my face shield?' And at the exact same time you're being asked to be that like emotional anchor for patients that don't have family around.

So you're trying to calm their anxiety by fielding phone calls—which you know you need to do to be there for their patients' family and give them updates. But those are…sometimes [they] get in the way of patient care. It's like trying to coordinate, giving time to the families that aren't there to try to paint the picture for them that we're trying to keep their loved one as comfortable as possible…you know?

But…we can't stay in the room all the time and hold our patients' hands either. Normally, if there is someone that shows up alone and doesn't have any family, we can at least try to fill that spot and be in the room with them as much as our job allows, but with these patients we're constantly trying to limit our exposure. And so in the end, you feel guilty because you're limiting…what you could potentially do for them.

I feel like we're just on the beach and we're like watching the tsunami coming and there's nothing you can do about it. You just know that it's gonna get worse. But you don't know exactly when it's gonna hit and you're constantly…on edge."

Lillian Dunn, 33 – RN at Swedish ICU, First Hill, lives in Beacon Hill

"When I get to work, I do feel like we're all in the same boat…and it makes me feel like I can do my job and put on my 'A' game essentially and try to fight this virus…

Personally, my life has changed, because I know I'm at higher risk for being exposed to coronavirus. So, it's changed because prior to this, I had a significant role in helping my dad take care of my mom and my mentally disabled sister…Even though I don't live with them, I took some of that burden off my dad, to help my mom when she had a stroke, because previously my mom was the primary caretaker of my sister, and now he's looking after both.

And so I feel a little bit helpless when I can't go over there and provide a helping hand, knowing that I could possibly pass on this deadly virus to them. I've already felt what it was like to possibly lose a loved one—when my mom was in the hospital with a stroke…The last time I was able to physically see my family was before all the issued preventative measures were instituted, and before I took care of a COVID patient—so that was the day before my birthday…March 15th. It was already apocalyptic the last time I saw them, because we put on masks and gloves before interacting with my family…It was strange not to even blow out your own birthday candles.

At first I was experiencing a high level of anxiety [in my apartment] knowing that I live with a roommate and I would not want in any way—if I was carrying the virus—to pass it along to her. So it's been like…religiously wiping down all the surfaces…She also works in the healthcare field, and is experiencing her own stress related to the situation, and is having to adapt by helping out in the ER at Harborview.

We are still trying to maintain being six feet apart from each other while also being supportive of each other… We're both going through adaptive stress right now in our fields. We check in on each other. We laugh together. We just try to…understand that we each are going through our own personal stresses.

I feel like I'm trying to, you know, live in the present, and be grateful for little things. Like today I just took a mental break after going on a two-hour bike ride, and was thankful that the sun was out and enjoyed a cup of coffee in isolation…But, I mean, I am trying to keep composure. But I do wake up with a feeling of dread.

Right now I'm actually brushing up on studying critical care topics, just so I can better prepare myself for the next time I go into work… and just try to be the best nurse I can be in this situation… I would never… like… abandon my position. I'm proud to be a nurse.

"It's easy to start feeling a bit lonely in this situation, but once I'm at work. I know that all these people I work with, we're all fighting this together… we want to see the light at the end of the tunnel.

Support the Hospital Workers in Your Lives

Recently, the Service Employees International Union (SEIU), which represents Swedish hospital workers, finally came to an agreement with Providence after sustained pressure from Governor Jay Inslee. The 8,000 Swedish Hospital union members will vote on the contract o by April 6.

A third First Hill ICU nurse, who was not willing to go on the record, said the following about the contract's stipulations: "Though it is a step in the right direction, it doesn't significantly address Swedish First Hill ICU nurses' concerns about staffing and patient safety."

On April 3rd, King County announced a 2.2 million dollar emergency fund covering childcare for first responders (including essential hospital workers). Though their overtime pay has been enhanced, Swedish ICU nurses are not currently receiving hazard pay.

While it's unclear what would tempt Providence to properly value the heroic contributions of their hospitals' workers, and in particular their ICU nurses, perhaps our community can support them in the coming weeks, in one of the following ways:

1. REACH OUT: Both Brooke and Lillie mentioned that family, friends and even people they hadn't heard from in a while have been contacting them, and that this has been a welcome boost. "I've gotten a few of those messages from people that I haven't heard from in a really long time, and it honestly helps a lot." said Brooke. Lillie adds: "I've also appreciated a lot of people reaching out to me personally." If you know a hospital worker, send them an email, a message on social media, a text, or call them.
2. SEND LUNCH/DINNER: Swedish Hospital ICU nurses have recently been asked to take on extra patients and have to spend 10 minutes both donning and doffing their protective gear before entering or leaving a patient's room. Plus, they're not permitted to bring their own lunches from home, so this gesture can bring significant relief when they are increasingly pressed for time. If you're in a position to donate a meal to ICU nurses, here's how you can do so at Swedish Hospital in particular: Have it delivered around noon (for day shifts) or 8 p.m. (for night shifts) to: Swedish Hospital First Hill, 747 Broadway, Seattle 98122. Normally, the ICU is on floors 6E and 8E, but has currently been expanded to include half of 9E and 7E. Din Tai Fung, Petra Bistro, and Southeast Seattle's own Musang have all donated meals that have been much appreciated. "We're all stress eating!" Lillie laughs resiliently.
3. DONATE TO SWEDISH HOSPITALS: Though Swedish Hospital representatives have not responded to questions about how food and supplies might be donated to ICU nurses, there is a new, COVID-19-specific giving page on their website where people can make monetary donations.
4. CONTINUE TO #MAKEAJOYFULNOISE: Seattlites have kept this going since its inception last Thursday, and there were multiple reports of it continuing last night in the Southeast. After a day cooped-up in quarantine, go outside at 8 p.m. and bang a pan, play an instrument, or cathartically shout into the night sky in support of hospital workers and other first responders.
   

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Ari Robin McKenna worked as an educator in Brooklyn, NY; Douala, Cameroon; Busan, South Korea; Quito, Ecuador; and Seattle, WA, and is now settled in Dunlap (just north of Rainier Beach) and writing. He is currently pitching a novella called, "On a Moonlit Landing." His reviews of fiction, a few of his poems, and contact info can be found at arirobinmckenna.com.

Featured image by Ari Robin McKenna.