Right before Memorial Hermann nurse Christie Purviance begins her day in the Northeast ICU, she does at least one thing for herself.
She always takes some time to unwind, maybe share her breakfast with her son and husband before she leaves for Memorial Hermann Northeast Hospital. Her day starts typically at 4:30 a.m. — an early start time, but she needs that space to mentally prepare before she leaves for the hospital.
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"I like to get there early, like around 6:30 a.m. I put my shoe covers, my hair-net and my scrub cap and my N95 with my surgical masks, " Purviance said. "Sometimes I would get anxiety and overwhelmed with all the masks. If you're claustrophobic, it's really hard to wear the masks."
Once Purviance arrives at the door to the hospital, everything changes. The quietude shifts into full-throttle intensive care mode.
"We usually have two or three COVID-19 patients in a perfect scenario," Purviance said. "As soon as I began work, I would look on the computer and check my patients and see if there's anything that needed immediate attention."
Purviance said the approach in the ICU unit is to reduce workers' chance of exposure to COVID-19, so healthcare workers "cluster their care. "
"We go and knock out a ton of stuff that we need to get done at one time," Purviance said. "If I need a 9 a.m. blood sugar and I have medications due, then I would go at 8:30 a.m. and get my meds, my blood sugar and then turn the patient."
For Purviance, that process ensures that she does not have to return to the room in 20 minutes, once again in full PPE. In total, there are about four or five times she must enter the patient's room, whether it's to turn patients or give medications. Purviance added that she easily uses 8-10 gowns per patient per day.
"It's a real process just to re-enter the room," Purviance said. "Many of these patients can be on up to 10 IV drips, continuously and two to three sedatives. You're constantly replacing their IV drips."
The one thing she makes sure to do when she walks into a room is to optimistically talk to patients, even if they are sedated and don't react.
"I would talk to them, as if they were awake. Sometimes it felt like I was talking to myself, because they are heavily sedated," Purviance said. "Some were on such high support from the ventilator. But I would try to cheer them up, tell them, 'Hey, it's Friday' or 'Happy Birthday' or anything I could tell them that was specific to them."
Purviance also stressed that she would always try to tell her patients what she was doing.
"I obviously would always tell them, 'Hey, I'm about to prick your finger, you're about to feel a little sting,'" Purviance said. "I just always try to tell them what I'm doing. If you're in deep sleep, if someone pinches or touches you out of nowhere, you would need a forewarning."
Out of the six months working at Memorial Hermann Northeast ICU, Purviance said she only saw four people survive COVID-19. Purviance now works at Memorial Hermann hospital in The Woodlands.
"Generally, it was bad news every day or no news," Purviance said. "Most of the days involved adding another medication because they are declining. A lot of the conversations were with the families. I really wish I could say that there were some great moments."
Entering the rooms of critical care patients could take a punishing toll on Purviance because of the dire condition of some patients.
"They would be the same for weeks at a time, a small and steady decline. From proning, turning and trying to wean the oxygen and the sedation, and they just could never tolerate it."
The moments when the four patients got off life support were the finest memories for Purviance, she said.
"I just remember this one patient, he was so sweet. He would just smile. When he was finally breathing on his own, that was the best moment," Purviance said.
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A day in the life of a Houston ICU nurse - Chron
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