Throughout the holiday COVID surge, Riverside Community Hospital rapid response nurse Erin McIntosh recorded a series of audio diaries, sharing her thoughts and experiences from the front lines.
She made the recordings after shifts spanning close to 24 hours, and witnessing young and old patients succumb to coronavirus. Despite the repeated tragedies, she makes every effort to connect those nearing the end to their loved ones.
It starts with a call from the bedside.
Here is her story — in her own words.
Just walking into a room sometimes, you can tell as soon you pass through the door and hear the patient breathing fast that the situation is dire. Normally, someone breathes about 12 to 20 breaths per minute, but these patients are gasping for air, using all of their muscles about once a second.
“Hello, my name is Erin,” I tell the family when I call them before intubation. “I’m a rapid-response nurse, and I’m here with your mother or father or sister. And I just want you to know that I’m here with them and they’re not alone. I’m holding their hand. We’re going to do everything we possibly can to take care of him.”
There’s a look on the face of this woman, sheer fright. She knows it’s coming. I can tell she’s afraid. I take the time, put on my gear, go in the room, and I grab her hand.
The first thing I do is get right at eye level. “My name is Erin, I’m here for you,” I say as calmly as I can. “I’m just a nurse. I’m going to take care of you. Do you feel me holding your hand? Can you hear me talking to you?”
She looks at me and shakes her head, still gasping.
In a soothing voice, I say: “Listen to me talking to you, close your eyes. All I want you to do is focus on breathing. Slow — slow down your breathing. In through your nose and out through your mouth, just like you’re blowing out a candle. Nice and slow. You got this.”
Fear is still in her eyes as she looks at me. Tears start slowly running down her face.
We have to intubate her, but I already know how that ends. First thing we have to do is call family. I look to another nurse: “Do you have the phone number for the family?”
“No,” she says, “I didn’t get the number. She was fine earlier.”
I look at the patient as she lies in the bed, breathing too fast. “Do you have a cell phone?” I ask. She gestures to the bedside table and I see it. I grab it and touch the screen, but there’s some kind of lock.
“Use your fingers and unlock your phone so we can call your family,” I gently tell her. Despite all the noise around us, I hear her say in a muffled voice, “My daughter.” I whisper to her, “You want me to call your daughter?”
She nods yes.
She can’t tell me the code. She can barely speak. She’s fumbling. She’s starting to lose consciousness.
“Hurry, please tell me the code so we can call your daughter. We have to call your daughter.” She keeps trying to unlock the phone, but it doesn’t work. “That’s not it, honey. Let’s try again. Slow down your breathing,” I say.
She’s more afraid now, and her vital signs are dropping. I shout for the doctor and call for meds as now I’m trying to work her phone and get it to unlock.
It’s too late. We don’t have a number for the family, and we have to intubate her.
I just hold her hand. “I’m right here with you,” I say. “I’ll take care of you. You’re going to be comfortable in just a moment.”
Pandemic home life
At work, I’m dealing with very sick people and regularly see a lot of suffering and dying. But then when my shift is over, I transition to something totally different at home. I have four kids that are excited to see me, and they just want to spend time with their mom.
Around the start of the pandemic, I lived in a hotel for almost two months because I was afraid to bring it home to them. Even now, I still have a ritual of right when I get home, taking off my shoes outside, throwing my clothes right into the washer, and taking a shower.
I have a 2 year old and a 3 year old who don’t understand, and they come running at the door. “I love you mommy, I love you,” they’ll say. They want to give me a hug, and I almost have to fight them off. Sometimes I’ll have my two older kids take them upstairs so they don’t see me because that makes it a little easier.
Their mom won’t come home
I always think about this one patient. I’ll call her Maria. She was the same age as me and had three kids. She got together with her family on Thanksgiving and got coronavirus. She started doing worse, and I went with her as she was transferred to the ICU.
She was just crying hysterically. “Listen to me Maria,” I said to her. “You have to slow down your breathing. You can’t keep crying like that.” It wasn’t crying, she was wailing.
“I want to go home. I want to see my babies,” she gasped.
If she didn’t stop, her heart was going to stop. That’s how low her oxygen levels were. All I could do was sit there and hold her hand.
“Listen to me Maria, I’m right here with you,” I told her. “You have got to slow down your breathing. In through your nose, out through your mouth. Please stop crying, please.”
She didn’t make it.
I keep thinking about that. Her three little kids won’t have their mom come home. It sucks that my kids have to deal with me having to go through so much. And maybe at times I’m not fully present, but I feel luckier than Maria.
A source of hope
The happy moments are hard to come by in the hospital anymore these days. I guess I would have to say the happy moment I’m having is that our numbers are not going up. There are no longer 250 COVID-positive in our hospital. We’ve kind of hovered around 220.
Unfortunately part of that number is the fact that many are dying. But it’s a good thing that cases aren’t increasing like they told us they would. It gives me hope that maybe the worst is behind us.