What It’s Like Being a Hawai‘i Nurse During a Pandemic
Here’s how local hospitals adapted to treating COVID-19 patients.
Editor’s Note: For our July issue of HONOLULU, we searched for stories from people all around O‘ahu about the moment COVID-19 became real to them. We spoke with a critical care nurse, care home operators, a mail carrier, a hotel worker who lost her job, a police captain and more back in April and May about the ways their lives at work and at home suddenly changed. Check back on honolulumagazine.com every week for a new story. Pick up the issue on newsstands in late June, subscribe or visit our online store.
Here’s the full version of Colene Geier’s story in her own words, as told to Martha Cheng. The 49-year-old from Kailua is a critical care nurse at Kaiser Moanalua.
photo: meri hoffsten
I was kind of watching the coronavirus but I’m an ICU nurse and don’t usually panic at these things because our health system is really good and on it. And then more stories came out and it was obvious that we were going to be canceling all of our trips—we had five trips planned between March 11 to the end of April—and this was a serious thing. I think the turning point for me was when it started hitting Europe so quickly. With SARS we saw a little bit of that, but not to the extent of this. And then within a period of three or four days, it just seemed like it was here. That caught me a little bit off guard. It was so fast and then it got really real when we were on our way to LA for my daughter’s national water polo tournament, and it was canceled.
Going into work mode was kind of good for me. You don’t worry as much because you’re very task oriented, you got to get this stuff done to prepare for whatever was coming. We’ve been constantly trained since Ebola—donning and doffing, when we put on and take off our PPE. It takes special training because you have to put them on and take them off in a particular order to prevent contaminating yourself. For the last two or three years, we’ve been training and we’ll get signed off on that every two to three months. So there wasn’t a fear of COVID-19, it was more about getting the wheels moving and getting everything prepared and ready, making sure that we had supplies and rooms for the projected numbers of ICU patients that we would potentially be treating. In mid-February those wheels really started gearing up and was the topic of morning charge meetings before I was going to go on vacation.
When you’re at work, it didn’t feel different taking care of COVID-19 patients from other ICU patients. But when you’d be driving home thinking about it—the early acute phases were really, really sick. We were proning them, which is something that we don’t typically do—it’s kind of a last resort when we can’t think of anything else that might help. We’re putting them on their stomachs, which allows more aeration at the lung fields. We did that right away with the first patient that we had based on research that was coming out of places that had already treated COVID-19 patients.
We also started utilizing baby monitors. When you’re in these COVID-19 patient rooms, we’re trying what we call custom cluster care—you don’t want to have to don and doff as much. Normally in an ICU, you’re in and out of your patient’s room two to three times an hour. But with these patients, we’re trying to group the care, do everything that we have to do in a two- or three-hour period, and then not go in again, unless you have to—trying to limit the amount of exposure and donning and doffing. So we started using baby monitors so that the people on the outside of the room could hear what’s going on in the room.
What did feel different is that Kaiser stopped visitors pretty early on. So people were sick, and they were by themselves, which is not typically the case, especially in Hawai‘i. I’ve worked all over the country and I think here in Hawai‘i, for the most part, people have great family support. So that felt different.
For that reason, because they’re alone, we have instituted iPad use so they can FaceTime with family and let them know that they’re here. A lot of patients are heavily sedated—we don’t really know what they can hear and what they can’t—but to have that voice of familiarity and to feel the love and support is huge.
For one of our non-COVID-19 patients in the ICU, he’s had a lot of medical problems and we were trying to evaluate where his care was going to go. We had to do a teleconference meeting with the family. But the elderly mother didn’t have an iPad or a computer—she only had a phone. So we had to work out how to do a conference that everybody could be on—it’s just kind of figuring out as we go, and trying to support these patients and the family members. Usually, in person, you can do that because you’re face to face and they can feel the empathy. Over the phone, it can be a little bit different sometimes. So we just want to make sure that they’re feeling informed and supported and that their loved ones are cared for.
I was supposed to be coming home from Portugal yesterday. For the last three weeks every day, I was like I’m supposed to be in Greece today. My daughter wasn’t that sympathetic to me because I was going by myself. She said, “You know, maybe that’s just the world telling you that you shouldn’t travel without me.”
Yeah, she’s changed her mind now. “Maybe I shouldn’t have said that as early as I said it,” she said. “I am not used to you guys being in my face all the time.”