Texas

Back at Dallas Parkland Hospital with nurses who still have a lot to heal.

Parkland Memorial Hospital nurses, saving lives on the front lines of the fight against COVID-19, have overcome the most debilitating medical disaster of the century.

Gone are the bulging eyes and hackneyed expressions I saw during an interview a year ago. Today, these same nurses laugh a lot, share personal milestones, and enjoy crisis-free workdays.

This single detail is most revealing: they are talking about the pandemic in the past tense. They go forward, albeit as very different people.

“We have lost a lot and are learning to live with this loss, internal or external,” said nurse Farah Ajani. “We are learning to live on.”

The entire Parkland campus looks very much like it used to. The lobby is buzzing with patrons and volunteers. Able-bodied patients are allowed to eat at the public food court. Even the gift shop is open again.

Nurses at Parkland Memorial Hospital share their experience with COVID.

Plexiglas protection removed. The walls, long hung with packages of personal protective equipment for each guardian, are bare.

Nowhere can one find the imposing, locked red doors that almost three years ago warned of the danger of COVID infection from the other side.

“I’m proud that you won’t find red doors in Parkland, and that’s just great,” Judy Herrington, senior vice president of medical services, told me.

COVID remains a common disease, but its treatment is part of the daily work of hospitals provided throughout Parkland.

“There are no red doors in Parkland, which is great,” says Judy Herrington, senior vice president of medical services. (Juan Figueroa / staff photographer)

When we spoke last January, Herrington asked how nurses “even show up to work every day, given what’s thrown at them.”

Today, with COVID numbers down and vaccines working, morale has improved a lot, she said. Despite the continuing shortage of staff – about 20%, as this time last year – “we are simply in a much better position.”

“We still have a lot of work to do,” Herrington said.

Nurse and department head Kelly Stevens, whose team has treated hundreds of COVID patients, said staff have gained enough confidence in just the past few months to shed their crisis mentality.

“Even when we were a normal unit again… everyone was waiting for that shoe to fall again,” he said.

We stopped by COVID Parkland during its “worst week” when North Texas saw a spike in coronavirus cases.

The nurses said they were completely out of breath during the holidays when they were finally able to get a decent vacation, go visit family and genuinely feel like there was something to celebrate.

“COVID is not holding us hostage like it used to be — not in our own lives, not in the hospital,” Stevens said.

Adjani, who has worked with Stevens through most of the pandemic, told me that the situation has improved so much that she was able to take the long-awaited step of being promoted to a nursing position at Parkland’s Women’s and Infants’ Specialty Health Unit.

“I wanted to make sure I didn’t leave while we were still in this crisis mode,” she said. “I had to see it through to the end.”

Left to right: Kelly Stevens, Nurse and Head of Parkland, Nurse Simone Brackens and...
Left to right: Kelly Stevens, Nurse and Head of Parkland Unit, Nurse Simone Brackens, and Traveling Nurse Tiffany Dixon chat during safety meetings at the 13th-floor unit, which Stevens is overseeing.
(Juan Figueroa / staff photographer)

Stevens said that managing the workforce during the pandemic has taught the trauma nurse the need to “be more human and help people more.”

Having spent most of his career on cases that ended in death, he was better prepared for the pandemic. He learned that a big part of his job was to teach resilience to people who weren’t as programmed as he was.

The key question he now asks when interviewing prospective nurses is, “What are you doing to protect yourself from burnout?”

“If you tell me, ‘I’m going to take a breath,’ that’s not the answer,” Stevens said. Ensuring it has an emotionally healthy staff is critical because “who knows when the next COVID will be?”

Ian Noguerra, who spent much of his first four years as a nurse battling COVID, said his lesson from the pandemic is that he realized how “it strengthened my will” to persevere in the profession.

Encouraged by his own marriage in November, Noguerra feels a steady sense of better days in Parkland – a far cry from the bleak atmosphere he described last January.

Left to right: Hannah Ramsey, ECMO specialist;  Teresa Taylor, director of care;  Farah Adjani...
Left to right: Hannah Ramsey, ECMO specialist; Teresa Taylor, director of care; Farah Ajani, Nursing Specialist in Women’s and Infants’ Health; Cathy Doherty, Acting Vice President, Surgical Services; Kelly Stevens, Nurse and Head of Department; and Jan Noguerra, Nurse and Assistant Head of Department.(Juan Figueroa / staff photographer)

Now Noguerra, assistant nurse manager on Stevens’ team, constantly monitors the well-being of his team, especially new hires.

Hiring good nurses is perhaps management’s biggest headache as institutions everywhere try to fill holes. With the onset of the pandemic, many have joined the lucrative traveling nurse industry, some have taken on less stressful jobs in healthcare, while others have left the profession entirely.

“We have not returned to a normal workflow,” said Teresa Taylor, director of nursing. “We still have times when we fight for staff.”

The more important message from both Herrington and Taylor was this: Parkland’s medical staff had come out on the other side of the pandemic.

“There’s a solid group that stayed from the beginning and went through it, and we’ve become stronger because of it,” Taylor said.

Another part of the staffing problem is that too many nurses want to go straight to specialized jobs, like in the intensive care unit, instead of building a good medical-surgical base, said Cathy Doherty, acting vice president of surgical services.

She is also concerned about the increase in violence – verbal, emotional and physical – faced by caregivers from patients and their families, which will prevent people from becoming nurses or push them away from the profession.

Parkland Nurse Kristen Maschino read an article on caregiver burnout on Wednesday that...
Parkland nurse Kristen Maschino on Wednesday read an article about carer burnout that was posted on a bulletin board in her unit on the 13th floor.(Juan Figueroa / staff photographer)

All six nurses I spoke with on Tuesday have their own horror stories about this. No one—certainly no one trying to cure the sick—deserves to go to work, to be yelled at, to have food thrown at, or pushed against a wall.

“I don’t use the word ‘violence’ often, but that’s the only word for it,” Doherty said. “No grace, no patience. It’s complete anger.”

I met Doherty at the start of the pandemic when I reported on the caregivers in the original “red box,” the tactical care unit where Parkland initially treated all COVID patients.

Doherty said the experience showed strength and resilience she didn’t know she had.

Like many caregivers, she has also had to grapple with the fallout from how months of often round-the-clock duties forced her family to go without her—and cost her time she can’t recoup.

“You feel guilty, which I still feel,” Doherty said.

My last interview also featured Hannah Ramsey, a former red booth night nurse and now a nurse specializing in extracorporeal membrane oxygenation (ECMO) in the intensive care unit.

In 2021, Parkland added ECMO machines to its lifesaving efforts in the most hopeless COVID cases. The device draws blood from the body, oxygenating it and ventilating it, functioning like a lung shunt at the bedside.

‘Whom am I going to see? My husband, my daughter, child? In one week, COVID tore apart this family from Dallas

After mourning so many deaths in the red box, including one new mother whose unexpected death nearly broke Ramsey’s team, she said working with ECMO has given her back hope that she can truly help the sickest of patients. .

She now sees women returning home to be mothers to their children, and finds she has more “cheerfulness in my step”.

Getting to this place among the victims of COVID was not easy. Ramsey remembered the day she realized she had become a woman who didn’t know how to create joy in her life.

Like many nurses I spoke to, Ramsey went into therapy. She took advantage of the resources that Parkland had made available to staff. She told family and friends, “Hey, I guess I’m not okay.”

She also began reaching out to colleagues, especially less experienced nurses, to open up a compassionate space in which they could talk.

There are simple acts of kindness that the rest of us could try: check out your nurse friends. Be courteous in all dealings with healthcare professionals. Try saying an extra thank you.

While these heroes continue to care for us all, nurses in Parkland, as in North Texas hospitals, still have a lot to do.

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