In the midst of a pandemic, almost every decision feels high stakes, and impossibly complicated. This episode will explore the difficult decisions our storytellers have made, to care for each other and themselves.
Our first story is from labor and delivery nurse Amelia Reeves. When tragedy strikes in the maternity ward, Amelia has to decide whether or not to bend the rules.
After Amelia’s story, our host interviews University of Pennsylvania Professor of Law and Psychology Tess Wilkinson-Ryan, to explore the psychology behind making decisions in a pandemic.
Stay tuned for Part 2 of this episode on Monday!
Story transcript
On this particular day, I'm finishing up a C-section which is going to allow me to be open to take the next available patient that comes up to the unit. I'm a labor and delivery nurse in New Orleans and it's early April. New Orleans was hit incredibly hard in the beginning with this virus. Mardi Gras had just happened. My absolute favorite weeks of the year had just come to a close when the pandemic hit the city.
I'd gone from dancing in the street with thousands of costumed people to being completely alone and quarantined off from anyone and everyone. From the highest of highs to the lowest of lows within a matter of weeks.
Work is kind of a double-edged sword for me. I'm single. I live alone. My family's out of state so on one hand coming to work means that I get to be around and interact with people, but on the other hand work is also just a giant ball of anxiety and stress. The fear of the unknown and the anticipation of not of if we get a positive patient but rather when we get a positive patient was absolutely taking a toll on me and my co-workers.
Overall, my personality is to try not to take things too seriously and try to find the humor in most situations, so I was trying my best to keep things light at work.
Amelia Reeves at the entrance of the “COVID Cabana.” Amelia is a labor and delivery nurse living in New Orleans.
We created a room where we could labor or where we would labor most of our positive moms and I dubbed that as the COVID-cabana. I jokingly told my co-workers that we should create a coveted playlist for the room which, would obviously include the sweet sounds of Barry Manilow's Copacabana as these beautiful babies entered the world.
I put a sign on the room that said COVID-cabana in those early weeks, and six months later it's still there.
I try my best to keep this positive attitude with my patients because I know that they are so afraid right now, but admittedly some days are definitely harder than others.
Like I said, on this particular day I was open to take the next patient and the ER calls. They tell us that they have a patient down in the ER who's about 20 weeks pregnant. She's complaining of some abdominal pain. They tell us that she's never been to this hospital before, doesn't see a doctor here and that her husband's down there with her.
I jot down a quick report and then I tell them that they can bring her up but her husband has to stay down in the ER.
In the early days of COVID, our hospital, like many hospitals had created a protocol concerning support persons at the bedside and we were only allowing a support person up with our patients when they were in active labor. So any of our patients that were coming up and we are just triaging and trying to figure out what was going on, or our overnight stays, 24‑hour stays they had to come up alone and could have no one with them. It was just if you were deemed to be in active labor could you have your support person with them.
And with that, the support person had to stay on hospital grounds for the whole three to four-night stay. So we were telling these partners that you could pack your snacks, pack your bags, because you can't leave the hospital once you come in.
The ER brings this patient up in a wheelchair and she's crying. She's writhing back and forth in the wheelchair so I quickly get her to a triage room. I'm helping her out of the wheelchair and she can barely walk on her own. So I help her get undressed and I notice a fair amount of blood.
Paper bags hanging up in the hospital hold each nurse’s N95 mask to be reused after each positive patient.
As a labor and delivery nurse, I feel like a lot of my interactions with patients is spent assuring them that everything they're feeling and experiencing is normal. Especially moms being pregnant and having babies, so much of the laboring process is unknown. So I spend a lot of time putting their minds at ease.
But in the times when what they are experiencing isn't normal, and I can tell that mother and/or baby's health is threatened, fear sets in my body. My adrenaline kicks in. And when I see the blood along with my patient's other symptoms, I get nervous. I get nervous for her, nervous for her baby, nervous that I won't make moves quick enough and will forget something.
But as nervous and as scared as I am, I'm not going to let her see that. I have to stay calm for her. I have to stay calm, stay in control for her.
I immediately call in for more help and we get a doctor to the bedside. He confirms that she's about to deliver her baby, so I call out to get her husband up to the bedside as quickly as possible.
As we're all running around, I'm trying to explain to the patient what's going on but she's crying. She's in so much pain. You know she's not in the right state of mind to understand what I'm telling her. And to top it all off, I'm trying to talk with her with a mask on.
Due to COVID, all staff are required to wear for a full shift, full 12-hour shift, masks. And here's this patient who's never been to this hospital before, completely alone, delivering her baby 20 weeks early and all she sees are a bunch of our eyes. It's such an intimate experience and all she sees were a bunch of strangers’ eyes.
Unfortunately, within a matter of minutes, she delivers her baby. And due to the prematurity, the baby does not survive.
The doctor hands me the baby and I wrap the baby in a blanket and put the baby on her chest skin‑to‑skin. She's crying and I'm trying to explain to her that she did everything she could. Nothing she did made this happen. I just keep telling her that I'm so sorry. I'm so, so sorry.
As I'm talk to talking to her, her husband comes into the room. He didn't make it in time. Everything happened so quickly and we couldn't get him up to the room in time.
He sees his wife and his baby and I start to explain to him what has happened and he just starts crying. I just think about how traumatic this is for him. He had to leave his wife down in the ER, seeing and knowing that she was in so much pain, knowing something was wrong. And now he walks into the room to see that she's delivered their baby. 15 minutes ago she was pregnant and now she's no longer pregnant and their baby did not survive.
Amelia sits on the machine that was brought into the COVID Cabana to create a negative pressure space.
I again try to explain to him what I was telling her that there was nothing they could have done to stop this. They came to the hospital as soon as this pain started for her. I just keep telling them how sorry I am, but I struggle because that doesn't seem like enough. I feel like nothing I say is going to help the situation. I mean, they just lost their child.
And as he's holding his wife, her husband looks up to me and he asks if his mother can come to the bedside and be with them. And I had to stand there and tell them that, no, they couldn't grieve together because due to COVID, he was the only person up allowed at the bedside with her and they couldn't swap out at any point during their stay.
How unfair. Pre-COVID, this patient would have been allowed as many visitors as she wanted at any hour of the day, and here I am having to tell them that they can't grieve together as a family. I felt like I was taking something away from them. It didn't seem fair.
Before giving the two of them some time together with their baby, I helped her get cleaned up. I change her sheets. I give her a new gown and I realize that they don't have any of their belongings with them. They came so quickly not knowing what was happening so they didn't have anything packed for an overnight stay.
And I know he's not allowed to leave the hospital according to our new COVID policy, but I just start to think. If there's any comfort from having her own belongings for the night, if that gave her any sort of comfort on what is probably one of the worst days of her life, if I could give her that, I would want to.
But I start thinking what if I let him out to go get the bag and then they don't let him back into the hospital because he's already been here? And now she has to spend the night completely alone after having delivered her premature baby. What if I get in trouble for letting him leave in the first place? What if he leaves and comes into contact with COVID out in the world in between leaving the hospital and coming back and then comes and spreads it? Does it even matter that they have their belongings? Like do they even care to have them? They literally just lost their child.
But eventually, I just if this was me, I would want this opportunity, so I go ahead and I decide to take the chance and just ask them if grabbing some items from home would be of any comfort, and they both agree that that would be something that they would like.
So I start to tell him that there's two entrances to the hospital and they came in through the ER so I tell him he's going to go back out through the ER and not say anything to anyone. Go home, pack his bag, and then when he comes back he's going to come in through the front entrance where there's a front check-in desk. They'll check his temperature and he'll tell them that his wife's upstairs in labor and they'll call up to us and we'll let him in.
He agrees. I take his temperature before he left because I knew that that's the one thing I can kind of control in this situation is they weren't going to let him back in if he had a fever, so he was good to go. He left later that afternoon and we got a call kind of before shift change and we let him in. He got back in no problem.
Amelia moved to New Orleans in 2015 for nursing school with her 2 orange brother cats, and has been soaking up all that the Crescent City has to offer, ever since.
At the end of the shift when I go down to her room to say goodbye, she's still holding her baby, but I noticed that she's changed from the hospital gown into her own PJs. And I think to myself that bending the rules was definitely worth it.
I come into work the next day and I take back this patient and there are plans for her to be discharged. I get all her paperwork together and I go in the room to go over everything. After going over the instructions, she stands up and at first I hesitate. I'm thinking I can't hug her. I can't get too close. What if I'm asymptomatic? What if she's asymptomatic?
But in a split second I was like, “Screw it,” and I just embraced her. We hugged and she immediately started to cry and then I started to cry and we just held each other.
And as she cried, I started to feel guilty. I should have hugged her yesterday. I should have hugged her yesterday when I couldn't find the words to lessen her loss. I should have held her yesterday when she was alone before her husband got up to the room. But COVID stopped me. COVID made me keep my distance. And as I'm hugging her and crying, I realize that this is the first time that I've embraced anyone, touched anyone in over a month-and-a-half. I've been completely alone at home away from my family, at times scared shitless of what's going to happen at work, and I mean she really needed this hug but I also really, really needed a hug.