Rush emergency department (ED) nurses Lauren Callahan, MSN, RN, and Jenna Pederson, MSN, RN, wanted to show compassion for a patient who arrived in the ED on Oct. 21 in the same way they usually would for any patient. But this time was different.
The nurses were dressed in protective equipment, including a face mask that only showed their eyes behind a plastic shield. They also had to keep contact with the patient to the minimum degree necessary to provide care. In fact, Pederson had to stay on one side of a strip of tape that divided an ER decontamination room, with Callahan and the patient on the other.
Only a few hours off a long plane flight, the patient had been brought to Rush for medical evaluation after a screening at O’Hare International Airport flagged the traveler as being at risk for Ebola, given that the patient reported certain symptoms and came from Liberia, which is one of the West African nations where Ebola originates.
Yet even as they took stringent precautions to protect themselves from infection with a disease that horrifies many, Callahan and Pederson were moved by the patient’s situation – alone, frightened and possibly seriously ill.
“It was very humanizing. You hear, ‘Ebola, Ebola, Ebola,’ but there’s a person behind Ebola,” Callahan says.
“Jenna and Lauren were a bit anxious at first, but when they looked into the patient’s eyes, their caring nature and professional skills took over,” says Dino Rumoro, DO, chairperson of the Rush Department of Emergency Medicine. “I was moved by their swift reaction and compassion for a person in need of help.”
While Rush’s infectious disease experts ultimately determined the patient did not have Ebola symptoms, it was a powerful and instructive experience for the two young nurses (both of whom are enrolled in Rush’s Doctor of Nursing Practice program). Here, Callahan and Pederson discuss the evening and how their training and compassion prevailed over fear. (For privacy reasons, the interview has been edited to omit references to the patient’s gender.)
Why were you the nurses chosen to receive the patient?
Callahan: Jenna and I have a hazmat (hazardous materials) background. We’re both part of the hazmat team at Rush. We’ve been in drills and PPE (personal protective equipment) training prior to this event. We’ve been in suits together that cover us from head to toe. We were very comfortable not only in the suits but communicating with each other as well. When we got the call and they said, ‘we need someone in the suit,’ I said, why not?
Was it difficult to get into the equipment?
Callahan: We were getting regular updates about the patient’s arrival time from EMS (Chicago’s Emergency Medical Services division), 45 minutes, 30 minutes, 15 minutes. We suited up around 15 minutes. With the help of everyone we were able to get suited up really fast to limit our time in the suits. It’s a team effort. There’s someone who’s dressing us, who’s checking us.
Pederson: Anna Candoleza (another ED nurse) was our spotter. She was there for every moment of doffing (removing the protective equipment), because you’re tired, you’re drained emotionally, you’re drained physically from wearing it.
What happened when the patient arrived?
Callahan: I met the patient in the ambulance bay with our EMS director, Dr. (Louis) Hondros. The patient was able to walk in to the decontamination room, was covered in a blanket, and then zipped inside an isolation bag. We asked about symptoms, presenting complaints, and then we waited for the infectious disease doctors to get involved.
Then we just chatted. We found out about the patient’s favorite food, kids, work, a friend in Chicago.
What was different about caring for this patient?
Callahan: The biggest thing was being reminded that there is a person behind Ebola. The patient was afraid of being judged walking through the hallway.
Pederson: The patient was saying, ‘I would never want anyone to be injured.’ This person wanted to find out if it was Ebola as much as we did, and was happy to see we were taking it seriously.
Callahan: It was a little bit hard, because we were trying to limit contact until we knew. The patient care, the actual care aspect, isn’t the hands-on that we were used to.
The patient was crying at one point. I knew where a hand was (inside the protective bag), and I put my hand there.
Jenna: Normally, if you had a patient who said the things that this person said, you would sit next to them and give them a tissue, take their hand. We couldn’t provide the personal touches that you would at the bedside. We only could provide comfort by talking.
How did you feel when the doctors said the symptoms didn’t indicate Ebola?
Callahan: I was relieved, for the patient, the patient’s family, the grandkids that we learned about, relieved for the MICU (medical intensive care unit) team, relieved for my co-workers, everybody.
Pederson: Still, we did everything we would have done if the patient had been high risk. We doffed (the protective equipment), and I preferred that. If we were going to start high risk, we’re going to finish high risk. It’s still good practice. Even if it’s 100 percent there’s no chance, we’re still going to doff the same way.
The training we had helped. They make you doff in a slow, methodical fashion. I took off Lauren’s equipment fully before I started, and I was roasting. I felt like I was in an oven. But it had to happen that way.
Were you scared during all of it?
Pederson: Before we started, you had all this built up anxiety. This is the first case, and everyone’s running around. Once I was in the room and fully dressed, I wasn’t scared. Here it is. It’s go time.
Callahan: It’s the same if you get a call if there’s a cardiac arrest. You rely on your training and your instincts. That initial adrenaline, we all have it in the ER, and we like it.