A group of medical workers from a ‘Hong Kong-style public hospital’ in Shenzhen accepted the urgent mission to look after the most serious patients who contracted the novel coronavirus in the city. Together with other ‘warriors’ across the city, they overcame unprecedented challenges and secured a turning point in the fight. Li Bingcun reports in Shenzhen.
Zhou Xingpu, a veteran nurse from the University of Hong Kong–Shenzhen Hospital, attends to a coronavirus patient in severe condition at the Third People’s Hospital of Shenzhen. (PHOTO PROVIDED TO CHINA DAILY)
Intensive Care Unit (ICU) nurse Luan Jiling had never dealt with adult patients before, and when he did, his first experiences were traumatizing. He found patients desperate, panicking, and believing death hovered over them. Luan is a pediatric nurse, yet his patients are gravely ill seniors laid low by the novel coronavirus in the worst-hit district of Shenzhen.
Adult care usually is more complex. As people age, they become more and more prone to chronic illness — and for those people, when confronted with the coronavirus, the danger of death is high.
Most ICU patients arrived at hospitals on stretchers. When they recovered and walked out, the encouragement for medical workers is everything
Luan Jiling, 26-year-old nurse from HKU-SZ Hospital
Besides the difference in choices of drugs and dosage of treatment, adult patients are also much heavier than pediatric patients, which brought additional difficulties in nursing.
Luan had been trained in this, but his clinical experience dealing with the issues was negligible, making his first practical experience a trial by fire.
“The pressure is huge. A mistake could have unimaginable consequences for patients.” Luan said.
The 26-year-old nurse was working in the pediatric ICU of the University of Hong Kong–Shenzhen Hospital when he was asked if he would take an assignment at the only hospital in Shenzhen that was admitting coronavirus patients.
Luan traveled across the town as part of the first group of medical workers seconded to the Third People’s Hospital of Shenzhen. It was Feb 1. As part of the post-’90s generation, he regarded the assignment as a challenge to take greater responsibility. He even considered that he’d be setting a good example for his son, who was only 2 years old.
Luan expected he would be treating infants and toddlers. Yet he was in for a shock. At the hospital, he learned none of the pediatric patients was seriously ill — it was older people who badly needed help. Most of them were over 50.
Luan Jiling, a nurse from the University of Hong Kong–Shenzhen Hospital, said the temporary assignment to the Third People’s Hospital of Shenzhen, the city’s major battlefield in the coronavirus pandemic, was challenging but fulfilling. (PHOTO PROVIDED TO CHINA DAILY)
Most were on life-support machines, and some were in induced comas. Some were even undergoing extracorporeal membrane oxygenation (ECMO), a ventilator often regarded as the last hope for saving the lives of coronavirus patients. Many patients were heavier than Luan, who weighs about 55 kilograms.
Luan’s first patient was a man over 60, with a 17-year history of hypertension and some other underlying diseases. His heart and lungs had failed, and there was systemic damage to his health. He was hospitalized in late January. He’s still in a coma on ECMO, and his condition continues to deteriorate.
Many ICU patients were deeply afraid. Luan recalled one patient who came out of a coma and seized Luan’s hand, holding it for more than 10 minutes and saying, “Save me! Don’t give me up!” Luan admitted he was strongly affected by incidents like that, seeing the fear and despair.
Luan was getting a cram course, trying to raise his level of expertise in a short time. Besides reading patients’ medical charts, the sharing and encouragement from colleagues also helped him. Four other nurses from the HKU-SZ Hospital had at least five years’ experience treating adult ICU patients. They formed a WeChat group to share everyday experiences, including technical challenges and emotional stress.
In late February, one of the patients under Luan’s care was discharged. Luan said he felt an incomparable sense of fulfillment. “Most ICU patients arrived at hospitals on stretchers. When they recovered and walked out, the encouragement for medical workers is everything,” he said.
Zhou Xingpu (second from left) takes a group photo with some other medical workers from various hospitals across the city in front of the Third People’s Hospital of Shenzhen on Sunday. (PHOTO PROVIDED TO CHINA DAILY)
Call from the front line
Ever since the coronavirus pandemic broke out in Wuhan, Hubei province, and then spread across the nation and around the world, Shenzhen have been one of the most severely hit areas. With 427 infections as of Wednesday, Shenzhen ranks fourth among all Chinese cities outside Hubei.
Reporting its first case on Jan 19, Shenzhen saw its disease situation worsen rapidly. On a single day, Jan 31, the city recorded 60 new cases. By the end of that day, there were 170 infection cases in the city, with 166 hospitalized in the Third People’s Hospital, the only hospital in the city admitting coronavirus patients. The hospital’s medical staff was quickly overwhelmed. The labor shortage was particularly felt by the nursing staff, which was treating the most severely ill patients in the ICU.
By late January, 36 ICU nurses were charged with the care of about 20 patients on average. However, according to national standards, every ICU COVID-19 patient needs at least six nurses.
The hospital appealed for help to shore up its already limited resources while also facing the possibility of ever-increasing patient numbers. The hospital asked government authorities to send help from other public hospitals.
The HKU-SZH responded by sending seven veteran medical employees — five nurses with ICU experience, an ICU doctor, and another doctor to oversee detection of viruses. The selected ones were all between 26 and 36 years old. Five were men, and two were women. Three members of the team have families to take care of.
The team joined dozens of doctors and nurses from other hospitals in Shenzhen. The temporarily reassigned workers have varied backgrounds, but all are working toward the same goal — defeating the virus.
Five nurses from the University of Hong Kong–Shenzhen Hospital join dozens of medical workers across Shenzhen to support the Third People’s Hospital of Shenzhen, the city’s only hospital admitting patients who are confirmed to be infected with COVID-19. (PHOTO PROVIDED TO CHINA DAILY)
Rising to challenges
Among the seven-member team dispatched from the HKU-SZH, six were assigned to treat the most seriously ill coronavirus patients in the ICUs. Before heading to the front line, they had tried to prepare themselves, but they were still unprepared for what lay ahead of them.
One pressing challenge is the difficulty of working in full protective gear. Most medical staff had no previous experience dealing with a pandemic. Wearing protective gear was something entirely new for most of them. It was also a test of their endurance and adaptability. They wore N95 masks, goggles, multiple layers of gloves, and protection suits. When wearing all that gear, it’s even hard to breathe, and the gloves make it more difficult to handle medical instruments.
Zhou Xingpu, a veteran nurse from the HKU-SZH, spent more than eight hours in the ICU on his first day at the Third People’s Hospital — double the time nurses normally spend on duty in intensive care. He recalled that when he stepped out of the ICU, his clothes were soaked in sweat that had trickled even into his shoes. His palms were wrinkled and pale. He described the feeling as “really uncomfortable”.
There is tremendous mental pressure. Patients suffering severe respiratory difficulties are in life-or-death situations continually. Ling Haining, a 30-year-old nurse from the HKU-SZH, said he felt high stress at the beginning. “I told myself I came here to help, not to make trouble,” he said. Ling said he feels pressure to keep up the intense effort, even when he is off duty. In his spare time, he practiced wearing protective gear and reviewed the day’s work.
Zhou Xingpu records coronavirus patients’ conditions at the Third People’s Hospital of Shenzhen. (PHOTO PROVIDED TO CHINA DAILY)
There was also an unfamiliar working environment. ICU treatment demands proficiency with medical equipment. There are standard protocols to be met and also the understanding among members of an experienced medical team. All of these situations require time to adjust.
It was a high-risk situation. By Feb 11, more than 1,700 medical staff had been stricken by the virus across the country. Six had died, according to the National Health Commission. The infection risk is especially high in ICUs. Intubation, a common treatment for serious coronavirus patients, can create discharges of contaminated blood or body fluid. There are droplets from other respiratory secretions. Luckily, medical staff at the Third People’s Hospital has escaped infection.
Additional stress came from changes to their daily lives. Most of them were doubled up in hotel rooms near the hospital. Most free time is spent isolated in the rooms. They can’t cook, and they don’t have free time. Their regular fare is boxed meals prepared by the hotels. The rooms have no balconies. Clothing has to be aired indoors.
Turning point
They endured the challenges through their shared sense of commitment and optimism.
Among the five nurses from the HKU-SZH, four had worked together in the ICU. Their familiarity with each other helped them deal with the unique challenges they faced. Throughout the ordeal, they gave each other support and encouragement. They found their own ways to relieve stress — reading, listening to music, doing yoga exercises, or watching soccer.
The Third People’s Hospital also offered support. There were regular deliveries of fruits, snacks, and even disposable diapers as they couldn’t go to the bathroom while wearing the heavy protective gear. Most tried to avoid the diapers by drinking less water before entering isolation wards.
There had been no suitable N95 masks for Bian Yuwei, the only female on the team’s nursing contingent, who has a small face. Her roommate, a nurse from another hospital, had tested positive for the coronavirus, but further testing showed she had not been infected. The head of the HKU-SZH’s nursing department went to the hotel to offer support to Bian and bring her face masks that fit her properly.
Their efforts were acknowledged by patients and their medical colleagues. Zhou said he got a thumbs-up after helping a patient save an unnecessary treatment. Ling earned praise from senior nurses for keeping good hand hygiene.
The city has finally seen signs of the virus being contained. After a peak, in late January, the number of new cases gradually declined. Since Feb 16, the city’s daily new cases have decreased to less than five on average, even zero on some days. As of Wednesday, Shenzhen had only two seriously ill coronavirus patients.
With the pandemic under control, the medical workers assigned to the Third People’s Hospital are expected to return soon to their regular duties. They’ve all made plans — going to the seaside with their families, going out together, or getting together with their comrades in arms for a drink.
Soon they will be back on regular duty, and their lives will return to normal. The pandemic may cease to be the main topic of conversation, and memories of the events may dim, but they say they will always be ready and on call for when the next crisis hits.
