Kristiina (Nieländer) Hildebrandt is a well-known member of our Toronto Estonian community and a 2-time recipient of an EFC Scholarship (2004, 2010). Today, she is working on the front lines as an ER nurse in Toronto. EFC asked her to share her experiences.
My name is Kristiina (Nieländer) Hildebrandt. I’m a Registered Nurse (RN) working in the Emergency Department at Toronto Western Hospital. Day to day, my role varies between Bedside (providing direct patient care), Triage (assessing and prioritizing patients presenting in the Emergency Room (ER)) and Charge Nurse (leading the ER team in the operation of the unit).
Since COVID hit, the core role of an ER RN has not changed. I continue to receive, assess and treat patients with medical emergencies. The biggest change is that our ER volumes are very low! At Toronto Western, we are seeing about half of the usual patient volume, possibly because many people with non-critical issues are fearful to come in. Without the “normal” overcapacity that we have become accustomed to, the ER is now functioning at its optimal level. We have a manageable staff to patient ratio. Patients are now more comfortable and are able to keep a sense of dignity as they are now being assessed and treated in a private room, rather than in the hallway or what has more recently become the norm, in the waiting room.
We are able to focus on the critically ill and treat everyone in a timely manner. On one hand, we hope people will remember, if their medical concern is not urgent enough to go to the ER during a pandemic, then it may not be an actual emergency! That being said, a medical crisis cannot be wished away, and people who are facing critical situations should continue to seek the help they need.
Where are the sick people? It is understandable that people are scared to come to the hospital these days, but assessments to rule out a heart attack, stroke or severe abdominal pain, among other emergencies, should not be delayed. Patients and staff are screened for COVID-19 upon entering the hospital, patients are physically separated and all staff are wearing appropriate personal protective equipment (PPE). Thoughts of safety are all encompassing. At this point, I’m pleased to report that I continue to feel safe at work in the ER; if you should need to visit the ER, so should you.
Nursing as a profession today
When I think about my job, I'm proud. It could not be timelier that the World Health Organization has declared 2020 to be the Year of the Nurse and Midwife. Florence Nightingale, the founder of modern nursing, was born on May 12, 1820, making 2020 the 200th year anniversary of her birth. Nightingale continues to inspire nurses all over the world with her legacy of dedication and innovation. In the Year of the Nurse and Midwife, amid a global pandemic, the eyes of the world are on our profession in a way that we could not have anticipated. I believe Nursing is one of the greatest professions, and I will continue to provide the care I was trained for to the best of my abilities.
PPE in ER
I have been lucky enough not to have experienced severe PPE shortages. At Toronto Western Hospital, PPE policies were developed very quickly in line with the Public Health Ontario (PHO), Public Health Agency of Canada (PHAC), and the World Health Organization (WHO) guidelines to preserve and ration the available equipment. Although, we have been asked to limit use and reuse of equipment such as face masks, N95 respirators and face shields, I have not been denied PPE to keep myself or others safe when it has been required.
I don’t worry so much about the coronavirus as I do about the health and welfare of my family, friends and community. For instance, I worry about the ramifications that COVID-19 has had on each and every one of us: the struggle to make ends meet due to lost wages, or the mandatory self-isolation and the mental health struggles associated with loneliness and solitude. I am deeply concerned for the elderly, those with frail health or disenfranchised individuals who have been neglected and abandoned.
I try to curb these worries with reason and rationality. I am comforted that as a society we have risen to the challenge to help and support one other. The generous, compassionate and altruistic masses outshine the fearful panic-driven crowds hoarding toilet paper with a self-interested attitude. As we move forward, I hope this pandemic will be enough to catalyze changes within our healthcare system, and that we continue to communicate truths and facts, implement the learned knowledge, and above all, treat each other with patience and compassion.
...and the future?
Looking back at the last five years in my life, there are many things that I would never have imagined happening (including a pandemic!), so I do not want to speculate as to what will be different five years from now. I hope we will be living in a safe, healthy society where hugging a loved one is not a threat or a fear.
Want to know more? Read First Person: Estos on the Front Lines - Teija Jogi - an acute care nurse at University Hospital in London, Ontario or First Person: Estos on the Front Lines: Tomas Saun - Surgical Resident at Toronto Western Hospital