A nurse at the Aga Khan University Hospital Nairobi (file photo)
**By Emilie Ashihundu
Local media outlets recently got hold of an exclusive story about the first Kenyan COVID-19 patient to recover after being put on ventilators at the ICU of the Aga Khan University Hospital – Nairobi (AKUHN). The man, who preferred to keep his identity a secret was in the ICU for 11 days. He later admitted that these were the most challenging days of his life.
He would not have made it without help.
In his corner during the fight against this deadly virus was a team of nurses and doctors, including Emilie Ashihundu, the Nurse Manager at the Hospital's ICU. Emilie's care for the critically ill began when her mother's heart rate, body temperature and blood pressure rose to near-fatal levels. She feared that her mother was going to die, but her mother survived. As she took her mother home from the hospital, Emilie decided to dedicate her life to ensuring that patients under her care walk out of hospital better than they came in.
Aside from her role in the ICU, she is also a Bachelor of Science in Nursing student at the AKU School of Nursing and Midwifery. In the story below, Emilie narrates her experience in dealing with COVID-19 cases at AKUHN, the challenges she's faced, the help she's received and her message for International Nurses Day.
The first patient
COVID-19 is a very new phenomenon. It is a race against time. Nobody was ready for it, however much we thought we had prepared.
Anxiety and fear pre-occupies everyone in the ICU.
We constantly ask ourselves: what if I contract the disease? What will happen to my children and the rest of my family?
As the ICU team, our most anxious period was when the first patient arrived. I remember that Sunday afternoon as if it was yesterday. The team and I had been in constant communication about this possible admission as I tried to complete my school assignments. As soon as the case was confirmed, I left for the hospital.
I arrived to find that the first patient had already been admitted and he was stable. Everyone was anxious in as much as we had prepared to the best of our ability. This was made worse by the information that was being shared on social media platforms. People were saying so many things and I could tell that my team was getting agitated, so my first role as the supervisor was to take the good ideas that were practical and use them as well as to dispel the information that was unnecessary to the team.
Were we ready?
To a large extent, yes, because the team and ICU had been prepared to host COVID-19 cases. We had gone through daily mandatory training sessions, drills and demonstrations; we had created a step-by-step checklist on how to put on Personal Protective Equipment (PPE) as well as how to carefully discard them (donning and doffing). In addition to this, we had a WhatsApp group where we shared resources such as videos on how other medical teams were handling the deadly virus within their ICUs. The Engineering team boosted our multi-disciplinary approach by fortifying the rooms and helping us take better care of ourselves to reduce self-contamination while discarding our protective equipment. However, as with new situations, we could not have predicted everything. We still grappled with how to communicate with colleagues inside the ICU when we were outside.
Anxiety and stigma
The truth is that anxiety reigns every day.
The hospitals provide us with enough PPE and everything else that we need but, we still worry about carrying the virus home and ask ourselves, who will take care of me if I contract the virus?
There was a time when our colleagues were afraid of us and there was a time we were labelled the “COVID-19 nurses". Also, at some point, there was an increase in sick-offs because everyone was worried about contracting the virus. This meant that those of us who stayed worked longer hours and took on multiple roles. We were fatigued, we were dehydrated from sweating because of the PPEs and we were scared.
Support is really important for healthcare workers now
We continue to support our teams by giving them reliable information, being there for them during donning and doffing and participating in the online weekly meetings held by the Hospital's Human Resource team to update us on everything about the deadly virus. Similarly, we have been provided with a dedicated counselling and support team to debrief us regularly as a team and individually. This helps with our anxiety and mental health.
Initially, the protective equipment was unbearably hot, uncomfortable and would not take into account our different sizes. The PPEs are now supplied in different, comfortable sizes and the engineering team now controls the temperature in the rooms so that we do not sweat as much as before. We also have access to showers to clean up after a shift, which is helpful. It shows that our CEO has been on our side 100 per cent.
Recovery of patients is my greatest happiness
Our most notable breakthrough was when our first COVID-19 positive patient recovered from the virus and was able to return to his family. It was covered by local media and this always makes me very happy: knowing that our combined effort as the ICU team sent someone back to his family.
As I prepare to graduate from AKU-SONAM next year in February, I recognize that certain aspects of my training helped me to deal with the unique situations that the pandemic has thrown me into. The Leadership and Management classes which cover managerial functions such as problem-solving, teamwork and delegation have helped me so much. As we celebrate International Nurses Day, I would like to encourage all nurses that we are in this fight together, and we need to stand with each other as we nurse the world back to health. I would also like to remind everyone to comply with government directives. Together we shall defeat it.
Stay at home and be safe so that we can stay at work to keep you safe.
**Emilie Ashihundu is the Nurse Manager of the Intensive Care Unit at the Aga Khan University Hospital Nairobi, and a Bachelor of Science in Nursing student at the Aga Khan School of Nursing and Midwifery based out of Kenya.