Several weeks into Phoebe’s response to the COVID-19 crisis, when intensive care beds were filled with critically ill COVID-19 patients and before reinforcements arrived in the form of dozens of additional critical care nurses and physicians, one Phoebe care team faced a life or death decision.  Not only would their choice determine whether a patient survived, it could also put their own lives at risk.  “It wasn’t a question of are we going to do this.  It was just, we ARE going to do this and give this man a fighting chance to live.  No matter the COVID status of these patients, they all deserve the same care,” said Phoebe critical care nurse Elli Gahman.
 
Gahman and fellow RN Lauren Hixon were at the end of another long shift in the medical intensive care unit at Phoebe Putney Memorial Hospital, a unit that had long since been transformed into an ICU specifically for COVID-19 patients struggling to survive.  They were bathing a ventilated patient when they noticed something was wrong.  “I remember hearing this really weird gurgling noise.  We looked at the endotracheal tube and realized it was no longer inflated.  The cuff on the tube was blown.  It’s no longer good, and we can no longer oxygenate this man,” Gahman said.
 
The two nurses quickly notified critical care intensivist Dr. Enrique Lopez, and the three gathered outside the patient’s room to formulate a plan.  “He was dying.  He didn’t have a lot of time,” Dr. Lopez said.  “We had to replace the tube.”  But doing so would put anyone who walked in the patient’s room at risk.  “All the air that was in his lungs – lungs being attacked by coronavirus – was just being expelled and was filling the room with the virus.”
 
Dr. Lopez suited up in a powered air purifying respirator (PAPR), something akin to a space suit that provided him clean oxygen to breathe.  The nurses didn’t have PAPRs, so Dr. Lopez insisted he would replace the tube by himself.  “He said he was going to change the tube, and I said ‘okay,’ and he looked like he expected me to say ‘good luck.’  But it was my patient, and I wasn’t going to let him go by himself.  No doubt,” Hixon said.  Gahman felt the same way.  “He (Dr. Lopez) said, ‘you guys don’t have to do this,’ but we’re a team.  We’re in this together.  We do this together,” she said.
 
Seemingly out of nowhere, a third nurse – Virginia Williamson – joined the group.  “Dr. Lopez ran past me and said the patient had a cuff leak.  I jumped up and went with him because I knew what he was about to do,” Williamson said.  Just moments away from heading home, she could easily have left the task to others.  “I could have, but I wouldn’t have been able to look myself in the mirror the next day.”
 
“The nurses helped me put on my PAPR, and as I walk in completely protected, there come these three nurses with just their masks and typical PPE (personal protective equipment),” Dr. Lopez recalled.  “I said, ‘you don’t have to be in here.’  They said, ‘we’re staying.  We’re doing this. Let’s get it done.’  They’re moms and wives with everything to lose.  There was no fear.  They had a warrior’s attitude.  It was bravery manifested.”
 
The trio of nurses admit they thought about the danger, but they never considered letting Dr. Lopez go in that room alone.  “He had to do a tube exchange that required more than just his two hands.  I felt like God chose me to be that patient’s nurse today, so I’m going to step in and do what has to be done,” Hixon said.
 
“I did think about it, but it didn’t matter.  It had to be done, and once Dr. Lopez got his PAPR on, he was very clear that anybody could step out, but we take care of patients.  It’s what we do,” Williamson said.
 
“The danger was definitely there.  I have a husband at home and a 3 year-old.  I know what this virus can do.  In the back of my mind I was thinking of it, but we took an oath to help people, to heal people, to be right alongside them in their darkest hours.  I would not have done it if I felt like I didn’t have adequate PPE and adequate preparation,” Gahman said.
 
“They very well knew every breath they took put them at risk, but they did it with no hesitation,” Dr. Lopez said.
 
Dr. Lopez says he sees that kind of bravery and commitment to patients from Phoebe’s nurses every day.  “I’ve got a ton of stories like that.  Every single day, the nurses walk into those rooms, and they know something could wrong and expose them.  You never see them saying, ‘woe is me.’  They just do it.  You would think they would walk around with this look of fear and emotional exhaustion, and you just don’t see it.  You can see the damage that the masks do to their face, but if you look into their eyes you don’t see it.  They do what they pledge to do which is to give everything they have to each patient.  And it’s an amazing thing to see,” he said.
 
May 6 – 12 is National Nurses Week.  The hospital’s chief nursing officer, Dr. Evelyn Olenick, hopes it is a time when people will acknowledge the vital role nurses play in our community and our country.  “Nurses really are the heart and soul of our healthcare system.  They are here for us every day, providing compassionate care in our greatest times of need.  At Phoebe, our nurses are truly vital members of an incredible team, and they have risen to meet every challenge during this COVID-19 crisis.  I could not be more proud of them, and I hope people in our community appreciate what they’ve done.  If you know a nurse, send them a card or give them a call this week.  Little gestures like that mean so much and give our nurses the inspiration and validation they need,” Dr. Olenick said.
 
Elli and Lauren and Virginia are proud to be part of that team at Phoebe, and they’re grateful for the opportunity to serve the people of southwest Georgia during this unprecedented health crisis.  “I think the community just rallying behind us and giving us all this love has been a huge part of what’s gotten us through this difficult time.  I can definitely say I’m very proud to live in Albany and super proud to be part of the Phoebe Family.  I’m very proud of what our employees and our hospital have done to pull together during this time,” Gahman said.
 
“We’re putting our all in it.  We’re busting our butts every day and trying our hardest.  I just hope everyone realizes we are doing our best, even though frequently the outcomes aren’t what we want.  We’re doing our best to treat them like they’re our own.  I treat all my patients like they’re my family member because I would want somebody to do that for me,” Hixon said.
 
Virginia Williamson is a contract nurse from Alabama who came to work at Phoebe in February, just before COVID-19 hit, but she already feels like part of the Phoebe Family.  She recently saw her actual family for the first time since arriving in Albany.  She spoke from her home where she was enjoying a full week off for what was supposed to be a celebration of her son’s graduation from college.  As much as she relished the rare down time with her family, her thoughts were with her new work family at Phoebe.  “I almost feel guilty for not being there.  We’ve all given blood, sweat and tears and to kick back at home, it feels like I should still be there trying to help.  I’m not dreading going back at all,” she said.
 
Williamson is back now.  She returned to work Wednesday, the first day of National Nurses Week.  She’s back in a Phoebe COVID-19 ICU, back on the front lines of a battle nurses continue to fight every day in hospitals across the country.  “This is the time where people can see the sacrifices that the nurses at Phoebe Putney make to serve this community,” Dr. Lopez said.  “They’re coming in here and getting it done.  No fear.  So brave.  They really are heroes, and I want everyone to know it.”