SPRINGFIELD — Stefanie Dinoia has spent the final 14 months of the pandemic caring for a number of the most severely unwell sufferers as a registered nurse in Baystate Medical Heart’s intensive care COVID-19 unit.
There have been moments of grace and reward in attending to the critically unwell and serving to them recuperate. Moments of battle and exhaustion towards a respiratory illness attributable to coronavirus that may impression each organ system and that continues to take lives. A stretch of time as properly through the state’s highest surge of COVID-19 hospitalizations and deaths last spring that she prayed to God “to get me via the subsequent hour.”
“My objective was to remain alive,” mentioned Dinoia of that point interval particularly that was marked by shortages of non-public protecting gear, in addition to altering federal pointers on security protocols. “I used to be grateful every single day that God woke me and that he woke me up wholesome, and that I might go in and begin my day and look after my sufferers and my households in no matter manner I might. And care for myself in-between.”
The 1983 graduate of the previous Baystate Medical Heart Faculty of Nursing is proud to have spent her practically 40-year profession at Baystate, to be an alumna of its former nursing college the place direct affected person care was a big a part of the diploma college’s curriculum, and to have labored via a pandemic along with her colleagues in offering such care.
“This pandemic was one thing none of us anticipated,” Dinoia mentioned. “I’m privileged and honored to have been a part of it as exhausting because it was and is. It has been the largest problem of my profession. Initially, my focus was sooner or later at a time after which as increasingly sufferers got here, it was to get via the subsequent hour after which the subsequent and the subsequent.”
She mentioned there have been some COVID-19 sufferers in intensive care who “have been with us a really very long time after which went onto the ground and ultimately off to rehab.”
“They have been very, very sick they usually made it,” Dinoia mentioned. “A tribute to medical, nursing, respiratory remedy and the well being care occupation. All of us labored exhausting. It was not only one particular person. We labored as a staff.”
Dinoia mentioned her years of expertise as an ICU nurse at Baystate ready her for what she referred to as the “mentally and bodily exhausting” nursing the pandemic required. This included the each day sporting of non-public protecting gear, caring for intubated sufferers respiratory solely with the help of mechanical air flow and serving to to position such sedated COVID-19 sufferers in a inclined place to enhance lung perform.
“Being a vital care nurse, we at all times took care of very intense, acutely unwell sufferers. I used to be already used to doing that,” mentioned Dinoia who earned her bachelor’s diploma in nursing from Fitchburg State College in 1993. “These may very well be sufferers intubated on account of respiratory or cardiac arrest or in isolation for no matter purpose. I’ve taken care of sufferers who had tuberculosis.”
Dinoia mentioned what the newly detected virus launched into well being care in its viral transmission by contaminated vacationers from China final January was the concern of being up towards an unknown.
“This virus is lethal and takes lives and it introduced the concern of the unknown,” mentioned Dinoia who took care of COVID-19 sufferers in ICU solely for the primary three months of the pandemic.
“We have been advised to enter the room and do no matter we might as rapidly as we might after which come out, however it was not a matter of going out and in of the room. You continue to wanted to go in and get important indicators and provides nursing care and switch your affected person. You continue to wanted to care for your affected person.”
She mentioned sufferers transferred to intensive care “have been acutely unwell, struggling to breathe and needing to be intubated.”
“I had three COVID-19 sufferers the day the ICU was expanded. They have been all so sick, all in a inclined place and intubated,” mentioned Dinoia, her voice breaking barely with emotion. “One of many chaplains, Rev. Ute Schmidt, noticed me on the ground and requested how I used to be doing. I mentioned that I used to be caring for sufferers as finest as I might. She mentioned God is aware of you’ll be able to deal with this. He selected you to be a nurse to ship care. I mentioned to myself, ‘Buck up. She’s proper.’”
Baystate now makes use of video conferencing software program that may be downloaded for households to attach with hospitalized members in isolation, one thing not accessible at first of the pandemic. Dinoia recalled working with a respiratory therapist early on round an infection management points to make sure one affected person who was near demise wouldn’t be alone.
“He was within the inclined place along with his head trying towards the window and I used to be in a position to put my hand on his shoulder and inform him it was OK to go to heaven,” Dinoia mentioned. “The attending doctor referred to as his household when he handed and I made a follow-up name to inform them he went peacefully and he was not alone. I used to be with him.”
Lack of testing early within the pandemic put everybody in danger, notably first responders, for COVID-19. Lack of efficient remedies for it and restricted understanding of the contagious virus inflicting it challenged hospitals and infectious illness specialists. The pandemic’s impression additionally challenged well being care suppliers throughout disciplines from emergency room physicians to respiratory therapists to the sphere of nursing the place a piece scarcity existed previous to its onset.
Hospitalization and mortality charges have decreased enormously within the state in current weeks as vaccination has elevated throughout all populations, however the pandemic has made the nursing scarcity worse and highlighted the necessity for extra nurses specializing in such space as intensive care.
Dinoia, who was acknowledged early in her profession for her compassionate care and extra not too long ago as one of many Baystate recipients of the DAISY Award for Extraordinary Nurses, was requested to mirror on her work as a part of Nurses Month.
“I’ve at all times liked vital care and I’ve at all times liked bedside nursing,” Dinoia mentioned. “My mom would inform me that I confirmed an curiosity younger in well being care as I’d be proper there watching her put a dressing on a small ulcer on the leg of my grandmother when she was unwell.”
Price-containment measures and adjustments in Medicare reimbursements funds resulted in hiring freezes at Massachusetts hospitals the yr Dinoia graduated from Baystate and despatched her to seek out full-time employment at Hartford Hospital for 3 years the place she labored in cardiology, on a medical-surgical stepdown unit and in addition within the working room.
“After three years the freeze lifted and I got here again to be employed fulltime at Baystate. I acquired concerned in vital care which is what I at all times needed to do,” Dinoia mentioned. “I labored medical ICU which ranged on the time from asthmatic circumstances to pneumonia to strokes in addition to with surgical ICU circumstances and with trauma resembling gunshot wounds or stabbing or from a serious automotive accident.”
Dinoia mentioned she likes the problem of caring for the “most susceptible” sufferers whose medical circumstances require the insertion of respiratory tubes, central strains into giant veins for the giving of medicines and different wants and drains and chest tubes to take away fluid and air.
She mentioned a part of the professionalism of nursing across the challenges of affected person care is to “simply get in there and do it and get it accomplished.”
She added that she “at all times knew” that she needed to spend her profession at a instructing hospital, which Baystate is because the regional campus of the College of Massachusetts Medical Faculty.
“This was crucial to me as a result of I needed to proceed studying,” Dinoia mentioned. “I’m at all times studying one thing new as a result of Baystate is excessive tech and leading edge and I at all times be taught from my sufferers. Serving to somebody get higher could be very rewarding.”
“We weren’t certain of that virus and that was scary, too,” Dinoia mentioned. “Women and men have been creating the situation from an infection and getting sick so rapidly and never surviving. I bear in mind the high number of deaths amongst ladies.”
Baystate was one of many first hospitals within the state to make use of choices just like the inclined place and the usage of a nasal cannula to ship high-flow of oxygen to assist cut back reliance on mechanical ventilation and the upper charges of mortality related to it for respiratory misery in COVD-19 sufferers.
“Now sufferers go to intermediate care and get placed on the BiPap (bilevel optimistic airway strain machine) or excessive move (oxygen remedy),” Dinoia mentioned. “When their PO2s (partial strain of oxygen dissolved in blood) get too low they get transferred into the intensive care unit.”
She added, “You probably have COVID and are in a position to recuperate at residence, that could be a blessing.”
“If a affected person is sick sufficient to come back to the hospital, we are going to care for them the easiest way we will and we do,” Dinoia mentioned. “We do every little thing we will to present them the final combating probability. I can truthfully say that.”
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