Ellen & Oliver
Oliver: “We work in kidney dialysis. We take care of patients that have kidney failures. Kidneys are not working, they need to be dialyzed. We do this so their blood can be clean.”
Ellen: “Our daily routine really didn't change much. But we just had to take extra precautions when it comes to things like, you know, dealing with the patients, and with all of our work basically. Like now, I have to screen the patients when they come to the clinic. You know, when each person comes then we have to screen them -- ask them different questions about any symptoms or any person that they’ve been in contact with from the time that they had dialysis to the time that they come back for dialysis. Because they do the dialysis three times a week, each week. So, that’s basically how it changed, is we just had to take extra precautions than what we were doing before.”
Oliver: “We also added faceshields. So it's more. For me, it's added stress to my teammates, because I'm a manager for the dialysis clinic. It's an added task. And for the patients, also one thing that we added these past few [months] is that the patients need to wear masks at all times inside the place, which we did not do before. But infection control is a big thing that we've always been doing, before even all of this happened. We just added the face shield, the mask that you have to wear all the time, and the patients are not supposed to come in without their mask on at all times during their treatment.”
Ellen: “Yeah, another change is also... before, the patient could eat like a light snack when they were dialyzing, but now they're not allowed to eat at all, which added more stress to the teammates and to the patients at the same time. Because the patient will get mad because they cannot eat, which is their usual, you know, they have to go away from their usual routine while they're in dialysis. They will get upset with you, but you have to explain to them that this is for their own good and for their own safety, and for the safety of the staff as well. Some of the patients, they don't understand or they refuse to understand, but you just have to be more patient with them. Just another change, added more stress! Some of our patients don't care, or they're just being stubborn.
E: “These conflicts mean that we have to interact more with the patient. It isn't the management's part. When patients don't understand, we try to explain over and over. Some patients, they do understand, but some refuse to understand. If that happens, I'll tell my boss. And though the boss is there, they'll just get mad at her, you know. One patient, he will fall asleep. Because he said that he doesn't want to breathe with a mask on, what we do is we put him up on oxygen and put the mask over the oxygen to cover his nose. And then while he's sleeping, he will take off his mask, which is a no-no right now. Yeah, so when I go in and out, usually I won't wake him up, I will just put the mask back on his nose, and he will wake up and curse at the teammates or something like that. And he will not care. We have some patients like that. But it is what it is, you know, we just give it up. If he curses at us, there's nothing we can do about it. We cannot turn away. That's the nature of the job. And sometimes even if I call my boss, he will curse at my boss. Well, without our medical director... our medical director will address the patient. But see, some stubborn patients, they don't change, you know, even if the medical director talks to them.”
O: “At my clinic, I just made a new guideline base, through the approval of our medical director. If they don't put on their mask or if they enter the clinic without their mask on, we're not going to put them in dialysis. They're not going to start treatment if they fight the policies. And if they're on the machine, and they start to take off their mask, then we warn them and we're reminding them three times. The fourth time and they still don't put their mask back on, we take them off dialysis and we send them home. We need to be strict with some patients, because it's for our safety and for other patients' safety.”
E: “We feel so proud that we are in the medical field. I mean I've always been so proud being in the medical field, helping other people. Although some ungrateful patients will say, "You wouldn’t be here if it weren't for us." But most medical personnel, we go above and beyond what's needed. Sometimes, even if it's not part of the job description, we do it. Even to the point that we’re helping with setting up an appointment for a different doctor, you know, those kinds of things. Or talking to the family members for some other issues that they aren't dialysis related. We do those things. But you cannot please everybody. But I've always been so proud of what I do. I mean, for me it's a dream come true to be a nurse. I love what I'm doing. You will not be happy unless you love what you're doing.”
O: “I agree with that. I've been a nurse for 25 years in April of next year. I have worked in the medical field since [my son] was a baby, and now his older sister's a nurse, and my second daughter's in nursing school, college. It really makes your heart feel big when patients appreciate what you do, even though there are some people that are -- like what Ellen said -- very ungrateful and don't care. Eventually, I just think that that's why they're on the machine. And then that's why their kidneys are not working, because they're not doing what they're supposed to do, if they're not taking care of themselves. The number one and two causes of these types of diseases are diabetes and high blood pressure. If you don't take care of yourself where you have high blood pressure or diabetes, that's why you end up in dialysis. They still continue to be stubborn and non-compliant even though they're already sick. The company's name DeVida means "he/she gives life." It's a Latin word, DeVida. So every day that we go to work, we give life. If those patients don't dialyze, then after a few days, they cook dinner and they die.”
E: “Yeah, sometimes it's really fast. Let's say they have to come to dialysis Monday/Wednesday/Friday. If they miss, some patients -- if they miss one day, they eat all kinds of foods, and they're not compliant with their diet and their medication -- sometimes they don't last the following day, they die.”
O: “Or they're in the hospital… so it's really important that they don't miss their three days a week. Dialysis patients with renal failure, their immune system is considered as immunocompromised. Their immune system is lower compared to you and me, and everybody else that doesn't have kidney failure, so they're at high risk for catching COVID.
O: “The greatest challenge for me is the patients following what they need to do, wearing their masks. It might sound simple, but right now we don't know -- you might have COVID, I might have COVID, [my son] might have COVID. It's just wearing simple masks and washing their hands before they get in the clinic, before they get out, and wearing it the whole time, not being stubborn. Non compliance, that's a challenge I think. When you see someone walking in Walmart or anywhere, as mandated by the state or Tarrant County (even any county in Texas) to wear a mask, lots of people still don't wear masks, wherever they go. It's just sad. How can we control it if nobody’s doing what they're supposed to do?”
E: “I have the same challenge because, you know, it really didn't change, like our work schedule stays the same. The only challenge that we have is dealing with, you know, the other people that are not doing what they're supposed to be doing. It's the only thing. Yeah, life really didn't change much for us. And, you know, other people who're not in the medical field, they don't have jobs, so then financially they become unstable. But with us, everything's still the same. The only challenge for us, we have to be more or extra careful with when it comes to infection control.
O: “It brings me hope seeing those patients, that they still come to dialysis, even though some are really scared. We also have different kinds of modality that we call hemodialysis -- those patients are dialyzing at home. It's a little bit complicated if I explain the process right now. But those patients only go to the clinic twice a month, to get their blood drawn and then go back and be seen by the doctor. We have patients who are so scared of COVID that they don't want to come to the clinic, or they don't want to go anywhere. So patients that still come, you see that they want to get better or still feel well, and come with a mask on, following up with their doctor, even though it's like this [gesturing to camera] right now, where some doctors do WebX rounds, and you can see that they're really concerned and they do what they're supposed to do. There’s the comfort that we know that we're going to be able to get through this by working as a team, reminding each other, reminding the patients and their families to stay safe. Being persistent and consistent in reminding -- we're educating literally every day. When I work every morning, I do homeroom with my team, reminding them to wear their masks, their face shields, even outside when they leave the clinic. So, I know that we can get through this with each other's help and working together as a team.”
E: “And keep on praying. Yeah, keep on praying. I think that's that's the only hope that we have for right now. I mean, whatever happens will happen when it happens. But with prayers and being positive about everything that's going on right now, I think we'll have a better outcome on this.”
O: “And we still stay positive. Like this coming week, our company, we have what we call “spirit week.” Each day we have a different activity, starting this coming Monday, to celebrate with the teammates, with the patients, in a way that we won't be violating infection control. We, in my small clinic, my team still does bingo day. So the patients can still stay happy. And we celebrate teammates' birthdays -- any celebration that we can do to stay positive and have a good outcome and a positive attitude. It's really hard. I'll be honest with you, this frickin’ COVID just needs to stop so we can live our normal lives again.”
E: “It's hard to wear a mask. It's hard! I work 16 hours a day. And I've been wearing that mask from 4:30 ‘till 8:30 at night. Even when I get home. And so, I'm so used to it, that even though I'm driving I'm still wearing the mask alone in the car! I didn't even notice it until yesterday my boss was telling me, "Hey, Ellen I saw you!" and I said "You saw me what?" "You were wearing a mask inside your car and you're alone in your car." I said, "Yeah I'm so used to it. I never even, you know, notice about it." And so I'm always wearing it now.”
O: “It's the new normal that's abnormal.”
E: “I think COVID will be part of our life in the future. Probably the mask will go away, eventually, and then just like a common flu. You know what I mean, there's the flu season every year --”
O: “So it's really gonna double jeopardy this coming winter with the flu season and COVID. Our flu season starts in September.”
E: “It's going to be hard, especially in the medical field, because if a patient, especially a dialysis patient, gets the flu, you don't know if it's a flu or COVID unless they get tested, and we don't do routine testing in the clinic. We just screen them, so we check them for fever. We can test now, but our clinic won’t be wanting to test. If the patient has no symptoms, and they want to be tested, right now the new policy in our company is that you can offer it to the patient. But what if all the patients want to be tested? And if most of those patients are positive and they don't have symptoms? And sometimes they say that the test is not accurate or something. Especially those rapid swab tests. So, I don't know.”
O: “At my clinic, we can do testing. So we only test patients that are exposed, for example, I have Patient A, who says "I think I got close." So, we can test them. We just don't randomly test anyone that wants. If I come in saying that I have a fever, or I have some cough that's new, that hasn't been with me for the last few days and then suddenly I have a fever, cough… we can test that patient. It's not like "Hey Oliver, can you test me for COVID tomorrow?" It doesn't work that way. But we have the capacity to test. And we have a process in place to do it safely that won't put the other patients or teammates at risk if we do the testing. You have to wear the right PPE, outside the clinic -- we don't test inside the clinic. We take the patient outside and we test them and send out to the lab and get the result, and now a patient is going to be isolated until we find out if this patient is negative or positive. They're going to be isolated in a different clinic, or they can be set dialyzing by themselves away from other patients.”
E: “Yeah, so I think that COVID is going to be quite a part of everyday life in the future, but it's not going to be as extreme as this as right now. I think people will, you know, get used to it. Some people probably develop antibodies to it or... it's just my theory. It's not perfect!”
O: “Yeah, that's why we need to stay very vigilant in protecting ourselves when we go out, because we have patients that literally don't have any symptoms, and they become positive with COVID.”
E: “It's not really good to talk about politics, but I think it's important. That's the thing that kind of disappoints me, because some politicians can use this to their advantage as compared to just helping each other, you know what I mean? So, different parties are fighting about who's better, and it's just a blaming game instead of just being together as one and helping each other. I think that's what... that's the only thing that disappoints me over what's going on. And it creates a lot of chaos, for the people, especially here in the United States.”
O: “The election is coming in November, it's a big issue right now -- how are we going to do the election? Are we going to be doing absentee voting? Are we gonna send the ballots to the people's houses? Are we gonna just not let them, and have to go to the precincts to vote? So there's going to be issues of cheating, and blah blah blah. So, it's going to be a big problem, a big mess. And party A and party B say, "Oh! they're cheating, they're cheating." No, we don't want to cheat. So, why not just work together and see? Our politicians are not there because they're dumb -- they're smart. They're highly educated. Why not think for the people, by the people, like what our Constitution says? They're there to help us. They should work together, and they -- regardless of which party they come from -- should work for the American people, not just their own needs.”
E: “Yeah, especially this time of pandemic. But that's not how reality works. It is what it is. It's just better for all the people here in the United States for them to just help each other and find out the solution from whatever is coming, instead of fighting against each other. Yeah, that's the only thing that disappoints me.”
Quotes edited for clarity.
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