Lessons From the Roller Coaster Life of an Italian ICU Nurse
Report from the COVID-19 Frontline
Tears do not roll easily from the eyes of veteran journalists who have covered death and destruction in many parts of the world.
I have covered war and catastrophe in Africa, Asia, Europe, the Americas, and the Middle East, and I was always dry-eyed at press conferences.
But I could not stifle the tears during a virtual press conference with frontline Italian Intensive Care Unit nurse Floriana Pinto.
Her wrenching experiences have many lessons for Americans, Europeans or anyone anywhere on the planet confronting COVID-19.
She was explaining how she and her colleagues have toiled trying to save lives in the tumultuous past weeks during the crisis of the devious novel coronavirus.
During the week, the 30-year-old who is already a veteran of the war against the pandemic spoke after a night shift.
She addressed journalists from the Geneva UN correspondents’ association called ACANU, along with others from her profession.
They spoke about the nursing profession and health workers in Italy and throughout the world. What they said indicated that many societies and governments have been riding roughshod over health and care workers for far too long.
“Our lives are like a continuous roller coaster right now because some days we have fear; we feel fatigued; we feel anger,” Pinto recounted.
“My hospital is one that has COVID and non-COVID wards to give care to everybody, infected people and non-infected people. And we had to go to the front-line, at the end of February,” she said from Milan.
ICU patients per nurse more than doubled
“I’m in the ICU and usually each nurse cares for two patients. When the emergency started, we had to rapidly get organized and had to enlarge our ICU with more beds — on two floors, having 40 beds, and with each nursing now caring for five patients,” said Pinto.
“So, now you can understand how much the situation changed. Nurses are crucial in this emergency now,” said Pinto.
She works in a big Milan hospital in Italy, which had been the worst hit country by the silent and lethal COVID-19 pandemic, until the United States jumped into that place on April 12.
In the same video press conference, Walter de Caro, president of the Italian Nurses Association rattled off some alarming statistics.
In Italy, some 15,000 health workers had tested positive to COVID-19 along with more than. 7,000 nurses. The disease had killed 26 nurses and 94 doctors, many likely infected on the first day of the outbreak in country areas due to a lack of personal protective equipment, or PPE.
“More than 4,000 people are in intensive care. This is a real collapse for our health system in the north of Italy,” he said.
World Health Organization Director-General Tedros Adhanom Ghebreyesus Tedros told journalists last week, “We are particularly concerned by the large numbers of infections reported among health workers.”
Tedros said, “The global spread of the virus has overwhelmed health systems, disrupted the global economy, and lead to widespread social disruption.”
When I was recovering from a cancer operation five years ago and getting chemotherapy, key ingredients that pulled me through it all was the compassion and support of the health workers at Geneva University’s Hospital, especially the nurses who seemed to run the show.
But cancer is not an infectious disease and the health workers offering tender care were in their regular uniforms and did not have to clad up masked in space suits and keep a distance.
Communicating with COVID-19 patients
“We try to do our best to find other ways to communicate with the COVID patients. We can’t talk; we can’t smile with the masks; so we find ways: and have learned to smile and talk with our eyes,” Pinto said with a glint in her eyes.
I was unable to hold my own tears back sitting in my isolated solitude, Zoomed into the current way of doing journalism.
She poignantly related how those Italian nurses have stretched their limits and spoke about crying on hearing of the recovery of a patient.
“Two days ago, I and a colleague of mine were having a shower after the shift, as we have to have a shower after the shift every day before leaving the hospital.
“And she said to me, ‘Today, we finally managed to awake the patient and then he talked with his wife with a tablet in a video call,’” said Pinto.
‘I started to cry’
“And then I started to cry, the first time I cried in a month, but I was happy. It was one of the best moments of my life. The second was after my niece was born.
“So, telling you this story. I want to say that nurses are like this. Nurses are in essence, lots of things, technical things, organizing things, but also relations and — all of these competencies; we are …a group who are fighting against this virus.”
And then she shifts to the topic of the press conference, “Nurses fighting COVID-19, State of the World’s Nurses Report, challenges and difficulties.”
“If we manage to have better working conditions and if the institution suddenly starts to recognize our profession, this would be the best one ever,” said Pinto.
Howard Catton CEO of the International Council of Nurses, a federation of more than 130 national nurses associations, representing the more than 20 million nurses treasured the experience from the frontline.
“It’s given us a very good overview of what some of the key public health messages and responses need to be,” he told journalists.
He also said, “This is the Year of the Nurse and Midwife — not the one that any of us had envisaged — but the COVID-19 outbreak is the most powerful demonstration of why we need to support and invest in our nursing workforce.
Global nursing crisis
“We must recognize that no country is an island; this is an international and global crisis and we need cooperation across borders to get much-needed supplies to healthcare workers, to share best practice, and to ensure manufacturers step up.
“It will be the greatest tragedy if we do not learn the lessons from this pandemic.
“We need to see hard actions around investment, support, and strengthening of health systems and the health workforce in the future.
“We call on politicians to be as brave and courageous as those nurses currently fighting COVID-19. Be as brave and courageous in your political leadership and say ‘yes’ to implementing all recommendations,” said Catton.
Looking at Italy, for instance, it is quite obvious that one of the reasons it was once the country in the world with the highest number of COVID-19 cases and death stemmed from the lack of resources such as sufficient quantities of trained workers and equipment to combat the disease.
Fighting for PPE and staffing
“We have to fight for proper PPE, for proper staffing,” said Pinto who said that Italian nursing sisters are among the lowest paid in Europe.
Italian nursing leader de Caro said, “The real problem is in the community and local areas because doctors and nurses had insufficient protection. It’s is a tragedy for our country.
“Until now, we have been a donor of nurses. We now have 5,000 nurses who work in the UK. Here we have a shortage of 50,000 nurses. We have nurses here from Italy, Albania, China, from Cuba as also from other parts of Europe,” he said.
In Britain, the UK Prime Minister Boris Johnson credited the country’s National Health System staff with saving his life after he was released from the ICU, in a statement on April 11.
“I can’t thank them enough,” the British leader said about the doctors and nurses at St Thomas’ Hospital in London, who took care of him following his admission with COVID-19.
“I owe them my life,” said Johnson who referred to the health workers as heroes.
Later speaking from the hospital after three nights in the ICU at the state-run hospital, Johnson said, “I want to pay my own thanks to the utterly brilliant doctors, leaders in their fields …. who took some crucial decisions a few days ago which I will be grateful for the rest of my life.”
The British prime minister was once seen as critical of the state-run NHS.
“People are being driven to use private medicine in despair at the NHS. There should be no shame in pointing that out. It should not be sacrilegious to say that the NHS is failing,” he had said in a speech to the British parliament on April 17, 2002.
The best reminder came from Pinto who said, “We have always been here caring for people because it is our profession.
“We are doing this now as the best we can. People call us heroes, But, despite our continuous struggle, we were not recognized.
“The nurses don’t want to be called heroes, but we really want to be considered as professionals. In this way, we can maybe get a real health care system with every professional having respect for the other.”
The ICN says that data from 191 countries reveals there are 19.3 million professional nurses out of a total nursing workforce of 27.9 million, and that their distribution around the globe is not uniform, with lower nurse-to-population ratios in middle and low-income countries.
- It says that 36 million nurses will be required by 2030, and that target will only be reached if there is an 8 percent increase each year in the total number of nursing graduates.
- Without this increase, there will be a shortage of 4.6 million nurses by 2030, primarily in the African, South-East Asian and Eastern Mediterranean regions.
The United States has 3.1 million nurses and they are currently working for the lives of many millions of Americans.
- There were on April 14, over 582,500 U.S. cases and more than 23,600 deaths, while the cases in Britain exceed 89,500 cases, with the death toll surpassing 11,300, while Turkey has reported over 61,000 infections and nearly 1,300 deaths, according to the Johns Hopkins University medical barometer.
The U.S. over the April 12 weekend overtook Italy’s death toll of more than 20,400 and that of Spain’s exceeding 18,000 to have the world’s highest death toll from the virus.