For new graduates starting their careers in healthcare, the challenge of working through a pandemic has been the ultimate learning curve. Facing the reality of this unprecedented moment in history, coupled with the stress of a burdened healthcare system, has given recent graduates a unique perspective during their first year on the job.
In our February instalment of the 2020-2021 speaker series, we had a chance to catch up with former UTIHI member and Registered Nurse, Peter Luong. Peter is a recent graduate of the Lawrence S. Bloomberg Faculty of Nursing program and has been working on the frontlines since Summer 2020. He is motivated by his love for people, science, and the duality these two components share in his profession.
In this entry, we learn about the difficulties and triumphs faced by healthcare workers as they do their best to treat patients in an environment with limited resources. We also examine what it is like being a new nurse during a time that is unlike any other and the measures that we, as a society, must undertake to protect each other.
UTIHI would like to dedicate this interview to all the amazing and selfless frontline workers.
Please enjoy this interview!
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Peter Luong is a Registered Nurse at the University Health Network, and a five-year member of the University of Toronto Chapter for the Institute for Healthcare Improvement (UTIHI). A graduate of the University of Toronto, he has completed a Bachelor of Science in Human Biology and Nutritional Sciences and has continued to pursue medicine through Canada’s #1 Nursing school at the University of Toronto’s accelerated Nursing program.
Graduating in the summer of 2020, he began working on the frontlines as a Registered Nurse at Toronto Western Hospital on both the General Internal Medicine and COVID units. Read his unique shared experiences as a nurse on the frontlines during the second wave of the COVID-19 pandemic.
Can you tell us a bit about yourself including your studies and career path?
I am currently a General Internal Medicine (GIM) Registered Nurse. Being interested in medicine and healthcare, my undergraduate studies focused on a double major in Human Biology and Nutritional Sciences. It was not an easy journey, as my nursing program was a second entry accelerated program; but in hindsight, the challenges have helped enrich me and made me who I am – and where I am – today.
What interested you in becoming a Registered Nurse?
No one ever really knows where they’ll end up in the future, we only have aspirations we hope to attain. My dream was to help people, coloured in the setting of healthcare and armed with the medical, scientific knowledge and interest I’ve always held, this aspiration helped me narrow my field. However, what really drew me to nursing was that after having multiple experiences in the lab by the bench, I felt like there was a missing duality to the science I was achieving – the human interaction. Nurses are one of the largest forces of frontline workers who work with their patients in addition to the interprofessional team in order to provide healthcare to their clients. From this, it was clear to me why I wanted to be a nurse.
What has been your experience as a Registered Nurse during the COVID-19 pandemic?
Newly graduating in the summer of 2020, I entered the front lines during the second wave of the COVID-19 pandemic. My last clinical placement as a student was cut short due to the pandemic, and even then, I could sense the evolving work environment; so, it has been several months between my clinical practice as a student and beginning my work as an official Registered Nurse. From reading and watching the news, I was more mentally prepared in facing the pandemic, however, the physical demands of nursing are taxing. Donning and doffing additional personal protective equipment (PPE) and working long hours encased in yellow gowns, face shields, masks and gloves for nearly every patient, along with the over-present vigilance of “COVID around the corner” – these take a toll on any person. From a new grad to a new hire, it was like transitioning from swimming in a pool to the deep ocean. However, I had many great staff to assist me while being precepted and practicing independently, and I am grateful and am still learning from all of them. Our teamwork is foundational to our healthcare practice.
From a new grad to a new hire, it was like transitioning from swimming in a pool to the deep ocean.
As a student who’s been practicing in clinical settings pre-COVID, working during the second wave was quite an exciting yet exhilarating experience that required prompt and vigilant adaptation. I floated between working my General Internal Medicine unit and the COVID unit, and the energy was distinctly different. Wherein GIM, there are many interdisciplinary team members – Physicians, Nurses, Social Workers, Physiotherapists, Occupational Therapists, Registered Dietitians, etc. – buzzing about, the COVID unit appeared more solemn. This was because our hospital institution was attempting to reduce the exposure risk by reducing the number of staff involved. From the hindsight of the first wave, the second wave flowed more smoothly. We had enough PPE, we knew how to properly don and doff, we were highly conscientious of hand hygiene and environmental sanitation, and we voluntarily underwent frequent COVID-19 swab testing of ourselves.
How has your hospital and team been dealing with the implications of the pandemic?
Arriving onto the frontlines during the second wave has placed me in a unique position to be both surprised by and yet prepared for the challenges of the COVID-19 pandemic. PPE was a highly popularized topic in the news when the pandemic first started, and indeed it is one of three pillars of COVID safety our hospital institution employs. The second is hand hygiene, and the third is environmental sanitization and cleanliness (including environmental organization, tidiness, decluttering of space). There are also confidential mental health lines available for staff surrounding COVID fatigue should we need personal support.
We take COVID-19 very seriously; anyone who’s not been confirmed negative by COVID will be immediately isolated by our Infection Prevention and Control (IPAC) specialists and placed under Contact/Droplet precautions until either their COVID-19 swab results return as negative, or until they’ve passed their 10-day (previously 14 day) quarantine period from their recent known date of exposure to COVID-19. Every nurse is also required to perform a COVID screen for all of their patients and remain vigilant for any new typical and atypical symptoms of COVID, report and place them on isolation immediately if any suspicions are raised. Our protocols regarding COVID are quite strict and we must adhere to them closely if we wish to prevent any more transmissions and outbreaks.
What are some challenges faced by your team during this difficult time?
A prevalent and persisting challenge many healthcare settings are facing during the pandemic is understaffing and patient over capacity. With the rise in COVID-19 cases in the community, there’s a correlational rise in related hospitalizations, and thus, more bedspace is required; and with the increase in outbreaks on hospital units, staff are also affected in more ways than one. From caring for more patients than usual, to getting ill with the virus, our system is burdened, but our dedication to our patients is just as resilient as the persistence of the pandemic. This disproportionate ratio of patients to staff increases the demand for more healthcare workers, more healthcare services, and more strenuous effort exerted on those who are able to work.
From caring for more patients than usual, to getting ill with the virus, our system is burdened, but our dedication to our patients is just as resilient as the persistence of the pandemic.
A less obvious challenge regards the patient on an individual level. As a hospital institution that values autonomy and respects every patient’s rights to make decision for themselves when capable, a present challenge many of us are facing include obtaining updated COVID-19 nasopharyngeal swabs from patients who refuse it, particularly when they’re on isolation for suspected COVID-19 and cannot be removed off isolation until otherwise confirmed. This unfortunately takes up bedspace of private room and semi-private rooms for other patients who are in need of a bed and healthcare on our unit. Even more challenging is when suspected COVID patients do not adhere by the isolation protocols and wander out of their rooms, into the hallways, nursing station, and other patients’ rooms – this poses a major risk to everyone. As we cannot hold patients against their will if they have full capacity, our methods rely on redirecting the patient, grounding them on the severity of the situation to help them understand why they’re on isolation, and distraction techniques. We then follow up with any contact tracing and necessary IPAC protocols for every patient who’s had contact with suspected persons under investigation. Indeed, isolation and restrictions are encumbering – we all understand this – however, we must adhere to them otherwise every effort we’ve enacted and sacrifice we’ve made would be in vain.
What has been the most rewarding experience so far in your role as a Registered Nurse?
My most rewarding experiences thus far, in a broad sense, include seeing patients regain their health enough to be discharged home. I’ve worked with patients who have stayed in the hospital for many months, even a year, due to poor physical and mental health, exacerbated by the long waitlist to long-term care facilities, and once they’ve drastically improved through the long aching hours that many healthcare workers dedicated, they were finally ready to be discharged to their new home. Even though nursing is undeniably hard work, seeing even one person get better serves as a reminder of why we do what we do.
What words of encouragement would you like to give other frontline healthcare workers?
The nature of our work is challenging, tough, and perhaps even core-shaking, but our work serves a higher calling. Our work is grounded in today’s science, but it also inspires hope for a better future to those we serve and their families.
Being a Registered Nurse on the front lines, is there a message you would like to impart on the general public?
During these times, we all face struggles of varying magnitudes, from one’s mental health to financial insecurity. But the common thread that will help us survive this pandemic is this – we are facing this all together, and so we must work together. Your many efforts and ongoing sacrifices are greatly appreciated, but it isn’t over. We must all keep doing our parts – whether it’s physical distancing, hand hygiene, vaccination, and keeping each other accountable – so that we (nurses and healthcare workers), can do ours.
We must all keep doing our parts – whether it’s physical distancing, hand hygiene, vaccination, and keeping each other accountable – so that we (nurses and healthcare workers), can do ours.
How do you envision the future of nursing, post-pandemic?
We are now in a new era. There’s no telling what it will look like exactly, but we have become much more highly trained and vigilant in infection prevention and control management of not just COVID-19, but other pathogens as well. I believe our heightened state of awareness will carry on to the post-pandemic future and our practices will remain ever more cautious.