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Fear, frustration, compassion and shame: What nurses are dealing with during the pandemic

(WARNING: This story contains graphic descriptions that may disturb or offend some readers.)

There are close to 450,000 nurses in Canada. Some work in hospitals, some in long-term care homes, some are privately hired, but they all share one commonality. Since the beginning of COVID-19, they have been on the front lines of an international pandemic that has taken more than 1.4 million lives worldwide, including 12,000 in this country.

The work they’ve done has been arduous and a risk to their personal safety and health, but they have persevered. The National talked to three nurses in three different provinces about their experiences, and these are their stories.

Clarice Shen, Toronto

Nurse Clarice Shen is a nurse in the intensive care unit at Sunnybrook Health Sciences Centre in Toronto. She’s seen first-hand the physical and emotional toll that COVID-19 takes on people. (Kevin Van Paassen/Sunnybrook)

Clarice Shen, 25, is an acute care nurse at Toronto’s Sunnybrook Health Sciences Centre. In January, just a year out of nursing school, she was caring for a patient who was exhibiting symptoms of a virus that didn’t even have a name yet.

He turned out to be the first patient to test positive with COVID-19 in Canada.

“There was a lot of uncertainty, but as a team, we kind of came together and supported ourselves,” Shen said.

When it became clear the hospital needed to expand the intensive care unit, Shen volunteered to work in the ICU to support the staff there. She’s been on 12-hour shifts in the ICU ever since.

A number of the things she has experienced when dealing with COVID-19 patients were new to her.

“From a nursing standpoint, the fact that a lot of patients with the virus get sick really, really fast — they can present to the hospital with very mild symptoms, and they can progress very, very quickly to the point where mechanical ventilation is needed — I was really taken aback. Because it is really traumatic to be put on a ventilator,” Shen said.

In her time in the ICU, Shen has helped care for dozens of COVID-19 patients and says most people don’t realize how hard it is to be intubated.

“I was caring for a patient on a ventilator and he had this thing where his body just on and off twitched, where his teeth would bite down on the ventilator. And his teeth were actually coming out, like, he bit off part of his tongue and his teeth were coming out, and there was blood everywhere,” Shen said.

I never imagined that I’d be in a position to tell someone ‘you can’t visit your loved one in the hospital.’– Clarice Shen

As hospital rules changed, Shen has had to tell the families of seriously ill patients that they could no longer visit, or that they must cut visits short. She says she’s tried to address the frustration she deals with daily by maintaining compassion.

“I never imagined that I’d be in a position to tell someone ‘you can’t visit your loved one in the hospital,'” Shen said.

“I try to help them understand what it is that we’re trying to do … helping them feel that I’m on their side, even though the situation might be really challenging.”

And Shen has held the hands of many patients in the ICU while they passed. Too many times, she says, a patient’s condition has worsened and they’ve succumbed to COVID-19 so quickly that their families couldn’t get there in time.

Clarice Shen, an acute care nurse at Toronto’s Sunnybrook Health Sciences Centre, describes how she creates a connection with patients in the intensive care unit who are often suffering, frustrated and scared. 0:25

One recent instance sticks in her mind, when she was at the bedside of a woman who died before her two daughters could get to the hospital. Chen was covering a break for the nurse who was the patient’s primary care provider, so she didn’t know the patient very well.

“All I could really tell her is that I loved the colour of her nails, and that her hair was beautiful, and that her daughters loved her. So I eventually just told her over and over again that her daughters wished that they could be here,” Shen said.

“It’s important she didn’t feel alone. I mean, it’s an honour and a privilege that I can be there for patients in their final moments.”

As cases reach record highs in Toronto and the city finds itself in a second lockdown, Shen says she wishes people could see what she sees in one shift in the ICU. She thinks it would scare them as much as it does her, and help keep them vigilant against contracting or spreading the virus.

“You know, last week you had two COVID patients in the hospital. And this week you have 15, and two waiting in the ER, and you have no beds in the ICU. And then you’re trying to get people out of the ICU who would benefit, potentially, from a few more days of staying there, because you need that bed. So, that is scary for me,” Shen said.

Meaghan Thumath, Vancouver

Meaghan Thumath is a registered nurse who works with homeless and marginalized communities in Vancouver’s downtown East side. (Richard Grundy/CBC)

Meaghan Thumath is a registered nurse who wears many hats.

She works with homeless and marginalized communities in Vancouver’s notorious downtown East side. She also teaches nursing, does clinical research, and participates in international deployments with The World Health Organization that have included work on Ebola and other outbreaks overseas.

Since the outbreak of COVID-19, Thumath has been harnessing her experience to care for patients in Vancouver who are largely without other options.

“Sometimes that can look like a homeless camp. Sometimes it’s a single-room occupancy building that’s owned by a private owner. Sometimes it’s a homeless shelter, and sometimes it’s a supported-housing facility,” Thumath said. “We find people where they are.”

I think if you can treat people with dignity, and be trauma-informed and understand sometimes people might be scared, generally people are extremely grateful.– Meaghan Thumath

Thumath’s patients are often dealing with many more issues than just possible exposure to COVID-19.

“So we are seeing a sort of twinning of the overdose crisis as well as COVID-19. And then on top of that, people are still struggling with HIV, and Hepatitis C, and other infections,” Thumath said.

She points out that asking homeless people to self-isolate or quarantine when they are exposed to COVID-19 presents added challenges that most Canadians with a place to live can’t begin to understand.

Part of her job is also training shelter workers in best practices for when people with symptoms show up on their doorsteps.

Thumath says she does the work, and takes the personal risks associated with it, because of how rewarding it is.

“It’s a huge honour, because people are so grateful for your help. I think if you can treat people with dignity, and be trauma-informed and understand sometimes people might be scared, generally people are extremely grateful,” she said.

Meaghan Thumath, a nurse who works with homeless and marginalized communities in Vancouver as well as on risky international health deployments, says she and her colleagues have to be ‘flexible by nature.’ 0:18

The personal risks she takes are significant. Thumath recently returned from a trip with the World Health Organization to South Africa, assisting with the pandemic response there.

She was also part of the team that helped repatriate people from Wuhan, China, to Canadian Forces Base Trenton in the spring this year. It was on that assignment that Thumath contracted the virus herself.

She says that experience helps her better understand what her patients are facing.

The toll her work has had on her family is something that weighs on her as well. Thumath is married and has two children. She writes goodbye letters to them every time she is deployed somewhere in case she doesn’t return.

“I’m grateful to my husband for being supportive, but it does weigh on me,” she says. “That’s the hardest thing — a drawer full of letters to them just in case I don’t come back.”

Shaye Fleming, Calgary

Shaye Fleming, a cardiac nurse, in personal protective equipment during a shift at Calgary’s Foothills Medical Centre. (Shaye Fleming)

Shaye Fleming has been off work since September. That’s when the 29-year-old caught COVID-19 while on a regular shift as a cardiac nurse at Calgary’s Foothills Medical Centre.

“It’s been over two months now, and I’m just starting to feel a little bit back to normal,” she said.

“I still get quite short of breath, and this isn’t like me, you know? I usually can run, walk, like, usually I’m quite active.”

The ongoing impact of the virus has left Fleming frustrated, and feeling another emotion she says she wasn’t expecting.

“I’ve been experiencing a lot of anxiety with it as well. When you’re young you think you’ll be fine, and I was one of those people that wasn’t worried about getting it. And so the fact that it has been a prolonged recovery period, and I’m lacking a lot of that stamina that I once had, yeah, it’s been hard for sure,” she said.

Fleming has tried to return to work twice, but was unable to both times. Her symptoms have continued to be too debilitating.

… That shame of not being able to go back to work when I felt like I should have been OK, that makes you feel pretty shameful as well.– Shaye Fleming

She hopes to try again this week. Not being able to go back to work has only added to her stress, she said.

“I haven’t been able to be there, and be a support for my co-workers and my colleagues,” Fleming said. “So, you know, that shame of not being able to go back to work when I felt like I should have been OK, that makes you feel pretty shameful as well.”

As cases spike in Alberta and around the country, Fleming says she hopes people heed social distancing requirements and listen to public health officials. But she adds that regardless of how people approach the pandemic, nurses will always be there to care for them if they fall ill, even though providing that care means a risk to their own health.

“We will care for your loved ones and for you, regardless of what you believe in and what you value at the moment during this pandemic,” she said. “Nurses will always be there for you.”

Shaye Fleming, a cardiac nurse at Calgary’s Foothills Medical Centre who caught COVID-19 during one of her shifts, describes how contracting the virus has given her respect for how serious and debilitating it can be. 0:33

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‘Have a little compassion’: Canadians on cruise ship with 4 dead still unsure how they’ll get home

With a flu-like illness outbreak, four dead and confirmed cases of COVID-19, it’s been a horrific week for the 1,243 passengers — including 247 Canadians — stuck aboard the Zaandam, a Holland America Line cruise ship that was sailing off the coast of Panama.

Now, passengers can add more problems to the list: although Panama allowed the Zaandam to pass through the Panama Canal, passengers still don’t know for certain where the cruise ship will dock, and when they’ll be able to return home. 

That’s because while the ship has plans to dock and let passengers disembark in Fort Lauderdale, Fla., county officials in the region are concerned about letting in a coronavirus-hit ship.

“They’re not wanting us there, so where are we going to go?” said passenger Cheryle Stothard of Toronto. She and her husband have been confined to their cabin for the past week, because of the illness outbreak. 

“Going through the Panama Canal is useless if we can’t get off in Florida,” said the 71-year-old.

Cheryle Stothard and husband Tony of Toronto are still aboard the Zaandam and have developed a cough and runny nose. (Submitted by Cheryle Stothard)

Since cutting short its South American cruise on March 14 due to the growing COVID-19 pandemic, the Zaandam has been seeking a place to dock so passengers can return home. 

On Friday, Holland America announced that 138 passengers and crew have fallen ill with “influenza-like illness symptoms,” and that four “older” passengers had died. The Zaandam is also carrying 586 crew members — one of whom is Canadian.

None of the dead is Canadian. Holland America didn’t provide a cause of death for the four passengers but said that the ship tested “a number” of patients for COVID-19 on Thursday, and two were positive.

Passengers grew hopeful on the weekend after learning that the Zaandam could pass through the Panama Canal. Late Sunday, the ship began moving through the canal.

But Holland America’s plan to then dock in Fort Lauderdale isn’t a done deal because Broward County, which includes the city, has yet to give the green light. 

Broward County Commissioner Michael Udine told CBC News that the county is already overrun with COVID-19 cases — more than 1,000 to date  — so he’s apprehensive about letting in a ship that will add to its problems. 

“We’re a hotspot here. Our medical facilities are taxed,” said Udine. “If there are sick people that have to come off, I want them to be able to come off … but where are they going to go? What hospitals are going to be able to take them?”

‘Somebody’s got to let us dock’

Udine’s apprehension is upsetting for passenger Margaret Tilley, who’s desperate to return to her home in Nanaimo, B.C.

“Let’s have a little compassion,” said the 71-year-old. “It just doesn’t seem right. Somebody’s got to let us dock.” 

The Zaandam began its cruise on March 7 and had initially planned to dock on March 16 in Punta Arenas, Chile, to let passengers off early. However, the country refused to allow passengers to disembark, so the ship set course for Fort Lauderdale. 

On Saturday, Tilley and her husband were moved to the Zaandam’s sister ship, the Rotterdam. Holland America sent the ship, along with medical personnel and supplies, to rendezvous with the Zaandam and transfer “healthy” passengers to the Rotterdam.

Just let us get straight from the boat to a vehicle and to the airport. We don’t want to stay in Fort Lauderdale.– Margaret Tilley, passenger

Both ships got permission to enter the Panama canal. Tilley said she wants Broward County to know that the healthy Canadians onboard won’t be a burden and just want to get home. 

“Just let us get straight from the boat to a vehicle and to the airport. We don’t want to stay in Fort Lauderdale.”

The Rotterdam cruise ship joined the Zaandam on Friday to deliver medical supplies and transfer healthy passengers to the Rotterdam. (Submitted by Margaret Tilley)

Udine said that all the passengers would have to be quarantined upon arrival, because some could be asymptomatic.

“There’s a lot of things that are going to need to be worked out by this cruise ship before they simply get disembarking in Broward County.”

Udine said the county will review a plan for how Holland America will handle the situation and likely make a decision soon. 

Meanwhile, more passengers are reporting illnesses. Stothard said that she and her husband Tony have both developed a runny nose and cough. That means they must remain in their cabin, on board the Zaandam along with other ill passengers, who are in isolation. 

“We’ve got to get off,” said Stothard. “The longer we stay on here, the more cases we’re going to have.”

Passengers Chris and Anna Joiner send a message to the Canadian government asking for help while stuck on board the Zaandam. (Submitted by Chris Joiner)

Why did they go on a cruise?

Some CBC readers wondered why passengers boarded a cruise on March 7 when COVID-19 was spreading globally.

CBC News asked several Canadian passengers aboard the Zaandam this question. They responded that when they started their journey, there were very few COVID-19 cases in South America. 

The continent didn’t have any reported cases until one was confirmed in Brazil on Feb. 26. 

Some passengers also said that, when they were set to begin their trip, there was no opportunity to get a refund. 

Tilley and her husband left Nanaimo on Feb. 28 and travelled for a week in Argentina before their cruise. She said only in hindsight does she see the warning signs. 

‘[The virus] was in China,” she said about that time period. “We thought South America would be safer.”

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Parents whose daughter died by suicide call for compassion

A Quispamsis man who buried his 21-year-old daughter this month after she succumbed to injuries suffered in a suicide attempt, says he’s been spending his haunted, sleepless nights working out his grief in Facebook posts that he wants shared as widely as possible.

“Depression is a boogeyman and you never know when it will strike,” Mike Murphy said in an interview about his daughter Maddy.

“We thought she was doing well, and then all of a sudden, just like that.”

Mike and his wife, Mindy, say their family’s story is not a cautionary tale about missed warning signs or a lack of resources.

It’s a call for kindness and compassion for those who struggle with mental illness and the burdens they carry.

Those who hurt the most, they say, may be the ones you least suspect.

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Mike says he’s been pouring out his feelings, often in the wee hours when he cannot sleep, tormented by the sudden and unexplained loss of his daughter, who did not leave a note.

His most detailed Facebook post is called “Maddy’s story.” It’s a portrait of his daughter and her struggle with depression.

Already shared at least 5,000 times, the Murphys hope it will be shared even more and that is why they agreed to an interview request from CBC News.

They want people to talk about mental illness, even though it may be difficult and confusing, and even though there are no easy answers.

“I remember thinking to myself, I can’t understand this,” said Mindy, recalling the days when her daughter was in high school.

“Maddy has such a great life. She goes to a great school. She’s got so many friends.”

“I couldn’t understand what was making her depressed, but I’ve learned along the way, that’s not how it is.”

Maddy at 14

From an early age, Maddy showed great promise as an athlete.

She played with boys on the Kennebecasis Valley Minor Hockey Association’s Pee Wee AAA Rangers team and would later play for Rothesay Netherwood, an elite private school outside Saint John.

At the age of 15, one of her highlights was to play on the U-18 Team Atlantic in Calgary for the Canadian Women’s Nationals.

Maddy excelled in hockey and played for Team New Brunswick in Prince George, B.C., for the Canada Games in February 2015. (Mike Murphy/Facebook)

But at age 14, and seemingly overnight, Maddy developed symptoms of Tourette syndrome.

“She woke up and she just wasn’t right,” Mike said. “She was displaying tics and stuttering and couldn’t talk.”

He says his daughter felt ashamed and around this time, she started retreating from her parents and her sister and even her twin brother, to hole up in her room.

“We were walking on eggshells for quite a few years,” Mike said.

“We knew that one wrong move would set her off and she would go into that deep, dark hole.”

2 previous attempts 

The Murphys remember another turbulent time when Maddy was in Grade 11 and afraid of what would happen if she came out as a lesbian.

Maddy graduated from Rothesay Netherwood School in 2016 and went on to study at the University of New Brunswick in Saint John. (Fundy Funeral Home)

“She was coming out of the closet, and she didn’t know how she was going to be accepted on that,” said Mike.

“I don’t think she was worried about what we’d have to say. I mean, holy cow, nowadays, who cares? We love her unconditionally no matter what. 

“I think it was about all her peers, and she kept that inside.”

Around this time, Maddy tried to commit suicide twice, in a short period, the Murphys say.

They responded by providing her with as much help as they could muster.

Maddy went to doctors and psychologists and had almost unlimited access to private counselling.

If she wanted to go four or five times a week, the Murphys made it happen.

They say Maddy was also on medication that seemed to work for her and with few side-effects.

They also say she became very self-aware and wasn’t afraid to ask for help when she felt her mood slipping.

We couldn’t have done any more. We couldn’t have tried any more.– Mindy Murphy, mother

“She didn’t have to call me to ask for an appointment,” said Mindy. “She was mature enough, and she knew.

“For us, I have peace knowing that we couldn’t have done any more. We couldn’t have tried any more.”

“And that’s what worries me, because if you asked what more we could have done, I don’t know what could have changed this.”

‘Thought she was doing really good’

After high school, Maddy took two years of an arts degree at the University of New Brunswick in Saint John and then decided to take a year off to figure out her future.

She had found a loving partner, and she and her girlfriend had moved into an apartment together.

Maddy was juggling four jobs and had just bought a car. (Submitted by Chyanne Murray)

Maddy had bought herself a little car and had paid a deposit on a golden retriever that would have been her emotional support animal. Although the dog was not yet born, she had named him Beckett.

She was working four jobs, at Rockwood Golf Course, Vito’s Restaurant, the Saint John Marina and Harbour Station.

She seemed happy, says Mike, and her Tourette’s tics had almost entirely subsided.

Mindy says she still talked to her daughter almost every day.

“Mindy and I thought she was doing really good there,” said Mike. “She seemed really happy. She was starting to get established in life.”

Mike says that’s why Maddy’s decision to take her own life has shaken them to the core. They say they had no warning.

“This caught us totally off guard, and I’m still dealing with that today. And I’ll be dealing with that for quite some time.”

Learning more about Maddy

The Murphys say they’re grateful to the first responders who kept Maddy alive Sept. 12 until she got to the Saint John Regional Hospital, as well as the medical staff who tended to her there.

Maddy was expecting to get an emotional support dog in January and had already named him Beckett. (Submitted by Chyanne Murray)

They say they got four extra days to spend with their daughter, and speak to her, even though she could not respond and may not have heard.

“We had those extra days to hold her, to hug her,” said Mike.

They also say it gave people a chance to say goodbye, and the Murphys were astonished by how many visitors came through the hospital room.

They were also surprised at how many people opened up about their own emotional struggles and histories with mental illness and how their daughter Maddy had been there for them.

The Murphys say this continued at the funeral home, where hundreds of people came to pay their respects.

“We were there for eight hours straight,” said Mike.

“That was the outpouring of support we had for this kid. That’s how many people she touched.”

‘Not one person would know’

The Murphys say they will go to counselling as soon as they’re ready.

They say their priority now is to get supports in place for Maddy’s sister and twin brother, who will also get counselling.

They’ve been driving Maddy’s car, lately. It makes them feel close to her.

They’ve also kept her phone. Sometimes, they look at videos that Maddy made with her friends.

“If you were to pick out the happiest kid in those videos, she would be the happiest,” said Mindy.

One recent evening, the Murphys went out for dinner, and it made them think how one never knows what another person is dealing with, or going through.

“Like all those people in the restaurant and not one person would know that we have just buried our daughter,” said Mindy.

“You just can’t judge anybody, and you just have to be kind.”

Need help?

If you or someone you know is suffering from mental health issues or suicidal thoughts, the Crisis Services Canada website is a good resource. You can also call them toll-free at 1-833-456-4566 or text 45645.

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