Here’s What It’s Like to Work in The ICU During The COVID-19 Pandemic

Registered nurse Joshua Pananganan at Pali Momi Medical Center’s Intensive Care Unit. He stresses the importance of sanitizing and wearing PPE as safety measures against COVID-19.

By Jim Bea Sampaga

The COVID-19 pandemic has really pushed everyone to live, adapt and survive in the new normal. 

Almost every two weeks, Hawaii residents and businesses await updates on the island-wide lockdown order. Meanwhile, government officials are trying to limit the spread of COVID-19 with lockdown orders and increased testing as the total number of daily cases continues to rise. 

As of writing, Hawaii is nearing a total of 11,000 COVID-19 cases. 

For our frontline healthcare workers, risking their lives and chance to spend time with family and friends are a big part of their new normal. 

In the age of masks and social distancing, Filipino nurse Joshua Pananganan works closely with COVID-19 patients as a registered nurse at Pali Momi Medical Center’s Intensive Care Unit (ICU). 

As part of his new normal at work, his everyday ICU routine isn’t complete without the proper personal protective equipment (PPE). 

“The first thing I do before clocking in for the day is ensuring I have the proper PPE—N95 mask, surgical mask, goggles or a face shield, and hospital scrubs,” Pananganan said, noting that putting on PPE usually takes 20 minutes. 

PPE is an important part of a frontliner’s uniform and Pananganan makes sure that he and his colleagues are always wearing one. 

“We all take this very seriously,” he said. “If someone doesn’t have it on, we remind each other. It’s important to not only keep ourselves safe but also each other and our patients.”

It’s hard to social distance with patients because providing care is a healthcare worker’s utmost priority. When there are COVID-19 patients in the ICU, they are intubated with at least five different IV infusions that are regularly monitored. Medications are given through the patient’s feeding tube. 

“Each time we go in and out of a patient’s room, we are putting on and taking off the plastic gowns and wiping down everything, which can be a tedious process,” Pananganan shared. 

Working closely with COVID-19 patients, he said that he and his colleagues are practicing social distancing with each other. 

“We gear up to keep each other safe. We can’t really eat together during our breaks anymore because we also need to be aware of our situation and maintain proper physical distancing between ourselves,” he said. 

Since the pandemic began, hospitals had to implement changes in taking care of their patients. In Pali Momi Medical Center, there are currently two separate ICUs—one for COVID-19 patients and another one for non-COVID-19 patients who need intensive care. 

The new ICU set-up has been tough for everyone because as cases surge in the state, hospitals are also operating at or near capacity. 

“It’s a little stressful going to work because we don’t know what to expect,” he said. “Our team is more spread out now and caring for more patients, so it can sometimes feel like we’re separated from each other. We also all have a challenging time recognizing each other when we are wearing all of our PPE.”

Despite the stress and challenges the new normal at the ICU brings, there is a stronger sense of teamwork and communication in their team. 

“Working together with my nursing colleagues, respiratory therapists and critical care physicians are the utmost importance to ensure that our patients receive the best plan of care and treatment needed to combat this complex virus,” he shared. 

Families are also a big part of the ICU team. Before the pandemic, Pananganan would always engage with family members, encouraging them to visit often and consoling them with hugs when a patient passes away. 

Now, hospital visits are done through video calls in an effort for families to “see” their loved ones amid strict social distancing rules. 

“We are used to family interactions and having them be part of the treatment plan. It’s sad when they’re not. Also, when a patient passes away, our staff are so used to being able to console our patient’s families. It’s not uncommon to see our staff hugging family members and trying to comfort them. We can’t do that right now and we miss it,” he expressed. 

Pananganan also worries that he might bring COVID-19 back to his own household. 

“I worry a lot about possibly contaminating others and bringing something home to our families, which is why we are so meticulous with our cleaning and PPE procedures,” he said. 

Some people still don’t believe the COVID-19 pandemic is real. But Pananganan reminds everyone that the virus is real and affects everyone without any discrimination. 

“As frontliners, we see [COVID-19] every time we come to work. It very much affects our patients, their families, our healthcare workers and our families. It affects the community,” he explained. 

The Filipino community has the second-highest COVID-19 infection rates in Hawaii. Pananganan highly encourages everyone to do their part in following the lockdown and safety guidelines. 

“Wear a mask when out, social distance when you are with others and no gatherings or parties… please!” he exclaimed. “Even though we know it is part of our culture and can be difficult, we want everyone to be safe… so we can safely do our job in making sure you and your families get through this pandemic.” 

At the end of the day in the ICU, Pananganan takes a moment to show appreciation.

“I end the way with a moment of appreciation for my health and well-being during this turbulent and uncertain time,” he shared.

“We just want everyone to stay safe, take care of each other and stay strong during this time. I hope the pandemic ends soon.” 

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