An impossible job: What it’s like to work in a pediatric ICU

An impossible job: What it’s like to work in a pediatric ICU

US & Canada

When Rebecca Hay was a teenager in Calgary, her father gave her his 2007 Canon Rebel camera and taught her everything he knew well-nigh photography. She took photos of the people she saw and the places she went, and fell in love with the art form, fascinated by its worthiness to help her see the world from variegated perspectives.

After moving to Ottawa to shepherd university, Hay began working as a wedding photographer on the side to help pay her tuition. She unsalaried to a travel photography typesetting on the municipality and shot portraits in her spare time. But photography was a hobby, not a career: without graduating university, Hay returned to Calgary to shepherd medical school.

In 2019, during her first year of residency in pediatrics, she was required to work well-nigh seven 26-hour shifts per month, withal with regular day shifts, all of which left her with little time for rest or photography. She was exhausted, sleep-deprived and constantly on her feet. During rare moments of quiet in the hospital, Hay brought her camera to work. She sat lanugo with friends and colleagues to photograph them and hear well-nigh their experiences in health care, sharing their stories on Instagram as part of a series tabbed “26 hr.” It gave her a endangerment to talk to co-workers well-nigh what they were seeing in hospitals, and to share those stories with a wider audience.

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In November of 2020, during an interview with pediatric resident Caitlin Marchak, the series took on a variegated meaning for Hay. Without caring for her patients and seeing them on their worst days, Marchak said, she left the hospital feeling burnt out with little left to requite to friends, family or herself. It was a feeling Hay had long struggled with herself but never talked well-nigh openly. “I knew then that I wanted to alimony sharing these stories,” says Hay. “If someone could finger less vacated considering of them, then that would be worth it.”

Hay now lives in Ottawa, where she works as a fellow in pediatric hair-trigger superintendency at the Children’s Hospital of Eastern Ontario, or CHEO. She continues to document her colleagues’ experiences, including in a miniseries titled “Invisible Pandemic,” which is well-nigh the pediatric slipperiness in hospitals caused by the surge in respiratory viruses this past fall and early winter.

We spoke to some of the health-care workers Hay has photographed.

Janet Morrison, PICU tuition nurse, Ottawa

“For a few months this past fall and early winter, we went from caring for seven patients to 20. We’re only staffed to take superintendency of seven. It was chaos. We overflowed into a second ICU, opened a third, and sooner transferred patients from our ICU to other hospitals. We were constantly waiting for self-ruling beds to shoehorn people who needed superintendency and had been waiting in emergency for 24 hours or longer. I worried that I wasn’t supporting my staff the way I should. It was such a rented few months. We’re coming out of it now, but we still don’t have unbearable nurses to superintendency for the seven patients we’re responsible for. I think you have to be a little bit crazy to work in the ICU. There are easier jobs, but there are none increasingly rewarding.”

Gunjan Mhapankar, pediatric resident, Ottawa

“The surge of pediatric flu, RSV and COVID-19 cases tested the limits of our emergency room and the unshortened pediatric public health-care system. It moreover unauthentic our mental health. It seemed like the rest of the world had moved on from the pandemic, but we were in this upturned situation with increasingly hospitalizations and fewer beds than in the peak of sultana COVID-19 cases. No child should be denied a ventilator or a bed or respiratory support, yet these are the kind of decisions we had to make. We had to triage who most needed respiratory support, while watching other kids and waiting.

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So many of our ICU staff were burnt out. Many people quit, and others went on extended leave to take superintendency of their mental health. It’s not pearly to rely on the tolerance and resilience of these wonderful, generous people to recoup for a lack of government planning. That undersong is something that every health-care worker carries with them: if I don’t show up to work tomorrow, the sick victual in the ICU is not going to get respiratory care. I remember having to say to a family, ‘I’m sorry. Two months ago your child would have met the criteria for an ICU bed, but now we just don’t have unbearable beds for them.’ It felt so ethically wrong. It was heartbreaking. You live with a very uncontrived sense of responsibility. But it shouldn’t be up to good people to go whilom and vastitude every day. It’s not a sustainable way to unhook care.”

Chelsea Cadieux, PICU nurse, Ottawa

“Late last year, I admitted a young girl without a bad car accident. Her younger brother had passed yonder in the same accident. Her mother was at the bedside with me, and she had to undeniability her extended family to let them know what had happened. I remember hearing the screams that came through the phone. They replayed in my throne for a long time after.

As a nurse, you try to be strong for your patients. I wanted to cry with them and hug them and let myself finger what they were feeling, but I couldn’t crumble on the ground. I had a job to do. That was the day I realized I needed to talk to someone well-nigh all the things I’d seen working in the hospital. But the problem with therapy is that plane when you realize you need help, the benefits we have barely imbricate it. It’s really a pitfall in nursing. You’re expected to deal with all this trauma, but you’re not given the tools to cope with it.”

Christa Ramsay, PICU senior respiratory therapist, Ottawa

“I’ve been working at CHEO in the ICU for 23 years. Before the viral surge, whenever a child died, I unchangingly felt like my team and I had washed-up everything we could to save their life. And if it was a life that couldn’t be saved, we hopefully made the dying process as painless and peaceful as possible.

During the surge, we were stretched so thin that it felt like we were never doing spanking-new work. We had dozens of kids, and we had to segregate which ones we were going to treat first, knowing that prioritizing one might be detrimental to others. We just couldn’t do it all. And so rather than providing excellent, timely, thorough care, we were running virtually putting out fires constantly. I used to dread going into work. When I left, I would get in my car, cry the whole way home, pull into my garage and just sit there, crying some more. It was days upon days and weeks upon weeks of never feeling like I’d washed-up a good job.”

Zoya Thawer, pediatric endocrinologist, Calgary

“The other day was really challenging. I got up at 5 a.m. to reservation a ferry, then started my day in a rented clinic where I was helping out a colleague, and I was moreover on undeniability for inpatients at the hospital. In the afternoon we had a lunch-and-learn, and it was the first time I’d sat lanugo all day. Just as I was well-nigh to eat, I got a phone undeniability well-nigh an urgent patient. By the time I attended to them and I was washed-up sorting everything out, the afternoon clinic had started and I was when to work. Not only are you physically depleted when you’re working, but there’s moreover the mental undersong of stuff on call—something could happen unendingly that you have to respond to immediately. It doesn’t matter that I haven’t had my lunch or a proper break.

It can be really frustrating when people say, ‘Self-care is really important,’ but then when you unquestionably squint at your day, you’re like, ‘There’s nowhere I could have really taken any time for myself.’ And it’s considering of how the system is structured and how much we’re expected to work. We talk a lot well-nigh exhaustion and how we can make people increasingly resilient, but it’s really challenging when the system isn’t set up to support you. We’re overworked and understaffed with no time to take superintendency of ourselves. If the system is lightweight us, there are very limited things the individual can do to make that better.”

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