“You worry here, you worry there”: Filipino healthcare workers on how they’re handling the pandemic.
When Lotess Varley’s step-down/telemetry unit at Baltimore Washington Medical Center was converted into a closed containment in May, she began wearing layers of personal protective equipment for her entire 12-hour shift. Just putting on all the PPE, including a face shield, N95 mask, boots, a head cap and rubber gloves, takes 10 minutes, she said.
“There’s a lot of things running through your mind even before the start of your shift,” said Varley, 28. Even simple necessities like communicating with other nurses can be difficult, she said, because the face coverings make it hard to hear each other.
Varley, a resident in Hanover, Maryland, has been a nurse in the United States for two years, and was a nurse in the Philippines before she immigrated. Before the onslaught of the novel coronavirus disrupted the globe, she had been adapting to working in the U.S. healthcare system and working with different machines.
According to STAT News, “4%, or about 150,000, of nurses in the U.S. are Filipino.” In some regions, like California, New York and New Jersey, they account for a larger share of healthcare workers. And as the coronavirus pandemic rages on, it’s taking a huge toll on the Filipino American community.
Varley and others in the healthcare field said the anxiety during the pandemic and changes on the job have been a big adjustment.
“When we started the transition to COVID it’s scary because as a person you’re still a human, not only a nurse,” Varley said. “You worry about yourself — when you go home how are you going to disinfect, in the hospital how are you going to affect the other patients.”
New procedures
When working with COVID-19 patients in her cardiac intermediate care unit, Kathy Valenzuela, 27, said she has to do what’s called “clustering care.”
The College Park, Maryland, resident explains the strategy for limiting exposure to the virus: “You have to do most of your care all at one time instead of going in and out because you want to go be in the room as little as possible but take care of them to the best of your ability at the same time.”
It was challenging for Valenzuela when she was assigned to COVID-19-positive patients, she said, because she had to prioritize certain patients and processes.
“[Y]ou still want to take care of them when they ask for something,” she said. “You have to explain to them, ‘Yes I understand that you have those things that you need and we’ll try to get those things as soon as possible, but we’re going to have to cluster, so it may be later than you would like.’”
Plus, the policies and procedures have been constantly changing as more information about the novel coronavirus and resources for workers become available.
Several of the nurses talked to for this story said pre-pandemic, PPE was considered disposable. But at the height of the equipment shortage in March and April, reusing things like N95 masks and face shields became common procedure. By June, though, most nurses said equipment had become more plentiful.
As an in-home caretaker, Alcon Atienza hasn’t faced big changes in his job, but he’s cognizant of following the recommended day-to-day precautions. At his patient’s home — the only place he travels these days — Atienza sanitizes and washes his hands more often, wears gloves when handling food and is just “being extra careful.”
These are among some of the guidelines from organizations like the Centers for Disease Control and World Health Organization for preventing spread of the novel coronavirus.
“I need to be fair with [my patient and his wife],” Atienza said. He has been working one-on-one with this patient, a 76-year-old stroke survivor. “They are very fair with me; they are taking care of themselves. I am taking care of myself, too, because I don’t want them to get the disease from me.”
Mylene Baltazar, 28, is a nurse in a pediatrics post-anesthesia care unit in Washington, D.C. She said new rules only allow for one parent at a time to be in the hospital with their child. Baltazar, 28, said parents have to check in at the lobby of Children’s National Medical Center, so before they enter the hospital the other parent is called down. This is to minimize possible exposure in the hospital and individual units.
Louisse Tayag, 27, who works as a dialysis nurse in Seat Pleasant, Maryland, said many pandemic-friendly procedures — being aware of hand hygiene and wiping down chairs between patients — were already part of the process in her workplace because they’re working with blood. Still, some things have changed — for example, patients can no longer eat while on the dialysis machine, doctors do televisits with patients, and caregivers or partners are no longer allowed to accompany patients.
And when they leave their hospitals and head home, most of the healthcare workers interviewed for this story said they follow some extremely strict routine to protect their families — changing out of work shoes before going in the house, stripping down their scrubs in a garage or separate room, putting the scrubs straight into the laundry machine and hopping into the shower immediately.
The personal cost
Many healthcare workers have had to make difficult decisions or completely change routines at home to protect their loved ones.
Paul Tarectecan, who recently completed his first year as a pediatric resident in Brooklyn, New York, said there are many fears associated with the virus.
“Initially, there was a sense of uncertainty, anxiety and fear for my own health and the health of my family, and to some extent there still is,” Tarectecan, originally from Hyattsville, Maryland, wrote in an email in June. He added, “I feel that in the back of most healthcare workers’ minds, there is this collective fear that the coronavirus is looming somewhere out there, dormant, but ever present.”
Baltazar’s mother and sister are nurses in different fields, so even though they can’t meet in person, they have each other as a support system.
“I guess misery loves company,” Baltazar said. “We just want to talk to each other about that and it makes it a little bit easier that somebody would understand what you’re going through.”
Baltazar said though she’s protected with equipment and doesn’t work on the “frontlines” of COVID-19, “I still feel so scared to go to work because even though you test these kids [for COVID-19] before surgery there’s such a high false negative [rate].”
Because Tarectecan and his wife are both healthcare workers in New York, they made the choice during the height of the pandemic to send their then-16-month-old son to stay with their family in Maryland for a month and a half.
“That was probably the most difficult period,” Tarectecan wrote.
Varley said she worries about her parents, who are senior citizens living in Cavite, Philippines. Her brother has a car but lives in a different city from them. Because of the lockdown restrictions, he can’t travel to help their parents as much as they might need it.
“If you’re a nurse here and you have your whole family in the Philippines, you worry here, you worry there,” Varley said. She’s ordered fresh produce, chicken and beans online to be delivered to her parents a world away. Many Filipino healthcare workers also send a portion of their earnings back to their families in the Philippines.
Baltazar lives with her high-risk parents, and the pandemic has changed the way the family lives. The three of them are each quarantining in separate rooms to avoid spreading the virus, especially to Baltazar’s father, who had heart surgery in January. They don’t eat together and don’t interact within a close distance of each other.
When Tayag’s parents tested positive for coronavirus, she and her siblings decided to stay in a hotel room and later, their cousins’ house. She was worried about her father, who has a medical history that could leave him more vulnerable to the virus.
“It was really terrifying knowing he had that history and hearing the stories of how COVID affected people,” Tayag said.
On Mother’s Day, though they stayed quarantined, Tayag and her siblings dropped food off outside their mother’s door to celebrate.
After two weeks in quarantine and a negative coronavirus test, Tayag went back to work as a dialysis nurse.
“When I was quarantined, I just … I felt like there was nothing to do and I like being able to go to work and do something and help those people,” she said.
Why do they do it?
That motivation to help people rings true for the healthcare workers spoken to for this story.
“With the Filipino culture you always take care of your elders, you always have your grandmother living with you, you don’t put your parents in a home,” said Tayag. “We had my grandmother living with us and that really instilled that drive in me to want to help people through healthcare.”
Tarectecan’s parents were nurses, which he says may have affected his career choice. But he said, “The reason I originally chose to pursue a career in medicine was because when I visited the Philippines in high school, I was deeply affected by the immense poverty that I witnessed, particularly among young children. I felt that medicine was the best way that I could make a positive impact on the lives of children like those that I had seen.”
And even though being in hospitals and clinics is particularly risky during the pandemic, the nurses and doctors say that their care and sense of duty for their patients keeps them going into work.
“Now more than ever, I felt as though I was fulfilling my duty as a physician,” Tarectecan wrote. “It was inspiring to see the nation band together in support of the healthcare community, and I am proud to have served my role during this historic time at the epicenter of coronavirus pandemic.”
Baltazar also said her patients are at the epicenter of her motivation. “I still go to work because I still love my patients, and I look forward to taking care of them,” she said. “Honestly even with that fear, when you’re at that bedside taking care of a kid, it’s like you forget you’re in a pandemic.”
Valenzuela added, “[W]e as Filipinos are very caring people, I think is what I’ve noticed, [which] drives me to become a nurse also. Nurses basically have the patience and the capabilities of taking care of people in any type of situations.”
Jacqueline B. Hyman is the founder/editor of Fil-Am Features. Reach out via email at filamfeatures@gmail.com or on Twitter @filamfeatures.
