It was late March 2020. Covid-19 had landed in the US, had washed through Seattle and ventured into the Big Apple, though as yet had only killed a few hundred New Yorkers. As the month drew to a close, Covid also made its debut in Philadelphia. Scientists around the world were playing catch-up with the little data that was available. And Temple University Hospital now opened its Boyer Building as a dedicated ICU for Covid-19 patients.
When Nurse of the Week Marissa Pietrolungo, BSN, MSN, CCRN, a 29-year-old cardiac care ICU nurse at Temple, arrived for her shift, she could see that her manager was troubled. More was awry than the usual headache of a shift being short one nurse. Much more. With the Boyer Building opening their doors for SARS-CoV-2 patients, the nursing staff was suddenly in need of 14 additional qualified nurses.
“The first time I went in the room, I was like,
‘Oh my gosh, trying not to breathe.’”
Pietrolungo automatically volunteered, and that same shift, she embarked on her first-hand experience with the soon-to-be-called “unprecedented event.”
During those initial Covid patient encounters, she knew enough—in the abstract, at least—to be well frightened. Pietrolungo told Temple’s Narrative Medicine Program (NMP), “The first time I went in the room, I was like `Oh my gosh, trying not to breathe.’ But there’s no way you can do that. And I’m in that room so much that I just honestly hope that my protective gear is protecting me.”
At first, things could be a bit surreal, but it wasn’t overwhelming. Pietrolungo says she started with an essay at preventive dentistry: “The first day, I did something simple like help my patient brush her teeth. She’d been in there for three days, but we were all so worried about transferring the disease that I don’t think anyone had thought about brushing her teeth. I brought in a toothbrush and toothpaste and mouthwash, and I set her up on the end of the bed. She was a Spanish speaker and we couldn’t really communicate, but she kept blowing me kisses.”
The lull was over quickly. As the Temple NMP’s writer described it, “Things in Boyer changed fast. The hospital filled with extremely sick COVID patients, many on ventilators. Normally, a cardiac intensive care nurse at Temple will care for one patient, sometimes two. Pietrolungo was soon caring for three ICU patients at a time – and quite often three to a room.”
But as things got worse, something seemed to compel her to fight harder to care for each of her patients and do whatever had to be done to help everyone through the long ordeal. Pietrolungo took initiative in devising ways to optimize the ward to function in worsening crisis conditions. She recalled for one interviewer that “We transitioned the rooms from holding one patient per room to holding two to three patients per room with makeshift curtains. We also turned the operating rooms into suites that would hold up to four patients on ventilators.”
She emptied trash, mopped floors, recruited fellow nurses to take shifts in Boyer, held terrified patients as they struggled to breathe, and tended to the care and final comforts of the dying.
When she was not strategizing or tending to a patient, Pietrolungo did whatever else had to be done. She emptied trash, mopped floors, recruited fellow nurses to take shifts in Boyer, held terrified patients as they struggled to breathe, and tended to the care and final comforts of the dying. In fact, she was the bedside nurse for 15 different Covid patients as they drew their last breaths, holding a mobile phone screen up so they could see their families one last time.
Looking back, she’s still not sure whether she contracted Covid herself during that insane spring, but there is no uncertainty in her description of her experience. The masks hurt. Wearing PPE for 12 hours is stifling. You have to confront fear before and during every shift, and every time you go home. You lose an unbearable number of patients, and it’s hard each time. What kept her going?
Pietrolungo says, “I go back to our responsibility to the patients… [who] are very sick and can take a turn for the worse in an instant.” And you have to marshal your fears; it’s the only way to get the job done. “Each time you enter the room, you are coming into direct contact with the disease, and you have to be okay with that risk to perform your job. If all I focused on was contracting the virus, I would not have been able to be the best nurse for my patients … I took care of my COVID patients like I would have taken care of anyone else.”
Congratulations, Marissa, for setting such an outstanding example of nurse leadership—and for the exceptional patient care, of course!
For a list of all ANN Covid Courage Award winners, click here.
To read an excellent interview with Marissa Pietrolungo, be sure to read the article on the Temple University Narrative Medicine site. Images from NBC Philadelphia video.
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