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Covid 19

Reflections of an ICU nurse: “The coronavirus is won with medical and social reasons”

“Faced with such an infectious virus, with hardly any pharmacological treatment and with a vaccine still to come, we must join all our forces to fight the pandemic without fissures, as if we were a rocky and invincible team; in which society as a whole, critical but at the same time supportive and committed, pulls the sanitary car to overcome the fierce attacks of the covid ”, says Alejandro Blanco Aoiz, emergency nurse at the Complutense University of Madrid

In an interview with EFEsalud , Alejandro Blanco reflects on the social consequences of the coronavirus, the undisputed protagonist of our daily lives since China communicated to the world its great destructive capacity by mercilessly infecting the vast majority of the population, in a special way to the elderly who suffer from other previous pathologies, such as hypertension, diabetes or heart failure.

Nursing lessons learned “piecemeal” in the Intensive Care Unit

Alejandro Blanco reinforced the ICU of the Hospital Clínico Universitario San Carlos de Madrid during the hardest phase of the coronavirus in Spain, between March and June 2020. Alejandro, who has returned to his daily work as an out-of-hospital emergency nurse at the UCM, responds to our questions, sometimes excited, about a disease “very difficult from a clinical point of view”.

“It is a pathology that basically attacks our lungs, causing  bilateral pneumonia , for which there are no specific medications and which kills quickly,” he emphasizes.

“And under this double medical-pharmacological condition, very stressful, the key to success was in teamwork , as always. All of us, in multidisciplinary communion, achieved the objective that was sought in the face of the coronavirus; that it was none other than to minimize the number of deaths caused by the infection, especially among patients with their health or immune system already damaged ”, says Alejandro.

The nurse Alejandro Blanco dressed in his PPE in the ICU area“We have learned together,” he emphasizes. One of the wonderful things that happened at those times in hospitals is that each and every one of us brought out our best qualities, even when we shared work with other professionals who weren’t to our liking. So to speak, we all work together against the virus ”.

“Personally, being one of the new ones to the UCI, I felt absolutely supported and very well guided from the first moment by the people who had been there for many years and who knew a lot. I never felt alone with a patient, even less when I did not know how to perform a nursing technique well. Even the intensive care technicians corrected some procedures for me. It was a pleasure learning from such experienced people, ”he says.

“During my second night of work – he signed up for that shift to reconcile his family life, he tells us – I arrived at my post, an ICU with six beds, recently assembled. My colleagues were two other nurses and two care technicians. The four of us were new and not only did we not know how to use the special PPE – personal protective equipment – but we also could not find the material and did not know the action protocols ”.
“ Luckily, ” he continues, “ Alicia , a nurse with more than 20 years of experience in the ICU, arrived . Very calm, she began to organize, teach us and direct us. When the shift change came at 08.00 the next day we realized that we had not even rested for a few minutes. I knew then that we would be able to face any situation of the pandemic, no matter how tough it was at first sight.

Alejandro Blanco, Emergency Nurse-efeWhat else has this pandemic revealed?

“How badly structured we have the order of values ​​in our head, that is, the priority of what really matters in life. Right now, we are afraid of the coronavirus, practically confined at home, on the edge of the precipice of the economic crisis, with pending jobs by a thread, but you realize that above all that there are other essential things such as health and people’s health; our physical and mental well-being ”, he estimates.

And does society take into account all health professionals equally?

“As the months go by, my reflection is that society in Spain does not adequately respect certain jobs, such as firefighters, true heroes in other countries, on which the idea weighs that they risk their lives putting out fires day and night goes to the salary … as happens in hospitals, where we take care of the sick to the limit of their possibilities . This scale of social values ​​cannot continue like this ”.

“Especially when a person who decides to study nursing or an auxiliary technician is surely not looking to get rich, but rather his goal will be to help people -reason-.

“These professions or others related to the public good must have the social recognition they deserve; And I do not mean that people come out to applaud on the balconies, that we have thanked it and are grateful from the heart, but that, for example, when someone tells you … ‘ I’m a nurse ‘ … you come to think: shit, she’s a nurse ! and he spends many hours of his life caring for hospitalized people. My profession is not paid by far .

Perhaps, Alejandro, your training and dedication are not appreciated enough?

“You can be the basis of why and perhaps it is also related to the fact that today we have an excess of information via the Internet with sources of all kinds, safe and reliable or manipulated and biased. If a person has a headache, it is not uncommon for them to self-medicate without the intervention of a professional, who is the one who can find out the cause of the pain in their head … it is like the health structure in Spain, which is partly based in pharmacology, ”he says.

“What would people think if we built a building without the intervention of an architect!… Surely someone would dare by following a tutorial on the web and applying a design app. In theory we could build a skyscraper, but no one with two fingers of a brain would think of putting that idea into practice ”, he says.

The Emergency Nurse, Alejandro Blanco
Alejandro Blanco : “I think that you have to make an effort and teach people how important it is to have a healthy health system, with its correct ratios, and that health is prioritized over certain economic aspects.”

So, the National Health System should base its action on prevention?

“We cannot have a health system in which drugs cure your disease, as happens many times, for example, in the case of cholesterol. If you have a bad diet, you run the risk of suffering from bad cholesterol or LDL, which in turn will affect the cardiovascular system, especially the coronary arteries and their consequent acute myocardial infarctions. The usual solution is a daily pill ”, he puts on the table.

“From the nursing point of view it is nonsense, since the medicine should be for acute cases. If you think about it, the solution is prevention; modify eating and nutritional habits, the way you eat, your hygienic-sanitary habits, do physical exercise, etc. It is not possible to neglect your health and take the pill so as not to suffer a heart attack. It’s sad to think about it.

And prevention measures are the key against COVID infections?

“Yes, everyone has to prevent the spread of the coronavirus by giving up portions of their personal interest for the interest of the common good. But it seems, once the origin of this second wave has been verified, that at present we pride ourselves on not having a social conscience… and it should be the other way around ”, he points out.

“In this sense, there are two types of people, those who are at risk of dying and those who do not. The disease is attacked in many ways and one of them is the vaccine, in which we have all placed great hopes, but the most important now have to be focused on the correct application of the set of personal and social prevention measures constantly and proportionate ”, he highlights.

“Just because we wash our hands every five minutes, like crazy, it doesn’t free you from contagion. Wearing a mask in a closed room, crowded with people, will not free you from the infection, since the air you breathe is stale and the immense variety of masks do not serve 100%, far from it, to avoid the virus. They are not hermetic and with filters ”, he highlights.

“Even so, there are people who should not do prevention because what we have to achieve is that they have zero risk of contagion, that is, people who have a greater risk of dying if their body is infected by the virus,” he clarifies.

In either case, Alejandro, as an experienced nurse, cannot stop thinking about the nearest future.

The Emergency Nurse, Alejandro Blanco“From the point of view of immunology, which is based on exposure to the pathogenic microorganism, when we obtain a vaccine, not everyone can be vaccinated, and those who do not get vaccinated will have to be exposed to the coronavirus; two situations that will lead to the general control of the disease, as is already the case with the influenza virus or flu ”, he explains.

“It should be remembered, he adds, that we give flu a relative importance, despite the fact that every year it causes many deaths among the population at risk. At the moment, the flu cannot be controlled or eradicated, although there is a seasonal vaccine every year ”.

“What we do have to take into account, as it could also happen with the flu, is that we cannot get everyone and everyone at the same time , the crux of the matter, since it would be catastrophic for a country like Spain to register millions of infections in few weeks. If 10% of these infected people suffered moderate or severe symptoms, all the hospitals would completely collapse ”, he remarks.

And what do you expect from this second wave of coronavirus, more pronounced in Madrid?

“It reassures me to know that today we have everything under control, given the experience of the hard phase of the coronavirus during the spring. Then – he recalls – decisions were made on the fly … beds were opened and closed … plants were opened and closed … even so, the level of response capacity was very high “.

“Now, we would know where to locate the ICU, UCRI or hospital recovery beds and how to better treat patients with the drugs and available technology, as it was possible to verify in the hospitals or in the Ifema – Madrid facility for congresses converted into a center sanitary- “, he assures.

“At this time, too, we must bear in mind that other illnesses or accidents continue to exist . We cannot stop attending heart attacks, diagnoses of malignant tumors, traumatic injuries or suicides because 60, 70 or 80% of the hospital infrastructure is dedicated to the coronavirus. We would be undermining the health system, which has to continue to function with surgical precision ”, he emphasizes.

The EFE journalist, Gregorio del Rosario, interviews the nurse Alejandro Blanco
Alejandro Blanco concludes the EFEsalud interview with advice to the entire population, especially dedicated to youth: “Prevention measures are essential to prevent infections, which are not only avoided by washing hands and putting on masks. Help to prevent infection is carried out with a set of hygienic-sanitary measures focused on diet, exercise, rest or avoiding unnecessary stress. I know it is a difficult social balance, but we must try with all our might … we must pay attention to reason and health professionals . Photographs by Antonio Herrera.

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