photo courtesy methodist le bonheur healthcare
Amanda Holder, intensive care unit nurse and medical response team nurse at Methodist Hospital - North.
May 12, 2020, marks the bicentennial of the birth of Florence Nightingale, the British social reformer (1820-1910) considered the founder of modern nursing. She became famous for organizing the treatment of wounded soldiers during the Crimean War. Today, nurses also find themselves on the front lines, this time battling an enemy — the novel coronavirus that causes the deadly COVID-19 — that can’t even be seen. Well before the current health crisis, though, nurses were the men and women we came to depend on, working in tandem with physicians and other medical professionals, to ensure our well-being. Here, we profile four nurses from regional hospitals, asking what drew them to their profession, what they have gained from it, and where we go from here.
Born in Halls, Tennessee, Amanda ("Mandy") Holder attended UT-Knoxville before moving to Memphis to be closer to her ailing mother. After earning a bachelor’s degree from the U of M Loewenburg College of Nursing, she interned at Methodist-North where, she says, “I matched perfectly with their Emergency Department.” She’s been an RN there since 2016.
What made you decide to become a nurse?
I always knew I wanted to work in healthcare because I sincerely wanted to help people and felt it was a calling since I was a little girl. I always wanted to make things right.
My mom suffered a major heart attack during my junior year of high school and needed bypass surgery, and it was really during that time that I realized I wanted to be a NURSE. She’s been in and out of hospitals since then and every time she’s been hospitalized, it was a nurse who called my family with updates, no matter how big or small. It was a nurse who held our hands and prayed with us, who lifted us up when we weren’t sure what the outcome would be. It was the nurse who taught us how to take care of her wounds. It was the nurse who taught me what signs and symptoms to look for that warranted a visit to the nearest hospital. It was a nurse who came by our room in the middle of the night with an extra blanket, just because she noticed one of us didn’t have one.
photo courtesy methodist le bonheur healthcare
Everything I remember from my mom’s health issues all start with a nurse. Of course, it took the whole healthcare team and I am grateful for each and every one of them. The nurses stood out the most to me, and I knew that I wanted to be that person for many other people.
I am a nurse because I care. I want to advocate, educate, and nurse patients back to the best state of health. Being at the bedside for the duration of a shift allows me to do just that. And it’s an amazing feeling when you make connections with patients and their families, and you see them through. We play a short part in their lives, but our impact can be profound. I’m proud to be a nurse.
Under normal circumstances — pre-COVID-19 — how do nurses coordinate care for patients with communicable diseases?
At MLH, our patients are treated with dignity and respect, regardless of circumstance or diagnosis, and we hold patient safety at the utmost importance. Communicable diseases are reported during beside shift change between nursing staff. If the disease is contagious, the patient will likely be in isolation with a sign attached to the door indicating the type of isolation. This alerts healthcare workers to wear the appropriate PPE when entering the room. Methodist has an internal website that allows associates to easily look up safety protocols and best practices. If we are ever unsure how to handle a situation, we may first refer to the document portal for protocols or follow the chain of command to identify an appropriate coordination of care. Prior to COVID, even a patient with a communicable disease could have visitors and they were provided appropriate PPE for their visit.
Nursing is one of the hardest careers out there, but it is also one of the most rewarding. It takes a lot of skill, ingenuity and attention to detail to be a nurse. But what is most important is your heart. If your heart is in the right place and you are doing it for the right reason, then there is no limit to the number of lives that your hands can touch.
Among the greatest fears during this pandemic is a lack of supplies. How do facilities prepare for a crisis?
We stay at a state of readiness, although the COVID-19 pandemic is certainly unprecedented.Because we review and update our emergency preparedness protocols, we were quickly able to shift those practices in response to COVID-19.
We have been able to utilize emergency stockpiles, and our Supply Chain teams are actively rounding (even on weekends), to take inventory levels and work to meet the needs of our units, all while anticipating needs based on current projections. The Supply teams at MLH have been utilizing current partnerships, seeking new ones, and collaborating with the city of Memphis to utilize non-healthcare vendors. They have also been communicating with both state and local health departments in order to receive supplies from the Strategic National Stockpile. And they have even started 3D printing face shields, now making over 1,000 face shields per week!
We are receiving an outpouring of support from our faith-based Congregational Health Network, as well, and have accepted handmade masks, some of surgical grade, and also donations from our community. This allows office staff to wear handmade masks while preserving surgical masks for clinical team members like me. It has been tough for everyone to source PPE, but our team is dedicated and has proven that they are up to the task. Our CEO has kept us up-to-date and informed every step of the way, as have our leaders from across our system.
In addition to the supply chain management team, we at the bedside have also been preparing for an increase of COVID-19 patients. During one recent shift, I helped to cross-train several nurses from other units on how to take care of ventilated patients in the ICU. As far as bed availability, Methodist recently started utilizing an intraoperative command center. This allows us to visualize room availability, transfers, ER patients and other needs so we can find bed availability appropriately and efficiently. This allows us to be more effective and innovative as a system.
Do you think “social distancing” is a new normal for mankind?
I strongly think that social distancing is the key to “flattening the curve” at this time. It is the single best thing that any person can do to stop the spread, in addition to frequent and effective handwashing.
It’s important to remember that social distancing will not last forever. It’s important for us to know that. This too shall pass. But, in the meantime, please do your part by social distancing yourself from anyone outside of your household. I know how hard that can be — I personally have not seen either of my parents for over three weeks. But I understand that by being distant, I can keep them safe. What’s a few weeks of social distancing compared to a lifetime of special moments?
I think it’s also important to remember that we are a kind and supportive community. We want to help our neighbors and those in need — and we can! We just need to remain at least six feet away while dropping off a loved one’s medication or a friend’s groceries. Family traditions can still be shared via FaceTime, Zoom, or other online platforms. Get together on a video conference for that Sunday evening family dinner. Schedule a call on Friday night for family game night. Make temporary new traditions. We are all in this together and it will take everyone taking this seriously in order to have optimal effects. The severity of this virus is seriously up to the people of this city.
There’s much doubt and fear associated with the current pandemi c . How do people best manage that?
I tell my patients and families that it is oka to be fearful. If we are slightly fearful, then we are naturally more cautious. However, we cannot let fear control our lives. Whether you are healthy or sick, we should all take the same preventative measures in order to minimize our risk for contracting the virus and also spreading it — remember, social distancing and frequent hand washing.
COVID-19 affects people differently. Some individuals will only have minor symptoms. Some may not have any. But those with little to no symptoms may still spread the virus to someone who then develops severe symptoms and complications. I mentioned social distancing and hand washing, but it’s also important to abide by CDC and local and state guidelines that currently include staying at home.
It can be overwhelming to have constant access to this ever-changing COVID-related information. Try to set aside an hour or two each day to educate yourself with new updates from reliable sources, such as MethodistHealth.org/Coronavirus. And for your mental health, take a walk outside. Create a new recipe. Spring clean. Organize your cupboards and drawers. Find something productive to do while staying at home. Be smart and cautious. That’s the best way to manage anyone’s concerns, whether you’re an elderly or young individual — healthy or sick — just be smart and cautious.
Are there any lessons you’ve learned from this crisis?
Be kind. That’s the greatest thing I have taken from this crisis on a personal level. Just be kind. Let’s not fight over the last package of toilet paper. Let’s not forget about out elderly neighbor who is getting chemo treatment and shouldn’t go to the store. Let’s not forget about our parents, who may also have health conditions but might watch our children. Let’s not forget about those patients who are alone in the hospital, or their family members who can’t be there. Let’s take this time to check on one another. Educate each other about proper hand washing and cross contamination. Let’s be kind. This is the time to help others and lift each other up. Call your friends and family, deliver a “happy” to a neighbor’s front door, cook a meal and enjoy it on the porch, or just write someone an old-fashioned letter of encouragement. Let’s be kind to another. We’re always stronger together. Be kind!
What would you like people to know about your profession?
Nursing is one of the hardest careers out there, but it is also one of the most rewarding. It takes a lot of skill, ingenuity and attention to detail to be a nurse. But what is most important is your heart. If your heart is in the right place and you are doing it for the right reason, then there is no limit to the number of lives that your hands can touch.
You will always face challenges in nursing, but you will never be bored, and you will always be needed. You will see lives start and inevitably you will see them end. You will make connections with some of your patients and families that you will never forget. Some days will be hard, and some will end in tears. But the good far outweighs the bad. This is a quote I live by: “If you are looking to find yourself, lose yourself in service to others.” That’s what being a nurse is all about.
