Being a health worker in the time of COVID-19 pandemic is akin to being a soldier sent to the battlefield. They help people fight the deadly virus, well-aware that doing so increases their risk of getting infected.

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Cyril Atienza, a nurse at The Medical City in Ortigas, is one of them. On top of the things she has to endure is the pain of not seeing her children since March 13.

She used to be with the hospital's Acute Stroke Unit before she was transferred to the high-risk department handling COVID-19 patients.

Cyril took to Facebook on March 24, uploading a series of photos that narrated how her battle began and how she and fellow medical workers are overcoming ongoing struggles.

"I had an elderly stroke patient that had an episode of desaturation and difficulty in breathing. So, she was put into a BiPAP (Bilevel Positive Airway Pressure machine or ventilator) to help her breathe and apparently, it was not resolved by it.

"She had an episode of fever, and a repeat X-ray was ordered. Then suddenly, out of nowhere, the patient's son came to me and said, 'I'm sorry, we did not tell you guys na we have a relative admitted in the same hospital under PUI.'"

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But even if they were shocked and frightened, Cyril and her teammates chose to still carry out their duties.

She continued, "'Sorry?' Imagine, a relative did not disclose those information. Why? Natatakot daw?

"Wala naparang gusto kong himatayin, gusto kong umiyakHindi namin masabi ang nangyayari sa mga kasamahan namin sa trabaho, kaso kailangan sabihin para sa safety ng mga mahal nila sa buhaySo, pakonti-konti, nagbigay na kami ng mga details sa nangyayari." 

Amid the unfortunate turn of events, Cyril could not stop thinking about her three children: Van Dyke, 15, Vyone Cyra, 10, and Vyanch Cyara, 5.

She decided to isolate herself from them even before Metro Manila was placed under community quarantine on March 15. Cyril then told her husband, Odilon, to bring their kids from Quezon City to his mother's house in Antipolo.

She recalled, "Una kong ginawa noon, tinawagan ko iyong asawa ko kaagad [para sabihin] na, 'Dalhin mo na iyong mga bata sa Antipolo bago pa mag-lockdown.'

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"Wala na. Naisip ko na isang buwan ko na sila hindi makakasama bilang simula na nga ng lockdown ng March 15."

The daily risk

At that time, Cyril's elderly patient was already categorized as Patient Under Monitoring (PUM) for COVID-19, "pero since may mga symptoms, we treat them as PUI," she clarified.

Hospitals worldwide have a stricter protocol for PUIs. They must be confined in "negative pressure rooms."

This kind of room is described by airinnovations.com as a room that "traps and keeps potentially harmful particles inside by preventing internal air from leaving the space."

Cyril's patient was not transferred yet to a negative pressure room, and was breathing through a BiPaP machine.

The nurse explained how this got her and her colleagues even more worried, "At that time, our rooms were not yet converted into a negative pressure room. And knowing that the patient is in a BiPAP, the risks are two times higher or more than the usual.

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"Eh, ayun, naisip ko nung time na inaayos ko iyong BiPAP ni lola kasi nagsasalita siyaSo, iyong buga ng hangin [mula sa machine] damping-dampi sa mukha ko at sa mga buhok ko sa mukha.

"Naiisip ko iyong mga anak ko, mga pangarap ko sa kanila, sa amin. Ganoon na kalala iyong anxiety ko bilang normal na tao lang naman din nga ako, hindi immortal."

But Cyril continued taking care of her elderly patient. "Pero ayun, tuloy pa din ang trabaho. Patient ko iyon eh. Walang ibang mag-aalaga sa kanya, ako lang...

"Naisip ko? 'Lahat sila, lola, iniwan ka nila. Hayaan mo, dito lang ako para sa iyo.' Ganoon naman na din, na-expose na ako. Samahan ko na siya.

"With no proper PPE (Personal Protective Equipment), no negative pressure room, I stayed with her—praying."

Shortly after, Cyril and her teammates were ordered to intubate the patient. "Sus ko, iyong nerbiyos ko kung alam niyo. Ma-e-expose ulit kami direct sa patient," she cried. 

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"Sanay naman kami mag-intubate ng patient. Madalas ginagawa namin iyan, e. Pero imagine, iyong kwarto, andiyan pa floating pa iyong particles if ever. Hindi pa kami naka-negative pressure dito."

Cyril said everyone in their team was nervous, but drawing strength from each other, they were able to accomplish the task. "Pero tuloy lang para naman ma-control yung kaya pang ma-control... Takot din sila pero andyan sila tumutulong sa amin.

"Kaya ganoon na lang kalakas loob ko na sumalang, e, kasi lahat sila andiyan. Walang iwanan."

Amid the stress and the risk of getting infected, Cyril proved her unwavering commitment to her job, and, above all, to her patient. She added, "Hindi ko puwedeng i-abandon iyong matanda kong patient.

"Sobrang takot na takot siguro siya. Gising kasi siya noon... Alam mo iyong in-embrace mo na lang, si Lord na bahala sa akinKahit pa ganoon iyong nangyari, walang nagbago-patient advocate pa rin."

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Though her posts on social media sound happy and her manner of storytelling seems optimistic, Cyril has moments of sadness. She recalled one instance, "Pagkatapos ko gawin lahat, saka na ako pumunta sa malayo, sa isang kwartoNagpahinga, umupo, nag-check ng phone, nag-update kay Odilon, at tumawag din sa kaibigan kong si Ice.

"Bigla na lang ako umiyak sa pagod, sa takot. Naisip ko mga anak ko..."

The PPE problem

The Medical City eventually transformed its Acute Stroke Unit into an area where PUIs and positive cases of COVID-19 are monitored.

"Since my patient had been labeled as PUI, they [The Medical City administration] decided to convert our unit into a COVID-19 unit," Cyril told PEP.ph on March 27 in an interview conducted via Facebook Messenger.

Her Facebook post included details on how their unit was slowly transformed and prepared for the care of COVID patients.

Initially, their team had to wear green laboratory gowns because they still didn't have supplies of personal protective equipment (PPE).

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They had to learn the proper "donning and doffing"—or disinfecting themselves after their duties.

"Iyong umpisa namin pinaggagawa iyong proper donning [putting on] and doffing [taking off]. Kahit ilang beses mo basahin nakakalito pa din, so lagi kaming tumitingin sa kodigo."

On March 17, a designated area for donning and doffing was set up within their workplace. "Nag-set up na sila ng doffing area and donning central area for all nurses," Cyril stated in her post.

Her fears subsided when their team received complete PPEs from the hospital's supplies department. "Masaya ako na panatag magtrabaho kasi protected ako kahit papaano.

"Thank you so much, Ma'am Pinky, dahil nakipag-coordinate talaga siya sa supply [department] namin, and she made sure na lagi kaming protected...

"Thank you sa head nurses namin and lalo na sa mga clerk na nawiwindang kaka-order ng mga supply para sa amin."

Cyril also revealed that, like most hospitals in the country, they are short on PPEs since these are expensive. "Eh, mahal ang PPE, limit lang ang pasok namin. So bahala na ulit si Lord sa amin. Tiwala lang!" she declared.

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After a few days, Cyril and her colleagues were transferred to the hospital's Intensive Care Unit (ICU).

She narrated, "Next thing we know, sa ICU main na kami lahat nagdu-duty, bilang iyon ang utos sa amin... Hindi bilang stroke nurse, pero bilang isang nurse—walang ibang label.

"Kung saan kami ilagay, kung saan kami magtrabaho, gagawin namin, basta makatulongSabi nga ng boss namin na si Doc Racelis, 'For the greater good.'"

The routine

In her interview with PEP.ph, Cyril revealed that not all nurses have been pulled out from their department to assist PUIs and positive cases. However, many of them have been quarantined because of their exposure to COVID-stricken patients.

"We have nurses that are being pulled out from another unit kasi kulang na staff, lalo na madami nang naka-quarantine. So nag-train sila bigla ng mga nurses to properly handle patients that are PUIs and COVID positive," she detailed.

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Cyril described their routine, "In the ICU, it's 1:1 patient to nurse kasi mga critical patient. "We start off by changing into light blue scrubs. We make sure na makakain na kami, 'tapos may dala na kaming water bottle na mga donations from the outside world, kasi mahirap na lumabas ng unit."

Their duties consist of "carrying out orders from a doctor, like medication, procedure, or laboratory exam; feeding the patient; oral care; bath," Cyril said.

"Depende pa iyon sa severity ng patient kasi madami talagang orders, madami procedures, so mabilis ang orasMinsan may magre-remind na lang sa iyo na may food na for lunch.

"Saka lang namin mare-realize na 12 p.m. na pala, so pipilitin kumain para hindi magkasakit. 'Tapos back to usual carrying out orders then until 6 p.m., endorsement to incoming nurse na."

The long-distance relationship with her kids 

From the house of her mother-in-law in Antipolo, Cyril and her husband Odilon transferred their kids to the house of Cyril's mother in Marikina.

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The city is less than an hour's drive from The Medical City, but she could not see them.

The 37-year-old nurse gets updates from her husband. "Iyong daddy, pagka nasa duty ako, pumupunta ng Marikina to stay with the kids and to bring food and to check on them.

"Iyong husband ko iyong tagapunta ng market for their food and same sa bahay namin. So nakakapag-update siya sa akin if andoon siya and if duty ako," Cyril remarked.

Thanks to video calls, she could talk to her family during her rest days. "Almost every off ko sila ka-video chat. Nakaka-usap ko sila via WhatsApp, video call on Instagram, Messenger. 

"Iyong girls sinsabihan ko na I miss them. Iyong boy, sa Facebook ko lang sinabihan kasi medyo binata na."

Cyril said her older kids know why she has to be away from them for now, but her youngest daughter is still having a hard time understanding the situation. "Sa lockdown, iyong dalawang kids sinabihan lang namin na may COVID, bawal lumabas, mag-vitamins and mag-sleep lagi. They don't ask naman questions.

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"Iyong bunso lang ang hindi masyadong nage-gets. She always asks me, 'When are we going home?'

And I just say, 'There are monsters outside. It's not safe to go out.'"

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