COVID-19 Nurse Confesses How It Feels to Watch Death on the Frontline
Jerlmell G. Lucero has been a nurse for nine years. The 28-year-old has been serving at the Amai Pakpak Medical Center (APMC) in Marawi City since July 2016. Lucero also served during the Marawi siege in 2017 that claimed dozens of lives and left thousands of its residents homeless.
Since he has no house in Marawi, Lucero, who goes by the nickname Mell, stays at the hospital’s dormitory. He is from San Martin Bacnotan in La Union, but was introduced to APMC by his cousin, who is also a nurse based in nearby Iligan City. Mell is part of APMC’s Task Force COVID19 composed of nurses, doctors, medical technologists, radiology technicians, and other health-care workers.
“We are the nurses assigned to handle patients admitted for COVID-19,” he said.
COVID-19 is the disease caused by the novel coronavirus known as SARS-COV 2. For two weeks now COVID-19 has spread through the country, with cities and municipalities locking down and imposing community quarantines. Many stores and businesses have shut their doors for now. Employees in the private sector and government offices are working from home to help contain the spread of this virus in an unprecedented pandemic that is spreading across the world.
Mell’s shift at the isolation ward was about to begin on March 10, when a suspected COVID-19 patient was admitted to the APMC.
“It’s so happened that I was outside of the APMC dorm when I met our team leader, who instructed me to prepare the isolation ward for a possible admission,” he said.
“Since I was the only available nurse, I was the first one to reach the isolation ward. Right after the ward was prepared, the emergency room called to say they were sending the patient directly into the ward. With no hesitation, I received the patient. At that time, I had no equipment—just the clothes I was wearing when I entered the isolation ward and my phone. That was all I had with me. I donned the full personal protective equipment gear and waited at the receiving area.”
Receiving his patient
“Once we were inside the isolation ward, I introduced myself to my patient, shaking his hand and placing it on my chest,” Mell said. “I could see in his eyes that he was trying to place my face, but, probably because of the PPE, he didn’t recognize me. He asked me: ‘Are you Meranaw?’ I answered, ‘no, sir, I am Ilocano. I also told him I would be his nurse for two days.”
“I explained the rules inside the isolation ward to him,” Mell added. “And I told him that he should call me over the radio if he needs anything. After that, I checked his vital signs. I found that he had a fever, was breathing heavily, and had a dry cough. I gave him paracetamol and oxygen support until his oxygen status returned to normal.”
“That done,” Mell said, “I returned to the nurse’s station where there is a window through which you can speak to the people outside of the isolation ward. My patient’s son asked how his father was. I answered: ‘He’s okay. He is fine.’ I also told my patient’s son that his father needs a prayer mat so he could pray.”
Mell continued his story: “After that, I returned to my patient’s room to assess him and check if he was still feverish. It was at this time that I interviewed him regarding his travel history, health history, and family history.”
“We also talked about his job and family—his children and two wives. We discussed his plans for his life, about his Arabic education, and Islam. He said his two wives were good women. He said he was thankful that his first wife, even when he took a second wife, did not stop loving him. He said the same of his second wife.”
“We talked about a lot of things, but I will never forget that he said he loves his family,” Mell said. “How worried he was about being lost to this world. At that point, he worried more about his family than for himself. We would also talk about why I was here in Marawi. What I told him was that I have a family here, and that is why I work in this hospital. He said that the jobs here are good. He also asked me why I chose this hospital in Marawi, of all the many hospitals. So I just told him that this was the hospital that hired me. Of all the hospitals where I applied, this was the only one that called, and I like working here.”
"We talked about a lot of things, but I will never forget that he said he loves his family. How worried he was about being lost to this world. At that point, he worried more about his family than for himself."
“After the interview, I told him he would undergo a diagnostic procedure to determine whether he does have the COVID-19 illness. He agreed to this without reservation. I checked him every two hours. Each time, his oxygen saturation levels dropped and his temperature rose.” Mell’s retelling shows how cooperative his patient was.
“Nobody else interviewed him but me. I remember that, on the first day, I asked him if there were any things that he needed, like food or something to entertain himself with. What he told me was that all he needed were clothes.” Mell said he saw to the other details of his patient’s comfort as well: “After that, I told his son to bring him clothes and his favorite food. I added that he needed a prayer mat and Quran. After that, I also told his son to bring an extension cord so the plug cord’s socket could be put near his bed.”
“Our procedures come with a bit of pain,” Mell said. “I told him he just had to bear it for a while. It was normal for him to cough and sneeze. They took specimens from him twice for NPS/OPS on March 10 at 8 p.m., and on March 11 also at 8 in the evening. With the first test, he told me his nose hurt. He didn’t complain when the second test was administered.”
“Over the two days I was his nurse, I was relentless in checking and assessing my patient every two hours,” Mell said. “I was just as persistent in updating the doctors and our head nurse,” Mell said. “Our morning routine was that I would always ask if he wanted to have coffee. I always brought him hot water and Nescafe in the mug kept at his bedside. I’d always offer him green tea after I’d have coffee with him. He wasn’t fond of green tea. At noon, I’d open bottled water for him, because one of his hands was hampered by the intravenous dextrose line.”
Mell said that he saw his late father in his patient. “My father is a deacon of our church,” the nurse explained. “He was very faithful in his religious worship.”
By the afternoon of March 11, Mell said that his patient told him that his intravenous drip site was painful. “Because I wanted to show the doctor his IV site, I asked my patient if I could borrow his phone so I could take a photo of the site and send the picture to over my Messenger app, because I wasn’t able to bring my phone into his room, as I was wearing my PPE. He agreed, and let me use his phone.”
As time wore on, APMC’s roster of patients increased, Mell said: “On March 12, we received three more patients. There was another nurse in there with me then, to continue patient monitoring and management with my first patient. He asked me if his results had arrived. I whispered my answer: ‘We don’t have it yet, Bapa. There is still no reply from Manila.’ As the days went by, he deteriorated. His oxygen saturation kept dropping. His temperature remained high. But he earned my respect because he did everything I asked him to do. He followed all the advice I gave him, and he took all the medicines that were given to him.”
Mell’s story gets progressively strained: “On the morning of March 16, 2020, while I was cleaning his room, he told me he was having difficulty urinating, so I gave him a bedside urinal. After cleaning and arranging his room, he said: ‘Thank you, son. Are my results in yet?’ I closed my eyes so I could answer: ‘Not yet, Bapa. Maybe the results will come tomorrow because the doctor is also angry over the long time it is taking to get your test results.’ My tears were threatening to fall as I left his room because my patient’s situation frustrated and saddened me.
“It was on that morning, too, that his family visited to bring food and drinking water. I told his family that their Bapa had improved slightly as of the last time I checked. His temperature was normal, but his oxygen saturation was still low,” the nurse said. “I could see the longing in my patient’s eyes. My patient’s son returned in the afternoon to again ask me about his Bapa. I told him that his father was not feverish and his status was improving.”
“In the wee hours of March 17, about 4 a.m., while I was checking my patient’s vital signs, he asked me again: ‘Are my results in yet?” Mell went on: “All I could say was: ‘Later in the morning, sir. Be patient just little longer.’ I returned to my bed, waiting for the doctor’s reply to my update on my patient.”
Dying before dawn
“Past 5 a.m., my patient called over my radio: ‘Saripada, Saripada, Saripada.’ I immediately instructed the other nurse to go straight to our patient and I would follow,” Mell said.
When Mell's patient went into arrest, he said, “I was outside his room trying to contact the doctor. Two of us nurses handled him. Once I got to our patient’s bedside, I could see he was slowly weakening, that he was having much difficulty breathing." Mell and his colleague gave the patient oxygen and what medical support they could until the doctor arrived to check his pulse and his pupils. The medical team gave him medication to restart his heart and initiated resuscitation efforts for 30 minutes.
The patient remained unresponsive.
“We really could not save Bapa. The doctor declared him clinically dead at 6:31 a.m.”
Buried before sundown
Mell’s patient was buried before sundown on Tuesday, March 17. He’d suffered, endured great pain, has become faceless, and is nameless now.
He’d traveled across the seas to fulfill his faith, then returned home. He met his death, as well. He was wrapped in white cloth, knowing that his death was imminent. Those who tended to his last rites wore disposable suits which were incinerated after his burial—because fire purifies, and ashes are sterile.
He died knowing he would die, but not what was killing him. The 58-year old patient had tested positive for COVID-19. The results he had been waiting so patiently for came an hour after his demise.
He died knowing he would die, but not what was killing him. The 58-year old patient had tested positive for COVID-19. The results he had been waiting so patiently for came an hour after his demise. The patient, according to those who knew him, was a deeply religious man who was well respected in his community. They say he traveled to Malaysia recently where he may have been infected with the virus.
Mell’s patient is one of the first few confirmed cases of COVID-19 in Mindanao, as the country saw an increase in the number of confirmed cases of the dreaded virus over the last two weeks.
He said that despite almost a decade of experience as a nurse, he has never gotten used to his patients dying under his watch: “It is painful, especially when the patient is hopeful he will recover, even when we know that this illness still has no cure.”
Mell also said health workers like him have been on the frontlines for years, even decades, but this one is different: COVID-19 is new and there is much we have yet to learn about the disease. This, he said puts more health workers like him at risk.
Amid all the attention health-care workers are getting, Mell has only this to say: “It is overwhelming, because, before, our profession was not really the subject of public scrutiny, or of such importance. Now we are needed. I just wish the people would also see us as humans: We get tired. We get sick and we feel pain. We also have families but, because we swore an oath to uphold public health, we will do our jobs.”
Mell added that he treats every patient as a family: “In truth, even if I’ve only been assigned to the emergency room as a frontliner, I still feel very scared. We risk our lives just to save lives. Despite the fear, I think of my patients as if they were my mother or my father, and of what would happen if they die.”
In this time of pandemic disease, Mell said he would be happy to see an empty isolation ward.