A line-of-duty nurse’s daily diary

How does a medical staff in isolation duty work?

Sonam Gayley, 27, is one of the nurses at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) who has successfully completed his isolation duty for a period of 18 days.

He is one of the many individuals who risk their lives to treat COVID-19 patients and subsequently the nation as a whole. The nurses’ actual duty period is for 14 days, however, during his phase, there were only two positive cases left and hoping to treat the patients well, he worked four extra days. Little did the nurses in his batch know that before they completed their duty, the number of COVID patients would increase drastically.

He stays in a hotel room and he starts his duty after being picked up by the hospital vehicle. He has to ply to and fro from the hotel to the hospital as nurses serving duty are not allowed to go out. The driver reaches them to the hospital and he also returns to his hotel room. There were six nurses, two doctors, one x-ray technician, and three supporting staff during his duty time. Their routine depends on the shift system where in the morning; he starts his duty from 8am to 2pm, and evening from 2pm to 8pm and night from 8pm to 8am. However, they have to do one shift a day.

“This duty is something very different from other duties and as a nurse, it is responsible to be cautious as it is very risky to us,” he said. Till now, the duty has been undertaken by those individuals who do not have family and kids.

Within these duty hours, they carry out daily services to the patients and if there is an emergency they attend to it while carrying out other services. They do not make unnecessary contact to minimize risk exposure with patients.

When he is on duty, he is completely dressed in protective gear, personal protective equipment (PPE) – a full length protective unsterile surgical gown, hair and head covered by a disposable head gear, face protected by face shield and a triple-layer face mask. His two hands are covered with unsterile surgical gloves while gumboots protect his legs. PPE is a one-time use and-throw gear and they have to wear it every day while undertaking their duties. Every day, for six hours, they have to wear the gear which according to him is quite uncomfortable, adding that he has to wear the gear for 12 hours when on night duty.

“Though it is a risky job, I feel safer with PPE and I am pretty sure that it will not infect me,” he said.

“I am doing this to serve my King and country in crisis.”

Depending on the number of cases shifted in the isolation ward, the nurses have to look after the patients.  After completing their duty for two weeks, they are moved to a different hotel for quarantine for 14 days. He said that he was quarantined at Jambyang resort with all facilities. Moreover, other staffs who are working in the isolation ward and the driver is also shifted to the quarantine center for 14 days. After the completion of the quarantine period, they return to their regular work in the hospital and the duty at isolation ward is replaced by another group of staff.

However, to minimize risk of exposure, the entire team of doctors, nurses, and the supporting staff are changed and on a rotational basis if they are deployed in the isolation ward.

Currently, there are 48 total confirmed cases in a country with 21 individuals in the isolation ward and 16 in the de-isolation facility.

Tenzin Lhamo from Thimphu