Health care workers are having to compromise how they do their work in the midst of the Covid-19 pandemic.

Chantal Masters is a palianation (palliative) nurse. Masters works within the field of palianative care which is a specialised medical care that assists people living with serious illnesses. She is an essential worker during the lockdown in South Africa and tells us about her experiences in caring for the terminally ill and infirm during the Covid-19 pandemic.  Her goal is to improve the quality of life for both patients and their families. Palianative care is based on the needs of a patient rather than their prognosis. Due to the Covid-19 outbreak, Masters and her colleagues of specially trained doctors, nurses and other professionals face particular challenges in doing what they are expected to do. Masters works for a private palliative care that cares for some 600 patients in Gauteng.

On average Masters sees four to six patients a day driving across Gauteng from Krugersdorp to Midrand, Benoni and Springs. About seventy percent of the patients that she works with are cancer patients who need pain and symptom control assistance along with guidance to ensure the best quality of life. This also involves the informal counselling of patients and their families about their future and what can be expected. Masters’ patients also include geriatrics and patients with Alzheimer’s, dementia, cerebral palsy, multiple sclerosis and ischemic brain injuries, among others. 

As told to Anna Moross. 

One of the bigger challenges of the current outbreak of COVID-19 is getting masks, gloves and hand sanitiser as it has become rather expensive. There has been a huge mask shortage and we have gotten to a point where some masks need to be cleaned and re-used. 

Another big challenge is the fact that a lot of our elderly patients’ families live overseas. Due to the closing of the borders families from overseas are not able to travel to South Africa.

I work with an elderly couple and care for them at home. The wife passed away recently and both of their children live overseas. I now have made it a part of my job to make WhatsApp calls and use Zoom to keep the family updated. It puts pressure on us as we are the comforter and often the funeral planner. It is sad that now an elderly man is left in a house alone with no family, it’s soul-crushing really.

I think it is important to understand what type of work I do as a nurse. Being a palianation nurse is similar to hospice work. Comfort and pain control for the people I work with is very important. I interact with high-risk patients and keeping them at home is our number one priority. I have therefore always been travelling to my patients even before the spread of coronavirus and the lockdown started.

At the moment when travelling to patients, there is no traffic. I can get from Edenvale to Greenside in 20 minutes, which has become quite convenient for me. Being stopped by the cops and roadblocks were not too common, but became more apparent since 18 April 2020. I get stopped quite a lot now but I have permits for this purpose.  

Another aspect that needs to be considered is the movement of our carers. The carers of these patients need to travel to look after patients daily. Many families have decided to allow for the carers to move in. Some costs need to be taken into consideration as well as the fact that most caregivers need taxis to commute. Do you take this risk? Or do you supply for the carers travel or accommodation?  

Eighty percent  of carers stay with their patients and some sleep on the couch. Being a carer is a calling and it is something you love and so you are willing to sacrifice your own family to look after what I like to call your ‘adopted family’. If one can’t make these things available other precautions are put in place such as clothes changing and washing. 

We use a team approach which entails a big team of doctors, nurses, physios and psychologists. We can no longer meet face to face and we talk on zoom or via WhatsApp.  

It is very different and we are reliant on technology to communicate. Our updates and discussions via these apps have worked but the support we give each other is all via the telephone.

I am based in a Morningside hospital and the whole hospital is on lockdown. No visitors are allowed and only if a patient is in critical condition can one member of the family get special permission to visit. This is sad as the end of life from a holistic approach can’t be done and it is something we strive for.

South Africa has not been hit hard. As the palliation society, we have helped to set out guidelines to decide who will receive the limited ventilators as well as how the medical community will explain death. Most medical professionals’ main aim in life is to save lives and we have to now create guidelines and worksheets to prepare the community for what the rest of the world has seen due to this virus. 

We are fortunate as we have been able to learn from the rest of the world. There is a lot of information out there about what not to do as well as to get a better understanding of what COVID-19 is.

Before this work I did trauma differently, this has taught me that we can’t be stressed as we have to stay strong for the patients well being. This is a precarious time and we need to take each day as it comes.

FEATURED IMAGE: The Covid-19 pandemic has changed how healthcare workers treat their patients. Photo: Courtesy Chantal Masters.