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National Nurses Week is May 6-12, 2020. We honor and recognize all of our public-sector registered nurses like Sharay Souza who are on the frontlines during this critical time. Thank you for making a positive difference in the lives of your patients and their families.

Having a baby is one of life’s most joyous moments. Giving birth amid the coronavirus pandemic, however, puts some constraints on this highly anticipated event and brings new challenges and fears for parents, babies and medical professionals.

“There’s always some risk that comes with having a baby,” said Sharay Souza, an obstetrics nurse at Hilo Medical Center. “But with COVID-19, there are added concerns about safety, keeping the mother and baby healthy, and protecting everyone in the delivery room. We want to make sure labor and delivery is safe and we’re able to provide the same level of care that we do all the time.”

No visitors

With strict CDC guidelines and hospital policies limiting visitors, an OB nurse may be one of the few friendly faces that a woman giving birth may see during her stay, providing medical care as well as comfort and support.

Hilo Medical Center’s OB Unit, which every year helps Big Island moms with bringing over 1,200 babies into the world, doesn’t have the normal hustle and bustle of visitors. “Families are not allowed to come and visit,” said Souza. “We allow one visitor per laboring patient and that visitor must stay with the patient throughout her entire hospitalization, there’s no switching out anymore. If a patient has other children, they are not allowed to visit.”

The restrictions are just another thing that the already anxious expecting parents must deal with during this time. Souza noted, “It’s not easy. It’s been more stressful in this new environment. But we are right by each of our patients’ sides throughout the entire process and throughout their stay here. We’re there for them as they face the challenges of a pandemic and having a newborn.”

Although the number of patients coming in has not increased, Souza said the unit seems busier because “women are waiting until they are in active labor to come in as opposed to early labor and having to stay for a longer period of time — so we’re more in a rush to get them admitted and make sure everything is processed right. And of course, we are treating not just one patient, but two. Every single day someone gives birth.”

The employees also have had to keep up with the many hospital policies and procedures that change daily such as implementing mask counts for each shift, changing cleaning solutions and cancelling or reducing hands-on education classes.

Increased risk

Healthcare workers like Souza are on the frontlines putting aside their own well-being and putting themselves at increased risk while they work. Even with extra precautions in place and personal protective equipment to protect patients, visitors and staff — N-95 masks, face shields, safety glasses and gloves for hospital employees, face masks for patients and visitors, regular cleaning and disinfecting of equipment, hand washing and sanitizing — the risks are still there every time they go to work.

“I absolutely worry about the risks of going to work,” said Souza. “When working with those in labor, we do not practice six feet distancing from our patients. We are right next to them, coaching them through labor, encouraging them, changing positions, assisting with breastfeeding.”

She added that if they suspect a patient has COVID-19 or has tested positive they have an isolation room for the mother and a separate isolation room for the infant. “If the patient chooses to breastfeed, the patient must wear a mask during breastfeeding. If the patient requests for the infant to remain at her bedside and not in an isolation room, the infant will be placed six feet away from her bed.”

Working 12-hour night shifts three days a week in addition to on-call days, Souza can be found in one of three areas on any given shift — labor and delivery, nursery and postpartum — so she’s constantly on alert, from recognizing possible complications and assisting those undergoing cesarean sections to administering medications to infants if necessary and helping mothers bond with babies. “As a night shift nurse we need to be able to make critical judgment calls because we do not have a doctor in house, and being able to relay our findings in a timely and precise matter is crucial for our patients, both the mothers and babies,” she said.

Added anxieties

As a single parent to a three-year-old son, Souza acknowledged that balancing work and home can be a little exhausting at times. With the coronavirus crisis, regular child care is not available, but she is fortunate to have the help of her parents when she is at work. Yet the pandemic has given her added anxiety for her son, who has asthma, and her grandmother, who lives alone. “I check on my grandmother daily, but now I can only do that with a phone call or from a distance, and she has expressed feeling isolated. And because of my son’s asthma I’m always aware of my cleanliness and taking the proper precautions prior to entering my home.”

As if the pandemic wasn’t enough, the governor has proposed pay cuts for state workers like Souza who would be greatly impacted. “I am the only means of financial support for my child and myself. My financial responsibility has not changed since the pandemic,” she said. “I continue to pay for child care regardless of my child not going. I still have student loans. I have to pay rent and all my utilities. It’s worrisome and the feeling of uneasiness does not settle well.”

Nevertheless, Souza continues to demonstrate compassion and courage, tirelessly helping to welcome babies and new life into the world during this unsettling time with thousands of lives lost due to the coronavirus. Although being an OB nurse in the chaos of COVID-19 is challenging, she still appreciates the joys of her job. “Each shift of my workday is filled with unique experiences,” she said. “One thing that keeps me motivated is seeing parents’ faces when they first meet their baby. It could be their first baby or their third baby, I get to share in the best miracle of all time.”