Une fois et toujours une paramédic / Once and always a paramedic

Publié pour la première fois le 7 avril 2021, cet article porte sur deux paramédics qui sont sorties de leur retraite pour travailler dans des établissements de soins de longue durée pendant la pandémie. Les questions et réponses de Joanne Di Tomasso sont en anglais. Les questions et réponses de Marina Carpine sont en français. / Published for the first time on April 7 2021, this interview is with two paramedics who came out of retirement to work in long-term care facilities during the pandemic. Joanne Di Tomasso replies in english while Marina Carpine replies in french.

What have you been doing during the pandemic? / Qu'avez-vous fait pendant la pandémie?

Joanne: I was recruited in April of 2020 to take part in a group of retired paramedics who were sent to care for elderly patients in long term care facilities in Montreal. I was first assigned to a hot zone unit where all 40 elderly residents were infected with Covid. In mid-June when the situation seemed to be under control, I was transferred to another facility to bring some relief to personnel who were to be going on well deserved summer vacation time. Health workers are basically exhausted physically and mentally and with a 3rd wave on the horizon and some cases of residents becoming infected, I am still at this facility. I am grateful for Marina, my friend, my confidante, my paramedic sister-in-arms who is also currently my co-worker. I am so grateful for her presence, her friendship, wisdom and her strong shoulder to cry on when the going gets tough.

Marina: Je m’en rappellerais pour le restant de ma vie! La COVID-19 n’était alors qu’à ses tout premiers balbutiements funestes quand mon ex-employeur, la Corporation d’Urgences-santé, m’a sortie de ma douce retraite le 13 mars pour me donner l’opportunité d’embrasser une nouvelle mission entant que consultante à titre d’agent d’information. J’ai relevé le défi et celui-ci à pris fin le 27 avril 2020. Et le lendemain, je commençais au Ciusss de l’Ouest en tant que travailleuse autonome pour agir à titre de paramédic, ainsi que personnel de soutien indépendant. Cette odyssée des plus singulières qui ne devait durer que quelques semaines s’est prolongée jusqu’à… maintenant. Et j’y oeuvre toujours avec passion, accompagnée de ma complice d’aventure et sœur d’armes, Mme Joanne Di Tomasso.

Dans votre carrière paramédic, vous êtes-vous déjà imaginé assumer un rôle comme celui-ci (est-ce que le fait d'être paramédic vous a aidé à vous préparer à un contact prolongé avec les mêmes patients)? / In your career as a paramedic, did you ever envision yourself assuming a role like this one (did any part of being a paramedic help you prepare for prolonged contact with the same patients)?

Marina: Il est plus facile pour certaines personnes de fuir face à cette crise que pour d’autres… et on ne peut guère leur en vouloir ni les juger, car en absence d’outils pour faire front, il y a de quoi rester en stupeur, car nous avons été des témoins silencieux de la présence du spectre de la mort. En ce qui me concerne, fort de mon vécu en Afrique pour une bonne partie de ma vie, où ma jeunesse fut bercée par des crises sociopolitiques, par des maladies virulentes, ainsi que par la précarité économique, j’ai appris rapidement à relativiser. Les Forces canadiennes de la réserve m’ont donné une excellente formation comme médic et ma carrière de trente-quatre années de service au sein de la merveilleuse famille d’Urgences-santé en tant que paramédic en soins primaires, ont été pour moi des atouts majeurs pour faire face au rôle que j’allais jouer en temps de pandémie. Certes, je n’aurais jamais imaginé, même pas en rêve cauchemardesque, qu’un jour, je ferais partie d’une armada de gens dévoués à la cause! La singularité de la mission m’a propulsée dans un monde qui n’était pas le mien, et ceci sans formation, sans préparation et soutien psychologique. Ce qui m’a aidée à rester au front en contact prolongé avec les résidants, c’est l’amour que je porte à mon prochain !

Joanne: I had retired as a paramedic quite a few years ago, having gone on to be a 9-1-1 emergency telecommunications supervisor for the Montreal Police Department and have been retired from that position also and if someone would of told me back in the day that in 2020, I would be caring for elderly people dying from a very dangerous virus, I would of said they were absolutely crazy! Yet, when I received a phone call on a Saturday morning, asking me if I was willing to come out of retirement to help, the answer was an immediate yes and by the next day, I was sitting in a hospital auditorium listening to a doctor lecturing on Covid and a suitcase was by my side as that night I was settled into a hotel room that would become my home for several months. I would have to say that nothing in my work as a paramedic ever prepared me for the prolonged contact with the same patients. It’s actually been the most difficult part of this mission. Usually we only have a very brief contact with patients as they are being stabilized, then transported to the hospital and we’re off to the next call. In this current setting, we spend our entire shifts caring for the same people that we get to know and establish connections with. Since the beginning of the pandemic, visitors have not been permitted to come see their loved ones. We therefore not only tend to them medically but we also become their emotional support as they literally have nobody else to be there for them. Many patients feel abandoned by their loved ones and don’t understand why they no longer see them. The only contact they have is by phone and by Skype. At the first facility I was at, I gave myself a very difficult and heartbreaking task. Many of my patients literally stopped eating and hydrating, wishing to die because they felt abandoned, therefore I decided to skip my lunch break and use my personal tablet to establish video calls with patients and their loved ones. That had to be one of the most difficult tasks I have ever had to do, listening to very heartbreaking and personal conversations and sadly, many of these conversations would be the very last contacts between many of them, as the majority of the patients in my unit went on to die from Covid.

What has been the most rewarding part of your work? / Quelle a été la partie la plus gratifiante de votre travail?

Joanne: The most rewarding part of this mission is knowing that you are bringing comfort and reassurance to some very vulnerable and lonely elderly people. It’s also the appreciation they convey for having someone to care for them in this very difficult time.

Marina: Je me dois toujours de compter fermement sur mes valeurs en tant que personne et ex-paramédic pour pouvoir surmonter les moments difficiles et de donner le mieux de moi-même! Je ne perds pas de vue quelle est ma priorité dans cette mission, soit le bien-être des résidants. Je me consacre à part entière à chacun d’eux, et je fais toujours de mon mieux pour être à la hauteur de leurs attentes. Je crois dans ma profession… le métier le plus beau du monde de mon point de vue, certes! En tant que paramédic-retraitée, je dois démontrer que je suis un atout pour l’équipe et pour le Ciusss de l’Ouest, mais surtout et avant tout… pour nos résidants ! En conclusion, quand tous les ingrédients qui façonnent le professionnalisme sont réunis, et que des marques de reconnaissance… de gratitude se lisent sur les visages burinés par le temps de nos sages, je sais que j’ai réussi à faire une petite différence dans leur quotidien. C’est la partie la plus gratifiante dans mon travail en CHSLD, car c’est à ce moment-là que je sais que j’ai atteint la plénitude.

Y a-t-il eu un patient en particulier qui vous laissera un souvenir spécial pour toujours ? Sans révéler aucune identité, pouvez-vous nous dire pourquoi ? / Was there one patient in particular who will leave a special memory with you forever? Without revealing any identity, can you tell us why?

Marina: En toute franchise et très humblement, je n’ai pas un résidant en particulier qui me laissera un souvenir spécial, mais bien plus d’un! Car chacun deux… tous autant qu’ils sont, me laisseront des souvenirs incommensurables. Ma psyché déborde de confidences sur l’oreiller, de doux et douloureux partages, de pleurs, de peurs, d’incertitudes, de détresse psychologique, de solitude, mais aussi de quelques petits bonheurs et de petits fous rires au détour d’une de mes innombrables pitreries. Plusieurs sont conscients qu’ils sont en CHSLD pour finir leur vie. Pour tous ces résidants, je tiens à les mettre sur le premier podium, car chacun d’eux est « LE » résidant qui me laissera. «LE» souvenir spécial pour le reste de ma propre vie! Pour les garder en mémoire et les honorer à ma façon, je croque leurs bouilles avec mes graphites, et leurs offres leur portrait en guise de merci! Pour d’autres, il sera trop tard. Mon cœur se fragmente à chaque fois qu’un résident nous quitte pour le long voyage.

Joanne: At the first facility I was at, there was a gentleman from a prominent Montreal family. I had been responsible for his comfort care and I would take time to sit at his bedside. Sadly his pain medication was not bringing him the relief he needed and one night as I sat at his bedside holding his hand, he looked at me straight in the eyes and said, “You know I could make you a very rich woman tonight with just a phone call.” And when I asked him why he would want to do that, he responded, “I am old, I am tired and I want to die, please help me die, I don’t want to see another day.” It broke my heart to say no and he was very upset and asked me to leave his room and not come back. My shift ended shortly after and when I came back the next day, I learned that he had passed in the early morning hours and I literally hid in a bathroom to cry, heartbroken that I could not help him with his final request and because he died being angry at me. I also will always remember a lady I cared for at the facility I am at currently. Last summer on the very first day I walked into her room, I noticed she had many books and a picture frame on the wall with the poem Invictus by John Donne. I have always loved reading and writing poetry and have had some poems published in literary magazines. When she saw me looking at the picture frame, I came to find out that she loved that poem also, because of her living with a debilitating disease and that she was an Oxford PhD graduate and professor of literature and was an accomplished poet herself. This woman was permanently bedridden and could no longer read a book on her own so I would take some time on every shift to read her a poem of her choice and discuss it afterwards. Sadly, she passed towards the end of the summer and when her family came to empty out the room, I met them to offer my condolences and tell them how I would miss this wonderful lady and the time I spent with her. She responded by saying, “Oh you’re the lady she told us about. She said there was a nice lady paramedic who also loved poetry and would read to her. Here, please, take this book, it was her favourite poetry book.” It was the first book that I had read a poem from on the first day we got acquainted. This book I cherish dearly and this lady I will never forget for her kindness and the passion for poetry.

What would be your guidance for your colleagues or former colleagues considering stepping forward to assume a similar role? / Quels conseils donneriez-vous à vos collègues ou anciens collègues qui envisagent de s'engager dans un rôle similaire?

Marina: Je pense que c’est toujours du cas par cas lorsqu’on veut s’engager dans une mission telle qu’on la vit en ces temps difficiles de la COVID-19. Cependant, je dirais à mon homonyme qui désire s’engager, de garder à l’esprit qu’il n’y a aucune formation à la clé, qu’il devra s’adapter à l’évolution rapide de la situation, il devra respecter à la lettre les mesures d’hygiène et de sécurité, qu’il devra garder toujours une attitude positive, et être proactif et avoir beaucoup de motivation. Et surtout… faire preuve d’une grande empathie à l’égard de nos doyens! Le lâcher-prise sera primordial dans certains contextes qui le dépasseront.

Joanne: What I would tell them applies not only to this role but also to everyone in the health care field. I would tell them that practicing the art of medicine is so much more than just applying what we learn. One of the goals of medicine is the care and cure of those with a malady and the “care” of those who cannot be cured. It’s important to remember that the verb “to care” is to feel concern or interest, attach importance to. Sadly, throughout my career as a paramedic and in some cases during this mission, I have seen people who forget that we are dealing with human beings who are scared and feeling very vulnerable, especially now in these very uncertain times. Being kind and understanding doesn’t demand more time or energy and it makes a huge difference for the person you are caring for.As for stepping out of an ambulance and out of your comfort zone, I definitely recommend it. The nature of the work will make you a better person and and an even better paramedic.