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Bold Silence

May 27, 2020

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On April 20, Lauren Leander, an ICU nurse in an Arizona COVID-19 unit, assembled with a small group of her healthcare colleagues to counter an anti-lockdown protest at the state capitol building. With crossed arms, wearing her scrubs and face mask, Lauren stood up to hundreds protesting the governor’s stay-at-home orders — some of the protestors were armed. “We realized how many people were carrying weapons,” Lauren recalls. “We felt like we were teetering on the edge of feeling unsafe.” Yet, Lauren and her nursing colleagues countered the crowd’s boisterous frustration with a silent resolve that spoke volumes for her fellow healthcare workers and gave voice to her patients silenced by COVID-19. AACN clinical practice specialist, strategic advocacy, Sarah Delgado, recently spoke with Lauren about her experience, and reveals the face and voice behind the mask.


Sarah Delgado:
I'm Sarah Delgado. I'm a clinical practice specialist with AACN, and I'm honored to be here with Lauren Leander. Lauren, can you tell us a little bit about what your title is, your unit at the hospital — just sort of describe your role for a minute?
Lauren Leander:
Sure. Yeah, no problem. Well, I'm Lauren Leander, a Phoenix native, grew up here. I went to school at Arizona State University, got my BSN there. I work as an RN. I had a year in a telemetry unit right out of school and then worked my way up to ICU, where I find myself now. I'm at Banner University in Phoenix. I work in the medical ICU. I've been there for four and a half years, and I also work, right now, currently, on our COVID unit. We're calling it a respiratory care unit. For the last five, six weeks or so, I've been specifically working there.
Sarah Delgado:
Okay, great. Can you tell us, just generally, what's it been like to care for patients with COVID-19?
Lauren Leander:
Gosh, it has been something unlike anything we've seen. It's this weird juxtaposition of the hospital being a ghost town, in the sense that there's no visitors, the hallways are empty, we're not doing elective procedures, but yet, you walk onto these COVID units, and it's just chaos. It's loud. It's noisy. We have all of the IV pumps outside of the room with long extension tubing to try to minimize the time that we're in the room.
Setting-wise, we're in our old tower right now, our old facility. The equipment is not what we're accustomed to, and the layout is not what we're accustomed to, but we're using these overflow units to protect the health of the individuals that are not COVID-positive. We're trying to cohort these patients together at the moment.
As far as acuity goes, my hospital's the biggest ICU in the state, and so we're kind of one patient in, one patient out right now, we're kind of doggy paddling and sort of staying afloat. We luckily have the resources and everything we need right now, but we've definitely kind of been teetering on this edge of, well, if there is another surge or if things do get out of control, we're going to have to start working with some of our surge management models that we've put in place.
Yeah, there's a lot to it. It's emotional. It's been just very heart-wrenching to see these patients come through the doors that don't get to have family members sitting at the bedside, holding their hand, like things would be on a normal day. A lot of them have been flown in from other cities across the state, and so they're isolated from their families. It's just been something unlike something we've ever seen.
Sarah Delgado:
Yeah. It's hard to imagine critical care without those visitors. That's such an important part of getting to know your patient, having the family there to talk to you about them and know them. I imagine that's a real challenge.
So, you mentioned being an advocate, and, of course, your recent experience, you've taken your advocacy for patients to a whole other level. Can you share the story of how you came to be on the steps of the Arizona [State] Capitol Building?
Lauren Leander:
Sure. Yeah. I think a huge part of it was really divine timing. My coworker, or a friend of mine, Jasmine, (she works at another hospital), her and I know each other outside of work. She had posted that there was going to be this rally against the stay-at-home orders, a rally in support of reopening the city and the state immediately. We had been hearing word of these rallies going on. They'd kind of been popping up across the state and across the country as well, and it wasn't until we saw the pictures of the healthcare workers in Denver that went viral for a little while, and we were just so impressed with what they did.
So, the idea really stemmed from inspiration in what they did, which was standing silently in counter-protest. And, we thought, "That is the kind of action that we could have in something like this. That's how we could be seen or be heard," and not in a way that was going to cause aggression or cause anything that could be extremely disruptive. So, we wanted to be a presence. We wanted to be there.
So, anyways, Jasmine sent me the post. I saw it 45 minutes, maybe an hour before the rally actually started. I happened to have the day off. I sent out a mass text to coworkers and people that I knew to see if anybody wanted to join, threw on some scrubs, threw my hair up, grabbed a water bottle, and we just went and decided to see what was going on out there.
Sarah Delgado:
Can you share what it felt like? We've seen the pictures and video of you standing there, and there's a lot of anger on the part of the people that you're facing. What was going through your mind, or what did that feel like for you?
Lauren Leander:
When we walked onto the grounds of the capitol [building] and the area surrounding it, the tension was just palpable. We could feel how frustrated these people were and how angry they were and how they wanted to be heard. They wanted to be seen and heard, just like we did, and they were making enough noise to get that done. So, when we showed up, we could tell that we were up against something much bigger than what we originally thought. I think there was a rally the day before that was quite small. There was maybe 50 people, and it did not take us long to realize we were up against a pretty big beast here.
There were nearly 1,000 people, probably more. The noise was just absolutely deafening. People were laying on their horns. There were cars driving around, buses. People were yelling. People had megaphones. Yeah, just the tension was definitely palpable.
We kind of had to regroup. We pulled everybody together, the four of us that went, and we decided to come up with a game plan. That was to stay silent and to not engage, to simply be a presence. We brought our masks for our protection and for the protection of the public. Obviously, there were some comments going around that we were dressing up or we were in costume as part of an act, but we truly wore it for safety, and we're glad that we did, because these 1,000 people, hardly any ... I don't even remember seeing maybe more than four or five people that had masks on. People were not protected. They were not social distancing. They were in very large groups.
Sarah Delgado:
I hear some of your nursing skills in what you're talking about. It sounds like you empathized with the crowd, in addition to sending a message that was very different from the message they were sending. You felt for them and their position and how frustrated they were with the closing of businesses because of the need for social distancing right now. You've talked in other reports about how you'd like to take the divisiveness of this issue out, and I'd love to hear, what ideas you have to move this conversation to a different level, to a different place?
Lauren Leander:
Probably two different things. I think one would be just putting the advice and the guidance back into the hands of science and the people that are studying this. I think we've gotten really caught up in the emotions of it and the frustration of being on stay-at-home orders and how it's affected us. Nobody has been without suffering here, not the people at home on stay-at-home orders and not the healthcare workers ourselves. So just moving this conversation back towards the people who know how we can get out of this in a safe and controlled manner and learning from other countries that have already, countries that are reopening in a safe and controlled way, where people are on the same page. I would love to put that spotlight back on the people whose jobs it is to help us get through this.
We're here to be that middleman between what the public doesn't see that's going on in the hospitals and the pain and the struggle that's there. But, also advocating for people in other communities that are vulnerable and advocating for even the people who are frustrated that they've lost jobs and lost their income and that just trying to reunify people.
Sarah Delgado:
There is potential to come out of a terrible time and find ourselves in an even better place than we were before. So, I appreciate your optimism. I think that's a really important lesson for us to learn. Do you have other ideas of lessons for nurses to learn, coming out of this pandemic?
Lauren Leander:
I don’t want to speak for any nurses, but I think that if they had been there with me and been able to look these protesters in the eye the way that I did and see them for who they are, I hope it would also give them, like you said, that compassion for what they're going through as well, because we weren't there to tell them what they're feeling and what they're doing and their struggle is wrong or doesn't matter. We were just trying to show up as the people that didn't have a voice.
So, for nurses, I hope that they could look these people in the eye and let them know ... I think we do this all the time, that, as a nurse, I will care for you, no matter what. No matter what your beliefs are, whether we think they are right or wrong or they follow science or they don't, we will take care of you, no matter what, and I hope that stays consistent throughout this entire thing.
Sarah Delgado:
I think that picture of you standing there in front of the protestor, you're conveying that. You're saying, "I'm here, and I'm strong. I'm going to care for you, no matter what." I think that's a really amazing message, and I know your primary advocacy was on behalf of patients, but, as a nurse, I appreciate you advocating for all of us, too. So, thank you for that.
Lauren Leander:
Happy to do it.


Note: Main page photo credit © Associated Press, Ross Franklin