“Things always happen Friday at 4 p.m.”

Longtime friends and colleagues Ann Marie Matlock and Debbie Guttierez are nurses in NIH’s Special Clinical Studies Unit, which serves patients with potentially infectious pathogens. They reflect on the experience of caring for several incredibly ill patients with Ebola and how crises have a habit of striking on Friday afternoons.

Transcript

Ann Marie Matlock: I remember telling my mom when I had the opportunity to first start to open the unit, she was like, “But you’re never going to be in there taking care of those patients, are you?”  And I said, “Mom, of all the places in the entire world to work, safety is the very first concern and we will, even if something says you only have to wear a mask, most of the time we’ll do a mask and booties and googles and all those other things for anything,” which we ended up completely doing for the Ebola virus disease.

Debbie Guttierez: Yeah.

Ann Marie Matlock: We wanted to make sure that because there was so much unknown, we couldn’t just pull out a policy or procedure from down the street and modify it and just put “NIH Clinical Center,” we really had to make sure that we were providing safe patient care, not just to the patients but for--

Debbie Guttierez: Yup. 

Ann Marie Matlock: --the staff.

Debbie Guttierez: And I just remember from July through August into September, we just kept looking at all of our policies and procedures, all the stuff that you put into place.  And then all of sudden they’re saying, “Well, you know, with this specific disease, for example the GI symptomology, we’re going to have so much trash, can our existing autoclave keep up with it?  And then how do we get it down there?  Well you know, this cart is kind of hard to push, maybe we need a new one.”  And everything just kept being revised, and I’m like, “Okay, can we just stop at some point because I’ve got to start training people.”

Ann Marie Matlock: The joke we always have in nursing about things always happen Friday at 4 p.m. and the very first phone call we get that a patient in West Africa is going to be transported here happened when?

Debbie Guttierez: Friday, 4 o’clock in the afternoon.

Ann Marie Matlock: Yup.

Debbie Guttierez: Yup.  I was actually shaking when I was dialing your number to tell you.

Ann Marie Matlock: Yup.

Debbie Guttierez: We’re getting a patient.

Ann Marie Matlock: The amount of staffing in order to make sure that the patients were well taken care of and the staff was well taken care of was huge.  I mean, a completely different impact than we had for any other patient population.  And for Ebola virus disease, nobody really knew anything--

Debbie Guttierez: Anything.

Ann Marie Matlock: --about it because everything had been done in West Africa so nobody really knew what worked or what didn’t work.

Debbie Guttierez: These were all healthcare providers who had cared for patients with Ebola in Africa.

Ann Marie Matlock: Right.

Debbie Guttierez: And so they were in our shoes 10 days ago.

Ann Marie Matlock: Right.

Debbie Guttierez: They would tell us, “Don’t touch us because it’s spread through contact.”  It’s a whole different level of care and it takes a certain kind of character to stop a physician or anybody else and say, “Stop, you need to listen to me.”

Ann Marie Matlock: Right.

Debbie Guttierez: “You’re not following the steps.”

Ann Marie Matlock: When we got the very first patient, we had several of the staff, your one nurse, the daycare provider said, “Thank you very much, but we’re no longer going to provide care for your child.”

Debbie Guttierez: Yup.

Ann Marie Matlock: And then wasn’t the husband who their basic employer said, “Thank you very much, you don’t need to come to work.”

Debbie Guttierez: “Don’t come to work.”

Ann Marie Matlock: Yeah, “Don’t come back to work.”

Debbie Guttierez: Yup.  There were bumps in the road, shall we call them?

Ann Marie Matlock: Yup.

Debbie Guttierez: But you know it’s amazing the whole community, the whole group, we just did it.

Ann Marie Matlock: All of our patients went home.

Debbie Guttierez: And walked out of here on their own power. Yeah.

Ann Marie Matlock: Yeah.  That’s what people come here to work and do.  It’s a public health hospital and this was a public health emergency.  Granted it was a global health emergency--

Debbie Guttierez: Yes.

Ann Marie Matlock: --because it affected the entire world but, you know what a really awesome way to be able to show the world that we are such a really wonderful resource--

Debbie Guttierez: It is.

Ann Marie Matlock: --and can help patients survive something that pretty much is deadly in any other country but here.

Debbie Guttierez: It’s been a very interesting, history-making journey.