"The aspects connected to art are part of the treatment"
An interview with Lili Quintero and Quique Chinea, two of the five citizen-commissioners for the Paediatric ICU project.
After the ritual applause at precisely 8pm (7pm in the Canary Islands) in appreciation of all health workers during lockdown, calm descends. But at hospitals and Paediatric ICUs—specifically the one at Nuestra Señora de la Candelaria Hospital, which is where our Tenerife Concomitancia is taking place—this calm never comes. A frantic day-to-day routine is the lot of the healthcare staff doing a job that is invisible but crucial to our society. Committed and dedicated to the care of patients, giving the best of themselves every day, the members of the ICU Paediatric nursing staff and citizen-commissioners in this Concomitancia tell us how they came to don their uniforms and make this job a way of life that changes the course of many people's lives.
How are you and what has been your experience of the pandemic?
LILI QUINTERO: In terms of our work in healthcare, it has undoubtedly been the toughest year we’ve lived through. It’s been really hard because even though we work in an ICU and deal with challenges every day with our patients, we had never faced a pandemic before. In early 2020, when the first person died in China, it felt distant. We didn’t get much information about what was going on and how the virus was transmitted, although we started to get warning signs from public health services. When it reached European soil, we literally started to tremble when we saw the level of work and stress in hospitals. We kept going with the optimistic sense that “it’s still a long way off” until late February when we saw the first cases in Madrid. And suddenly, we get to the hospital one day and they tell us to do PCR tests on the children in our hospital and turn everything upside down. Once all the patients tested negative we moved them to the neonatal unit boxes and started working with adult patients. The problem with COVID is that it’s difficult to stabilise patients. Also, we didn’t know what approach would work best, we gradually tried different types of treatments.
QUIQUE CHINEA: Virtually overnight we went from caring for children to adults, with everything that entails. Since June, we’ve gone back to working with children, with all the restrictions that are still in place in the hospital today. It has changed the way we work, the mere fact that the children can’t see our faces, that we can’t give them a smile, is something we miss a lot.
“People normally criticise the health care system, but if you talk to anyone who has had serious health issues and spent time in hospital it’s a different story, because they start to realise the work that we do. Each day we do everything in our power and more, when patients leave they are very grateful, and so are their families”
In the health sector, the work of nurses and carers is usually invisible in the media. Has the pandemic changed this?
L: At first, hearing the applause every day gave me goosebumps. Unfortunately, perhaps because of the low standard of information in our society, our work has been pushed into the background again. People only remember things as crucial as health and education when they really need them. It’s a problem to live in a society that can forget so easily. We’ve always had the sense of being the filling in the sandwich, the bit in the middle that’s always forgotten. The top layer is made up of the most visible doctors with the most social recognition. Nursing is a rewarding profession but it’s underappreciated.
That leaves vocation: how did you become nurses?
Q: I wanted to study physiotherapy, because I played sports and I was interested in sports recovery. But my grades weren’t high enough so I enrolled in nursing. I came to like it more and more each day, and in June it will be my 21st anniversary as a nurse. In my first days in a ward, with 30 patients under my care, I did ask myself: What did I get myself into? Is this what I want for the rest of my life? Will I be up to this? And yes, I’ve come to realise that the answer is yes. It’s a career that demands a lot of responsibility, commitment, concentration, and maturity.
“In my case it was a love story rather than a vocation. One of my high school classmates was in love with nursing and we had a competition to see who would get the best marks. In the end I got in and he didn’t. I wasn’t convinced when I started the degree, but after the internship in my first year it got under my skin, the patients won me over (in that case elderly patients rather than children). I’ve had some existential crises along the way, when I had to figure out on my own how to manage very complex situations that we weren’t trained for”
Did you already like children before you became parents?
Q: I wouldn’t say I lacked empathy before becoming a father—I have an eight-year-old son—, but it changes your perspective and makes you appreciate your home, your health, and the things that really matter. Life is very fragile, and everything can change in a second.
L: I had an obvious existential crisis not when I became a mother but when I became an aunt. I had to make peace with myself and learn to draw a line between my personal life and what happens in the hospital. Otherwise it isn’t possible to have a healthy, happy life.
Dealing directly with the patients is a source of many anecdotes, do any spring to mind?
L: I particularly remember a little girl with Down’s Syndrome and heart disease, who was with us from the age of 2 to 8 months and we treated her like a niece. And I remember a little boy, he’s 16 now, who had multiple injuries after falling from a height of more than 15 metres. I’ll always remember a really special night when the Eurovision final was on and he had just woken up.
Q: I’m thinking of a teenager who was admitted at the age of 14 with a tumour. It wasn’t very aggressive but it was in a delicate area, and the operation left him a quadriplegic. Now he’s almost 20 and he comes to see us, he’s walking well, he even got his driving licence. I also remember a little girl who fell from a great height, breaking her back and shattering her ankle. A year later I saw her jumping around on the beach. In 2010, an Irish girl was on holiday here with her family and had to have her appendix removed. But it turned out to be a much more serious condition and she received a lot of blood transfusions. So when Spain won the World Cup she boasted of having Spanish blood! Last year she enrolled at Liverpool University to study social therapy, and she still comes to Tenerife on holiday and visits us.
How did your participation in Concomitentes come about?
Q: The link was through our mediator, Felipe G. Gil, who has been a close friend for many years. On a trip, over a beer, I told him that I wanted to take on new challenges at work and I told him about the need to help children know more about their stay at the paediatric ICU.
“After a while he told me about Concomitentes and how my idea could fit the bill, so I convinced the most like-minded people on the team to join in. It wasn’t hard, as three of them are my close friends and the fourth is my partner. So it all started with a conversation between two friends and a series of coincidences that led us to being here today”
What has the experience been like over the last two years?
L: In my case, it’s taken me out of my comfort zone and into a world that I was totally unfamiliar with. It has been fantastic, and an opportunity to look at what we can do in the unit through new eyes. I’m eager to see the final result, but I’m also sad that it’s ending. I would love to keep in touch with the interesting people I’ve met and see each other again.
One lesson you will take from this adventure?
Q: When you interact with people from your own circle, you don’t realise the importance of the work you do, we tend to undervalue it. This project reaffirmed that we have a very important job, that our work is valuable. And I won’t forget the meeting we had in Madrid with the citizen-commissioners of other projects. We felt that we were in our rightful place, valued as professionals.
L: When you become used to being a professional it becomes part of your everyday life, you don’t see it as anything special. But during this time I got the sense that our work and our value as major caregivers within the healthcare system is not recognized. I was surprised by how much curiosity we aroused, so I’d focus on the humanization of hospitals, helping patients more, and making hospital work more visible.
How do you see the role of art in healthcare?
Q: The hospital has a budget, and anything that’s not medical is left out, including art. There are many initiatives connected with art, usually from the private sphere, and that’s part of the treatment. Keeping patients happy and entertained helps them recover.
"It’s a job in which something that benefits you has positive repercussions on all the other parties"
The audience for your Concomitancia is the nursing staff, the patients, and their families. What’s your approach for working from this multiple perspective?
L: When we started we were clear about wanting it to benefit the children and their families. But then, with the ideas that were being thrown around, we saw that it was also going to help us to reach our patients better. It’s going to provide us with tools to reach different kinds of patients and it will also help the patients deal with their situation in an ICU and the parents who have to delegate and entrust the care of their children to others.
What do you hope will remain after the project is completed?
Q: As one of our citizen-commissioners, Ruyman, says, we want this to be our legacy. We don’t aspire to work in a paediatric ICU forever and we want to leave this artwork as the start of something, so that our hospital and others will begin to look after the emotional side, not just the illness. This is something that has been confirmed by the research carried out by the psychologist, Sara Miguel. This project will be the start of something else.