Breath. Emergency nurse Lila V. Hageman-Sheehan reminds herself as she steps in the doors of Massapequa General. It’s 1988 and Hageman-Sheehan, having recently earned her RN through a specialized nursing program through her high school, is walking into her shift at 7 p.m.
The overnight shift is unpredictable, as are all shifts at the bustling ER, but the twilight hours are welcomed by Hageman-Sheehan. A young mother of four, her children hardly notice her absence. Her three-nights on, four-nights off schedule ensures Hageman-Sheehan’s is there for little league games and PTA, she even served as the school nurses for a time.
Back on the floor, it is gearing up to be a busy night, Hageman-Sheehan learns from the nurse who she’s replacing for the night. The beds are full, and it wouldn’t be unusual for her to have 18 patients within the 12-hours on the clock. Hageman-Sheehan gets the run down from the outgoing nurse before making the rounds, introducing herself to her patients for the evening. The visits begin with a smile and a quick hello, but they’re more than beats eye.
“They are mini-assessments,” she explained. “You’re introducing yourself, but you’re also prioritizing which patients need immediate attention. You’re noticing things like how they’re breathing and the way they’re acting. The entire shift is an on-going assessment.”
The outgoing nurse shares one last nuance before heading home, the elderly woman in room 8 will not leave are ailing husband’s side while he’s hooked to machines as doctors rush to find a diagnosis. Hageman-Sheehan makes a mental note to get her a recliner.
For Hageman-Sheehan and her fellow nurses, patient comfort is a critical component of patient care. Remembering names of family members and showing up with a tray of food while they wait uncertainty for their loved one’s prognosis, is a lesser known responsibility of an ER nurse, but a vivial one all the same.
“We make sure they have what they need,” Hageman-Sheehan said. “These are the things that nurses pass along to each other at the end of a shift. We’ll get to know if they prefer the lights dim or if they think it is too loud, we’ll get them ear plugs. It is those personal touches that make the difference.”
Like for many nurses, Hageman-Sheehan views the job as more of a calling. It is in her DNA. Growing up she watched as her mother studied to become a nurse, inspiring her own love for caring for people. It’s a trait she’s passed down. All of her children, now grown, are involved in the medicine field in some capacity.
Hageman-Sheean worked the overnight shift, 7 p.m. to 7 a.m., for 18 years. She started out at the now-defunct Massapequa General before earning her RN in 1988, a bachelor’s degree in 1994 and joining Winthrop Hospital in 1999, where she has remained for more than 20 years. Practicing medicine requires continual learning. Today, Hageman-Sheehan has a number of certifications next to her name: Lila V. Hageman-Sheehan BSN, RN,CEN,NYSAFE. She is currently earning her master’s degree in nursing administration and holds the job title of nurse manager of the emergency department at NYU Winthrop Hospital in Mineola.
Though she is no longer a bedside nurse, Hageman-Sheehan role centers on patient care at one of the most fast paced hospitals in the region. NYU Winthrop Hospital’s Department of Emergency Medicine treats more than 81,000 patients each year (roughly 300 every day). It is considered one of the busiest on Long Island for people with acute illnesses and victims of accidents and violence.
Because a visit to the ER can be a stressful experience and despite a high volume, Hageman-Sheehan and her staff of 353 are continually making efforts to deliver compassionate care to patients when they need it most. The administrative work includes mentorship of the young ER nurses. A natural teacher, it’s a beloved part of the job. Though Hageman-Sheehan’s schedule is more traditional now, she is known to work from 6 a.m. to 6:30 p.m. from time-to-time to help transport patients or sort through resumes to make a new hire.
“It is hard to walk away,” she said. “You have bad nights. You have sad nights. We see happiness, too. I always tell the staff that they are touching people’s lives and that is rewarding.”
The staff encounters a wide spectrum of patients and symptoms. As a Level 1 Trauma Center, they are trained to handle the most critical emergencies. In fact, it’s Nassau County’s only trauma center with full adult and pediatric capabilities with a dedicated 10 bed unit with specially trained nursing and support staff to care for the special needs of children.
There are eight districts within the ER alone to deal with specific types of patient care. For example, a nurse can be assigned to critical care one day (helping those suffering from cardiac arrest or a stroke) and the next day be assigned to pediatrics. Cases can be as minor as a sprained ankle or as serious as an overdose or gunshot wounds.
Now, in the midst of the COVID-19 pandemic, the nursing team is forced to adapt once again.
“It is both emotionally and physically exhausting for all the staff,” Hageman-Sheehan said. “The ‘normal day’ in the ED is nonexistent. Frontline staff are experiencing a large volume of critically ill people all at once. Textbooks and drills provide you with the knowledge needed to provide care, but nothing prepares you emotionally.”
The hospital has made provisions to make sure the staff has what they need to care for patients and its Department of Social Work has been available to assist the staff and has scheduling tele-sessions for emotional support. Hageman-Sheehan said the overwhelming support from the community is helping the staff make it through the hardest shifts.
“If we were to take a deep breath every time faced with stress, under the current circumstances, we would be hyperventilating,” Hageman-Sheehan said. “In all seriousness the staff are remaining focused at the tasks at hand and getting the job done. But really what has been carrying the staff through their shift is the outpouring of support from the community. This is providing respite to the entire workforce during their shifts, the generosity we have experienced has been unbelievable.”
During this time, nurses, techs, clerical support and supply chain have signed up for extra shifts voluntarily. The leaders, including Hageman-Sheehan, are there seven days a week supporting the efforts of medical workers.
“Countless staff have called and asked what else they can do to help,” she said “They are all superheroes!”
As Hageman-Sheehan, and all ER nurses, know first hand, some incidents have a lasting impact. One unforgettable shift was the horrific case of a gang member who sexually assaulted a female toddler, who was treated at Winthrop. The incident was undoubtedly heartbreaking for the staff, but prompted the soon-to-be implemented Sexual Assault Forensic Examiner (SAFE) Program at the hospital. SAFE provides comprehensive training to facilitate best practice medical and psychological care for the treatment of survivors of sexual assault, performed in the context of forensic evidence collection.
“You never know what your shift will be like,” Hageman-Sheehan said. “Nurses have to be prepared, resilient and be able to change their plan of care on a dime.”
According to a recently published National Nursing Engagement Report, 15.6 percent of all nurses described having feelings of burnout. ER nurses also seemed to be at a higher risk for burnout, with 20 percent of ER nurses reporting feeling unengaged, according to the poll. As an administrator and a mentor to young nurses, Hageman-Sheehan is diligent about keeping her nurses refreshed and ready to treat patients.
“I have never been a proponent of 12-hour shifts and it is so important for nurses to take a break in between shifts to clear their minds,” she said. “I am all about taking a breath and pausing. I have been that nurse where you feel like you’re overwhelmed, but there is a lot of comradery. There are a lot of distractions, but there are also a lot of resources. Every nurse has their own assignments, but no one is ever alone. Nurses are a team. Like one big family.”