The Triumph of Good

By Kanaka Sathasivan, MPH

“One of my favorite book series to read is The Lord of The Rings trilogy,” says Mila Sprouse, MSN, RN, CCRN, NE-BC, EdDc. “As a hobbit, Sam believes good must triumph over evil. When the world is at its darkest, dawn will come. And it is this stubborn belief in goodness that ultimately reminds Frodo of his courage and brings light back to the world. I believe that we are the Sams and the Frodos in our COVID-19 journey.”

Responding Together

As director of critical care services at Houston Methodist Willowbrook Hospital, Sprouse has actively responded to COVID-19 for almost a year. In that time, her team has worked on converting regular units into critical care units, cohorting COVID patients. Nurses have come and gone over the past year. The pandemic has caused higher patient ratios, creating a stressful work environment as nurses strive to maintain high quality and safe patient care.

However, Sprouse has also seen nurses overcome incredible challenges over the past 10 months. “I am so humbled and privileged to work for and work with amazing individuals. Their energy, resiliency and love for one another showed at the height of this pandemic. They kept coming back every day no matter how hard the situation was.”

Sprouse’s critical care team ― nurses, secretaries, patient care assistants, physicians and nurse practitioners ― has also been supported by every department in the hospital. “We had athletic trainers who became our turning team and manual proning team; we had medical-surgical nurses who became nurse extenders; we had day staff who flipped to night shift; and leaders from other departments helped as runners. It was the entire ‘village’ that rallied behind us. It was heartwarming.”

Weathering the Storm

Sprouse’s pride in her colleagues and her team is acknowledged alongside the overwhelming toll of moral distress on health care workers. “We’ve seen so many sick patients, multiple deaths in one day, entire families affected after a gathering. Our most loyal team members have been able to handle the difficult times. We leaned on each other and continued to encourage each other. We watched each other's backs. We prayed together, cried together and laughed together.”

By verbalizing their situation and their emotional state, Sprouse’s team worked together to find a way to make it through the unpredictability of the pandemic. Realizing that everyone was doing what they could to help each other was also key to staying grounded. As a nurse leader, Sprouse learned from her team’s example. “As long as they see that we all roll our sleeves up and work together, it will be okay. Being able to talk about their feelings helped tremendously.”

Sprouse also credits her team for being able to separate work from home. “Most, if not all, of my team members have great family support. They go home to their loved ones as I do, and we disconnect as much as we can. When we come back again, it is all hands on deck.”

Finding Small Wins

Team morale was helped by recognizing and celebrating small wins. “We continued to provide safe and quality care and, with all that was happening with COVID-19, we managed to squeak by with multiple safety and quality awards for the team,” says Sprouse.

She also found herself surprised by the compassion of strangers and all the good across the world. “I have always known that the world is full of human kindness. I just did not realize how omnipresent it is. From elementary kids sending us cards and posters to encourage us to the community supporting us to Facebook and LinkedIn posts from people around the world. It truly was overwhelming, and at times I just want to cry with gratitude because it made me feel so not alone.”

Sprouse and her team worked to educate themselves to reduce their own fear in the face of the novel coronavirus. “Are nurses scared of getting the virus? Absolutely! However, we have been educated on how to protect ourselves and our families. The more we learn about the disease, the less fear we have.” Sprouse keeps the most important part of her work in mind to remain courageous: “We are there to take care of critically ill patients — being afraid will not help them.”

Maintaining Hope

“Hardship is not new to me,” Sprouse says. Before her four decades in nursing, Sprouse grew up in and attended nursing school in the Philippines. “Hope and grit kept me going.” Throughout the pandemic, Sprouse has appreciated the power of hope, both for her staff and for everyone in the world. “Hope is what my team and I cling to every day. In the words of Admiral McCraven, ‘The only thing more contagious than a virus is hope.’”

Staying hopeful in the face of the severe morbidity and mortality associated with COVID-19 took deliberate and thoughtful work. Every Sunday, Sprouse sends a "reflection" email to her staff, a habit she had started even before COVID. Filled with encouragement and recognition of what her staff did well that week, it also contains gratitude for being there together.

“It became my way of writing to my team about how much they mean to me and, more importantly, to our patients,” she says. “It also became a source of hope for some who would tell me in passing, ‘you sent your reflections late last night,’ or ‘your reflection resonated with me’ or ‘your reflection was funny and hit the mark.’”

Through these reflections, Sprouse’s staff is well aware of her love for The Lord of the Rings. At the height of the winter surge, as staff members were overwhelmed, she sent out this poignant quote from protagonist Samwise Gamgee:

“It's like in the great stories, Mr. Frodo. The ones that really mattered. Full of darkness and danger they were. And sometimes you didn't want to know the end. Because how could the end be happy? How could the world go back to the way it was when so much bad had happened? But in the end, it’s only a passing thing, this shadow. Even darkness must pass.”