Lilian Perez-Posadas/Photo courtesy of Pacific News Center
The siren of an ambulance pulling into the Guam Memorial Hospital premises always brings along a cloud of foreboding. The hospital staff prepares to receive the patient, whose uncertain fate triggers a collective fear and anxiety.
“(Patients) keep coming in. They need help and attention and there is always a concern that we don’t have a bed so we need to find a bed for that patient,” said Lilian Perez-Posadas, GMH administrator.
The oft-maligned government hospital has been crammed with Covid and non-Covid patients since the second wave rolled in by the early part of July. Behind the masks of bravery, GMH employees lug a sense of trepidation given their constant exposure to the coronavirus. As of mid-September, the number of GMH employees who have been stricken with Covid-19 has gone up to 55.
In the past three months, GMH has been on death watch on a daily basis. On certain days, two deaths occur less than an hour apart. As of the last week of September, Guam’s Covid-19 death toll was hitting close to 50 while the tally of confirmed cases had gone over 2,200. Numbing statistics continued to come out of the labs.
“We feel beaten sometimes,” Posadas said. “We are human beings. It’s sad. It’s painful. It’s difficult. We feel for the patients as much as we feel for their families.”
But the staff does not have the luxury to pause. “We have to get up. If we get numb we can’t take actions. We have to keep fighting,” Posadas said. “We know there’s light at the end of the tunnel.”
No matter the condition of a patient, Posadas said, “we don’t give up. We give it all.”
A registered nurse, Posadas has been in the health care field for 43 years. She received an associate degree from the University of Guam's School of Nursing and Allied Health in 1975 and was first hired as a licensed practical nurse at GMH in 1976.
She earned a bachelor of science in nursing at UOG in 1989, and master of nursing from Washington State University’s Intercollegiate College for Nursing Education in 1993. She worked at GMH for 29 years until her retirement in 2006. She came back 10 years later as a member of the GMH Board of Trustees. She served on the board from July 2016 to December 2018, while working as a registered nurse at United Airlines.
In January 2019, Gov. Lou Leon Guerrero appointed Posadas to lead GMH, which is typically a battlefield for clashing politicians.
Now, GMH is the war zone for Covid-19. And as the chief of the frontline army, Posadas said she is confronted by the “most challenging experience” in her career as she tries to navigate an unchartered territory.
“For one, Covid-19 is a new disease,” she said. “There are lots of unknowns, lots of uncertainties. So even though we planned and prepared for it, when something comes up, it causes anxiety, fears and concerns.”
Even prior to the pandemic, GMH has been grappling with limited resources, a predicament that has been exacerbated by the pandemic. As it hits surge capacity, GMH is forced to resort to makeshift solutions.
“Because of the uncertainties, we are constantly moving beds around to make sure that we can accommodate patients. We are constantly training people to make sure they follow the CDC infection control guidance,” Posadas said. “We always have to shift lanes when we deal with compounding issues that are occurring all the time.”
In a topsy-turvy situation, disagreements among the staff are inevitable, she said. “We are human beings. We have meltdowns. We argue. We disagree, but at the end of the day, we have to regroup and agree on a solution to a problem,” she said. “We just have to treat each other with respect. It’s not about the argument, it’s about finding the best solution.”
Amid the stress and tears, the staff occasionally steals moments to take a deep breath. “We pray hard. We also have humor in between. You got to have humor. It’s tough but there are moments when you need those positive chemicals to get out because this is a long-drawn battle.”
Posadas said she works 12 to 16 hours a day. “My brain sleeps for two hours but it is awake because many things have to be done. As long as I get two to four hours of sleep at night, I’m good to go the next day,” she said.
Despite the pains, Posadas said, the job can be gratifying. “We feel rewarded when the patient pulls through and get reunited with their family. Those are our biggest rewarding moments.”
Having to deal with public criticisms is the most dispiriting aspect of the job, Posadas said.
This is nothing new. For decades, GMH has been a subject of scrutiny, a magnet for scandals and prone to conspiracy theories.
“There are comments in the community that we are taking this opportunity to let the patients die so we can get more federal funds. That is such a warped mentality. We are here to save lives, not to let people die just to get federal funds,” she said.
“In every society, there are always negative critics, who find faults in everything but they are not offering help. This does not help the staff who sacrifice their own lives. Criticisms don’t help them.”
What the tired and sleep-deprived staff needs, Posadas said, are “support and encouragement.”