For much of her early years, Adriana Augusta could not have imagined being a nurse—in fact, the sight of blood was frightening to her. But all that changed, when at 23, she found herself in a hospital emergency room with pregnancy complications resulting from preeclampsia. Her baby was born with hydrocephalus, and Augusta, having suffered a heart attack in the process, was in a coma for seven days.
Mom and baby survived and, 16 years later, Augusta and her daughter are in good health. The experience, however, forever changed the course of Augusta’s life.
By her side, when she woke up from the coma, was the nurse who had stayed with her through the ordeal. A person of deep faith, Augusta believes that was the moment she received her calling to become a nurse—to give back the same level of care she received, to others who needed it.
Leaving behind years of course work towards a career in banking insurance, Augusta set upon her journey to become a nurse—and there was no turning back. She worked as a caretaker for the elderly to pay for nursing school, and eventually was hired as a nurse technician at one of the larger public hospitals just outside São Paulo, Brazil. She worked there for almost 12 years—including during the first two years of the COVID-19 pandemic that hit Brazil hard.
On the front lines of the COVID-19 crisis
The first case of COVID-19 in Brazil was reported in February 2020. Brazil quickly became the epicenter of the outbreak in Latin America and the country with the highest rate of transmission in the world, resulting in more than 700,000 reported deaths.
“When it all started, we were doing everything we were told to do but nothing was working and it felt like we were in the middle of a war,” recalls Augusta. “The toughest part was when patients who were brought to the hospital would tell us their families had abandoned them. But that was not the case, families were following the required procedures. It affected the patients really hard and it was very difficult for the staff caring for them.”
Health workers themselves were dealing with difficult choices in their own families, while also grieving colleagues they were losing to the virus. Augusta herself contracted COVID-19 at a time when her father was going through an unrelated but serious medical issue. He could not understand why Augusta was staying away from him and began to take actions like refusing to eat until she was there. At a certain point, Augusta says, she broke down to be with him. “We were not sure of anything we were doing back then,” she adds, recalling those heart-wrenching final days with her father, who sadly did not survive.
But through the toughest days, the staff was committed to being there for their patients, she says. “We could have stopped working and stayed home to protect ourselves, but we remained united and did whatever was needed to make the situation better. We took on more shifts when there was a shortage of staff and devised various protections to go home to our families safely.”
Building resilience and joy in the workplace
Nurses in Brazil have always been over-worked and under-appreciated, Augusta notes, but acknowledges that the spotlight on health workers during the pandemic has improved some things for the better. For example, the public hospital she worked at implemented the ReConecTAR program in 2021 to help boost well-being, satisfaction and engagement in health workers’ day-to-day working environment. This collaborative initiative by the Institute for Healthcare Improvement (IHI) and Hospital Sírio-Libanês (HSL), launched with support from Johnson & Johnson Foundation at 100 public hospitals in Brazil, aims to identify the main obstacles to joy at work that healthcare professionals face, and seeks to address them by implementing practical solutions.
Augusta notes that changes happened in small ways—like the addition of proper dressing rooms for nurses to change their clothes before and after their shifts, something they did not have before, and in big ways, too—like hiring more staff. Since the program was implemented, the hospital improved its nurse-patient ratio from 5 nurses attending 28 beds to 12 nurses.
“To become a nurse is my choice, but I want people to understand that nurses are not machines, we cannot be expected to attend 50 beds at the same time,” reminds Augusta. She is grateful for the attention Johnson & Johnson is bringing to issues like stress and burnout among nurses and helping health workers become resilient.
More recently, Augusta made the choice to leave the hospital and work in a smaller primary healthcare unit to focus on promoting good health and the prevention of disease. It’s a change of scenery from the emergency room of a big, complex, urban hospital where she attended patients brought in from car accidents, bullet shots and suicide attempts, to helping people manage blood pressure and diabetes.
The change of pace also allows Augusta to focus on some of the things that bring her joy personally, including spending more time with her family and volunteering at church. In addition, she plans to finish her studies to become a registered nurse, something that was stalled when the pandemic happened.
“I love being a nurse because it is so many things and we serve so many different roles,” she explains. “We are psychologists, we are the father, the mother, we are the friendly shoulder, we give spiritual support —it's not just about giving out medication, if that was the case, we could just form an assembly line. Nurses are truly essential to a patient’s healing process.”