One on One with Lyrea on the Special Clinical Studies Unit

Hey guys! I’m super excited to kick off the Scrub Talk: One on One series with one of my NIH Nurse Residency cohort-mates, Lyrea Sample. Let’s get right into it.

Tell us a little bit about what you do — what kind of setting you’re in, what your patient population looks like, what your duties consist of, etc.

I’m a nurse on the Special Clinical Studies Unit (SCSU) at the National Institutes of Health Clinical Center. I work in a high containment infectious disease ward. This is a specialized unit that opens when research protocols involving highly contagious diseases that require isolation need to enroll patients. The entire unit is negative pressure with various types of biosecurity.

When I’m not working on the SCSU, I work on the hospital’s Adult Medical-Surgical Telemetry unit, which sees patients for infectious diseases, pulmonary, vascular, rheumatologic and immune disorders.

I work with patients that are infected with diseases such as Ebola, Nipah virus, Marburg virus, and other emerging infectious diseases like COVID-19. I provide direct care and also assist with administration of investigational drugs.

Take us through an average day in the SCSU.

When I arrive in the morning, I change into paper scrubs. I then attend the morning huddle with the Principal Investigator (PI) and other healthcare providers.

To enter a patient’s room, we have to don personal protective equipment (PPE). There’s a special donning process that involves a trained observer, called a “Watsan,” guiding you through the steps so that no element of the PPE is compromised.

Two nurses enter the patient’s room at a time to tag-team care. We stay in the room for two hours at a time, then rotate nurses; however, our PAPR helmets do provide enough oxygen for up to six hours.

There is a nurse monitoring every patient room from the outside, to spot any sudden changes. Also, each room has a speaker that the patient can use to communicate with us.

We have to be very careful when exiting the rooms to prevent cross contamination. Just like donning PPE, there are particular steps we follow to doff.

When we’re done for the day, we dispose of our paper scrubs and we have to shower before we can leave.

What kind of training is required as an SCSU team member?

We train monthly with the NIH police and fire department to make sure that we’re prepared in case our unit gets activated. We have to know the proper steps for donning and doffing PPE, how to transport patients on enhanced isolation, and how to transport specimens and biological material. Also, we study the protocols for the research study and review emerging diseases.

What is one thing you love about your specialty? One thing you hate?

I love my specialty because I’m directly involved with clinical studies that result in the creation of vaccines. I also love caring for patients with rare diseases.

What I hate the most is the donning and doffing process. You know the proper steps by heart, but you cannot move faster than the Watsan that is giving the instructions. It’s a necessary evil, though.

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Keep up with Lyrea by following her on Instagram at @itsme_lelo! In the meantime, check out our one on one with Cristely, who works on a COVID-19 unit in San Francisco.