NEW YORK – “I want to be a nurse,” declared Marilou (Malou) Bugarin after she attended with her aunt Katrina a graduation ceremony of her uncle at the Far Eastern University in Manila. At the same time, she also saw nursing candidates that were having their own rites at the auditorium. She was just 9 years old then.
“They were dressed in their dainty white uniform, white stockings, white shoes and white nurse’s cap,” Malou told the Philippine Daily Mirror in describing her admiration of the nurses.
“What the mind conceives and the heart believes, you will achieve,” seemed to be what Marilou had in mind pursuing her career. Fast forward to several years later, she was on the same stage where her uncle stood and received a diploma, receiving her own with a Bachelor of Science in Nursing degree.
Between that time and the day she fulfilled her dream, she heard of Richard Speck, who in July 1966, murdered eight nurses and students from South Chicago Community Hospital in the U.S. There was one survivor; a student nurse who saved herself by hiding under a bed. She was a Filipina by the name of Corazon Amurao. Two other Filipina nurses, Merlita Gargullo and Valentina Pasion, did not survive. Pasion was from the same province where Malou was born in Jones, Isabela known for its tobacco, corn, peanuts, and lumber. She comes from the municipality of Jones, a small town of Ilocano folks who practically knew each other.
Speck’s murderous spree was a headline story in several newspapers both here and in Manila. Malou was a freshman in college when it happened but being young and idealistic, her mind was focused on her studies and was not bothered by the incident. Her parents were also not deterred since her dad, who was then working in America, had petitioned her before he went home to retire.
Although she was already an Operating Room (OR) nurse at the university hospital where she finished her studies, she grabbed the opportunity her dad offered. After two years of practical learning, she was ready to explore other horizons of nursing.
She has fond memories of her hometown in Jones where she grew up together with her three younger siblings — all boys. They looked up to her as their big sister – their “go to” person whenever they needed something or wanted to seek counsel even when she was already in Manila – about 245 miles away from Jones or a long, 10-hour drive from Jones to Manila in light traffic.
A novice nurse in America
Most immigrants, new and old alike, experience difficulties transitioning or adapting to a new life in America or elsewhere in the world. A new environment, a new community, weather, time, custom and tradition, language, and culture pose a feeling of vulnerability and insecurity. Fortunately for Malou, she had relatives that gave her the support and security of a close-knit, loving family. She lived with them in Midwood, Brooklyn which was near Kingsbrook Jewish Medical Center where she first worked.
But working nights as a novice Medical/Surgical nurse in the Acute Rehabilitation Unit and in charge of 21 acute patients was a challenge. Malou arrived in America in 1976 and she was then a newbie with working permit prior to receiving her licensure. It was her welcoming work exposure to a 300-bed capacity hospital with a separate rehab building in a neighborhood of Brooklyn that was pre-dominantly black and far from the subway train station where she lived. She was one of 10 Filipina nurses working at the facility then.
“You could imagine what I went through; a single, young woman working night shift during that period,” Malou recalled. But Malou, a very-focused person at achieving her goals, was determined to live it out and face the challenges head-on. Instead of commuting to work, she had arranged to be driven to work and back to home. Her assignment worked for her, too, since she wanted to broaden her experience and get a good baseline before moving into a special field.
New doors opened for advancement
She did not have to wait long. A year after passing the U.S. Board exams and obtaining a license, she transferred to SUNY Downstate Medical Center, where she has stayed until now for 41 years. “It is a teaching hospital, that is why I chose to stay here that long,” Malou said.
From then on, it opened new doors of advancement in her career; first, by being in the Adult Critical Care; second, becoming a Head Nurse for 15 years; and third, as Director of Nursing for Medicine, which was a big promotion for her. As administration change and reshuffling of roles happened, she was assigned as Administrator of Patient Throughput. She was managing the in and out of patients, collaborating with all the disciplines involved in admission and discharge, and in addition, as a Staffing Coordinator – making sure that the hospital has adequate nursing staff.
As a nursing professional, she has heard or read about pandemics such as the plague, the cholera, the Spanish Flu and now the coronavirus or COVID-19. “We’ve also watched movies about pandemics but I never imagined that I would experience it myself,” said Malou. “Although I am not a direct patient caregiver, in my role in patient throughout and staffing coordinator, I’ve seen it all.”
The first time she stepped into the Emergency Room at the peak of COVID admissions, she was shocked. “It looked like one of the movies I’ve watched came to reality. The volume of COVID patients next to each other crowded the Emergency Room (ER), even at the hallways outside of the ER. This includes the direct care givers, doctors, nurses, techs, nurse assistants all dressed in their complete personal protection equipment (PPE) and they looked like astronauts moving around.”
Malou described the scene at the hospital as very scary and overwhelming. “Honestly, I felt an intense fear that I never felt in my entire nursing career. I began to panic. I had to pause to collect and remind myself that I’m here for a purpose.”
“At a critical time like that, as a nurse, our first and foremost instinct is to remember that you are there to fulfill the commitment you made — the reason why you chose the profession,” Malou explained. “You made the commitment to take care of sick people and do the best you can to help them get better and be well again through your professional expertise, empathy and compassion.” In the process, Malou continued, a nurse should also think of her safety by observing and implementing guidelines set by government authorities such as the CDC, DOH and the Institution’s guidelines on infectious disease and others. “Protecting yourself by wearing the standard and proper PPE is in itself protecting your patient, yourself, your family, and the public,” she added.
Malou did not take care of a COVID-19 patient personally. But she said: “I salute all the front liners who were dedicated, committed and for their bravery to come to work day after day risking their lives and their families, knowing what they have to deal with during the crisis. She herself had to take extra precaution to safeguard her family every time she went home.
The hospital was designated exclusively for COVID-19 patients and had nurses from out of state. One situation that stuck in her mind is when one of the nurses called her requesting for an ICU bed for a patient who just coded. Code 99 or Code Blue in some hospitals meant emergency and it seemed like the norm at that time. “You hear it announced almost every 10- to 15 minutes. I know there was no available ICU bed but to alleviate the nurse’s fear I said, ‘I’ll see what I can do’. Within minutes, another Code 99 was sent, it was for the patient next to the first one.
When she went to the nurse to let her know that she tried her best to get a bed, the nurse told her, “It’s okay Ms. Bugarin, they both passed away.” The nurse’s patients died one after the other in less than an hour.
“I felt so bad for him and I felt helpless. Patients were dying right, left and center and it seemed like we were not doing enough.” Malou did not expect the nurse to come to work the next day but the nurse told her that he was to be at the hospital for his patients. “He was not alone who felt that way. Surprisingly, sick calls from nurses were at a minimum. They called out only when they were feeling some symptoms or actually sick,” Malou said.
Malou credits the team effort and support they have for each other. This was what drove them to come every day to continue to struggle and fight the battle against the virus to save their patients.
Nurses have unforgettable experiences dealing with their patients. They are aware of their professional responsibility but sometimes, they become emotionally attached to the patient’s family of a terminally ill patient or to the sick patient directly. Among many of her experiences, Malou shared the story of a 17-year old girl with terminal cancer of the bone.
“She was ventilator dependent, went through several series of chemotherapy, surgeries and everything. She felt she was a burden to her elderly grandmother who was taking care of her. Her mother had died and her father lives in Europe,” Malou began narrating the story.
The girl knew that despite everything the doctors had done for her, she was not going to have a normal life again. She had called her dad to come to the U.S. because she decided it is time for her to go. The father opposed to have her ventilator taken off and argued that she cannot decide for herself because she is a minor. Within two weeks of that call, she turned 18 and called him again to say she can now decide on her own. The hospital’s risk management, ethics committee and everyone got involved and eventually with a heavy heart her father gave in to her wish. She chose to join her mother on her mother’s death anniversary.
Malou did not have children at that time and yet she felt the love of a daughter to a mother. Aside from being compassionate, empathy with patient comes out naturally in the life of a nurse. “I have so many unforgettable experiences to share but it will take you forever to listen,” Malou said.
Already pressed for work and demands of quality living, she finds joy with her community involvement with her husband, Ernie, an accountant and an entrepreneur who DJ’s almost every week at parties of Filipino-American organizations. They have been married for 34 years and have two daughters; Nicole, 33, and Megan, 28, who are both single and none of them want to be a nurse. Said Malou: “They told me, one nurse in the family is enough.”
She serves as the executive vice president of the Ilocano American Association, Inc. and a secretary of the Ladies for Rizal, Long Island, NY chapter. She is also active in several church groups such as the San Lorenzo Ruiz Association, The Poon Nazareno, Our Lady of Manaoag, among others.
Malou also teaches line dancing lessons every Wednesday at the Immaculate Conception Parish at the Jamaica Estate in Queens, New York. At one time, she initiated her own fund-raising campaign to benefit the church through her line dancing sessions which netted $10,000. With all these activities outside of the workplace, she has been recognized by several organizations such as the Philippine Heritage Center and Team United Maharlika Foundation.
“I want to be a nurse,” Marilou Bugarin said when she was just 9 years old. She has fulfilled that dream. The sight of people dying left, right and center engulfed her. And yet she remained calm, collected, and focused. “I’m here for a purpose,” she reminded herself. Her journey continues with her calling in service to humanity.
With this year’s World Health Organization’s (WHO) designation of 2020 as the International Year of the Nurse and the Midwife in honor of the 200th anniversary of the birth of Florence Nightingale, the Philippine Daily Mirror has launched “Nurses: Their Calling in Service to Humanity Project.” Our goal is to know them and make known their work. We interviewed several nurses for the work they continue to do. They come from different regions in the Philippines and from the metropolitan New York tri-state area.