My Covid Story

Nick, a nurse (RN) on a general medical ward of an urban academic teaching hospital in a Northeast city, takes much of the experience of treating COVID-19 patients in stride. His refreshing approach is inspiring and reinforces that nurses are the heart and backbone of our healthcare institutions, under both normal and pandemic circumstances.

Interviewer (JH): Nick – can you share a bit about where you normally work and what the transition has been like at the hospital when preparing for COVID-19 patients and now treating them?

Nick: The tone of the hospital has definitely morphed over time. In the beginning, there was this sense of the calm before the storm. We were watching what was happening in Italy and New York and we were scared. It was eerie. We cleared out the unit. Had half the number of beds as usual. There were no nutritionists or social workers around; just “essential” workers. We didn’t know anything, really, in terms of what to expect.

At first, too, we thought that the floor where I worked, which is a general medical floor and is completely nurse driven without PCAs [Personal Care Assistants] — we thought it would either be converted to an ICU [Intensive Care Unit] or to a COVID floor. It wasn’t. So, I volunteered to float and was put on a neuro[logy] floor in the hospital that was converted to a COVID floor. That, too, was weird because I’ve only been a nurse for two years and I was suddenly training much more experienced nurses on how to assess and treat general medical patients because they were only used to examining and treating neurology patients; it had been a long time since they treated complex, sick, medical patients.

I was working some shifts on my usual medical floor, which they converted to palliative care. And some shifts on the Neurology floor that they had converted to a COVID-19 ward. No visitors were allowed in either location, which was also eerie. Although, I’ve gotten a bit used to it and it actually makes my day more manageable, less busy; I kind of realize, now, how much time I normally spend with patients’ families, as opposed to directly caring for the patient. Now, it’s only the latter. Under the circumstances, it does ease the stress somewhat. The downside is that I find it very challenging when I need to share bad news with families over the phone. It’s extremely hard to comfort them adequately.

The saddest circumstance for me was a couple who had both been treated in the ICU. The husband came to our COVID floor, in recovery. But his wife had passed away 4 days prior.

JH: Any particular stories that stand out from your time caring for patients on the COVID floor?

Nick: The saddest circumstance for me was a couple who had both been treated in the ICU. The husband came to our COVID floor, in recovery. But his wife had passed away 4 days prior. That was super sad. The husband was, understandably, in a complete haze.

JH: A few related questions: Do you worry about contracting the virus yourself? Have you had ample equipment for protection? Was there ever a time that you haven’t felt well protected or when personal protective equipment (PPE) was not available in adequate supply?

Nick: Well, now the general medical floor is mixed – some COVID-19 patients and some non-COVID-19 patients. So, we have a pretty good protocol for wearing masks and putting on N-95 masks on top when we are entering a COVID room. We’re also fully gowned and with gloves. I was nervous in the beginning, but not anymore because I’ve gotten used to the routine. Again, when we were preparing, there was kind-of the calm before the storm. But in our state, people have been really good about staying home and social distancing, and the hospital planned really well, maybe because it’s an academic center.

In some ways, I feel more supported and protected because we are super well-staffed. The supervisor actually makes sure we are overstaffed. Instead of our usual 3 or 4 patients per shift, we are caring for 1 or 2. It feels pretty manageable. The administration at our hospital has also been incredibly supportive. And, as I mentioned, without family members in the rooms and on the floor, it actually feels less busy.

JH: Have you heard of any spread between patients in the hospital, perhaps carried from a COVID patient to a non-COVID patient via the healthcare provider?

Nick: No. I haven’t heard of any iatrogenic cases in our hospital. I think because the supervisors have been purposefully overstaffing the units and have put such a careful, stringent protocol for masks, and everything in place. Also initially, the census throughout the hospital was down because things like elective surgery were cancelled. I think that the hospital is beginning to start those types of usual activities again; so, the numbers of hospitalized patients may pick up.

JH: Speaking of masks, for how long do you wear them before they are sterilized? And, can you say more about the equipment as well as how it differs between COVID-19 patients and non-COVID patients?

Nick: For COVID patients, we put on a gown, new gloves, and face shield or goggles in addition to our N-95 mask. We take the gown off in the room, clean our hands immediately after leaving the room, and the masks are sent each day to be sterilized. They come back two days later in a burger to-go package with our name labelled. So, we each keep the same couple of N-95 masks that we rotate.

In non-COVID rooms, we wear a regular mask, sanitize our hands before entering, and wear a new set of gloves.

JH: Have you been tested yourself, either for the virus or antibodies?

Nick: I have not been tested. I haven’t had any symptoms. We do have to complete a symptom survey each day before we’re allowed to enter the hospital. There is an app, created by the hospital that we fill out on our phones or other device. When you approach the entrance, each hospital worker has to show the color bar on our phone to security who is at the front, wearing masks themselves. Each day has a different color code. Then, you’re also required to use hand sanitizer.

JH: Are there patterns that you’ve noticed about treating COVID-19 patients? Or any particularly difficult stories that you’re able to share

Nick: On the general medical floors, where I’ve been working, the COVID-19 patients are mostly people who had been in the ICU and are now extubated. We need to look out for respiratory decompensation. We had one patient where that happened and he needed to return to the ICU. That was worrisome and scary. A lot of patients who we’ve taken care of have been Hispanic; so, sometimes there is a language barrier. The usual hospital interpreters are not around due to Corona; so, we use a phone service if we need translation services. Many of the patients also have underlying health conditions, like diabetes.

JH: Have you had any colleagues who have gotten sick from COVID-19?

Nick: One nurse who had the risk factor of an autoimmune disorder.

JH: What are your thoughts, based on your observations and experiences at the hospital, about next steps for all of us in terms of how to continue to curb contraction of COVID-19 and abate the potential risks?

Nick: I think we should maintain the lockdown longer and phase back more slowly, although I’m not certain just how long since I worry about depression and even suicidal if stay at home orders last too long. I think that if people who are symptomatic or have been in contact with someone who tests positive are self-isolating, we’ll reduce the rate of spread. I do want to say, too, that I feel confident now that we have enough beds and equipment in the hospital to take care both of those who have the virus and those who need to be in the hospital for other reasons. I think people should recognize that they are safe to come to the hospital for other reasons like chest pain and other emergencies. I know this is true at our hospital anyway. Not certain of the situation at other places.

JH: Are there any positives that you’ve taken from the whole experience?

Nick: Honestly, I fell lucky to have a job. I have two close friends who both lost their jobs in the current economic climate. Also, my colleagues have been super supportive. The culture at the hospital has been very positive and collaborative; lots of camaraderie. We all recognize that, under the circumstance, we are each doing the best we can and learning and adapting as we go.

JH: Thank you, Nick; you are doing an amazing job and providing a true service to all of us. You and your colleagues are real heroes.

Nick: It’s funny because I’ve been one who really doesn’t need or want the fanfare. I understand it – like when I leave the hospital, there are always people waving, banging pots, or shouting thanks from their apartment balconies. But I see it as my job; and, as I mentioned, I’m grateful to have a job right now, especially one that feels fulfilling and purposeful.

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