In early April 2020, I took a 2 week assignment in New York City at one of the hardest hit hospitals to help out on the front lines of COVID 19. COVID 19 is a pandemic with the likes of which the world has ever seen. A respiratory borne illness, highly contagious, ever changing, and certainly not susceptible to the heat as we had hoped. I have had some interesting and different experiences in my life as a traveling nurse, but this experience was like no other. Though I was only there two weeks, what I learned on the front lines of COVID 19 in NYC remains invaluable.
A New Yorker Spirit in the Front Lines of COVID 19
Dearly Beloved, we have gathered here today to get through this thing called life.
Prince
When humans are faced with something as grave and stressful as a pandemic, you see the best and worst in people. COVID 19 has rocked every corner of our lives as we know it. Emotionally, spiritually, financially, and physically. I know I am not alone in experiencing the quickly changing and vast amount of emotions since this pandemic has started. Fear, panic, worry, guilt, depression, shame, but also love, gratitude, compassion, and empathy.
I had never been a huge fan of New York City. The fast paced life, the dirty, loud streets, the abrasive and abrupt culture, the skyscrapers that block out the sun. But The Big Apple finally stole my heart this time. New York has been through many a tough time throughout its history, most notably 9/11 in my generation and now being one of the first U.S. epicenters of the corona virus pandemic.
Turns out New York’s toughness also means a fierce and loyal spirit, and an uncanny ability to come together in the most difficult of times. I experienced New York in a way I hadn’t before and saw kindness, compassion, gratitude and generosity. There was an omnipresent appreciation for healthcare workers. Cheering and pots banging rang out through the streets at 7 pm shift change. Gratitude was expressed for front line workers with signs and billboards and words of thanks. Starbucks gave free cups of coffee, pizza shops gave out whole free pizzas, lunches were bought, companies donated merchandise, the list goes on. The air was heavy, and there was suffering and pain but New York was on the offense with kindness and generosity and I’ll never forget it.
Pandemic Medicine
I went to work on the front lines of COVID 19 in NYC with a disaster relief company that works in conjunction with our national government entities such as the Department of Health and Human Services and also FEMA. They respond to crises both nationally and internationally, and are physician led and owned. They normally set up their own temporary hospitals and have their own policies and processes to address the crisis.
For this particular assignment on the front lines of COVID-19 however, they actually were tasked with opening a hospital within a hospital. We went to open up a few floors of a hospital with our staff to help offload patients from the surrounding hospitals within their system while also making them “clean” hospitals (no COVID).
As a former ED nurse, I had worked my fair share of crazy situations and am used to chaos and being busy. But I had never worked in a true mass casualty event, much less during wartime or in a pandemic situation such as corona virus. As a mass casualty event the sheer volume of patients alone is enough to overwhelm resources, then you throw in it being a pandemic and it’s a whole different ballgame.
How it differs
The big differing factor of course in a pandemic is that as the health care provider you are putting your life on the line and risking your health in taking care of these patients. There may be times of danger in regular nursing such as a combative patient or being exposed to a patient with tuberculosis, but these are not regular every day occurrences. During a pandemic, we put our health at risk every time we go give a medicine, take vital signs, check a blood sugar, or help a patient to the bathroom.
With that being said, that changes how we care for our patients as we now also HAVE to take our own health into account. If there’s definitely one thing I have learned about pandemic medicine it is that no one will fight for your own protection and health but yourself. That may sound severe, but it is true. You have to be responsible for yourself and speak out if you don’t feel safe. Because if we all get sick, who will care for us?
We still try to take the very best care of our patients we can, but it’s different. As a nurse, we are tasked with seemingly endless list of things to do a day and we are used to constant bustling in and out of patient rooms as needed throughout the day. But in a pandemic, we have to learn how to slow down, don the appropriate PPE (personal protective equipment) prior to entering a patient’s room, consolidate our efforts, and be ok with the fact that we simply cannot do it all.
That last bit is a hard pill to swallow. Be ok with the fact that we simply cannot do it all. Nursing is a tough job on a good day and it’s difficult if not impossible to get it all done, but being a pandemic situation compounds that. We can’t give every medication on time, we can’t always spend time with our patients, we can’t always attend to their daily hygiene, we can’t always do hourly rounding, we can’t always intervene quickly, etc. The sheer volume and severity of the situation in addition to the personal health risk makes it an extremely trying situation.
Tips for Working Front Lines of COVID 19
In working the front lines of COVID 19 in New York I adapted a few habits that helped me get through my time there as safely as possible. Here are a few tips!
- Take your time with your PPE – Make sure you are donning and doffing correctly and assure you have the proper PPE, your safety is paramount.
- Plan your hydration – It gets hot in all the garb you wear! I made sure to hydrate a lot before my shift, during lunch, and after my shift. I really only tried to allow my lunch time during my shift as the only time I removed my PPE and hydrating as well as eating.
- Break time consideration – We definitely need breaks when we can, just be careful when you are around others and taking off that mask for a few minutes or for your lunch, distance yourself from others or take lunch outside by yourself if you can. You can just as easily get exposed unknowingly by a coworker as a patient. I’ve known it to happen.
- Consolidate your efforts – Try to combine your things to do in one effort; vitals, meds, toileting, blood sugar checks, etc to limit exposure in the rooms. When I was in NYC, the hospital graciously adjusted medication windows to 2 hours instead of the normal 1 hour. Meaning we could give medications to patients up to 2 hours prior and 2 hours after scheduled time, which helped immensely to consolidate our efforts!
- Clean bag/dirty bag – I may be a little OCD, but this is what I did. Have a “clean bag”, something you keep wallet, keys, phone, food, etc (I don’t like to bring my purse in personally) and a “dirty bag”- dirty scrubs, reusable PPE. I am known as an alcohol wipe hoarder 😂 and have these in my pocket at all times to wipe down my water bottle, phone, other used items during the shift and then can place them in the clean bag.
- Change of clothes– Luckily the hospital I was in provided scrubs to wear, but if not bring an extra pair of clothes or scrubs to change into after work and put the used scrubs in a “dirty” bag you can place safely somewhere
- After work routine – Upon getting to the hotel, I immediately peeled off my other clothes/scrubs, left shoes outside door, and hit the hot shower. Scrubbed with hibiclens (surgical antibacterial soap) and then my normal soap. Not sure how hibiclens affects viruses, but I figure couldn’t hurt to take extra precaution!
- Most importantly, TAKE CARE OF YOURSELF! – Perhaps get up a little early and have some reflection time or journaling time, yoga time, prayer time. Make time for yourself. Talk with friends, family, coworkers for decompression, it is such good therapy. Couldn’t have done it without my coworkers, family, or friends! Exercise and eat well, get plenty of rest, take vitamins so your body is ready come what may. Know that so many are in your corner and supporting you!
Do it Scared
I never thought of myself as a particularly brave person, but somehow I did it anyways. I have been a long time anxiety sufferer, but that’s a story for another time. When I was in between contracts and jobless and saw what was going on, I just couldn’t standby and not do anything.
Obviously no one anticipated the situation we are in today, so we are still learning, adjusting, changing. This is certainly not a job for everyone, but if you feel you can contribute to this battle, we need you. 💪 As we surge into this new wave, we are ramping up a new battle with hotspots all across the U.S. It’s a literal war zone out there.
I think it all was summed up pretty perfectly in my Facebook post as I left New York after 2 grueling weeks.
**Long post***
I’m not crying you’re crying…sitting here crying at the airport and not even exactly sure why! I think just finally starting to process everything now that I am going home and I have time to reflect and of course not to mention I am exhausted! Worked 12 13 hour days out of the last 14 days 😳
Where to even begin to explain the last two weeks…
I’ve experienced just about every emotion /feeling there is in the last few weeks from before I left for New York to now. I have had some highs and lows; guilt, boredom, lack of purpose, fear, frustration, anger, anxiety, sadness, sorrow, but also joy, laughter, humor and camaraderie.
To my coworkers here: Thank you for making this crazy assignment bearable with your hard work, dedication, humor and putting up with my constant stream of profanity. I’ve been told I have a Tourette’s whether it’s breaking out in to random song or what my family likes to call “ the positive power of profanity “. 😂
To my family and friends: it’s been hard to keep up with all of the amazing texts, calls, messages of prayers and hope, good health, well wishes and all! Though I may not be able to get back with you all you will have no idea how much that helped carry me through this time!!! I can’t thank you enough. ❤️
To my awesome neighbors, roommate, and friends helping take care of my house, yard, and my beloved Benny 🐶 : I can’t thank you enough! You put my mind at ease for things at home as I left last minute on a whim to work in the most bizarre, crazy, scary situation I have ever experienced!
To my family aka “chicks with chainsaws”(wouldn’t you like to know that story !) : thank y’all for your support and the zoom meetings we get to do online so I can see all of your beautiful faces and catch up. Such a precious thing and even though we are apart, we are in each other’s 💕hearts.
To New York: I never have been a fan of yours prior, not really a big city girl. However, I have been extremely impressed with your fierce spirit and your uncanny ability to come together in the most difficult of times. I have experienced New York in a way I haven’t before and seen kindness, compassion, gratitude, and generosity. You are the thready pulse of the United States, attacked by Covid, on the brink of death and organ failure, yet you fight like hell through your sense of community and strong spirit to rise again. 💪🏻May all the cities and towns of America follow in your footsteps in strength and unity. We will meet again in happier days! 🙏☺️
To God: Um what were you thinking when you told me to go here?!! Jk. Thank you GOD for my protection, my safety, my health, things happening just as they should, and my many millions of blessings!!
Last day was yesterday, and in typical last day fashion, it was a doozy. Started out calling a rapid response, patient had a fall, fire alarm test, craziness with admissions and discharged and topped with a good ugly crying session with a patients’ family member. PSA: crying and dripping snot under 2 masks and a face shield and plastic gown in a nearly 85 degree room is not as easy as it looks, nor advisable. 😳😳😩🔥🔥🔥
I also learned a lot about Med surge nursing, how to manage time, meds and prioritizing. I didn’t have as much time as I would have liked to spend with some patients do to the nature of the job but did get sweet on a couple of patients and was able to get them to crack a smile. One asked me if I was a country music 👩🎤 singer. Southern accents are somewhat of a novelty here 😂. I spent more time than I would care to disclose with colostomies and the gas that could make an elephant faint. 🤢🤮Hats 🎩off to the Med surge and floor nurses, I wouldn’t be able to last!!
But the most important thing I learned? The strength of the human spirit. COVID has literally brought the whole world to their knees and you see the very best and the very worst in everyone. This is far from over. But in the end, we are ALL humans through fear, love, hope, joy, anger, happiness. That’s what makes us human. So come on world 🌎, continue to be kind to each other, have compassion and faith. Love wins! ❤️❤️
Was it hard? Yes. Was it stressful? Yes. Was I scared every day? Yes. Would I do it again? Absolutely.
Stay safe out there everyone! Gypsy love ❤️
Katie
