04/20/2020
A friend posted this today and I wanted to share a harrowing and heartbreaking story of what working on the front lines of Covid-19 is like.
One of my friends is a travel nurse who decided to go to NYC to help during this pandemic posted this today.
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Day 1 on the NY Covid ICU:
Almost every inch of this hospital has become an ICU. My section is a converted conference room and library in the basement of the hospital. The library is the staging area, where we put our brown bags and N95s with our names on them, to reuse for a week. Once you gown up and enter the double doors to the converted conference room, you are on one of the many Covid units here at this facility. There was no organization when I arrived. I was told to put on my PPE and get to work. I will never forget what I saw the first time I walked through those doors.
It was like something out of a dystopian sci-fi novel. The patients all lined up next to each other, every single one of them on a ventilator, maxed out on vent settings and sedatives, each with a multitude of drips, a central line and an arterial line. Some of the patients are proned, a disturbing sight that has been having some degree of success. Alarms are beeping left and right. I can still hear the vent alarms now several hours after leaving work. The site and sounds of it are all consuming. Once you enter the unit, it feels like you're swimming in a nasty sea of Covid.
I am laughing now at all the talks I had with my experienced ICU RN friends who were prepping me on how all my drips would be behind glass, so I didn't have to interact with the patients when changing them out. They were giving me advice on how to safely remove my contaminated PPE. They just care about me, and their facilities are not overwhelmed as they are here in NY. At their hospitals every Covid patient they have is separated in their own negative pressure room, possibly with an antechamber room.
My reality is so drastically different. Put your PPE on, enter the Covid unit and that is where you stay circulating around 20 Covid positive patients in that same gown for 6 hours prior to lunch. I spent all day running my ass off, and only sat down once on my lunch break, only used the bathroom once on my lunch break. Eat lunch, briefly remove your N95, then come back to the unit for 6 more hours of Covid. The mask is uncomfortable and the plastic gown feels hot. My only real PPE at this point seems to be that I've been an athlete all my life and spent the last few weeks before this hiking up mountains and sleeping at high altitude, maybe that will help me.
No time for orienting nurses here. I'm thrown into a pretty heavy assignment from the get-go, one of my patients a bit sicker than the other. It is a literal sink or swim environment. I'm surrounded by other travel nurses. We all jump in to help each other out. The disease process seems to have no specific prototype type as to who will develop severe complications. These patients are of all different races and body types and varying ages too, and for the most part not as old as I thought they would be. As the day progresses it becomes clear that one of my patients is more and more unstable, and I wasn't sure he would make it until the end of my shift, but as nightshift rolls around patient is still precariously hanging on.
I leave work and the tears start flowing. I start thinking about the moment I was finally able to grant a wife's request, just to talk to her husband. The morning was a dizzying bluster of OG tube feeds, drawing labs, and refilling drips and medications. Pharmacy is backed up, critical drips have to be ordered 2 hours + in advance. If you don't stay on top of your drips running out, your patient is literally left high and dry. The charge nurse could seen how busy I was with my 2 heavy patients, and she firmly let the wife know how busy I was. In my mind I was just trying to keep my patients alive and there simply wasn't time to chat.
Finally, I am slightly caught up and able to grant her request. She tells me she is aware of how sedated he is, she just wants me to put the phone up to his ear. I do so. She tells him she loves him and what they will do when he comes home. She talks to him for about 3 minutes. When she is finished I get back on the phone with her and she tells me this was the best 3 minutes she has had since he'd entered the hospital several weeks ago. She told me just how grateful she was to me for doing that. I promised to take good care of her husband. Imagine if you're loved one was fighting for their life on a ventilator and all you could get were those 3 minutes. It absolutely broke my heart. At the end of the day, I honestly felt that this phone call that I kept putting off all morning was the only truly important thing I did all day.
We are doing everything for these patients, and nothing is working. After all the hard work, I left with the feeling that both of my patients were getting worse. The unstable patient very nearly coded at the end of my shift, and I stayed late to help out the next nurse. As medical professionals we appreciate progress and results. As an ER nurse my instinct is get you in and out asap. That doesn't happen here. My patients yesterday had both been in the hospital for over 2 weeks now.
The nightshift nurses had to tell me to go home. You just want to stay and help, even though it won't really matter. There's no end to how much work these patients need in their fragile state, but the reality and prognosis is grim and disheartening.
On the way out I stop by the office as I still don't have my schedule for the week or know if I even have to be up to work again the next day. I find out that I have the next day off, part of me is extremely relieved, but another part of me wants to be with my same patients again. Now I know I will likely be floated somewhere else, maybe not in the basement this time, and I won't see my patients again. As I walk out of the hospital a hopeful message, my hospital has discharged 637 Covid + patients.
I walk out into the dark and start towards home. Its a 30 minute walk and kinda cold, and my feet are already so sore, but I am scared of contaminating an Uber with my dirty scrubs and my phone battery is only on 2%. About 5 minutes into my walk I hit a cab stand. I tell a driver I am coming from the hospital and that if its ok with him I will ride with my mask on and then wipe down the seats with my viricidal wipes afterwards. He said that'd be great. He drops me at my hotel and I wipe down the seat and he asks, "Mind getting the door too?" I smiled and wiped down the door and he said thanks.
Go up to my hotel room and my parents have sent me flowers. Called my mom and told her about my day, and we both cried, especially when I told her about the phone call with the wife. I tell her how heartbroken I am but also glad to be here, that I am learning a lot, and that I thought I hung in there OK with these critical patients. Here for this now, here for these people, and I'm not giving up on NY. 🗽🌇💝
