The COVID-19 Journals

I’m a nurse on the frontline of covid-19

When I first heard about Coronavirus rapidly spreading throughout the world, I had no idea that this was going to affect my life in such a drastic way. I figured it would get to New York City eventually, but I wasn’t prepared for how much it would change everything. I had left for Bali before the virus had spread past Washington, the first spot it showed up in the United States. I was gone for 12 days and when I returned back to New York, the world as I knew it was gone.

I came back to a ghost town, a total lockdown. Bars and restaurants were closed, people were ordered to stay at home and six feet apart. I swear I saw a tumbleweed roll across the streets of TriBeCa as I lugged my suitcase to my apartment. Everyone was off the streets and tucked safely in their homes. The few that were outside had masks and gloves on in hopes it would protect them from what little we knew about the virus at the time.

My first day back at work in a Neuro ICU at one of the biggest hospitals in Manhattan, I walked into our manager calling a huddle before our shift started. This has never happened before so I knew whatever he was going to say was big. He went on to tell us that we were becoming an all COVID-19 ICU and all our neuro patients would be transferred elsewhere as soon as possible. We would be getting N95 masks but we were expected to reuse them. The CDC and the hospital said we didn’t need N95s but our unit manager thought otherwise. Since we are working with ventilated patients that become airborne the second the vent is disconnected, it’s important to have an N95 on in each room in case something like that happens.

From there, the unit started to fill up with COVID-19 patients quickly. We opened the neuro step down unit and the neurosurgical floor as COVID-19 ICUs soon after. The ICU nurses are helping to staff and work as a resource on these new ICUs. It’s such a huge learning curve for the nurses on these floors and a serious crash course to ICU, but everyone is working hard and learning fast. I am incredibly proud of the resilience of all of the nurses I now work with. We started working as a team of one step down nurse and one ICU nurse that are assigned four ICU patients. A lot of us are becoming friends and finding solidarity in one another to get us through the difficult shifts.

The majority of patients have at least one comorbidity, usually more. We see a lot of patients with diabetes, asthma, a smoking history, cancer, coronary artery disease, obesity and high blood pressure. Almost every patient is on Propofol for sedation, Fentanyl or Dilaudid for pain, a paralytic drip to allow their lungs to rest and have the ventilator take over, and at least 2 or 3 drips to keep their blood pressure up. They are also being proned, or turned onto their stomach, to increase their lung function. This takes a team of three-four people to flip them onto their stomach and then onto their backs again after 12-16 hours. This virus is vicious and patients are getting very sick very quickly and can circle the drain and die within a few hours without much notice. We work so hard to save them, but sometimes we just can’t. I have seen more people die in these last few weeks than I have my entire nursing career.

It’s also heartbreaking that these people are dying alone, without their family. I brought the unit iPad into a dying patient’s room the other day so her husband could say goodbye on FaceTime. He sang to her and said his goodbyes for over two hours, begging her not to go. It was sad to hear, especially when she passed away a few hours later and the provider had to call and tell him she was gone.

I watch my coworkers work diligently for their 12-hour shifts to keep these patients alive and provide excellent nursing care, despite the non-ideal situation. We are reusing our masks for multiple days and we definitely aren’t given hazmat suits like the healthcare providers in Italy and China had - just flimsy yellow gowns. On the bright side, we are given scrubs to change into at work so we don’t have to bring COVID covered scrubs home with us.

At my hospital, we are not sharing ventilators between two patients and so far there are enough ventilators for each patient that needs one. I know this was a “possible option” that was shown on the news and placed immense fear into the families of those sick with COVID-19. We had a family learn their young family member was going to die soon and ask if he was sharing his vent with another patient. The doctor speaking to them said, “No, we do not do that here. We have done everything possible for your family member and our team gave him the best chance possible.”

I’m on the front lines - yes, but I’m not calling myself a hero. In fact, most nights I feel far from it as patients are dying all around me. What keeps the fire inside me alive is when we successfully extubate a COVID-19 patient and they get to go home to their family. We had one man cheer with the minimal energy he had when he got extubated, and so did the ICU team there with him.

Despite all the changes at work, all the sadness around us and the fear of the unknown - the community of New York City is coming through for us and making our lives easier in any way they can. People are hand-making masks as well as surgical caps for us to protect our hair and sending them anonymously to our unit. We have meals provided to us from local businesses or patient’s families almost every shift that we work. We get thank you cards from strangers, encouraging messages written in chalk outside the hospitals, and people holding signs expressing their gratitude. Even the NYPD came through with lights and sirens to bring us donated masks. The amazing cheering for the essential workers at 7 pm each night brings me to tears every time. The city loves us, and we love them. We are all united during this difficult time and we will all get through it together.

And I wouldn’t want to be anywhere else.