En español | When COVID-19 attacked Americans, nurses and other health care professionals became our first line of defense. They have been compared to the firefighters and police who responded to terrorist attacks on 9/11.
In some places, like New York City, they were plunged into a desperate struggle to save lives. In other places, from Maryland to Minnesota to Washington state, they worked to test as many people as possible to stop the spread of the disease, to prepare their hospitals and clinics for the inevitable onslaught, and to cut through the red tape hampering their efforts.
With calm courage and quiet determination, nurses are helping others. Here are some of their stories.
Robin Krinsky, 60
Clinical nurse at the Mount Sinai Hospital in New York City. She has been a nurse for 37 years.
"I have been a nurse since the beginning of AIDS crisis in the early 1980s. That was nothing compared to this. The rise of the coronavirus has been so rapid, so vicious. There is a lot of stress. But I didn't get into nursing for the glamour.
My husband is a nurse, too. Our son works in a hospital as an administrative assistant. We do the social distance thing ... even in a Manhattan apartment. I partly cope with humor; it has got me through life. I just hope it lasts.
Everyone on the front line is exposed to the virus — the pregnant nurse, the nurse with an underlying condition, the older nurse, the healthy nurse. Everybody is on the ledge. My duties used to be logical and organized — nothing unusual, certainly nothing catastrophic. Now it's hectic. I describe it as organized chaos. I don't know what I am going to walk into. Everything is ominous. I just want to make sure my patients are breathing. This is the new normal.
The worst part of my day is this: Every day, we find out how many patients are coronavirus-positive, those who died, those on ventilators. We find out how many nurses are virus-positive, or who are quarantined because they are symptomatic. Every day, those numbers rise. I have not been tested for the virus. We don't have enough tests in New York for all health-care personnel.
I don't care about the consequences. I will not stop doing what I love to do. Nurses are leaders. We are a special breed. During disasters— and the coronavirus is the ultimate disaster — we don't walk away. But I am scared every day."
Jacque Waugh, 56
Registered nurse, has worked since 2012 in the emergency room at Abbott Northwestern, an urban hospital in Minneapolis, Minnesota. Prior to that, she was an EMT with the hospital for 18 years.
"It has been a steep learning curve for us. The first week or so that we were trying to navigate this, we didn't have a good solid plan on how to handle symptomatic patients. We didn't know exactly how the virus was spread.
Because of a limited number of testing supplies, the only patients getting tested are those who are symptomatic and going to be hospitalized or symptomatic health care workers. If patients with symptoms are stable, they're likely to be sent home and advised to quarantine.
When I'm working in triage, we immediately escort a symptomatic patient back to one of our negative pressure rooms, if one is open, where the air gets pulled out of the room and goes through our ventilation system and is filtered. These rooms make the air safer for us to breathe.
I'm somewhat concerned for myself, my husband and our two daughters. We're pretty healthy. If we do come down with it, I think we would come out okay, though there are still a lot of unknowns, such as long-term repercussions: Could there be lung scarring since it attacks the lungs pretty hard?
Before this crisis, in a busy ER, it was starting to feel like an assembly line: Let's get these people through as fast and efficiently as we can. Currently, it feels more like I can step in and be of use. With the extremes of where this job can take you, it challenges me to engage my faith daily.
I had a teenager a week and a half ago who appeared very anxious. He was there for another health issue, but had asthma and there was concern that he could have COVID-19. This young man said at least three or four times — even as he was vomiting at one point — “Thank you so much.” It was remarkable for a someone this age to show that sort of appreciation.
That's the stuff that feeds the soul: when you're able to touch someone else's life and you've had this bonding moment when they're feeling vulnerable."
Carrie Hedges, 58
Registered nurse at Suburban Hospital, a Johns Hopkins facility in a Maryland suburb of Washington, D.C. She has been a nurse for over a decade.
"When the outbreak hit, all elective surgeries were canceled, so I became part of a crew testing people for the COVID-19 coronavirus.
Three nurses and several administrators work in the hospital's garage. People who have symptoms consistent with the virus, and have a doctor's referral, drive up at an appointed time. I insert a nasal swab into the patient's nasopharynx and rotate it for about 10-15 seconds, which can be uncomfortable. The specimen is then sent to the hospital's lab.
You can see anxiety on peoples’ faces. Most handle it well. A couple have been in tears because they fear the results. Certainly, we feel for them. We're hearing that about 17 percent of tests are coming back positive.
I feel reasonably safe. My hospital has had enough personal protective equipment. I wear double gloves, an N-95 mask, a face shield and a gown. Of course, we don't know everything about how the virus is transmitted, so, yes, there is some anxiety about being around people who think they might have it.
So far, we've not been overwhelmed and luckily are wellequipped.
What inspires me most is the nurses who have stepped up during this crisis and volunteered to help out doing whatever they can. Three weeks ago, I would have never guessed I would be helping run a COVID-19 testing center. But I am fortunate to work with dedicated and resourceful group of hospital workers who have collaborated to create an effective testing center.
When the outbreak was first getting serious, people spontaneously brought protective equipment to the hospital and donated it. And one day a number of people showed up and cheered the staff. Many patients, who no doubt did not enjoy having their noses swabbed so thoroughly, thanked us for being there for them."
Carol Totz, 51
Works the night shift in the ICU at Lehigh Valley Hospital-Pocono, a small community hospital in East Stroudsburg, Pennsylvania. She has been a registered nurse for 29 years, the last 19 in the ICU.
"We get the sickest of the patients who need to be intubated and on ventilators. Since this is so new, a lot of what we're trying is a learning curve — what we've learned from China and Italy.
If someone is on a ventilator and awake, they're often trying to fight it, so they are sedated for comfort to give their bodies time to rest. We do mouth care every two hours and turn them so they don't get bed sores.
It's all compounded by the fact we have to go in with isolation gear. We're doing the best we can with what we have. We have a shortage of supplies but no shortage of patients.
I am concerned about my health. I'm in that target age, 51. I worry I will bring something home to my husband and two children. I bring sweats with me and change into those after work. Then I change into a robe in the garage at home and run upstairs to take a shower.
I worry I won't be able to go back to Connecticut to see my dad. He's 78, not in great health, a prime target for COVID.
I'm not an anxiety-ridden person, but I had a panic attack the other day. After being a nurse for 29 years, it is difficult to be faced with situations that seem futile and not necessarily be able to help.
It's always rough when a patient dies, but now with so many dying, it's more heartwrenching.
All of us fear what we are going to be like when this passes. Are we going to be a bunch of PTSD zombies?
The hope is that we can wrangle through this and get it under control so we will have more success stories — that they'll start to outweigh the deaths. They tell you the death toll every night on the news, but they don't tell you the numbers that are getting well and going home. They need to start doing that to give us hope."
Mary Sue Gorski, 63
Director of Advanced Practice, Research and Policy for the Washington State Nursing Care Quality Assurance Commission in Tumwater, Washington. She's been a registered nurse since 1978.
"We're looking at all the regulations — which ones we can ease up on for nurses in a crisis situation. We're waiving fees and ramping up licensing so they can get licensed within 24 hours.
Part of the Coronavirus Aid, Relief, and Economic Security Act removes federal barriers to providing home health service to Medicare and Medicaid patients by nurse practitioners.
About 50 percent of Medicaid patients are seen by nurse practitioners. The new law makes a big difference to meet this unprecedented need. Before this, nurses couldn't get their patients access to medical supplies — they needed a cosigner, a physician. It was very limiting, especially in rural areas.
Morale? Overall, it's positive but weary is more descriptive. We have people working very hard and volunteers registered and willing to go wherever their services are needed. I get many calls from individuals — what can and should I do? A lot of people out there are ready to step up.
But they're frustrated because they don't feel protected, They don't have enough equipment. It doesn't keep us from doing our job.”
Catherine Best, 40
From Plano, Texas, Best has been a nurse for 18 years. She has worked part time at an assisted living facility for the past two years.
"We started our residents having meals in their rooms in late March. That's hard on them because mealtime in the dining room is social time for them. Everything has been removed from the bistro area as well. That's where a lot of our residents would get a snack or coffee, and maybe read the paper. Family members are not allowed to visit and our residents can't go out with them during this time. Our team assists them to FaceTime with their families, which helps, but it's just not the same.
We have to be very vigilant because immune systems of older patients have decreased and patients with dementia aren't as able to keep their hands clean and avoid touching their faces. We check them for signs of COVID-19 every day — take their temperature and look for other symptoms.
I'm the only registered nurse there. We have three licensed practical nurses and the caregivers for about 78 people. We've locked the back door and they take our temperature when we come to work. We wash our hands like crazy and wear gloves for all the medical procedures.. I handle skin care, wounds, temperature checks. We're between them and the doctors."
Melissa Mendez, 35
Assistant nurse care coordinator at NYU Langone-Brooklyn Hospital, Brooklyn, N.Y., Mendez has been a nurse for 12 years.
"I am a nurse in a COVID unit with 30 beds. I am also a wife and a mother. My husband is a New York City police officer. We are constantly on edge. Our biggest fear? Bringing home the virus to our 5-year-old son.
I always have been as honest with our son, Joshua, as possible. During this pandemic, I have been the most honest with him. We sometimes watch the news together on television. So I had to let him know that people are dying from this virus. I had to explain why he cannot visit his grandparents; why we cannot go the park and play; why, when I come home at night from the hospital, he cannot run over and hug his mother.
It is nerve-wracking because you don't know what you will encounter on a given day. You can walk into a room and talk with one COVID-19 patient who requires minimal oxygen assistance. Then you walk into another room and the patient is gasping for air, on the brink of intubation. You're stressed and anxious as a nurse. One of my colleagues recently tested positive for the virus. You just want to make sure you are protected correctly, more so that there is no chance you bring home the virus to your family.
I am so scared every day. I leave work, get into my car and cry. I have to do that before I come home because I want as much normalcy as possible. But in the back of my mind, I always wonder, “Did I wash my hands properly? Did I wash my clothes properly? Did I wipe down my car properly?''
Yet, I not only think of myself and my family during this crisis, I constantly worry about my patients. Understandably, most people never really understood the importance of our jobs — until now. We are the ones holding your loved one's hands when they take their last breath.”
Penny Blake, 63
Emergency room nurse at a large community health hospital in South Florida. She has been a nurse for 43 years.
"We are the ones who see patients come through the door and triage potential COVID-19 patients away from the general hospital population. We are in the most dangerous spot. If there is a risk of exposure to a health care worker, it's higher in the emergency department.
In our local area, we've had 50 or 60 cases and a couple of deaths. We are trained to use personal protective equipment, how to put on and take off the gowns we use and when to use them. I feel confident I have the knowledge to protect myself, but we don't have enough PPE. All hospitals are rationing their equipment. When the surge comes, they don't want to run out of equipment. That puts us at risk.
I don't think my facility dropped the ball. I think they are doing everything in their power to get us what we need to do our job. But the supply is not there. We are facing a crisis that is very similar to being in war. You are trying not to step on land mines. We are going to be having a lot of PTSD, especially as we begin seeing some of our colleagues getting sick or falling from this.
I am 63. I have high blood pressure, so I am in a higher risk category. I worry about getting really sick. Will they have a ventilator for me if I get sick? But I worry just as much about bringing it home to my husband. I have been waking up at 2 or 3 in the morning and I can't get back to sleep. I feel like I am going through menopause again."
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Natalie Correll-Yoder, 60
Clinical nurse specialist at NorthBay Healthcare in Fairfield, California. She has been a nurse for 39 years.
"Our hospital has been preparing for the COVID-19 virus for longer than most. In February, I was one of several health care workers sent into self-quarantine for two weeks after a patient at our hospital became the then first documented case of community transmission of the virus in the United States.
I wore a mask and gloves and did not go outside. We have one bathroom, so we spent a lot of time wiping down everything. I took my temperature several times a day and checked in regularly with the health department.
One day, I did have a low-grade fever, and that was scary. I was tested for the coronavirus, and I was negative. I had caught a common virus that goes around. My son, who is 14, was quite distressed that I couldn't hug him. That was the first thing he wanted to do after the quarantine.
There was no question that I'd go back to work. I love what I do and would never choose anything else. I have done this work for a really long time, and I have seen a lot of things. I am a person of faith. I have a good team, and we have each other's back.”
Francisco Diaz, 54
A nurse practitioner at Mount Sinai Morningside Hospital, New York City, Diaz has been a nurse for 19 years.
"Until the COVID-19 crisis, I was working as a nurse with diabetes’ patients. In that role, I have been quite fortunate to live a life outside my job. My brushes with diseases, in most ways, have been limited. Not now. This deadly virus affects my whole life. I am now working 12-hour shifts, and worry about bringing home the infection. I can't be oblivious to the pressure. It's getting to me.
In my new assignment, I essentially monitor patients for pneumonia, Many of them have COVID-19. I am also trained to have conversations with families. I owe it to my patients. I am one of the few Hispanics and Spanish speakers in my small department. Families need to speak with me. Because of our shared ethnicity, they trust me implicitly.
I am not afraid of the virus. I am afraid I won't be able to continue working if I contract it. I know a colleague who is sick with it. It is part of the deal. I am afraid that if I get sick, I would have to stop working. But I already assume that I carry the virus — it's easier that way. I am more circumspect because I don't want to spread it. We don't socialize as much. Once in a while, I have felt under the weather. Sometimes I sneeze. It's probably from pollen, but I think, ‘Oh, my God.’ So I check my temperature.
Hospitals are very tricky places. They are not safe. We do things that have risks involved. COVID-19 has changed our working environment. There is more pressure to take care of yourself. I am more careful now. Before we had the luxury of not wearing protective gear. We have to consider the amount we use, how long we use it. Our focus is the prevention of infection — washing your hands, keeping at a safe distance in the cafeteria, identifying symptoms. We worry if we have enough masks, enough sanitizer. I wear my hospital badge outside the hospital, just in case the police stop me on my way to and from work.
The hospital has made every effort to let us know that our work is being recognized. It has made it clear that we should not work in conditions where we are compromised. Still, the challenges are enormous. I never have seen anything like this pandemic."