Working directly with COVID-19 | Thank You!!!

Due to topic nature and strong language, reader’s discretion is advised!

I write how I speak, that’s a problem when writing because more often then not, it doesn’t translate well in written form of communication. In fact, I went through several drafts of this blog but seems that they were too formal, good but too damn formal.

So here’s my week… little preface, besides my photography career, I work as a nurse in a local hospital. Until recently, we were considered the Geriatric/Infection/Vent/non-acute Telemetry (heart observation) unit. Our unit was the first one to receive the COVID rule-out patients and we were prepared for it… mentally/physically … so we thought…

For years and I’ll honestly blame the upper management on this one, b/c of them, we were the bastard child of the system, our unofficial anthem was Sak Noel – Loca People. Youtube that song (user’s discretion is advised) to get an idea. It wasn’t really until our previous and current manager, where we, as a unit, finally begin to feel that our needs are somewhat met. However, a lot of things changed several weeks ago, when COVID officially entered United States. Personally, my self and many of my colleagues, feel that it was here months ago, but we didn’t know how to call it or what it was – we are the crew who works with that ‘statistical’ population at risk. Nonetheless, here we are…

I came in on Tuesday, got my assignment, and went to work. Prepping for interdisciplinary rounds, answering phone calls because we don’t have unit secretary, assessing the current state of the patients, arguing with people who aren’t washing their hands – FUCK, DAMN IT, WASH YOUR FUCKIN HANDS BETWEEN EACH PATIENT YOU PIECE OF SHIT OF AN MD!!!!!!!!!!     & THIS WAS EVEN BEFORE COVID. Here’s a fact, just b/c some has a specific job title doesn’t mean they are a nice person, it just means that it is their job.  Then, time to give out meds – doesn’t seem like hard gig, but for every patient, I need to gown up, glove up & go into the room, wait for patient to finish taking meds and not actually choke on the pills, then come out, rewash up, go to computer that HOPEFULLY didn’t log me off and repeat the whole process. All while, waiting for pharmacy to bring in meds that aren’t on the floor and now after I finished pt #8 (or 9, 10), I have to go back to #1 and bring the meds that weren’t there earlier b/c pharmacy didn’t restock – no, I’m not blaming pharmacy b/c they also have to verify the safety of the meds – just b/c the asshole doc who wrote the order didn’t check the goddamn blood work; & when pharmacy caught, and called the doc, HE ISN’T PICKING UP THE PHONE. At same moment, another Doc, dressed up, gloved up and actually giving patient a bed pen – have you seen this?! No? I HAVE, it’s the type of human beings I admire, they care! 

I stepped off the unit to get a bite (its around midday), first bite in my mouth since I woke up at 4am and code is announced on my unit. I run back (yes, nurses run, not like in movies or over dramatizes, but we actually RUN) full code in progress. Patient didn’t make it. FUCK!!!!!!!!!! Another statistic. Clean the patient, while MD notifies the family, then file the necessary paperwork – phone call from another family member who is checking up on their loved one (talk about having multiple personalities – I’M PISSED B/C I just lost a patient but have to switch and talk about another pt, know and reassure that they are safe, currently comfortable, know they pertinent labs/test/vital signs results). Now I’m thinking and second guessing if I missed something with?! Notify bikur cholim to wrap the body and take her to the morgue. Did I miss something on my assessment?! Did I allow her to die in pain an agony? What if it was my grandma? Well damn it was in 2011, my grandma, while being on the ventilator who taught me a LIFE LESSON.  Now I want to drink and/or use the bathroom but no time to do that. Earlier, notified ICU MD about another patient who doesn’t look so good. For the Intensive Care Doctors, every time there’s a rapid response or code activated, they have to go – after 4+ RRTs throughought the hospital that Wednesday, I lost count how many more there were. Another patient on our unit, with oxygen saturation of 60 (90+ is ideal) is crashing – call the Rapid Response Team – 40minutes later, RRT finished, he is intubated, somewhat stabilized; back again to my earlier request of a patient who doesn’t look so good,  ICU Doc, sends me an ICU fellow and THANK G-D for her; I give her two patients to evaluate and now we are running TWO more RRTs nearly at the same time – one ICU doc in one room and second doc in the other room, two patients being intubated & stabilized. FUCK!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! That’s only my unit, not even end of the day; what about the rest of the hospital and their codes, their RRTs?!

Finally, it is 7pm, my relief is here, my friends from night shift (I’ve started on the nights and had an opportunity to go to day shift), and they’ll take over. I go home, I think about my family, I call my grandma and tell her again, – if you want fresh air, go on the balcony!).

Two days later, Friday, I return. My main unit is short staffed, more staff are out sick with (+) COVID, I’m being sent to our secondary unit/wing. Luckily I’m working with two other nurses who are amazingly smart, kind hearten people -TEAM work. I’m also assigned to be in-charge and I’m orienting a newly hired new-grad. nurse. First, I LOVE orientating and teaching new-hires, I feel like I’m being intellectually challenged and kept on my toes, I also feel like its an opportunity for me to give back to the nursing community/education but I hate being in charge, b/c it usually means dealing with extra administrative duties.

Normally, when I teach, I’m know to be hard-core: I teach a lot, I cover a lot of ground, I don’t take easy and give easy 1-2 patients, I give everything. We work together, I cover as much info as I can as to what we’re doing, why we’re doing and how we’re doing. What supposed to take 10mins, while teaching, takes 40min because I need to explain the thought process, normal and abnormal findings. Add 8 patients to that, and being in charge – Oh FLUFFFF MY FEATHERS!!!!!!!!!

Then a code is heard overhead, few minutes later another one is announced. My main unit calls a code, then a second in different room – that’s FOUR CODES at the same time in the hospital… phone rings and family wants to check on their mom. Mom isn’t doing so well, earlier in the day, her blood sugar was 36 (critically LOW), luckily its up now and she’s more alert but she’s on my ‘eye as critical’ one. This woman has been in the hospital 1 month, daughter is crying on the phone how she wants to see her and and speak to her, but mommy is too damn tired to press a button on the phone and talk with her daughter. Another family calls for different patient; more teaching for my new student. A local pizza store baked SHIT LOAD OF pies for the staff, delivered it and now bosses are delivering it to the units – THAT IS A HELL OF A NICE GESTURE, THANK YOU THANK YOU THANK YOU!!!!!!!!! Another code somewhere. Another RRT on my home unit (not my wing), more teaching opportunities. My Daughter calls and asks me a question in science… damn, I want to pee. Then one of my relatives texts me and tells me that he grandpa (one of my uncles) who is covid+, now having symptoms enough to feel like going to the hospital – managing that via text, another patient had a bowel movement – my self and pca are cleaning her b/c pt is morbidly obese and one person physically cannot handle to do the job. Family calls about “mom”, the low-sugar-in-the-morning-mom – saying how she is calling and mom isn’t picking up her cell phone, overhead call for RRT somewhere, “I need to do whatever it takes to keep this woman alive so her daughters could hear her, at least one more time!!!!!!!!!!!!!!!!!!”

640pm, My shift is coming to an end, the unit with 19 patients is being told that we only have ONE nurse available. I ended up staying and continuing the best I can possible to care for now 10 patients. Another nurse became available and he gets in around 1130, I hand-off to him and finally SIT DOWN, since 630am. I change out of scrubs, take my stuff, and my home-unit calls a code. I grab the crash cart and assist remotely (mind ya, I’m in my regular clothes now). My home unit, 35patients, has 3RNs, 4 PCAs, respiratory therapist, MD, PA, working up a code. I get the ‘go ahead’ from charge RN, and head out.

It’s midnight, I thank again everyone with whom I worked this past hours – people who provide physical and more importantly emotional support to get through this. I finally go home. More then any other day, I’m thinking if “mom” will get to speak with her daughters and sister at least once more, if 54 y/o confused woman will be stable enough to go home in AM, if my other patient will brake the fever..

I spend nearly 17hrs wearing the same set of masks and face shield b/c in truth – WE, as the hospital system, DON’T HAVE ENOUGH to go around and reuse after every patient. Damn gowns, are great to workout in and get a sweat on, but keeping one for hours at a time while running between patients is…. something else.

NYC RN in Hospital during COVID shift

My daughter calls me, its midnight, I’m wondering why she isn’t sleeping :). I’m seeing signs on the trees and garbage cans by the hospital. Signs of hope, signs of appreciation, signs that maybe there’s somebody out there understands the darkness we are facing with this bug.

Ironically, its photography (skills that started honing in mid 90s) used to preserve these memories….& found out that local channels 7 news reported about this message of hope.

I get into the car, my wife send me a quick text, before I get to open it, she calls me and we talk while I drive home. We talk about her day – home schooling four kids and managing their fights, we talking about my Uncle who went to the hospital, talk about our parents, we talk about photography and how much we miss it.

Finally a chance to turn in for the night, send a quick text to staff I worked with, thank them for making the day easier, another set of texts of staff/friends who are ill… thank you all!!!