July 28, 2020

Covid-19 keeps striking in new places. These nurses are hot on its trail.

Daily Briefing

    Thousands of nurses are being bussed throughout the United States to help alleviate provider shortages in coronavirus hotspots, and although they've already faced many obstacles, many say they'll continue traveling and helping patients fight Covid-19.

    Q&A: What nurse leaders can do today to prepare their frontline for Covid-19

    Traveling to Covid-19 hot spots

    Health care professionals across the country have volunteered to travel to coronavirus hotspots and work at hospitals that are experiencing influxes of patients with Covid-19 and staff shortages. Thousands of clinicians traveled to New York, which was an epicenter of new coronavirus infections at the beginning of America's epidemic, and now, providers are being bussed around to different hot spots throughout the country, such as Arizona and Texas. Some even have ordered their own personal protective equipment (PPE) to prepare for the trips.

    In the case of traveling nurses, many are contracted by staffing agencies and usually arrive in groups at hotels close to the facilities where they'll be working. Some, like contract nurse Gabriel Leyva, traveled to New York just a few months after they finished school. Others, like Jennifer Byrd, a 31-year-old ED nurse from Knoxville, had more experience.

    But one sentiment that was consistent among the nurses was that they didn't quite know what they were "getting into," according to Leyva, 34.

    'It's made me a better person and a better nurse': What it's like on the front lines of Covid-19

    Byrd said that when business at her home hospital was slow, she decided to "go somewhere else that needed help." Since then, every day Byrd's been on assignment has been "completely different," whether that's working in the ED in New York, in an outdoor coronavirus testing site in Iowa, or in a critical care inpatient setting in Phoenix.

    For instance, at the ED in New York, Byrd said she was working up to 14-hour shifts and caring for very sick patients. "One day, your patient might just be on two liters of oxygen, and the next time you come in they're on a breathing machine," she said.

    And now, while working at an ICU in Arizona, Byrd is seeing how treatment for Covid-19 is "constantly evolving," she explained. "One day we'll give a certain kind of medication, and then a couple days later there's been new research, so we try a different kind of medication or antibiotics. … They're doing trial medications out here, which is pretty interesting to see."

    But moving from hospital to hospital, nurses are bound to face some obstacles.

    For instance, Byrd said she's often worried she'll encounter PPE shortages at her new locations. "In New York, Iowa, and Arizona I've had plenty of PPE, but I do bring a lot of my own," she said. "I have my own respirator. I have my own N95 masks that I bring just in case. That's one thing I always worry about: Do they have enough stuff to keep me safe?"

    Byrd said she's also struggled to adjust to new protocols at each hospital.

    "[E]very hospital" and every unit "is different," Byrd explained. "I normally work in an [ED], so I'm used to having patients for a very short time, and then they go to the floor or they go home. In Arizona, where I'm in the critical care unit, I have the same patients all night, and figuring that out has been a bit of a challenge."

    Some of the nurses also have reported feeling anxiety about their own health and worrying about how their families are coping in their absence—not to mention the stress of caring for seriously ill patients.

    For instance, Leyva said he and his family were concerned about his health when he left for a six-week assignment in New York, but he said he quickly picked up ways to protect himself while at work. "It's nurses from all over the nation coming together to overcome this virus," he said. "You learn to adapt quick. It's something I'm learning with each deployment."

    And Jaime Zamora, who traveled to work in New York right after graduation and who now works in Texas, said he feels drained after seeing the way the novel coronavirus continues to spread. "I'm constantly arranging FaceTime calls with entire families. I've seen many brothers and sisters crying. [Covid-19 is] a family disease," he said.

    Similarly, Byrd said working at the ICU in Arizona "has been a bit of a challenge" emotionally. Since she spends a lot of time with her patients, she grows more attached to them, which can make it harder for her to cope when a patient's condition deteriorates.

    Tonya Waddell, one of 1,400 Fresenius Medical Care North America employees who've volunteered to travel to help address staff shortages the epidemic, thought she wouldn't be able to continue after spending just two weeks working with Covid-19 patients.

    "At the time, I thought two weeks was my limit, honestly. I didn't really realize I could stay longer," Waddell said, explaining, "I almost allowed fear to take over."

    Further, the nurses have said that, despite the fact that America's coronavirus epidemic is worsening, they still encounter people who don't believe the virus is real, which can be frustrating.

    Waddell said she's grown tired of social media posts claiming the coronavirus isn't real, and she took to Facebook to urge her friends to wear masks and social distance. "The virus is real, and to see it with your own eyes, it was—unbelievable," Waddell said.

    Byrd said she deals with coronavirus skeptics "all the time."

    "I can sit here and tell you experience after experience that I've had in a couple of months, and seeing it firsthand, and people still just don't believe it," she said. "It's so crazy to me. Science doesn't lie; science is real."

    But Byrd is hopeful people will come around. "I'm hoping that, as we continue to learn more, more people will take it seriously and the experts will be taken more seriously. I am hopeful that it will get better."

    And despite the stressors, the nurses plan to continue helping Covid-19 patients for as long as they're needed.

    "That's what I became a nurse for: to help," Zamora said. "I'm working every single day until it's time to go home."  

    Waddell already has spent a three-week deployment in Boston and two additional weeks in Chicago, and she's considering a fourth trip to Texas and Arizona.

    "It's hard, but it's like you have to know you made a difference. Even if it was bad. Even if the person doesn't make it. You made a difference. You tried," Waddell said. "I definitely think it's made me a better person as well as a better nurse" (Hennessy-Fiske, Los Angeles Times, 7/23; Stewart, Vox, 7/22; Buckner, Washington Post, 7/8).

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