Travel Nurses On the COVID-19 Front Lines: Natasha’s Story
This week’s travel nurse COVID-19 front lines story comes courtesy of Natasha, RN, BSN, ACLS, a 31-year-old critical care nurse from Philadelphia who is currently working in an assignment in Bronxville, New York.
I care, I want to help—this is what I was meant to do. But this level of staffing and lack of PPE just puts what little staff we do have at high risk.
Natasha has been a travel nurse since June 2019 and tells TravelNursing.org that she was already on assignment when the pandemic broke out.
What is the situation like at your current facility?
“[In] the weeks leading up to the full-blown epidemic, rules and policies were changing every few days. At first, we were being reprimanded for using our N95s in the ICUs by administration because ‘we should only be using them when you are planning to suction your patient’—which is something I anticipate every time I go into my patient’s room as an ICU nurse.
[Now,] they are reprimanding us for spending more than 20 minutes in patients’ rooms, but I am being put into a room with 4 critically ill patients that I am being asked to keep alive so that is an impossible task. We are currently being given one N95 that we are expected to keep for the week. Along with the N95, I am given one face shield and hair net that I am expected to use for the shift. The charge nurses are trying to look out for us and doing their best and if there is an extra around, they give it to us, but it is like we are dealing drugs.
Due to the aerosolization, we are no longer bagging patients during codes. Last week I did CPR on 3 patients. This has also changed. We are now only pushing medications and shocking shockable rhythms during codes for these patients with minimal staff in the room to limit exposure.”
Do you feel like you have adequate PPE?
“No, I do not feel like I have enough PPE and we do not have enough staff to ensure minimal exposure. Mind you, during the shift I just mentioned, I was pulled to one of our makeshift ICUs that were created during the rise of COVID, so my fellow nurses in my home unit were taking care of 8-9 ventilated patients. We are very at risk.
Luckily, I have a can of Lysol that I spray my N95 with at the end of each shift, along with the rest of my uniform and shoes. A lot of staff has been exposed, which may contribute to the lack of staffing, but we were already short-staffed to begin with. Perhaps if administrators would have allowed us to protect ourselves from the beginning, this wouldn’t have happened.”
Can you describe your typical shift?
I used to come in for a 12-hour shift, but due to the workload, I typically end up doing 15 or 16 hours. If I am on my unit, the first thing I do is don my face shield and N95. I come into the hospital with a hair net. I try to get a report from the night shift staff and am typically interrupted by the need to refill 3-7 IV bags that are keeping my 8 patients alive.
After I have gotten a breakdown of my patients’ drips and vent settings, I am scrambling from room to room without a break for many hours to give medications, draw labs, etc. There is no time for phone calls, there is no time for “fluff” — it’s just “do everything you can to keep them alive.” I don’t matter anymore, I am a robot with some skills and my function is to save whoever I can.
Typically, I will have several patients desaturating at once and I am forced to assess which room I go into first. The 37-year-old is 88%, the 70-year-old is 84%, and the 50-year-old is 87%… so I go into the 37-year-old’s first, try to get his sats up, then the 50-year-old, then the 70-year-old. That’s how I’m being forced to function right now.
I was in a room the other day for 11 hours with 4 intubated patients who were very ill and likely had very high viral loads. If I was not in the room, the patients would have died due to me not suctioning their airways and not keeping their vasopressors adequately titrated.”
What has been the hardest part of working as a travel nurse during this pandemic?
“I am a very hard worker but being placed into a situation where you are told you have to care for 4-9 vented patients who are all dying is physically and mentally taxing. I have so much exposure, it’s not even funny. It’s like people are pretending not to notice and I am just the sacrificial lamb.
I care, I want to help — this is what I was meant to do. But this level of staffing and lack of PPE just puts what little staff we do have at high risk. Honestly, I’m sure I will get the virus, I just hope that my immune system is strong enough to fight it off. Emotionally, it’s challenging. I am seeing people who are all different ages with no and few co-morbidities become very ill, go into ARDS, and then kidney failure from this, and I wonder if that’s God’s plan for me.”
What has surprised you the most about working as a nurse during this time in history?
“I think one thing this has shown is what leaders we are as nurses. All the titles and egos from all different positions disappear when you are trying to keep people alive. We all have to function as a team.
I found myself working with a group of patients the other day and was basically directing an attending cardiothoracic surgeon on the plan for my group of patients. He listened to me. In another situation, I probably wouldn’t have been as forward but the situation has pulled the leader out of me because that’s how I have to adapt to keep my patients alive.”
What kind of fears do you have currently about working as a travel nurse during a pandemic?
“I think I speak for all nurses, not just travelers, when I say that I am afraid of contracting the virus and falling very ill.
Specifically, as a traveler, I am worried that if I do fall ill, I won’t be able to see my family. I haven’t seen them since Christmas and I don’t know when I will see them again.”
How you are taking care of yourself?
“I am trying to be kind and forgiving to myself. I am trying to remember that these are not normal circumstances—this is a pandemic. I am one body in this ocean trying to keep everyone alive, but at the end of the day, it’s not completely within my control.
I am actually really grateful in this time that we have the technology to Facetime friends and family, especially others in the field. It allows me to feel connected even when we are miles apart from one another. I think having the ability to speak with other nurses and friends in healthcare during this time has been really helpful emotionally. I’m sharing a lot more on social media then I typically would because I honestly need support right now. It’s helping.”
What advice would you give any travel nurse thinking about taking a COVID assignment right now?
“Please allow yourself to get adequate sleep and take care of your bodily necessities like hydration and nutrition first and foremost.
Be prepared mentally to work in really challenging conditions and know that everyone your working with is stretched extremely thin. Please come prepared to work — there is a lot of money being offered, but the truth is no amount of money is going to make what you’re walking into acceptable.
At the end of the day, remember that we are trying to save the lives of other humans, but we are only humans and that we are not in control of the universe’s greater plan.”