Nursing on the Front Lines of COVID-19

Adding a surgical bouffant to cover my hair, I then place a CAPR (controlled air-purifying respirator) on my head and connect the respirator to the battery pack. When I sense airflow against my cheeks and the under-chin shield puffs out lightly, I know I’m protected from exposure to the potentially infectious atmosphere inside the patient’s room. I’m safe — at least, I hope I’m safe.

A second RN observes every step of my preparation to ensure no breach of the infection control protocol. She’ll also watch as I take off the PPE as well, which takes even longer. It involves using alcohol-based sanitizer between each glove layer and then bleaching both the CAPR and the bottoms of my shoes to complete the decontamination process.

Pressure

Every day in the medical ICU delivers unique challenges, but working in the rooms of a patient with COVID-19 — a disease whose worldwide outbreak the World Health Organization (WHO) recently declared a pandemic — ensures a high-pressure shift like none other. Nearly every shift at our facility is short-staffed because the COVID-19 protocols require us to use extra nurses in the observer/secondary role for each patient contact.

In these conditions, clustering care is imperative, both to reduce the amount of time the door is open and to husband our supplies. As cumbersome as the CAPR is, it’s ultimately more comfortable than the claustrophobia-inducing N95 mask, which we anticipate using more in the weeks to come. The CAPRs, hand sanitizer and all other PPE are hot commodities. We’re not out of supplies yet, but it’s a conceivable worry.

Isolation

The hospital has restricted visitors in the confined area due to the high risk of transmission and also because we can’t spare the extra masks and gloves. Patients with mild symptoms are bored, suffering from social isolation. The higher-acuity patients, even those facing possible mortality, are generally only able to communicate with their families via video chat apps like Skype and FaceTime.

Working behind the “authorized personnel only” curtain means having food delivered, adjusting to the CDC’s rapidly evolving recommendations and fielding an absurd number of phone calls from family (as well as journalists pretending to be family). There’s a sense of sterility, vigilance and purpose.

Real Life

Coronavirus is the stuff movies are made of: a real-life Outbreak or Contagion in my city and my hospital. I confess that it’s tempting to get hooked on the drama of it; panic is proving more contagious than the virus itself.

Still, while the media may be provoking disproportionate public alarm (as you might have noticed if you’ve tried to buy toilet paper or Lysol wipes lately), working on the front lines makes it impossible to escape the gravity of the outbreak. There’s no arguing that people’s lives are indeed at risk.

I’m not particularly fearful that I’ll contract the virus. We’ve implemented precautions that would prevent transmission of the tragically lethal Ebola virus, much less a mild-to-moderate respiratory illness. Nevertheless, I’m now painstakingly diligent to avoid contaminating my community.

Trying to Be Positive

This is a daunting and uncertain time to be a nurse. I’m honored to have the capacity to care for those in need during this challenging epidemic. That assignment requires me to summon a variety of nursing qualities: tolerance, critical thinking, endurance, integrity and adaptability. I am often in awe as I witness these qualities in my colleagues every day. I’ve felt little choice but to rise to the occasion as well.

My message to you is this: The COVID-19 epidemic is a dramatic reminder that we humans are both so fragile and so resilient. Be kind to one another. Avoid the pandemic panic; proceed with caution. Don’t touch your face, cover your cough and please — wash your hands.

TIFFANY SWEDEEN, RN, BSN, CPRC/CPC, is a critical care nurse and clinical instructor. She is a mom, writer, meditator and VW van road-tripper. Follow her on Instagram @scrubbedcleanrn or visit www.recoverandrise.com.

In this Article: COVID-19, Leadership and Management, Self-Care and Wellness, Stress and Burnout