New nurse on the frontlines

Submitted by McGill University
October 27, 2020

I graduated from nursing school in December of 2019 and started to work as a Candidate to the Profession of Nursing (CPN) in the beginning of January 2020. Never would I have expected to go through an experience such as the Covid-19 pandemic. Especially not during the early years of my profession. I work on a unit that has been designated as a “Covid-19 unit” in my hospital, and the hospital I work in was designated as the 3rd hospital where Covid-19 patients would be sent upon reaching full capacity of the two other ones in Montreal. Our unit was divided into a “yellow zone”, for positive patients with less severe symptoms, and a “red zone” for patients presenting with what we called “severity criteria”, for example, needing more than 3L/min of oxygen, having blood oxygen saturation levels inferior to 93%, needing a BPAP or possible intubation, etc. The 20 rooms in this section of the unit had had negative air pressure systems installed in the space of a day and most of them required N95 masks. I was assigned to this section of the unit, and I was scared every day I went to work. I live with my mother and 3 younger siblings, which means if I got Covid-19, they probably would get it as well. I was forced to work full time and to go from an evening shift to a night shift. My patients ranged from 20 year-olds to 80 year-olds and still, we could not predict who would make it and who wouldn’t. Everyday, we lived with uncertainty. When the first wave ended, I noticed I hadn’t actually touched someone without wearing gloves in the space of almost 5 months. I became a nurse because I like human connection, and I had been deprived of this since the beginning of the pandemic. It is difficult to establish a relationship with a patient when, to enter his/her room, you have to be wearing a waterproof surgical gown, gloves that go up to your elbows, a hair net and a surgical cap, an N95 mask that makes it hard to breathe and makes the bridge of your nose bleed, a face shield and shoe coverings. Every morning when I woke up my patients for medication or blood draws, their first reaction was to be afraid of me. And I can’t blame them. If I was to be woken up by someone dressed like an astronaut who’s face I can barely see, I would be scared as well. Both of us were afraid. The patients were afraid because they didn’t know what was happening to them and we were afraid because we didn’t know any more than they did. Courses of treatment changed every week because we were constantly trying new things when the last course of action failed. Our patients developed unforeseen complications because the virus attacked not only their lungs, but their heart, their liver, their kidneys, etc. One of my patients, was 35 years old and otherwise healthy. He had no history of disease or chronic illness, yet in the middle of the night, he woke up in a panic, sweating with his heart racing and a tightness in his chest. I quickly ordered an ECG and we found out that this otherwise healthy young man was actually having an acute myocardial infarction (in simpler words, he was having a heart attack). These kinds of cases were everyday occurrences, and nobody knew what to expect anymore. As a healthcare professional, this feeling of uncertainty is the worst thing in the world. Nurses develop a certain intuition with time, but during the pandemic, we couldn’t rely on that. Our patients were complicating and deteriorating and alone. No visitors were allowed, except if the patient was in his/her final hours, then we could allow forĀ one visitor to come, for a maximum of 20 minutes, and say goodbye for the entire family. Being on the frontlines meant living with uncertainty, heartbreak, hopelessness, and fear every single day. Fear that our stable patients would suddenly deteriorate and require mechanical ventilation, fear that we would bring the virus back home to our loved-ones, fear that how we were intervening was useless. Covid-19 has been a horrible experience, and, on the brink of a new wave, will probably continue to be so. Nonetheless, it has made me a better nurse. It has forced me to adapt and learn rapidly. It has made me develop new ways of communicating with patients. And it has showed me at what point life is fragile, whatever your age or previous state of health. You learn these things when one of your patients, an 18 year old girl, ends up intubated and in a coma, only 20 minutes from being admitted.

It really is a “war against covid”, and us nurses, orderlies, doctors, respiratory therapists, etc. are all veterans. We have persevered in the face of death, pain, and suffering, and we have come out the other side as better health professionals and better human beings.