I make eye contact with my door monitor, signal I’m ready to go in. He’s a staffer from another unit, graciously joining me today to ensure I stay safe while caring for my COVID-19 patient. Like the nurses from his unit that sent a gift basket of sweets, snacks, and encouraging notes, his presence is reassuring.
I begin the motions that have become ritual. After two minutes of careful donning, I wear the personal protective equipment (PPE) that allows me to care for COVID-19 patients: a mask, a gown, and a face shield. As I crimp the thin metal over my nose that shapes the mask to my face, I note my skin cringe where fabric has rubbed during my last few shifts. Ready, my door monitor gently opens the door so I’m able to go inside before closing it carefully behind me.
The room, one I know well from my years working the unit, lays awfully quiet except for the gentle flow of oxygen through a nasal cannula, the occasional chimes from a monitor, and my patient’s rhythmic breaths. Typically these areas are full of sound during the day, including family members, consulting staff, coworkers, and even the hum of the hospital through an open door. This is different.
My patient lays quietly in bed, still shifting under the veil of delirium that often accompanies patients after a stay in the ICU. The abnormal quiet does not mask the severity of the situation. My patient is sick, really sick like the many others who are on the road to recovery. The intensive care visit and the severity of the interventions needed to keep my patient alive still hang in the room. It can be seen in the medications I’m giving, the interventions I’m completing, and the confusion that still clouds my patient’s mind.
While my trip into this room has many purposes as staff continually cluster care to conserve PPE and reduce staff exposure risk, this specific one holds a personal importance to me. I chose to be a nurse to advocate for patients, through thick and thin. This is not something that changes when the going gets tough. But with changing recommendations, increased need for PPE, and the world on shutdown, much of what I cherish about my job through connecting with the humans around me has been stripped away. However, in the times of greatest change, humanity still shines through with careful planning and coordination.
I hear the chime I’ve been waiting for. It’s a ring I know well: a video call.
When I first pick up the phone, I’m greeted with my own reflection, one that I barely recognize. A mask covers the complete lower part of my face, an image that I’ve gotten used to since the CDC expanded its mask recommendations to include the general populous. However, a reflective plastic shield covers my whole face from scalp to chin, pressed securely to my forehead on a foam block with tight elastic. What little of my hair can be seen with its tight bun lays obscured by the forehead foam block and glistening plastic. The only part of my skin I can see is a small strip above the mask and below the forehead block. In all honesty, my visible skin looks blotched and distorted from continued PPE use and emotional exhaustion. While I am resoundingly grateful that I have enough PPE to wear, I cannot help but note this life-protecting equipment makes me look far from the warm and welcoming nurse I strive to be.
I hear the voice I’d been talking with throughout the day as the image switches to a face I do not know. “Nurse X, its so nice to see you! Thank you for helping me make this call.”
I smile as I see the family member’s image. My reflection shows in the corner of the screen and I note my wide smile can only be noticed as a hint around my eyes. “It is my pleasure. Let me see if I can set you up to see each other. I do have a few other things to do while I’m in here but I’ll try to be quiet so y’all can spend time together.”
“Thank you, Nurse X.”
After a few minutes of rearranging the room so that the phone stays plugged in, I hear the family member’s voice exclaim happiness and gratitude at seeing the patient’s face. The patient’s eyes flicker open and I hear jumbled words. While I try to give them as much privacy as possible, I still hear the kind words the family member shares with the patient even though delirium and exhaustion clouds the patient’s responses. I finish my work before returning to the phone.
“I want to give y’all some time together—I’ll leave the video call on while I’m out of the room. Before I go, is there anything else I can do for you? I know this is not easy.”
“Thank you, Nurse X. I don’t need anything; you’ve done so much as is.”
“It is my pleasure. I’ll be sitting right outside of the window watching to make sure y’all are safe. I’ll be back in a little while. Take care.”
I walk to the door and knock on it. Through a window I see my monitor who’s been watching the whole time to ensure I did not have an accidental exposure. We nod to each other and I begin the process of doffing and hand hygiene. When I’m finally out of the room and safely discard the used mask, I take a deep breath of unfiltered air with gratitude while I perform hand hygiene again. Sweat soaks my scrubs from the hot PPE and I know from my monitor’s expression, red marks and sweat must mark my face too.
Hours pass and I perform the process of entering the room multiple times. Each time I go in I see the family member and hear their voice. Before I leave again, we’d repeat the routine, “Is there anything y’all need?”
“No, Nurse X. Thank you so much for what you’ve already done.”
Finally the day has dwindled until dusk has taken the sky outside and my shift is almost complete. I enter the room for the last time during my shift. Ever fatefully, the family member is still there on the video call.
“I just wanted to let you know that I’m getting ready to leave for the night.” I rearrange the phone so that it faces me and I place my hand on my patient’s shoulder. “It has been a pleasure working with you both.”
The family member starts, “I cannot express how grateful I am for all that you and your coworkers are doing. You all have truly blessed us with your time and risking yourselves to help us heal.” The family member’s words continue, kind and honest.
I respond, “I am so honored to be able to care for y’all today. This is what we are here for. Times are not easy, but in this y’all are not alone. It is my pleasure to care for you both.”
I finish my work for the day. I complete the routine of going home that I’ve grown used to: take off scrubs, put in disposable bag, put on clean clothes, exchange fabric mask from day (not PPE for isolation rooms) for clean one, drive home, strip clothes at door, toss scrubs and clothes into washer with help of significant other, go straight to shower without touching anything with help of significant other, and scrub myself clean.
At last, I pull on a clean pair of clothes and sit on our porch. I gratefully inhale the fresh air without the mask that has become second nature to me. I catch up with my significant other, then my family over the phone. All of our discussions indirectly center on the same thing “are you ok?”
“Yes, I am. We’ll get through this.”
When the stars have reached their full bloom, I find myself alone on the porch. At last, I let the tears I’ve been holding in reach my worn cheeks. They are not reflections of sadness, or joy, or pain, or any one feeling. They are expressions of pure emotion. They are tears that encompass the humanity of today, at its worst and its best.
For, in the end, we are human.
Written by Nurse X
*Note: This is an accumulation of experiences of a progressive nurse caring for COVID patients. This short story is not about a specific person for patient privacy though the experiences shared reflect what is happening at a hospital during this pandemic*