As the coronavirus swamps the country's doctors, hospitals and emergency rooms, it's become clear that the U.S. healthcare system is not ready for this pandemic. How could it have been? A registered nurse with a decade of experience who did not want her name or workplace revealed said she’s “never seen anything like this.” At her hospital in the northern part of California she's seen standardized health practices thrown out the window—they now routinely reuse sanitary equipment that previously would have been thrown out after each use. She also fears she may have the coronavirus and that she could be infecting her patients. She said she has been exhibiting symptoms for weeks. While her fever has subsided —she took off work a few days during that—her cough is persistent. However, the Centers for Disease Control won’t approve her for a test, and she’s continuing to work treating patients with coronavirus in an emergency room.
She walked VICE through one of her most recent shifts:
At about 3:30 a.m, I woke up, long before my alarm. I have had a lot of trouble sleeping because of anxiety over questions like:
What will we be out of today?
What decisions will I have to make today?
I looked at my phone, searching what news happened overnight. I tried to find the most current statistics so I can just get an idea of how bad it will be today.
Knowing I might not get a lunch break, I packed protein bars and a water bottle into my pocket so I could stay fueled if I couldn’t get a break. Because I need to change out of everything after my shift, I packed a bag of clothes, too. It’s more prep than getting ready for a standard shift.
The 6:45 a.m. arrival
I was anxious walking in, thinking, What am I walking into today? I talked with my coworkers over what symptoms we have been most recently seeing. Things are changing so many times a day. It’s hard to stay up with the most recent issues.
What my fellow nurses were scared of this morning was the fact that the World Health Organization said coronavirus is airborne.
We don’t even have the airborne precaution gear that I’ve been seeing China and Italy using.
Before this, there was a large abuse of the emergency system: people going for primary care and bullshit-type things. All that bullshit is entirely gone now. Everyone that’s coming in is incredibly sick. So while we technically have less patients than we usually would in March, the patients are much sicker.
We had four known positive patients at this moment but there’s a lot of others who we presumed have corona but we couldn't test them. We had to send them home and say, “Rest and fluids and come back if you feel like you’re dying.” We think they have corona but we send them home with an inhaler because we don’t have enough tests. We have been discharging about 75 percent home.
There’s a large number of elderly patients—almost an entire nursing home tested positive in fact, but then there’s also a large number of people in their 30s to 50s whose cases aren’t severe. The severe cases get admitted to the hospital. The majority of the ones getting admitted are above age 60.
I saw several cardiac arrests this day where the person was found unresponsive. When we know nothing about the person we are told to assume it’s COVID-19. A cardiac arrest patient in his 40s died and we are assuming it’s COVID-related. There’s just a lot of assuming the worst right now.
The lack of equipment
We are only using the N95 respirator mask during high-risk procedures like intubating. Otherwise, we are told not to use them. We have been using droplet masks which are not as safe. Before noon, we ran out of face shields.
As another patient we believed had COVID was being admitted, a hospital doctor asked for a face shield. I told them we don’t have any more. So, they said, “I’m not going to go see the patient then.”
I said, “You’re not gonna go see the patient?”
They said, “Not if I don’t have the right equipment to keep myself protected.”
They didn’t physically see him. They just called him on the phone. So that’s all really scary to me because as a nurse, I just feel more obligation to see patients so I'll do what I have to do even if I don't feel like I have what I need.
There are people that feel a moral obligation to keep themselves safe, so they can continue working, so there are a lot of moral and ethical issues coming into play that we’ve never really dealt with before.
An ER doctor also refused to see a patient with upper respiratory issues because that doctor has asthma. It’s difficult to see. I see the fear in the doctor’s eyes. They are scared shitless right now. I would say the doctors are more freaked out than the nurses, which makes me wonder what info they are getting that we aren’t. One of the doctors even said, “We’re all fucked.”
The rush to create masks
The more we ran out of supplies as the day went on, the scarier things got.
By the afternoon, our managers had us in an assembly line in our back office making face shields out of whatever we had on hand. Which in this case happened to be laminating paper. We took that and cut it in the shape of a face shield and then stapled a medical wrap to the shields so we could wrap them around our heads.
We had a meeting about how things were changing. Staff meetings are so vital that the entire staff usually attends now. Some people are even coming in on their day off to stay up to date. Traditionally, only a few people would attend these meetings.
To me that says the staff is scared out of their mind right now. My anxiety is going through the roof.
The end of the shift
Before leaving work, we were told to put our droplet masks into paper bags so we could save them for the next day. We wrote our name on the paper bag and we put in all our shit, which we would usually throw away, into them. The bags are being stored at a nurse station.
Before this crisis, we were always told not to reuse masks, to throw everything in the room away, always get a new set of everything. But now, we are told to reuse masks all day long and even longer. I think this has been putting us, and our patients, at risk.
As for testing, right now, health systems are working on getting their own testing up and running so we don’t have to rely on the CDC but I do know that our viral swabs are on backorder as well. So even if we have the testing capability the question comes, how many test kits do we have? Would we start triaging who we actually test? If we don’t have enough swabs only the sickest of the sick will continue to be getting tested. And I think COVID is spreading through the community at a much higher rate than we know because we just don’t have the testing.
I myself have asked for testing and have been denied. One of my coworkers recently treated a corona-positive patient and now she’s exhibiting symptoms but she doesn’t qualify for a test because she was wearing protection. Many nurses are begging for tests and we aren’t getting it. It’s just not available yet.
I have a lingering cough. I’m working through it, as are many of my fellow nurses with their possible corona symptoms. We feel someone has to be there taking care of the patients, however.
But there’s the fear: am I spreading it by being at work? Should I even be at work? I don’t know the answer.
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