On the Frontline of COVID-19: Tips from a Travel Nurse

COVID Nurse with Face Shield

What I learned working on the frontline of COVID-19 as a travel nurse

In early April 2020, I took a 2-week assignment in New York City at one of the hardest-hit hospitals to help out on the frontline of COVID-19. COVID-19 is a pandemic with the likes of which the world has ever seen. A respiratory borne illness, highly contagious, ever-changing, and certainly not susceptible to the heat as we had hoped. I have had some interesting and different experiences in my life as a travel nurse, but this experience was like no other. Though I was only there two weeks, what I learned on the frontline of COVID-19 in NYC remains invaluable. 

Embracing the New Yorker spirit

When humans are faced with something as grave and stressful as a pandemic, you see the best and worst in people. COVID-19 has rocked every corner of our lives as we know it. Emotionally, spiritually, financially, and physically. I know I am not alone in experiencing the quickly changing and vast amount of emotions since this pandemic has started. Fear, panic, worry, guilt, depression, shame, but also love, gratitude, compassion, and empathy.

I had never been a huge fan of New York City. The fast-paced life, the dirty, loud streets, the abrasive and abrupt culture, the skyscrapers that block out the sun. But this time the Big Apple stole my heart. New York has been through many tough times throughout its history, most notably 9/11 in my generation and now being one of the first U.S. epicenters of the coronavirus pandemic.

It turns out New York’s toughness also means a fierce and loyal spirit. And an uncanny ability to come together in the most difficult of times. While working on the frontline of COVID-19 I experienced New York in a way I hadn’t before and saw kindness, compassion, gratitude, and generosity.

There was an omnipresent appreciation for healthcare workers. Cheering and pots banging rang out through the streets at 7 pm shift change. Gratitude was expressed for frontline workers with signs and billboards and words of thanks. Starbucks gave free cups of coffee, pizza shops gave out whole free pizzas, lunches were bought, companies donated merchandise, and the list goes on. The air was heavy, and there was suffering and pain but New York was on the offense with kindness and generosity and I’ll never forget it.

Pandemic Medicine

I went to work on the frontline of COVID-19 in NYC with a disaster relief company that works in conjunction with national government entities such as the Department of Health and Human Services and also FEMA. They respond to crises both nationally and internationally, and are physician led and owned. They normally set up their own temporary hospitals and have their own policies and processes to address the crisis. For this particular assignment on the frontline of COVID-19 however, they actually were tasked with opening a hospital within a hospital.

We went to open up a few floors of a hospital with our staff to help offload patients from the surrounding hospitals within their system while also making them “clean” hospitals (no COVID). As a former ED nurse, I had worked my fair share of crazy situations and am used to chaos and being busy. But I had never worked in a true mass casualty event, much less during wartime or in a pandemic situation such as corona virus. As a mass casualty event, the sheer volume of patients alone is enough to overwhelm resources, then you throw in it being a pandemic and it’s a whole different ballgame.

The big differing factor of course in a pandemic is that as the health care provider you are putting your life on the line and risking your health in taking care of these patients. There may be times of danger in regular nursing such as a combative patient or being exposed to a patient with tuberculosis, but these are not regular everyday occurrences. During a pandemic, we put our health at risk every time we go give a medication, take vital signs, check a blood sugar, or help a patient to the bathroom. With that being said, that changes how we care for our patients as we now also HAVE to take our own health into account.

If there’s definitely one thing I have learned about pandemic medicine it is that no one will fight for your own protection and health but yourself. That may sound severe, but it is true. You have to be responsible for yourself and speak out if you don’t feel safe. Because if we all get sick, who will care for us? We still try to take the very best care of our patients we can, but it’s different. As a nurse, we are tasked with a seemingly endless list of things to do a day and we are used to constant bustling in and out of patient rooms as needed throughout the day. But in a pandemic, we have to learn how to slow down, don the appropriate PPE (personal protective equipment) prior to entering a patient’s room, consolidate our efforts, and be ok with the fact that we simply cannot do it all.

That last bit is a hard pill to swallow. Be ok with the fact that we simply cannot do it all. Nursing is a tough job on a good day and it’s difficult if not impossible to get it all done, but being a pandemic situation compounds that. We can’t give every medication on time, we can’t always spend time with our patients, we can’t always attend to their daily hygiene, we can’t always do hourly rounding, we can’t always intervene quickly, and the list goes on. The sheer volume and severity of the situation, in addition to the personal health risk, makes it an extremely trying situation.

Tips for nurses on the frontline of COVID-19

While working the frontline of COVID-19 in New York I adapted a few habits that helped me get through my time there as safely as possible. Here are a few tips for those of you who may find yourself in a similar situation soon.

  • Take your time with your PPE. Make sure you are donning and doffing correctly and assure you have the proper PPE. Your safety is paramount.
  • Plan your hydration. It gets hot in all the garb you wear! I made sure to hydrate a lot before my shift, during lunch, and after my shift. I really only tried to allow my lunchtime as the only time I removed my PPE and hydrating as well as eating.
  • Break time consideration. We definitely need breaks when we can, just be careful when you are around others and taking off that mask for a few minutes or for your lunch, distance yourself from others, or take lunch outside by yourself if you can. You can just as easily get exposed unknowingly by a coworker as a patient. I’ve known it to happen.
  • Consolidate your efforts. Try to combine your things to do in one effort; vitals, meds, toileting, blood sugar checks, etc to limit exposure in the rooms. When I was in NYC, the hospital graciously adjusted medication windows to 2 hours instead of the normal 1 hour. Meaning we could give medications to patients up to 2 hours prior and 2 hours after the scheduled time, which helped immensely to consolidate our efforts!
  • Clean bag/dirty bag. I may be a little OCD, but this is what I did. Have a “clean bag”, something you keep wallet, keys, phone, food, etc (I don’t like to bring my purse in personally) and a “dirty bag”- dirty scrubs, reusable PPE. I am known as an alcohol wipe hoarder and have these in my pocket at all times to wipe down my water bottle, phone, other used items during the shift, and then can place them in the clean bag.
  • Change of clothes. Luckily the hospital I was in provided scrubs to wear, but if not bring an extra pair of clothes or scrubs to change into after work and put the used scrubs in a “dirty” bag you can place safely somewhere.
  • After work routine. Upon getting to the hotel, I immediately peeled off my other clothes/scrubs, left shoes outside the door, and hit the hot shower. Scrubbed with Hibiclens (surgical antibacterial soap) and then my normal soap. Not sure how Hibiclens affects viruses, but I figure couldn’t hurt to take extra precaution!
  • Most importantly, TAKE CARE OF YOURSELF! – Perhaps get up a little early and have some reflection time or journaling time, yoga time, prayer time. Make time for yourself. Talk with friends, family, coworkers for decompression, it is such good therapy. Couldn’t have done it without my coworkers, family, or friends! Exercise and eat well, get plenty of rest, take vitamins so your body is ready to come what may. Know that so many are in your corner and supporting you!

Do it scared.

I never thought of myself as a particularly brave person, but somehow I did it anyway. I have been a long time anxiety sufferer, but that’s a story for another time. When I was in between contracts and jobless and saw what was going on, I just couldn’t stand by and not do anything.

Obviously no one anticipated the situation we are in today. We are still learning, adjusting, and changing. This is certainly not a job for everyone, but if you feel you can contribute to this battle, we need you. As we surge into this new wave, we are ramping up a new battle with hotspots all across the U.S. It’s a literal war zone out there.

I think it all was summed up pretty perfectly in my Facebook post as I left New York after 2 grueling weeks:

The most important thing I learned? The strength of the human spirit.

COVID has literally brought the whole world to their knees and you see the very best and the very worst in everyone. This is far from over. But in the end, we are ALL humans through fear, love, hope, joy, anger, happiness.

That’s what makes us human.

Was it hard? Yes. Was it stressful? Yes. Was I scared every day? Yes. Would I do it again? Absolutely.

Stay safe out there everyone! Gypsy love

– Katie, whispers of the wando