An ER Nurse’s Report: What I’ve Seen on the Coronavirus Frontlines
An ER nurse in one of the hardest hit areas in New York City shares what it's like to be on the frontlines during Covid-19.
Courtesy Lisseth DeGracia
Lisseth DeGracia, 38, is a registered nurse and mother of three from Lakeville, Minnesota. At the end of March, New York’s Governor Cuomo issued a nationwide plea for doctors and nurses from other states to assist with the crushing load of Covid-19 cases caused by the coronavirus pandemic. DeGracia signed up to help. While cases are plateauing in New York, the city expects to see many thousands more deaths (there have been over 10,000 so far) before the outbreak is contained. DeGracia had just finished her first week when we spoke with her.
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A nurse answers a call for help
I got a call from a nurse friend who said I should look into it, that they were desperate for qualified nurses. After the Ebola outbreak of 2013, I became fascinated with epidemics and earned advanced certifications in mass casualties, critical care, trauma, and infectious diseases—exactly the skills that were needed for the Covid-19 pandemic.
At first the company that hired me was going to send me to Washington State and I accepted the position. But after Governor Cuomo’s plea, the company reassigned me to New York City—specifically to one of the hardest hit hospitals in the area. That made me think twice. At first I was hesitant because I’m a mom—I wouldn’t be able to fly home to see my family, I wouldn’t be able to see my kids at all for months—but the more I thought about it, the more I realized this is what I’ve been training years for.
My family helped sealed the deal. My mom told me I absolutely had to go and she’d take care of my kids. Then my son said, ‘It’s so cool! You’ll be a part of history, me and my friends are going to learn about you in school!”
In less than two weeks, I found myself in New York City, staying in a hotel room donated to medical workers and ready to start my first shift as an emergency room (ER) nurse on April 6, 2020. I had signed up for 13 weeks, working 48 hours per week. Currently, I work four 12-hours shifts per week (with overtime if I choose to take it).
The first day in a coronavirus ER
I’ll start with the burning question that everyone keeps asking me: Is it as bad as it looks on TV? No, it’s worse. If someone would have told me what I am seeing with my own eyes I would never have believed them. (Here’s a similar frontline report from a nurse in Wuhan, China, where the outbreak started.)
It started with orientation. I walked in the door and they gave us 90 minutes of training, that’s it. All hospitals are different and it normally takes weeks to get trained in the different systems and procedures. Basically, they gave us the most basic instructions, a set of personal protection equipment, and then threw us into treating patients. Normally I’ll have three or four patients in an ER or even just one if they are critical, but that day I was assigned eight to 10, and every single one of them was critical. I was literally stepping over beds to get to people. Questions? The staff there was so amazing and willing to help in any way they could, but everyone was so busy, so if we had a problem we usually had to try to figure it out on our own.
Courtesy Lisseth DeGracia
Dealing with death
On my first day, I was looking for supplies and opened what was supposed to be a supply closet. It was full of dead bodies. They had two beds pushed together with the rails down and bodies just stacked on top of them. They had to temporarily store them in any spot they could find until room could be made on the refrigerated trucks, which would take them to funeral homes where they could be claimed by loved ones. Except the funeral homes were full, which meant the trucks stayed full, which meant the supply closet was full.
That was when reality really hit me, this is what I am dealing with. I can’t even tell you how awful that felt but I couldn’t stop and process it, there were so many patients that needed help. I ended up walking over ten miles that day and didn’t even get so much as a sip of water until I was nine hours into my shift.
I saw patients dying all around me, patients who should have been in the ICU but didn’t even make it out of the ER. There was one woman I’ll never forget, she spoke Spanish and there wasn’t an interpreter available so we couldn’t communicate. Finally, I stopped talking and just held her hand. She couldn’t breathe and I could see she was terrified, but all I could do was hold her hand. And she just clung to me so hard. I don’t know what happened to her.
People don’t understand, this is so hard. The stress is unreal.
Antiquated machines and equipment shortages
Some of the equipment was outdated. How do I even turn this thing on? How do I know it’s going to work? The other thing is that even if you have enough ventilators, you can’t use them unless you have enough filters to put in them. Otherwise, you’re sticking a tube down the person’s throat and basically opening up a portal for germs to douse everyone else in the area. So if you have limited filters, you have to really consider if you can save their life. There isn’t time for extra precautions but you have to protect the healthcare workers too.
A lot of patients who go on vents don’t make it. Normally, we would put patients on a ventilator regardless, because even if they don’t make it, it will give their family time to come to the hospital to say good-bye. In that case, it’s for the family’s welfare, not the patient’s. But now families can’t come into the hospital, so intubating the patient might prolong an inevitable death, and, worst of all, it takes a ventilator away from another patient who needs it. America does not understand what running out of supplies really looks like. It looks like someone suffocating [to] death. Alone.
On a normal day, a few people in the ER will need to be put on oxygen but with Covid-19, every single person needs oxygen and they need so much more than even the worst patients I’m used to seeing. This disease moves so quickly, someone will come into the ER out of breath and we’ll put them on oxygen but it only helps for an hour, maybe two, before we have to raise it again.
Many people are dying alone
Probably the hardest thing is just the chaos everywhere, all the time. I’m always running and yet there’s always more patients. Everything happens so fast and because no one is allowed in with them [due to Covid-19 precautions], they’re dying alone, sandwiched in between strangers, with no one to comfort them as they go.
There was one day when a man kept calling, over and over, saying he had to speak to his mom who was a patient. Finally, we were able to arrange a FaceTime call. She’d been in the hospital for two days and during that time her other son and her husband had died. She was dying. The call was to allow her surviving son to tell her about their deaths and to say good-bye. He kept telling his mom that it was okay for her to go, that their family would be there to take her to heaven. He was trying to help his mom [to] not be scared to die. But she was all alone. How could she not be terrified? It was one of the most heartbreaking things I’ve ever seen.
Courtesy Lisseth DeGracia
Care and protection for medical workers
I’m young, I’m healthy, I might get sick, but I’ll be fine. Every day we get a gown, mask, face shield, and gloves. We have to wear it for the entire shift though, and you can’t change it unless it gets torn or soiled. This makes it hard to eat or go to the bathroom, so a lot of times I just try not to. I won’t get into gross details but I can tell you it’s obvious I am seriously dehydrated. I also try not to eat anything that has to be held with my fingers. If it doesn’t have a wrapper or can’t be eaten with a fork, I don’t touch it, which can be a bummer because restaurants from all over the city are bringing us tons of delicious food every day. But yeah, that slice of pizza? I’m not picking it up no matter how hungry I am.
Some companies are offering ‘crisis contracts’ where nurses are brought in from out of state and then made to work 21 12-hour shifts in a row, with no breaks. They pay a ton of money but it puts patients and nurses at a higher risk of mistakes and illness. I’ve seen nurses who just can’t take it and quit in the middle of the shift. After this is over, we as a country really need to reassess how we take care of and protect our medical workers.
A new reality
Already, I have learned so much and I can tell you it’s made me a better nurse. I have more independence here to make decisions and troubleshoot problems and I love that aspect of it. I love the adrenaline rush, I’m not gonna lie.
This has also given me a whole new appreciation for my profession in general and for the nurses here in particular. I have never in my life seen health care professionals collaborate and strengthen each other to get through hard shifts like I have in the past week. Everyone is so appreciative, anywhere you go with scrubs on everyone thanks you. A little boy yelled ‘thank you nurse!’ out of his bedroom window and offered me snacks yesterday.
I still wake up every morning and it doesn’t feel real. The first week felt like a whirlwind but I still have 12 more to go. One thing I wish I could tell everyone is don’t you dare take one second with someone you love for granted. And stay home.
—As told to Charlotte Hilton Andersen