Republic resident Stephanie Wells has been a nurse since 2004, including 11 1/2 years in emergency rooms. She’s due to receive a doctorate in nursing practice from Missouri State University on May 15. But when the COVID-19 pandemic came to the United States, she decided not to wait around for her online graduation ceremony. She contacted a company that pairs nurses with jobs, and with her extensive experience, she soon landed a seven-week assignment in New York City, the global hotspot of the pandemic. She’s been there since April 11.
“I knew that if I didn’t come, I would regret that I wasn’t here to help, because I saw this city was hurting. I just had that calling to go help,” she said. “While I might have been nervous and scared to leave home, it’s going to be worth it in the end.”
Wells is working at New York Presbyterian Hospital in Queens. She said the 11-hospital system had processed about 1,000 nurses traveling into the area when she arrived nearly three weeks ago. After two days of online orientation, she spent her first day in the emergency room.
“The first day was the only full 12-hour shift that I’ve had in the ER,” she said. Wells called that first shift “intense,” and recalled one patient who accidentally dislodged a breathing tube. Staff members had to flip the patient over and wait for someone from anesthesiology to arrive to re-intubate, because anesthesiology is the only department allowed to intubate patients during the current outbreak.
“I sat in my car and cried for a few minutes” during that first shift, Wells said. She also registered 18,000 steps on her FitBit by the end of the day, and slept most of the next day.
Since that first day, because of the shifting needs of the hospital, Wells has moved out of the emergency room and into other areas, including intensive care units.
“I’ve been to 3 different ICUs, the ER holding area where patients wait to get admitted, and helped open a floor that was taking patients out of the ICUs. (In) all the ICUs, including a couple of areas that are turned into makeshift ICUs, all the patients are COVID-positive. All the patients either have ventilators or trachs, which is the tube in the neck. They’re on all sorts of medications – lots of stuff to keep managing,” she said.
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New York reported more than 1,600 COVID-19 deaths last week, even as it appears the city has turned a corner. Many other patients remain in intensive care, and the death toll will likely continue to grow by hundreds per week in the near future.
But in the midst of the outbreak, there are signs of hope. One of those is a constant musical refrain: every time a coronavirus patient is discharged from her hospital, someone plays the song _Don’t Stop Believin’_ on the loudspeakers. On the day Wells arrived, a sign in the lobby proudly announced that 56 COVID-19 patients had been discharged over the past 24 hours. That’s 56 repetitions of the same song in one day.
Wells recalled a conversation with another nurse: “I asked her, ‘Does that ever get old?’ And she said, ‘No, to me it’s uplifting, because it’s something that we’re doing right.'”
Just days before Wells arrived, things looked much different. She’s heard stories of doubled-up beds in rooms and more beds lining the hallways, all full of sick patients in the weeks before she got to New York.
“It seems like there is optimism now. From what I was told, there were lots of frustrations when this started: too many patients, not enough staff. Seeing people that are getting better is helping,” she said.
Contributing to the optimism, Wells said the hospital staff has plenty of resources to handle the patient load now. “Every patient who needs to be on a ventilator is on a ventilator. Every nurse has their N95 mask. Every nurse in ICU has a face shield,” she said. A “command center” stocks personal protective equipment for anyone in the hospital who needs it.
Another positive sign: Wells said a social worker is visiting recovering patients with an iPad, making Facetime calls so patients can see their families. Many of the patients are unable to speak because they’re still using equipment to help them breathe, but they can see the screen, wave, and make a connection with family members who aren’t allowed to visit.
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But Wells cautions that it’s not all good news, even now. Many of the patients she sees are dealing with novel complications. In addition to needing ventilators, some have to go on dialysis because their kidneys are failing. Other patients have had fingers or toes turn black because of circulation problems caused by the disease.
Wells has also been surprised to see younger patients among those who have required serious intervention. She noted one intensive-care patient especially, because he’s a year younger than her. “He was 35, and I’m 36. He’s super sick. The older people are real sick, too, but it’s crazy to see the amount of younger people, as well.”
The seriousness of those cases and the way the illness spreads causes Wells to worry about plans to lift restrictions, even in areas like Missouri, where the case numbers aren’t especially high yet.
“While it does seem like the numbers are going down, you’re still getting the positives. The scary thing is they’re saying about 50% of people that have coronavirus don’t even show symptoms or it’s so mild it seems like allergies. That’s really scary when you think of the elderly (and) compromised population,” Wells said. “If they start opening up too soon, and there’s people that are asymptomatic and they go out and talk just a little bit…it could infect 10-15 other people.”
While conceding that there are other opinions about the timetable for re-opening, she hopes officials will take things slowly.
In addition to her word of caution, Wells has another message for people back in Republic: “Don’t believe everything you hear or read on social media.”
She tells about one social media story that claimed patients are being left to die in New York hospitals without help.
“One of my friends shared a video to me. It was a nurse practitioner talking about how her friend is at a hospital here in the city and they aren’t taking care of patients like they should,” Wells said. “I’m not seeing that. I’m seeing nurses taking care of patients the way they need to be taken care of. We are in those rooms, we are next to those beds, we are hands-on with those patients. Even if we’re scared that we’re going to drag COVID back home or we’re going to get it ourselves, we are taking care of those patients to the best of our abilities.”
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Wells is living alone in a studio apartment during her seven-week stint in New York. She’s staying in touch with her family and friends via FaceTime, phone calls, and text messages. Some of the visiting health care workers have formed a private Facebook group where they can talk about their experiences, share subway advice, find running partners, and generally stay connected.
On her days off, Wells has been able to do something most visitors to New York would never do: drive around the city. With traffic almost nonexistent, she’s been able to drive even in midtown Manhattan, visiting Central Park and other well-known locations. She’s had an opportunity to experience New York pizza and New York cheesecake, and has documented many of her stops with photos, including a shot of an almost-empty Times Square.
Her favorite days in the hospital, she said, are when she’s called on to use her nursing skills to their fullest. That’s not always possible, because sometimes the most urgent need is for someone who can perform basic tasks that are often done by non-nurses in other circumstances.
“I’ve been doing this for 15 years. I can take patients. (The best days are) when I have my own patients and I’m managing my team and things are going smooth, and I’m still able to bounce around and see if anyone needs help with something,” she said. “I like being able to use my skills.”