During my hospital residency in 2020, I worked in several ICUs, all of which had been converted to COVID-19 wards. My residency class had to deal with circumstances nurses haven’t had to deal with since the 1917 Spanish Flu pandemic, or ever before.
At the start of the pandemic in North Carolina, student nurses were removed from all hospitals during our final clinical rotations because of a “mysterious disease.” This was supposed to be the time that we rolled up our sleeves and got to work. But because we weren’t registered nurses yet, we weren’t allowed or expected to provide care or comfort to patients — even though that was the expectation after graduation, which was just around the corner.
Graduation and Beyond
As part of the college graduation process, my class made oral presentations to the Board of Nursing, explaining how the non-traditional student learning processes of those last few weeks had prepared us to become nurses — as if we really understood what that meant or what we would have to do to when we became nurses. NCLEX exams were suspended for a while at the start of the pandemic, so we were to be called “graduate nurses” until we could take the licensure test.
As a graduate nurse, I got hired by my first and current employer. What a great feeling, right? I had a job! I would finally experience my first rotation on the night shift, while taking residency-based classes during the day. I must admit that losing sleep to attend classes was the worst part, but it got me closer to my goal.
What Have I Gotten Myself Into?
The night of my first rotation, my very first patient was lying alone, dying. I did all I could to comfort him — but to no avail. I guess I looked a little overwhelmed when I walked out of the room because another nurse came over and tried to reassure me. When that didn’t work, he introduced me to the fire escape stairwell.
I found out that the stairwell wasn’t just a heart healthy method for getting from floor to floor; it was where nurses and residents went to cry.
Normally, a patient with a poor prognosis was transferred to palliative care, but what happens when the palliative care unit is closed due to the pandemic? For the first time, I saw patients dying alone, and by the time I finished that tearful trip to the stairwell, I vowed, “No more!”
My colleagues and I proceeded to do what nurses have always done — we figured out how to fix the problem. We set up video chats to make sure our patients had some way to be with family when they passed.
When we found a problem, we fixed it. We repeated this pattern over and over again.
Each new rotation in a COVID-19 ICU made us feel like we were patients who had just undergone CPR, been brought back to life, and were back on a ventilator for the next round. On every new rotation we started over with new preceptors with no new details about COVID-19, just new requirements for what must be documented and when since each unit was different. Do I take vitals every hour or every four hours? Do I have to turn that patient every two hours? What if they are proned?
Finding a Home
My second rotation was when I began to get the hang of it all. But I was exhausted. I needed to find some semblance of a work-life balance. Then, nurses started getting COVID-19. When my preceptor got COVID-19, I was left alone. Everyone on the unit said if I needed anything just ask, but they were all so busy trying to save lives. Who was I to bother them?
That’s when the doubt creeped in. Am I good enough for this? Will my patients suffer needlessly because of me?
I think about how I felt then and how I feel now, and I realize how far I’ve come.
On my third rotation, my new preceptor began teaching me the specifics of my job specialty. No more strictly COVID-19 nursing. I was now able to look for a home — a team to be part of. It took me until my fourth rotation to find my home on the neurologic science ICU, but I am so glad I did! It meant I was finally able to achieve work-life balance.
I found a tightly knit, welcoming team and, surprisingly, discovered that the work wasn’t as scary as I thought it would be. Suddenly, everything was in balance and I felt better than I had since I started as a nurse.
Coming out of this pandemic and residency at the same time made me a COVID-19 nurse and survivor. When I graduated from the residency program, I felt like I was part of history. Everyone was talking about “the year of the nurse” and healthcare heroes, and I had been part of it.
I owe a big thanks to the surgical, palliative, orthopedic, and med-surg nurses who temporarily gave up their regular jobs to help shore up the hospital’s COVID-19 ICUs. That’s what nursing means to me — find a need, fill a need.