“I am a nurse. I am Asian American. You’re probably wondering how these two things correlate. The one keyword is coronavirus. The coronavirus itself does not discriminate against people, but people discriminate against people.
Since this pandemic, I have taken care of countless positive COVID-19 patients of all ages and races. I was asked to self-monitor numerous times, which includes checking my temperature twice a day for 14 days. I’ve yet to hit the 14-day mark, because each time I had taken care of a positive or high-risk patient, I would have to restart my monitoring.
I have also taken care of patients with xenophobia towards Asian Americans, due to the pandemic. Many of these patients have asked to switch nurses but due to the shortage and prevention of decreasing exposure, sometimes that is not possible. I’ve been told, ‘Go back to your country,’ although I was born and raised in America and am not of Chinese ethnicity. I try not to take it personally but how could I not? I sit in my car after a 12-hour shift, mentally and physically drained, tearful. I sometimes wonder if I should say I’m symptomatic just so I can get tested and self-quarantine to avoid this type of hostile work, even if it’s for a few days until my test results are back (I will be expected to return if they’re negative).
But then I think, this pandemic is more than just about me. Why would it be fair if I decided to stay home because I was fearful? We’re all afraid for one reason or another. Why would it be fair to my coworker who had to work extra hours because I didn’t show up and for them to increase exposure to their children, husband, mother, father, grandparents?
I continue to work because I am a nurse and I feel as if it’s my duty to do so, no matter what the obstacles are. I am a nurse who works at an underserved community clinic. I am a nurse who works in an emergency room. I am a nurse who works on a general inpatient pediatric floor. At three different locations. Since the pandemic, I have worked countless days in a row on an average of 10 to 12-day stretch working days, evenings, nights, random shift lengths without a day off accumulating up to 80 to 100 hours. I’ve parked my car in crevices to take three-hour power naps, lying on a makeshift foam mattress in the back of my trunk after a 12-hour shift to head into another 8-hour shift. I’ve gotten my first urinary tract infection because I’ve been told to plan my fluid intake times because I won’t be able to take my mask off. I hold my urine until the end of my shift or at least until I can’t hold it any longer.
I’ve come home through the back entrance of my home and headed to the basement to strip off my scrubs. I’ve headed into the shower and visciously scrubbed my skin until my eczema flares up to match the raw, peeling skin behind my ears from wearing masks all day to make sure I’m clean. I’ve headed into my bedroom to sleep alone, without my special someone. I’ve woken up in the middle of the night with racing thoughts about the pandemic, unable to fall back asleep. I’ve limited my exposure to my family, whom I see on my one day off. My grandparents, whom I haven’t seen in weeks, only live next door. I’ve been too scared to stop into a gas station with my clean scrubs on before my shift to grab a coffee, so I work through my shift exhausted.
I want to tell my family and friends that I’m beyond tired and scared but to spare the burden, I tell them I’m okay because I want them to have one less thing to worry about during this time. This is now my norm.
In the ER:
Recent hospital policy has required all staff members to fill out an online daily work pass to be shown that essentially is an oath taken to state we are not sick. An assembly line occurs at the main lobby entrance with hundreds of employees lined up. Each employee shows their daily pass to check-in staff, then heads down to the next staff who checks temperatures, then to the next who provides a mask to wear for the entire shift. That is one mask to be wore in all patient rooms for the entire 12-hour shift. After this process, I head into the ER. I look around to see doors shut tight with multiple signs taped on the doors. Droplet. Contact. Isolation. COVID rule-0ut patients or positive patients filling each and every room and only one precaution cart of personal protective equipment (PPE) for every three rooms, slowly emptying to little or no gowns and gloves left. We’re told to cluster our care and be in the room as minimally as possible to preserve PPE, as well as exposure, but this makes me feel guilty. I want to feel like I am providing these patients with my absolute all, but how can I if I’m told ‘we need to preserve PPE’?
Recently, we’ve been told that the ER no longer allows visitors. Now these sick patients aren’t allowed family and I’m the closest thing they’ve got in the meantime. How am I expected to provide limited care without feeling guilty now that they don’t have their families with them? These are sick patients by themselves, so fearful for their lives. An elderly Italian patient I was caring for once said to me with his broken English, ‘I don’t want die.’ I was speechless and my heart broke. He had family in Italy, I couldn’t imagine what he was going through with the recent news about Italy’s coronavirus affects. I wanted to hug him but have been restricted to do so because of ‘social distancing and the no touching rule.’ I wanted to tell him it was going to be okay but how could I when I really didn’t know if it was going to be okay? How could I possibly give him false hope during this time of uncertainty?
In the inpatient pediatric unit:
Different hospital, same process. I head to a designated entrance for staff, am asked the screening questions, have my temp checked, and am provided with a mask. I head up to the unit, which is surprisingly quiet but there are a few rooms still full of varying ages, from less than one year to 17 years old with multiple different diagnoses, including respiratory symptoms. I was assigned to care for a 2-month-old baby with a sign of unclear infection, as well as a 14-year-old with rhabdomyolysis, a breakdown of muscle tissue that releases a damaging protein into the blood. The pediatric unit now only allows for one visitor during the entire inpatient stay and that visitor cannot leave at any given time. If that visitor leaves, they cannot return until the next day. It must be the same visitor throughout the entire stay. The visitor is screened daily with temperature checks and questioned about a sore throat, cough, and other respiratory symptoms. This is now their norm in the pediatric unit until their child is discharged.
I head into my first room with the 2-month-old and see the mom on the hospital bed with papers spread throughout. Mom is working from ‘home.’ Due to the recent policies, she no longer heads into the office but works from her computer in a hospital unit with her sick 2-month-old, who is sporadically crying. Her eyes are heavy with dark circles. Mom also has two other kids at home with the dad, who she hasn’t seen in 48 hours. I now have to somehow tell Mom that the doctor decided to order a COVID rule-out test on her two-month-old, who has a dry cough and runny nose. To take precautions, I am expected to relay this information to Mom and swab the child myself. I gown up in my astronaut-like suit, gown, respirator, goggles, and gloves. Mom stares at me with confusion, but with somewhat relief when I tell her because she too wants to know why her child is so sick. The swab is slowly shoved down his tiny nostril and a high-pitched shrill cry is heard. Now, Mom must anxiously await 3 to 5 more days until the test results are back.
I head into the next room, only to find my patient in a fetal position wrapped in a hospital blanket with an attached IV pole running. He’s still sleeping. He has not seen his family in 3 days due to the visitor restriction policy. His mom is a single parent and had to stay home to watch the other siblings, since school is no longer in session indefinitely due to the coronavirus. He was alone, no visitation from friends or family, and it broke me. That a child had to be hospitalized alone, suffering in discomfort because he was too shy to ask for pain medication. Not one point during the hospitalization, other than the admission, did he see his mother, who typically would have advocated for him.
In the clinic:
Many other primary care offices closed and doing telemedicine, but the clinic remains open since it’s federally funded. On my way in, I see a pop-up tent outside the entrance with a few of my coworkers gowned up like it’s Halloween. Dressed like the Pillsbury doughboy with poufy white gowns, masks with face shields, gloves, head caps and shoe covers, unrecognizable. We’ve had patients request to be screened in their cars parked in the parking lot because they are too afraid to come in. Elderly patients with chronic pulmonary conditions and oxygen levels in the 70s (the norm is typically 94% and above) and respiratory distress come as if we’re an emergency room. Phone lines are ringing off the roof with not enough nurses to triage due to the COVID-19 hysteria.
This has happened all within the past month. This pandemic is no laughing matter. It is more than just a nightmare. It is our reality and we must band together to end it in hopes that one day soon, we can go back to what we considered our ‘norm.’ It will only get worse before it gets better. So please stay home if you can and take part in #stoppingcovid19. Be kind in the process because we truly don’t know what others are going through.
To my fellow frontlines, especially my fellow nurses: It’s okay to be scared, but know you are not alone. We will get through this because ‘this too shall pass.’ In the meantime, this is the time to support one another, especially those new graduate health professionals during such a time. Be kind to one another. I am you; you are me, we are all one. In this together, we have each other.
Sincerely,
Your Asian American Nurse in the Frontlines.”
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