My patient lay on her side, her back heaving up and down. At first, I was afraid that perhaps she was becoming increasingly short of breath.
As I moved closer and saw her face, I noticed she was crying. Streaks of tears rolled down her smooth brown skin.
"Are you in pain? Are you feeling more shortness of breath?" I asked.
She shook her head no and wiped tears from her face. "I'm here all alone," she sobbed, her eyes bloodshot and glossy with grief and fever. "I'm scared."
She was the first COVID-19 patient I'd cared for as a nurse at St. Francis Hospital and Medical Center in Hartford, Conn., and an unforgettable reminder that with the ballooning numbers of cases and deaths, each is an individual, a life interrupted by a deadly pandemic.
She was a woman in her 60s who had been diagnosed with breast cancer. She was beating it with outpatient treatments. But after she spiked a fever and a cough, she tested positive for the virus.
Her family had rallied around her after the mastectomy, visiting her in the hospital, brightening her room with balloons and flowers.
Now, like all the other hospitalized coronavirus patients, she was scared and fighting alone, isolated in her room, the door closed to prevent viral spread, visited by only medical staff in head-to-toe protective equipment.
On the general surgery floor, where I work at St. Francis, patients rarely died before the pandemic. Our unit usually cares for patients with gunshot wounds and pancreatic and esophageal cancers, requiring complicated surgeries, drains and multiple intravenous medications. Surgeons remove bullets and cut out cancer or a near-burst appendix. We nurse patients back to health through time-tested medicines and protocols.
Now, conditions that were once easily managed, like diabetes, hypertension or asthma, could lead to serious complications in patients with COVID-19. Recently, we lost two patients in 24 hours, and another one came close to dying, prompting our unit secretary to burst into tears. She wondered if we would have to print more "death packets," the formal paperwork that goes to the state. These forms had been gathering dust, in a desk at the charge nurse station, before the virus came to Connecticut.
Our critical care units are filled with ventilated patients who are having difficulty coming off breathing machines, despite the best efforts of the skilled staff of doctors, nurses, anesthesiologists and respiratory therapists. There is no vaccination and no definitive treatments for this virus, which devastates the lungs in severe cases.
I was a police reporter for 23 years at the Hartford Courant before deciding to become a nurse. I went with police on drug busts while wearing bulletproof vests, rode with state troopers driving more than 100 mph and went alone to homicide scenes in high-crime neighborhoods with only a press pass to protect me.
Not much scares me, but the coronavirus did. In early January, I began seeing bootleg videos from Wuhan, China, of nurses weeping after their shifts, their faces bruised by the tight seal of their N95 masks as they watched patient after patient die. Nurses are a tough bunch; they don't normally cry like that. There were stories of colleagues in their 30s and 40s coming down with the virus, requiring intubation, and of patients suddenly dying — even though a day earlier they seemed to be getting better.
This was clearly no flu virus.
It is surreal to be a nurse in 2020, which was ironically dubbed the Year of the Nurse. We were to have celebrated our profession along with Florence Nightingale's 200th birth anniversary.
There is now little recognizable about our daily routine, starting with having our temperatures taken before every shift and wearing masks 24/7 in the building. A Connecticut Emergency Preparedness mobile field hospital was built, in a day, on what used to be the emergency room parking lot. Our hospital president, a physician, has traded his business suits for scrubs and a mask.
Our hallways are devoid of the normal bustle of family members, patients walking around the unit or teams of doctors teaching on daily rounds. We pause for a twice-daily prayer offered over the hospital-wide intercom by clergy, a respite from the frequent calls for an emergency "rapid response."
Fear is a constant — fear of losing another patient, of contracting the virus, of bringing it home to our families.
And yet, we do what nurses do best: We adapt. Along with our nursing assistants, we take care of our patients, despite all the new obstacles. N95 masks are so tight they dig into my face, leaving marks long after they're removed. Our scrubs are covered by long protective gowns and shoe coverings. Our hands are gloved, depriving our patients of human touch.
On our critical care floors, most patients are sicker, sedated or intubated, sparing them from the ever-present conscious fear of succumbing to the virus. Our patients on the medical surgical floors are awake and alert and frightened. They are often watching the news and the growing death toll.
On this anniversary of Florence Nightingale's birth, we are challenged to rise to her teachings. Nightingale, who cared for soldiers during the Crimean War and was considered to be the founder of modern nursing, proved that a brighter, cleaner atmosphere helps cure patients.
So we open the shades of our patients' rooms to let the sunlight in, write positive messages on their white boards and push them to take deep breaths. My managers had the idea to give greeting cards with "bling" to each of our patients, signed by the staff.
And we might put pictures of ourselves on our gowns, to make sure our patients know the face behind the mask.
Tracy Gordon Fox is an RN on the general surgery floor at St. Francis Hospital and Medical Center. This piece was written for The Hartford Courant.
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