Authors

  1. Maouyo, Rachel BSN, RN-BC
  2. Noon, Bridget BSN, RN, CCRN
  3. Hobilla, Barbara BSN, RN, CEN
  4. Kim, Hojung BSN, RN, CCRN
  5. Roush, Karen PhD, RN, FNP-BC

Abstract

Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely-and often more personal-perspectives on professional, policy, and clinical issues. Best of the Blog is a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: http://www.ajnoffthecharts.com.

 

Article Content

Editor's note: The recent protests against stay-at-home restrictions across the country are painful to watch for nurses most affected by the pandemic, those caring for COVID-19patients. Four RNs working in hospitals in New York City who are graduate students at the Lienhard School of Nursing at Pace University decided to work together with one of their professors to share their thoughts on behalf of nurses on the front lines.

 

There are refrigerator trucks filled with bodies outside our hospitals. Many of us have to pass by them when we go into work, knowing that among those bodies are the patients we cared for yesterday, and when we leave 12 hours later, some of the patients we cared for today will join them. Even harder to handle is the knowledge that among those bodies may be a colleague or friend, fellow nurses who caught COVID-19 while caring for others. It is heartbreaking and terrifying because we know that we too could end up in a body bag shelved in a refrigerator truck.

 

So, it is no wonder that the sight of people protesting protective measures generates such strong emotions for us-anger, fear, sadness. Anger that in choosing to ignore restrictions, or insisting on the right to risk their own health, they are also gambling with our lives. Fear that their actions will jeopardize the tenuous progress we have made, at great sacrifice, in tamping down this virus. Sadness that anyone should feel the need to risk their health and endanger the health and lives of their family and community.

 

Those of us working in hospitals see the worst of the illness: EDs crowded with patients struggling to breathe, the patient who is talking on the phone with her daughter one minute and being intubated in severe distress the next. We see the patient on six IV drips, lying on his stomach with his back exposed, a tube down his throat while one of us holds a phone up to the door so family members restricted from coming into the hospital can watch as the rest of us provide emergency care. Perhaps it will be some comfort to them to know how hard we worked to try to save them. We see the suffering, the loss, the final goodbyes taking place over FaceTime, the sadness of dying alone in a makeshift room in a temporary ICU.

 

We try to find time to hold our patients' hands because we know family members cannot. Some of us pin a picture of ourselves to our gown so patients can have a connection to a real person, not just the muffled voice of a faceless clinician behind a mask, covered head to toe in personal protective equipment (PPE). PPE that is still in short supply. Yes, now we may get a new N95 for each 12-hour shift, but that is still far from the best practice of a new one for each patient. And it's getting harder and harder to provide good care. As more nurses are getting sick, we are working even more short-staffed. Sometimes we can't provide basic care-the measures that are so important to ensure dignity and comfort for every patient.

 

But everything looks normal . . . Meanwhile, those suffering economic fallout are wondering, "How do we live?" Their jobs have disappeared, their livelihood stolen from them. The rent or mortgage payment is due in a few days and they have no money to pay it. Sure, maybe they can't be evicted for now, but how are they going to come up with three or four months' rent when this is all over? How do they feed their families in the meantime?

 

When they look around, everything else looks normal. In many areas of the country, they may not even know anyone who has gotten sick, let alone died. Their hospitals are still quiet. For them, the obvious threat is not illness, it's poverty. The loss is not of a friend or father or son, it's of their livelihood, their ability to care for their families. They fear they will never recover.

 

We understand. Though we are all confronted by the same threat-COVID-19-our experience of it differs dramatically. We as nurses are immersed in the human suffering of the illness itself, while many others are immersed in the human suffering of the economic and social fallout. It is easy to let the pain inherent in our own perspective blind us to the pain in the other. And to forget what the real enemy is and what we can do to overcome it.

 

Please hold on just a little bit longer. The stay-at-home strategy is working. We can see it in our EDs; the numbers coming in are slowing. We can see it in the decreasing number of deaths across the city. Every day we are more hopeful. Lifting the restrictions too early or too quickly will lead to a resurgence of cases. This is a stealth virus-it's estimated that at least 25% and as much as 80% of people with the virus don't have symptoms. It lurks in communities quietly before it explodes. We here in New York City are dealing with the aftermath of that explosion. Stay-at-home can prevent your community from experiencing it.

 

A choice we shouldn't have to make. Many Americans say they're willing to risk getting the virus in order to get back to work. How is it that in this rich and resourceful nation, so many people are trapped in a situation where they are willing to risk illness and death to be able to keep a roof over their heads and put food on the table? Let's redirect the protests to those who can do something about that-instead of demanding that the government end the safeguards that are working to protect us, demand that they provide more effective, timely resources to get us through this crisis with both our lives and our livelihoods intact.