Note: Names have been changed for the sake of privacy.
Infection House: Before we get started, how are you doing?
Ryann Jordan: I’m okay! I’m working overtime until all this is over, so I’m a bit tired. But otherwise holding together.
IH: What is your role in the medical system? In which state, city, hospital, and unit are you working?
RJ: I’m an ICU nurse at a large hospital in New Orleans.
IH: We know all this is anything but normal— but can you walk us through a normal day?
RJ: When working on the COVID units, there is a certain flow to the day. I come in and get the bag where I’ve stored my N95 and surgical masks. Then I head to my patient assignment and get a report from the previous shift. I then plan my day and figure out how often I’ll need to go into the room. We try to cluster our tasks together. It’s better to go in the room and get your assessments, medications, re-positioning, blood draws, etc. done all at once. This minimizes your potential exposure to the virus. Each time you enter the room, there is a process to put on all your PPE [personal protective equipment], and another process to take it off as you exit. Of course, there are times you need to enter the room that you may not have planned for. Many of these patients are intubated, and may require suctioning. Restraints may need to be applied, or adjusted. Problems with the IV lines may need to be assessed and solved. So the plan of the day adjusts to patient needs, and to changes made by the medical team. You do all that for 12 hours, and hopefully you’re able to make some progress with the patient. Then you give a report to the next shift, and go home, and get ready to do it all again.
IH: On average, how much time do you spend caring for an infected patient? How does that time compare prior to the pandemic?
RJ: In the ICU, our ratio is usually one nurse per two patients. On the COVID units, it’s 2-3 nurses per 2-4 patients. So the amount of time we have to spend with patients is similar. But the amount of time we spend actually in the room is definitely less than normal, because we are trying to reduce our exposure to the virus.
IH: Is there time to form any sort of relationship or connection with your patients, or is action too urgent?
RJ: This depends on the patient. Most everyone who is in COVID ICU is intubated and sedated. So there’s really no opportunity to have a decent patient relationship there. If they get better and are able to have their sedation decreased and their breathing tube removed, then that opportunity may exist. But I personally have not had that happen with any of my patients yet.
IH: At your hospital, where is the line drawn for incoming patients— who gets care, and who is sent home?
RJ: I can’t speak to this part of things— I’m not down in the ER where those decisions are being made.
IH: What precautions are you taking to prevent transmission within the hospital? Are they sufficient?
RJ: We’re doing a few different things. First is cohorting COVID patients together. This means that an entire hospital unit will be reserved for patients with confirmed COVID infections. Other units are being kept ‘clean’— meaning that no COVID patients are admitted there. This hopefully keeps the virus out of those clean units. Of course, healthcare workers can still carry infections from place to place. So that’s why COVID patients have strict PPE requirements in place. These normally consist of an N95 mask, surgical mask, face shield, gloves, and gown. We are also trying to limit the movement of staff from COVID units to non-COVID units. As for sufficiency, I cannot say. They feel logical and necessary, but it’s very hard to track the spread of the virus.
IH: The news reports understocked hospitals and widespread inability to attain necessary equipment. Is this (and other news) accurate to your workplace?
RJ: We do mostly have what we need, but we are making changes to how we use PPE, similar to many other hospitals. Masks which are meant to be disposable after one use are being reused for weeks at a time. Gowns are used for an entire shift, instead of a new gown each time you enter a room. Our standard cleaning and disinfectant wipes are in short supply, so we are using a bleach solution instead. Recommendations for PPE use change sometimes, but it’s hard to tell if that’s in response to our supply issues, or new recommendations from experts, or something else.
IH: In your experience, how has the federal government responded (or not responded) to the needs in your state? And how has your state responded to both your hospital’s needs AND the federal response?
RJ: This is a bit too high-level for me. I’m in the weeds, so it’s hard to measure how things have been handled at a state or federal level.
IH: What stories (good or bad) can you share that have impacted you in these unsettling times?
RJ: All the stories you see in the news of people pulling together to help each other, to take care of each other, to lift each other’s spirits— this is why we’re human. This is our purpose. It’s nice to be reminded of that during these hard times. All my friends sharing their music, skill, and creativity on social media, people finding ways to reach out to each other despite great distance. Our lives are disrupted, but the empty space has been filled with joy and music. I hope we can retain some of that focus.
IH: How has this situation changed you (personally, spiritually, politically, responsively, etc.)?
RJ: Personally, I’ve been heartened to feel friends and family checking in on me and supporting me. I often feel like I don’t need much support, I’m just doing my job, etc. But working in this stressful environment does take a toll. It’s easy to feel very isolated just moving between your house and your job, seeing only work colleagues and very sick people. Small gestures can mean a lot in this situation. Politically, it’s reinforced the need for systemic change in many aspects of American life, particularly the labor and healthcare systems. It’s revealed that people at the bottom generate wealth, and should be compensated accordingly.
IH: What needs, advice, or requests, if any, do you have for our readers and the public at large?
RJ: The best thing you can do is respect the quarantine. It sucks, but you have to remember this virus is incredibly easy to transmit. You may be infected and have no symptoms, and go see a friend, and now they’re infected and might have serious symptoms. Or they might feel fine, and end up passing it on to someone at the grocery store. And the spread continues. Respect the quarantine. Check on your people. Help each other. Advocate for political change, loudly. Let’s use this to make the world better.
Ryann has asked that in lieu of personal donations, you donate to the Krewe of Red Beans’ Feed the Front Line, an innovative New Orleans nonprofit focused on feeding hospital workers, keeping struggling restaurants alive, and paying local artists and musicians. It’s a great project! You should check it out!