Dispatches from the front lines: Nursing students on their time at coronavirus hot spots

Three graduate students from the VCU School of Nursing traveled to New York and Seattle to work at facilities besieged by the COVID-19 outbreak. They share their experiences.

Two nurses in hospital scrubs.
Clare Shanley (left) with a colleague at North Central Bronx Hospital. (Courtesy photo)

The coronavirus pandemic has strained health care providers around the world, particularly those in the areas hardest hit by the virus. In response, health care workers have been traveling to COVID-19 hot spots to provide desperately needed care for patients sick with the virus. Three Virginia Commonwealth University School of Nursing graduate students are among those who have journeyed to the front lines of the crisis in the United States. They shared their experiences with VCU News.

Casey Lombardi

Lombardi serves as a transplant nurse at VCU Health and is a master’s student, family nurse practitioner concentration, in the School of Nursing. She left for New York in April to work at a hospital overwhelmed with COVID-19 cases and remains there on duty.

I decided that I should go to New York because they obviously were struggling and a lot of people were sick. And my job was nice enough to give me a leave of absence. This is why I became a nurse. I remember in nursing school learning about New Orleans when they had Hurricane Katrina and how amazing those nurses were, sticking by their patients even though they were endangered too. I was so moved by that. So when this happened I knew that I wanted to go to New York and help.

Casey Lombardi.
Casey Lombardi.

I'm at Elmhurst Hospital in Queens, and they’ve called it the epicenter of the epicenter of the outbreak. They've had among the most coronavirus deaths in the country. It was a little overwhelming at first, but I just had to get used to the unit. Where I am used to be a surgical unit for elderly patients and now it’s just a coronavirus unit. Literally every single unit in the whole hospital became a coronavirus unit, so pretty much every patient that we see is positive for corona. Fortunately, they’re cleaning one of the units to make it a non-coronavirus unit because it's starting to slow down a little bit. I work 48 hours a week in four 12-hour shifts. I do night shifts, so I'm exhausted. But honestly, I've been volunteering to do some extra hours, too, because what else am I going to do? I might as well work and help out the other nurses.

I work with some great nurses. Most of them are from agencies and came to New York to help, too. Some have been here since the beginning. Things have started to get better, but the stories that some of those nurses have told me — I don't know how they're still here. A lot of them have gotten sick, and there's some who are returning to work now. They’re total heroes. You can feel a sense of purpose as soon as you walk in the hospital. Even when I first got there it felt like everyone was there for a purpose and everyone was working together. We all have each other's back. If someone's struggling, we’re ready to help each other out. We all take care of the patients together. That’s been an amazing piece of it.

I know I have to be there for these patients. Their families can’t be there for them. A lot of my patients are immigrants and don’t speak English. And here I am dressed up like a robot in protective equipment and they're scared. They know they have this virus and that many people have died from it. I feel like I want to be with them more and give them encouragement and maybe joke with them a little bit more and try to make them laugh. In the news, they make it seem like it's just a lot of older people who are sick, but there are so many young people who don't have any medical history that are getting sick and dying. That's so hard. I couldn't imagine being healthy one day and then having to go through all this.

We've had a lot of deaths unfortunately, but we've also had so many patients get better and leave. Just yesterday, there was a mariachi band outside. The wife of one of the band members had been admitted awhile back and was finally getting out. So they were there playing to show their gratitude for the nurses and doctors. That was sweet. We see a lot of that. When I’m walking out at the end of the shift, people will be out there yelling, “Thank you,” and that means a lot.

When all this is finally over and we can actually go out, I hope we don't forget about this experience and we don't take any of the things that we're doing — like going to concerts or to restaurants or just hanging out with a friend or a loved one — I hope we never take that for granted again.

Jeannette Kim

Kim works as a senior clinical research nurse and clinical educator for an outpatient medical surgical unit at the National Institutes of Health and as a commissioned officer in the United States Public Health Service. She’s also a master’s student in the nursing administration and leadership concentration in the School of Nursing. Kim was deployed as a public health officer in March to work at a facility in Seattle that had faced a COVID-19 outbreak among the residents and staff. She has since returned to the NIH.

I went to Seattle in March to assist with the outbreak there. As public health officers, we go to these places where they need staff. A lot of the places where the outbreak has hit, the staff members have been really affected by it and a lot of them haven’t been able to work because they're also dealing with coronavirus. We get sent there to augment the staff and to help the facility until they can bring in some contractors. We were providing patient care at a facility until it could arrange to have their own contractors come in. Then our mission was complete and we were ready to return home or deploy to another location.

Jeannette Kim.
Jeannette Kim.

I think that with everything that's happening right now the state of everyday life changes. So it's important for not just health care professionals but everyone to be as flexible as possible. When I received word that I was being deployed, I had less than 48 hours to get ready and go. I had to drop everything that I was doing, both personally and professionally, and go on this mission. It was a bit of a shock, but this is hard for everyone right now.

It was a challenge because we didn't have much staff from the facility itself. We had maybe two or three nurses who were working that hadn't tested positive yet out of about 70 staff members originally working there. We're there to assist 60-plus residents or patients, and there were eight nurses, so it was a lot to deal with. It was physically challenging. We're seeing that a lot — where people on the front line are coming down with the virus and people are doing their best to step up as best as they can.

I'm back at the NIH now. We're performing screenings of everyone who is entering the NIH. We've been screening hundreds of people every day, working 12-hour shifts to maintain 24-hour coverage.

My main purpose in becoming a nurse was I wanted to genuinely help people. So being sent to this place where they needed people to step in, I was ready for it. When you go into nursing, you work day in and day out helping people, but there's also this greater mission that's happening right now with the pandemic. There are so many nurses who want to help, but they don't know how they can. I was lucky that the choice was made for me. When I set out on my career 10 years ago, I had this idea in my head that I wanted to make a difference in some way. I feel like experiencing what's happening right now it's all coming full circle. This is what I set out to do.

It’s difficult for everyone right now because nothing is set in stone. Everything’s constantly changing, the guidelines are changing, new symptoms are emerging, everything is fluid, and I think that we all need to be as adaptable as we can be in order to get through this. This is going to continue — it’s not letting up anytime soon. As bad as that sounds, we have to do our best as health care providers, and as people, to do what we need to do.

Clare Shanley

Shanley has worked as a nurse in the emergency department at Chippenham Hospital in Richmond for the past five years. She’s close to finishing her master’s degree, family nurse practitioner concentration, in the VCU School of Nursing. She traveled to New York on April 3 to serve as an intensive care nurse and remains there working.

I wanted to find a way that I could help somehow. A friend of mine had sent me an email that she received about this staffing agency. I got the email Monday morning and I called them, and I had signed on by Tuesday afternoon, and then I was on a flight to New York on Friday. The need was urgent, so they moved things along very quickly.

A hospital ID badge.
Clare Shanley's ID for North Central Bronx Hospital. (Courtesy photo).

I'm working at an intensive care unit at North Central Bronx Hospital. My experience is in the emergency room, but they're so desperate for any kind of critical care nurses that they put a lot of ER nurses in the intensive care unit. I'm taking care of some very sick patients. I’m on a contract where we signed on to do 21 days straight before you get a day off. It's been exhausting physically and mentally. I wasn’t just trying to learn a new hospital system and my new role and being in a different city, but also obviously working straight through was difficult.

I feel like everything that has happened in my nursing career has prepared me for this and led up to this. I've felt like so much of what I'm doing right now is what I'm supposed to be doing and what I'm meant to do. Even though I'm technically an intensive care nurse up here, my ER background has been helpful because this is like a combat hospital. We’re just making do and having to adapt a lot. And a lot of these patients have gone into cardiac arrest, so I feel like my skills in that department have been helpful here, especially to a lot of nurses who maybe haven't had as much experience dealing with that.

Obviously working in the ER I see death and suffering quite a bit, but usually it’s a patient in cardiac arrest or who's in distress and they may end up passing away, which is terrible and tragic and does take a toll on me emotionally. But it's been different to be here where I'll have these patients for three, four or five days and then they'll pass away and it's a completely different kind of devastating. I've interacted with their families over FaceTime and I've held their hands and washed their faces and it feels very personal when I lose a patient.

I received so much support from VCU and from Richmond, just strangers reaching out to me on Instagram and telling me that they're proud of me. And that is the kindest thing. It’s part of what has made me think that this was absolutely the right decision. My instructors at the School of Nursing have been so amazing. I've been getting text messages checking on me, and I couldn’t feel more supported.

I'm staying in a hotel with 800 other out-of-state health care workers who all flew in to help with the pandemic, and there's a great sense of camaraderie. I feel like this is probably the most important thing I will ever be a part of as a nurse. The teamwork has been just amazing. We're all away from our families and our loved ones and our work families. Nurses are a very tight-knit community and when you work with the same people over and over again, you all know how you like things and we've all been adapting and figuring each other out as health care workers and as caregivers. We're all out of our element, but we’ve really come together.

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