Theresa CerJanic, MSN, BSN, RN, CCM, ACM; North Vista Hospital
Making a Difference Every Day During Unprecedented Times

I woke up on a Saturday morning in late February and my daughter asked me if I was going to run my usual errands? She suggested we get some non-perishable foods considering what was happening in Wuhan, China. I said sure and off we went to the grocery store, to home depot for N95 masks and gloves and, a few other places. I did this as I did not want to be condescending by stating it was not necessary to prepare as none of that disease would come to our shores. Little did any of us know what would come and the impact of a pandemic known as COVID-19, where signs and symptoms include: fever, chills, cough, shortness of breath difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat congestion runny nose nausea or vomiting diarrhea, and unexpected death. At the time of writing, COVID-19 cases in the United States totaled 1,802,470 and total deaths reached over 105,156. Work, life, & balance has new meaning and my dedication to remaining a nurse during this turbulent time is inspired by the nurses I work beside at North Vista Hospital in North Las Vegas.

Nurses I work with include: ICU, Emergency Department, Psychiatric Units, Med-Surge, Specialty Units, Wound Care, Cath Lab, Operating Room Nurses, and fellow Case Managers. These nurses went to extraordinary measures to combat the fear of the unknown. The question they asked themselves is how do you protect yourself, remain dedicated to your patients, and not get sick or worse die? These nurses met the challenge and never balked, even when they saw their fellow nurses come down with COVID-19, and suddenly the caregivers became the patients.

Everything changed regarding infection control techniques as they knew it. They improvised by distancing themselves from patients, by writing vent settings, drip settings, and pertinent medications on glass doors to remain safe as they cared for critically ill patients in the ICU. They extended tubing on pumps to bring them to doorways. Physicians changed medication regimens to decrease the frequency of interventions delivered by bedside nurses. Oxygen saturation became the number one vital sign, and ventilators and oxygen demand with high flow treatments required nurses and respiratory therapists to be at the top of their game. These treatments include high flow oxygen through nasal cannulas and positioning patients’ prone side. Proning patient positions give their lungs a rest and increase the flow of oxygen into the body. Medications were introduced as well as newly developed plasma therapy that required physicians and nurses to treat patients with medications just released or approved for patient care. As they watched patients suffer and die, never once did they say no. Instead their response was “just tell me how to do this”.

None of this care would be possible if it were not for the dedication of nurses and physicians who put their lives on the line treating patients with a disease that the Centers for Disease Control and Prevention and the World Health Organization (WHO) did not know anything about a few months ago, and only provide limited information as it became available.

The constant changes in isolation patients and their treatment regimens required staff to be flexible, treating patients with isolation requirements changed based on guidance from the CDC. These changes for all healthcare workers was maddening, as healthcare workers only wanted to keep themselves safe. Creativity was a necessity as physicians and nurses came up with facemasks made from headbands, hardhats and plastic face shields. This innovation united all of us as we worked to solve needs for the employees at risk as we cared for very sick patients. Some of us stood back and played a supportive role to allow the much sought after Personal Protective Equipment (PPE) like N95 masks, PAPPR’s and isolative gowns, to be used by nurses. doctors, nursing assistance, housekeeping, and ancillary services who were risking their lives as they went into rooms and cared for patients or cleaned up after contaminated rooms. This kind of comradery united all healthcare workers. Are we heroes? Some say we are. I say we are ordinary people doing extraordinary acts of love to ensure we all went home to our families and came back without spreading to others. We did not flatten the curve, we inverted it.

Am I inspired now to remain a nurse? I would not want to be anywhere else as I work with nurses who dressed from head to toe covering themselves to deflect any airborne particles from sticking to them. We all have nicknames for each other as people became unrecognizable in their get ups. We cheered as our nurses and physicians recovered and returned to work. One physician even returned to us with his oxygen in tow. This is not a job, it is a commitment, a calling that you do because you love what you do.

Amanda Fries; St. Mary’s Regional Medical Center
The True Character of the Nursing Profession

The profession of nursing has always had a reputation, both good and bad. In my nursing career, I have (quite literally) heard nurses described as angels in scrubs, selfless and sacrificial; and as glorified maids who simply follow the doctor’s orders and keep the place tidy. Both perspectives are simplistic at best. While family, friends, and acquaintances of mine acknowledge that nursing is a difficult job, most of them don’t know why it is challenging. And it is even more problematic with the immense tasks and responsibilities of the job to explain to those outside the field. Yet suddenly, as COVID crept across the nation towards my hometown, no explanation was needed. My perspective and the rest of the world’s perspective of the profession of nursing has changed in the last few months. COVID has challenged me to adapt and learn quickly because suddenly I found myself in a place of influence and leadership that I did not have before. And it inspires me to pursue higher education and professional development opportunities to be deserving of such trust from the community.

When the world began changing with COVID-19 I felt awkward at first to be the recipient of gratitude. I had a difficult time understanding why I would be thanked for what I have done for years. But one day I left work and work did not stay in the hospital. I saw frightened patients behind masks in line at the grocery store. I heard of nurses quitting their jobs or living in their garages to protect their families. I became anxious every time I heard my family members cough or clear their throat, knowing that I had worked three shifts on the COVID unit that week. I think, as a nurse, I had lost my perspective too and buried under the years of doing my job I forgot that I provide an irreplaceable service to my community.

Nurses are now called heroes by our community, but they have always been heroes. I have not yet met a nurse who could not tell me exactly why they got into the profession of nursing, which is also a difficult endeavor, and their reasons are always formed from a deep-rooted compassion for their fellow man. Nurses go to work because its their job, but they are a nurse because they are heroes. Nurses have always been made of the stuff that would face infectious disease, workplace violence, and our own fears of suffering and death every day of every year, pandemic or not. The incredibly difficult profession of nursing has always been this way. COVID-19 just put it on the television.

Sometimes in the day to day work of nursing it is difficult to remember the why behind it all. But over the last few months I found myself being the only tie between patients and their loved ones. I spoke with our infectious disease team and relayed as much information as I could to families who had no choice but to stay away from the hospital. I have heard the desperation, frustration, and cynicism of the COVID-19 pandemic both at my workplace and at home. I have come home mourning over ill patients on the COVID units and their families and I have prayed more now daily than ever before.

I chose nursing when I was fourteen years old because I wanted a practical way to help people; I will be going back to school to pursue my doctorate so I can help my community. COVID-19 made me determined that the next time my community is scared and sick I want to be there for them again, and hopefully I will be even more prepared. Even after all the gritty and terrifying news coverage, the challenging and heartbreaking experiences, and the long months of masks and fear from the patients, nurses will be there for you again and again.

Umunnakwe, Emmanuel RN; University Medical Center of Southern Nevada
Giving Back to the Community: Why I Answered the Call to Serve as a Nurse in My Community during This Time of Crisis

COVID-19 has affected many aspects of our lives, and due to its infectious nature, many governments were obliged to instill lockdown measures to contain the epidemic. In addition, people were advised to observe social distancing, hand hygiene, and wear face masks. Unfortunately, the number of COVID-19 cases continues to increase by the day. As a consequence, many healthcare systems across the globe have been greatly affected. Most hospitals do not have adequate funds to buy the much-needed tools, such as protective gear and ventilators. Besides, there has been a shortage of skilled nurses to cater to the increasing cases of the pandemic. Therefore, I responded to the call to serve my community as a nurse in these trying times because caring for the physiologically unstable population is my true calling, I have a duty to do so as a patient caregiver and advocate, and I have the necessary qualifications as a Registered Nurse.

Caring and compassionate care to me means stepping up at a time when all other resources and sector has failed; the dedication, skills and interventions of a nurse can make a great positive impact to the community, meaning it is one vocation for me where I have to make a difference in the society while being aware of the health risks involved. Coronavirus is a highly infectious disease-causing pathogen that spreads through coughing, sneezing, droplets of saliva, and nasal discharge, among other means of transmission. Disturbingly, at the moment, the pandemic has no vaccine making it intimidating not only to the general public but also to the frontline healthcare practitioners because no one is immune to the illness. Despite the said risks, my passion for serving humanity did not die away when COVID-19 set in. Instead, it was reignited by the plight facing the entire healthcare system. For this reason, I took the opportunity to serve COVID-19 patients through the administration of drugs, the provision of mental, emotional and moral support, despite the risks involved, as this is the profession that makes me truly happy. My passion for exploiting new ideas and knowledge kept me awake all day and night reviewing and researching on ways I could contribute to the best of my ability to see that this novel virus is well managed.

Besides, I have a duty to take care of all patients and be their advocate. Being a nurse by profession, I understand that we are among the most critical professionals when it comes to safeguarding public health. For that reason, we are required to act with dedication and compassion, in providing healthcare services to patients to ensure their quick recovery. Therefore, attending to COVID-19 patients is not only a moral duty as a nurse but also an ethical principle I swore to uphold.
Thirdly, I have the necessary qualifications to take care of COVID-19 patients. Besides possessing a Bachelor of Science degree in Nursing, I have several professional care giving certifications. For instance, I have undertaken a Transcultural Nursing education course, which equipped me with the necessary skills to handle patients from all races and ethnic groups. Besides that, I have a lot of knowledge and skills on how to deal with COVID-19 patients, thanks to both institutional and on-the-job training. If a person who is as sufficiently educated and qualified to handle the epidemic and the risks it poses refused to do the job, who would accept to take care of such patients?

Additionally, in these unprecedented times, I decided to give back to my community by looking after COVID-19 patients because nursing is my true calling, I have a moral duty to prevent the loss of lives, and I possess the skills required to handle such epidemics. The first reason why I accepted to take care of COVID-19 patients is the fact that I have always wanted to be a nurse as it gives me the chance to save someone’s life. Secondly, all nurses have a moral responsibility to protect lives and attend to matters of public health importance. Moreover, I have the necessary educational qualifications, professional certifications, training, skills, and experience needed to do the job.

Finally, I was motivated to serve during this crisis period knowing the world is not used to impromptu sentinel events like COVID 19 and everyone is in distress, not knowing what to expect. People with the virus are most times stigmatized and conditionally abandoned to their fate, which makes it very difficult for those patients during this period. My ability to dispense comfort, compassion and listen to people infected with the novel virus, as I provide nursing care to them, while properly protecting myself from getting the virus goes a long way to healing those affected, and passing a strong message of hope, not only to those affected but to the entire community, that getting the virus is not a death sentence; love and compassion does more healing than medication. This is my message and motivation as I continue to serve in my capacity during this crisis period.