Pandemic Junction

Susan Pietrocarlo

My story, the story that I want to share with you here, begins in early March of this year 2020. At that time, I found myself at a bit of a crossroads. A friend called and asked me to take a position with her hospital as an ICU staff nurse. My first thought was, “Why on earth would I do that?” since I was ready to accept a healthcare management position for significantly more money.

At this time, as you know, hospitals were starting to gear up for an emerging, rapidly evolving situation: treating patients with the virus called SARS-CoV-2 that causes COVID-19. It was a difficult situation since there was no vaccine and no specific therapy. The healthcare community was learning on the fly since no one had previously encountered this syndrome.

I have no great wealth so my dream of someday having my own foundation to help make the world a better place, to be a philanthropist in any large, significant way, was not to be. However, I have always stepped up and lent a helping hand to friends in need and volunteered, whether it be working at a food bank, a health clinic for the homeless, or fundraising.

During this time, this personal and professional crossroads in March, I found myself frequently thinking of my father who died two days before final exams in the first quarter of my first year at the GSB. My father had emigrated to the United States from northern Italy and a prouder American would be hard to find. He was also so very proud of his daughter, me. As the years passed, my father has lived in my heart and mind and his values, as well as my mother’s, are deeply ingrained in me.

My friend’s offer to return to bedside ICU nursing intrigued me. Over the years I have learned to listen to my feelings, to intuition, and to signs. During this time I was “spring cleaning” when I found a small poster that someone gave me at Penn during my undergraduate years. It was a copy of an old World War II poster with a picture of a nurse and the following message: “Become a Nurse – Your Country Needs You.” You cannot make this up! I took this as a sign, no pun intended.

By now you can guess what happened. I returned to critical care nursing and loved being back in the Unit. It was hard work but I really liked the staff and felt respected. However, I was stunned by the lack of PPE (Personal Protective Equipment) and the use of one-time-only disposable masks, gowns and face-shields for entire shifts and sometimes several shifts! Also, no shoe covers! I washed my hands so often, sometimes up to forty times in a shift, that they bled from being so dry and irritated. I am fairly certain that most of you have seen pictures on social media of nurses with marks and deep furrows all over their faces after wearing their masks. These bruises are real and look worse in person than in the pictures. I should know because I am one of those nurses.

I never thought that I would witness in my lifetime a global pandemic like the one we are living through now. Only the so-called Spanish Flu over one hundred years ago can rival the human devastation of COVID-19. More than that, I could never imagine that in this great country of ours that we could not protect those essential workers, environmental services, respiratory therapists, doctors, and nurses with adequate PPE.

At the time of my writing, there have been 206,433 confirmed cases and 5,872 deaths in California. I have been present at fourteen of those deaths. I have also been present when patients have been extubated, survived, and left the hospital for rehabilitation or been discharged straight home. I want my patients to gently leave this earth surrounded by their loved ones. This is usually not what happens. Most have died in Code Blue situations, which are often futile at this point since there are no more treatment options open. On the other hand, I have run into a room so my patient with a DO NOT RESUSCITATE order did not die alone.

I had an RN as a patient who we needed to intubate. I promised her that I would not let her be in pain, that we would take the best possible care of her and urged her to stay strong and fight. She left the hospital six weeks later, discharged to her family’s care. We (nurses, doctors, and respiratory therapists) all stood in the lobby and “clapped her out the door” when her family took her home. I went in the bathroom after she left and cried – tears of joy!

The PPE situation is not getting any better. There is truly a shortage of ICU beds, now more than ever, and there is a nurse staffing issue. Many nurses are working double shifts; they need to stay over because there is no one to replace them and you can’t leave two ventilated patients with multiple life-support IV infusions without a nurse. We are admitting more sick COVID-positive patients than ever.

On one of my days off in early April, I received a call from the Critical Care Director at 8:00 p.m. asking me to come in since an ICU nurse had suddenly become short of breath and developed a fever while at work. Of course, I said yes. As I was driving to the hospital, I suddenly saw flashing lights behind me. I was the only car on the road. After I rolled down my window, a very polite California Highway Patrol officer told me that he clocked me at 105 m.p.h. I was so shocked, all I could say was “NO WAY!”

I told him why I was on the road. When I said that I was a Critical Care RN, he thanked me for my service and called me a hero. I told him that I was not the hero, just doing my duty, and if anyone was a hero, it was him.

The CHP officer, whom I will call Chad, proceeded to tell me that he knew what a difference a good Critical Care RN makes for a patient’s outcome since he had a four-month-old son who was born premature and was in the NICU for ten weeks. Chad said that he and his wife were “terrified” that he would bring the virus home to his son. He asked my advice on what measures he and his wife could take to protect his son and we spoke about that for five minutes or so. I asked him if the CHP was supplying him with disposable gloves and hand sanitizers and he said that he was lucky to get two pairs of gloves to last his shift and no hand sanitizer. I had six pairs of disposable gloves in a plastic bag in my car and two unopened small bottles of Purell, which I insisted he accept.

Besides kindness, what I saw in his eyes was sheer terror that he could possibly harm his son just because he was doing his job. He called me a hero and again I said, “Don’t call me a hero.” I drove the speed limit the rest of the way to the hospital and I also cried part of the way. By the way and needless to say, no ticket.

I remember in March telling nurses and doctors that some of us are going to get this virus and some of us are going to die. So far, at my hospital one physician and twenty-two nurses have contracted the virus and become ill. None have died, but very few have fully recovered.

I never thought that I would find myself on the other side of this, the patient side, until I was diagnosed with COVID-19. I felt like I really didn’t need a test because I knew. I felt the virus inside me. I have spoken with other nurses and physicians who tested positive and they said the same thing – you can feel this virus.

The week before I was diagnosed, I had worked five days and had just finished working three days in a row, all twelveto thirteen-hour shifts. Needless to say, I mainly rested during my well-deserved weekend off. I felt a bit sluggish and did not have much energy, but did not think too much about it until I woke up Monday morning. That changed everything. I was coughing, felt short of breath, nasal drainage, eyes burning, fever of 101.8, and felt like I could not even move, I was so fatigued.

Of course, my doctors and I are absolutely convinced that the virus was transmitted while I was at work. I spent the first week blaming myself, but the truth is that the PPE is just not meant to be re-used, but simply disposed after one-time usage. That nasty SARS-CoV-2 probably worked its way in through my eyes despite my wearing goggles, mask, and a face shield.

Relatively speaking, I feel like the luckiest girl in the room, because my most severe symptoms only lasted ten days, I didn’t need to be hospitalized and my oxygen saturation never dipped below 95%, although I am more a 99% to 100% person. I did lose my senses of smell and taste and I lost my voice for about a week. My voice is almost normal now and my senses of smell and taste are very slowly returning.

If I remember correctly we had two physicians and three registered nurses in our class, so if any of you are reading this…we can talk later.

I contracted this at work but someone contracted it from someone else, maybe someone not wearing a mask who was asymptomatic and transmitted it to someone with multiple risk factors. What I am trying to say is that this virus touches all of us in one way or another. No one is above it and no one can buy their way out of it.

I seriously pray and hope that those who have not been taking this virus seriously by not wearing a mask, by attending gatherings both large and small, and by not physically (socially) distancing will now begin to follow the recommendations set forth by the CDC. Ego has no place here; caring about your fellow man/woman/child and being a decent human being is all that should count these days.

I have been flabbergasted, gobsmacked, call it shocked, driving home from work through neighborhoods to see people not wearing masks. If I can wear a tight N95 mask for up to twelve hours at a time and not eat or drink anything during this time, can’t these people at the very least wear a mask when outside running errands? Believe me, if you don’t like wearing a mask (by the way, none of us do) you won’t like being on a ventilator and restrained so you won’t pull out the very tube that is saving your life.

During these times, wearing a mask is one of the most selfless acts, a true act of patriotism.

My intentions here are not politically motivated. I only wanted to tell the human side of this story. If you could only see what I have seen in the Intensive Care Units you would understand my dismay at our failure to make sufficient efforts to flatten the curve. My patients with COVID-19 ranged in age from thirty-two to eighty-five, and yes, the thirty-two-year-old died in late March.

During the past four weeks a friend would send me a different Bible verse each day since I do believe in the power of prayer. My favorite verse was Matthew 21–22: “Whatever you ask for in prayer you will receive if you have faith.” I have prayed for patients many times at their request or their family’s request during this COVID crisis because they need positivity and support and because I have been asked to do so.

How lucky are we that David thought of this project and spearheaded this campaign to put our stories, lessons and vignettes into a book. David, I insist that you leave these comments regarding your generosity in the book. It is my story after all and you gave me a platform to tell it.

What I want most of all is to be able to see my family and friends, hug them, and travel, especially to my beloved Italy.

What’s next for me? I am on week five of my recovery and doing well.

I plan on returning to work in the ICU. Hopefully, I do have antibodies and my plasma can be used to help the sickest of the COVID-19 patients as well as the red cells and platelets

My parting words to us all: Better to Rest at Home Six Feet Away than Rest in Peace Six Feet Under. That’s my motto now. That, and Don’t Call Me a Hero.