What She’s Seeing A couple of my germaphobe patients became super calm after the virus hit. They were like, “It’s my time to shine!” It was like a victory lap. I’ve had other patients hoarding their medicine the way other people hoard toilet paper. A bunch of people asked if they could get a three-month supply because they were worried their pharmacy was closing. I had to toe the line. Nobody needs to hoard their medicine. Scarcity triggers poverty mind. How She’s Pivoted Since the Pandemic Broke We’re all traumatized. Everyone is afraid of dying, but we don’t usually talk about it. It’s good we’re talking about death. But the doctors on the front lines will need time to process. It’s very tough for someone who is used to winning. I think there will be PTSD (post-traumatic stress disorder) for healthcare workers. Things She Never Expected to See This is the time of year when some of my patients start to taper off their medicine. But now those patients are like, “Nope!” None of my patients want to taper. In addition to all the trauma going on, no one knows when this will end, and that is a huge issue in psychiatry. We can’t give any real reassurance. So, I’ve been talking to my patients about adapting and resilience and the Buddhist concept of open hand and not grasping. This idea that you’re better off floating when the ground is shifting. RELATED: Coronavirus Alert: Global Cases Top 3 Million, Signs of Outbreak Slowing What He’s Seeing At the assisted living facility, you have regular clients who can do the social distancing and stay in their rooms, and then you have the memory care unit. That’s tough, because they’re not able to understand. You find them in each other’s rooms or sharing food or utensils, and it’s the unfortunate perfect storm for infection to pass. A patient has a high spiking temperature and a little shortness of breath, and then they’ve wandered and you find them in another person’s bed. It’s a huge effort to try to manage that. How He’s Pivoted Since the Pandemic Broke I’ve come across so many people who belong in the hospital, not home — but they’re afraid to go because they don’t want to be exposed to the COVID-19 virus. Because of that, a lot of patients prefer to pass away at home. Things He Never Expected to See I’ve never had this much death and despair around me — not in my 20-year career. It’s not about me and my emotion, it’s about the loved ones who are dealing with these challenges. To cope, I’ve been doing a lot of meditation and I exercise six days a week. And I focus on my purpose: to impact lives. If I can do that each and every day, then it’s complete. We’re all going to be patients one day. What She’s Seeing I became very sick with COVID-19 early on. Luckily, I didn’t have to be admitted to the hospital, but I still have residual shortness of breath and fatigue. At this point I’m not worried about being contagious; I wear a mask and wash my hands. A number of us got sick at first. Now we are focusing on being on site and providing care to COVID-19 and non-COVID-19 patients and providing staff support. The pandemic will end, and our work will continue. Everyone is going to have so much grief to process. How She’s Pivoted Since the Pandemic Broke Normally I’d be in the hospital room with a family. But now I’m doing a lot over the phone because families can’t visit the hospital. The other day I was on the phone with a patient’s daughter and son outside, and I was able to say prayers for her and for them. I asked them what would they want me to pray for? They talked about their mom’s love of the woods and nature, and I was able to give thanks for her and her life. Things She Never Expected to See I’m seeing a lot of death. When I’m moved to tears, I let the tears come. The grief is so hard. How do you cultivate resilience? We are really stretching ourselves trying to figure that out. But we also laugh. I was with a chaplain recently and we were in stitches laughing about the chicken Caesar salad sandwich we were eating. If there’s anything silly or funny right now, we will laugh. We’ll put on music in the office and jump up and down. We had Pink on the other day. RELATED: The Telemedicine Tipping Point Is Here, and Laws Have Changed to Make It Easier to Access What She’s Hearing I get maybe 40 calls a day from nurses who are traumatized and need someone to talk to. It doesn’t stop. I talk to my family. Thank god nurses are so good about being there for each other. Before I do a shift in this hospital, I feel a pressure in my chest. It’s so scary. I feel very haunted and sad. It’s hard not to be depressed and anxious. We have our families to think about. I live with my dad, who’s almost 93, and my husband. I have four kids. How She’s Pivoted Since the Pandemic Broke I’m so passionate about getting nurses the resources they need. They don’t have enough PPE. It’s more like soldiers given guns, but there’s no ammunition in the guns. It’s war out there. My colleagues have gotten sick and ended up in the hospital. I’ve lost friends to it. I’ll have conversations with an administrator at one of the hospitals in Boston or in western Massachusetts — where they’re not protecting the nurses and patients while they should be — and it’s so frustrating. I can’t sit quietly and watch such damage. Things She Never Expected to See We are really worried about the mental health and welfare and the stress response. We are trying to set up hotlines that our nurses can call in to if they feel they need someone to talk to. The last six shifts I worked, I cried all the way home. Unless you see it, you won’t believe how fast people get sick and how little time you have to save them. It’s like watching someone suffocate and there’s nothing you can do. And they can’t have their families there, so nurses are using their own phones so patients can talk to their own families. It’s so sad. I really hope I never see anything again like this in my career. RELATED: Coronavirus Glossary: Key Terms About the Pandemic Explained What He’s Seeing Most of the people who come in are low income — a lot of undocumented immigrants. That’s our population. They live on top of each other at home. We tell them to quarantine, but if you’re from El Salvador you’re living with nine other people. How He’s Pivoted Since the Pandemic Broke I had to use someone else’s face shield who was going off a shift, because we didn’t have enough protection gear. You have to sign out the N95 face mask like you have to sign out morphine, because they don’t have a lot to go around. Usually you never use an N95 unless you have a patient who has suspected TB (tuberculosis) or flu symptoms. You would treat the patient and the mask would immediately get thrown away. You shouldn’t be using it for 12 hours in a row, but I do. Things He Never Expected to See Our hospital has a morgue in it, so normally somebody from the morgue will transport someone to the funeral home. That was two-and-a-half months ago, in the early days. When somebody expires, we wrap them like we normally would. But then we have transporters who take them to the refrigerated truck, because there’s no more room in the morgue. The funeral homes are overwhelmed as well. I went to a funeral two weeks ago for someone who died in a car accident, not COVID-19. I spoke to the funeral director and he said he gowns up with anyone who is a suspected COVID-19 death. They don’t know what can be transferred post-mortem. RELATED: Expert Tips on the Coronavirus Crisis: Be Prepared, Don’t Panic What She’s Seeing A lot of death. On a normal day, you’d see a patient and say, “Let’s get you to the hospital.” Now we recommend urgent care and to avoid the hospital at all costs. My first COVID-19 call was a 35-year-old who was having trouble breathing. He ended up on a vent. Last night I had someone in cardiac arrest because of COVID-19. He was in his mid-eighties. He declined really quickly. How She’s Pivoted Since the Pandemic Broke I came into this field to help people. But within that first two weeks I was definitely crying — that gasping for air, dry heave crying — because it’s so upsetting. We all talk to each other. As horrible as it sounds, you have to make jokes. You have to. Things She Never Expected to See In mid-March we were insane with calls. Every call was a pandemic call. One day we did five calls in four hours. Right now, my department is running 24/7 duty crews. I’m averaging anywhere from 50 to 90 hours a week. But when you see someone who’s having trouble breathing and they’re so grateful to see you because they know you’re going to be able to help them — it’s such a good feeling. 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