Ross Feinman is a registered nurse in LIJ Medical Center’s emergency department. He is also a professional paramedic.
I’ve been an emergency department nurse for more than eight years, including the last four at LIJ (Long Island Jewish) Medical Center. Right now, we are dubbing LIJ as “COVID city” because it is the center of this pandemic.
When I arrive for my shift at 7:30 a.m., the ambulance bay is empty. All patients are inside. It’s quiet . . . for now.
We have a team member screening all patients outside the emergency department. It’s very important to screen them so we don’t mix COVID-positive patients with those who aren’t sick with the virus. We have a responsibility to our patients to keep them safe.
Inside the hospital, the constant calls overhead for medical response are accelerating. We hear them every ten to thirty minutes. Patients are crashing to floors, needing air and breathing tubes. Some of them are no longer with us.
Taking care of COVID-positive patients has been a challenge. We provide chest therapy, an airway clearance technique to drain the lungs. We have also been proning patients, which means turning them to lay on their bellies. This helps them breathe easier and has saved a lot of patients from being intubated.
At LIJ, patient overflow has crept into the emergency department of Cohen Children’s Medical Center. That’s how packed we are. Taking a look back outside at our ambulance bay, there are no more available parking spaces, each filled with a Northwell ambulance and some are from out-of-state, FEMA-activated ambulances. One is from Chicago.
Big thanks to them. We need them.
LIJ Medical Center has a beautiful lobby, like a resort or hotel. But you wouldn’t know it right now. I used to take breaks on one of the calming sides of the lobby, but they are using it for COVID patient overflow.
As much as we want to say we are trained for this, we are not. We are not trained for a pandemic. We are not trained for people quarantining. We are not trained for social distancing. The problem is, we can’t send people home fast enough. And we don’t have space to bring people upstairs.
Regardless of these challenges, everyone—doctors, nurses, environmental workers, and many more—at the hospital has stepped up. The community has stepped up, bringing supplies and food. We are all working together to take care of as many people as possible. While it may seem as if it will get worse before it gets better, I tell myself, every day we are a shift closer to it ending.
Later around 8:30 p.m., my shift is over. I walk to my car after a thirteen-hour day. You can see marks on my face from peeling off my N95 mask.
Nicole Fishman, RN, is a nurse manager at Huntington Hospital.
During the COVID-19 crisis, there’s been an even greater focus on caring for our patients as whole people in light of very limited visitation policies. They sometimes get scared having minimal contact with their friends and families. But my staff and I have been proactively calling family members and giving them updates on their loved one throughout the day. We are also using iPads and tablets to FaceTime and Skype with families, so they can share their love with our patients.
When we are communicating with families through tablets, I think about my own parents and how I would want them to be treated if they were in this situation.
It’s been amazing getting so much support from throughout our hospital. All of the people we’re caring for are either suspected or confirmed COVID-19 patients. So everyone is isolated and requires a higher level of care. We are managing this by working as a team, staying strong, and supporting each other in any way that we can. As expected, we’re taking everything day by day.
Wearing all of this additional gear can make it harder to breathe, which is why we need more frequent breaks. I try to take advantage of any time away, going outside for fresh air and to clear my head.
All of Huntington Hospital’s employees have been so appreciative of the meals that we’ve received from community donations. It’s been very helpful to not have to worry about cooking or preparing food. We can focus on what matters most—our patients.
One thing I’ve been surprised about is that younger patients—people in their forties, fifties, and sixties—are deteriorating faster than I would have anticipated. Some don’t have a past medical history of preexisting conditions.
I’m fortunate to have a very supportive boyfriend who’s at home cooking and taking care of things while I’m out fighting COVID-19. Many of the other nurses on my unit have supportive significant others who have been writing encouraging letters and packing food for us.
When I leave work, I take several precautions in an attempt to protect my boyfriend from this dangerous virus. I change my shoes before I get into the car and shower immediately when I get home. I take all of my clothes off right by the door and throw them straight into the washing machine on a hot water setting. I feel safer being on my unit versus out in the community because we’re all wearing the proper protective gear and the unit is constantly being cleaned.
Elyse Isopo is a nurse practitioner in North Shore University Hospital’s Intensive Care Unit.
Every morning and every night, I take my temperature to make sure I am healthy enough to take care of my patients. The hospital has been on mask mandate for a little over two weeks now. At the hospital, it’s scary, but rewarding at the same time. First and foremost, I want to thank everyone for your concern and help. The cards and food coming in from the community has been great in keeping morale and our spirits up.
The unit I work in is a COVID quarantine unit, the highest acuity and sickest patients we have in the health system. The patients’ average age is in the fifties, but we have people who are in their twenties, thirties, forties, and fifties—much younger than we expected . . .
In the intensive care unit, one of many now throughout the hospital, we are using ventilators to help patients get enough oxygen. Under normal circumstances, not all ICU patients are on a vent. But right now with COVID-19, everyone in the ICU is on a breathing machine. This oxygen is helping them survive.
During the day, nurses come from all over to help us. Our nurse practitioner helps us monitor patients and gives us breaks. Everyone has come together to help. Our community is so important to us here. We just took the breathing tube out of one patient and are celebrating. We are all so excited. It was our second extubation of the day. It’s great work.
Throughout the day, we need to take a deep breath and keep going on, powering through this unique situation. I’m on day five of doing thirteen-hour shifts. I’m tired. But I get to go home soon.
When I do get home, it’s a little emotional. My nine-year-old daughter Eva usually runs and hugs me when I arrive. But we have social distancing now and she has to stay away until I properly decontaminate.
I don’t bring anything into my house and have set up a decontamination station in my backyard. The kids bring the garbage out. We have a whole routine. My decontamination center includes Purell, Lysol wipes, and a garbage can. I make sure I wash my hands and take my scrubs off. I’m happy because I get to see my kids, but it’s a little stressful because I can’t yet hug them until after I shower . . .
Jeffrey Zilberstein, MD, is vice chair of medicine and director of Southside Hospital’s intensive care units.
Working during COVID-19 has been challenging. I think that’s the best way to put it. We keep getting more patients and since so many patients are very sick, they are having longer hospital stays. Given the number of patients we’re seeing with the virus, we have opened the neuro ICU, surgical ICU, and cardiothoracic ICU to care for these patients. Each has a separate staff/team, although we are all working to care for COVID-19 patients together.
Given the large number of very sick patients that we’re caring for, I am inspired by our staff every day and am seeing examples of us being “truly together” (one of our values) on a daily basis. They are willing to help any way they can, often “running into the fire” very willingly. Cardiologists and nephrologists, for instance, are helping me and my team care for our COVID-19 patients. I’m working with them in a capacity that makes the best use of their skills, supports the team, and ultimately helps our patients.
Every day is different for me. There are days when I’m able to see patients and then there are other days that it’s more important for my team that I do more leadership-related tasks to support the staff and operations. Sometimes that feels like making organization out of chaos, but we always manage to do it, and I’m so proud of our team for doing that.
Southside Hospital is committed to making sure that our employees, especially those caring for COVID-19 patients, are taking the necessary time to rest and recharge. I make sure to not bother people on their off time whenever possible. I am also “calling in the cavalry” by obtaining resources from other Northwell locations or from the outside to relieve our staff whenever possible. Overall, our staff is resilient and I know that we will get through this.
When I come home from the hospital, I have stopped our family’s usual practice of having the kids come hug me at the door, which is getting hard for them as time goes on. So we’ll have to figure out how to manage that going forward. To prevent spreading germs to them, I make sure to change and take a shower before I speak to my family. I have also been trying to have playtime with my kids to help mentally keep myself going, although it has been hard to find time with the number of emails and things that need to be addressed after work hours. When I get home I sometimes feel part-human and part-android thanks to all the work emails.
I have been running for a while and meditating, both of which have been beneficial lately. The other day I ran on my treadmill with a monitor that made it look like I was running in Patagonia. That really helps to center me.
Bernard Robinson, EMT-P, is a regional director for Northwell Health’s Center for Emergency Medical Services, overseeing daily operations of one of the largest EMS agencies on the East Coast.
The dramatic miniseries Band of Brothers details the bravery and fear shared among the members of the US Army’s Easy Company, the 506th Regiment of the 101st Airborne Division in World War II. The company faced extraordinary circumstances, which called for extraordinary individuals and teamwork. Each carried another through seemingly insurmountable odds on D-Day and other battlefields.
As an emergency services worker on the front lines of the COVID-19 pandemic, I share the same camaraderie and uncertainties as those heroic men did so many years ago. There’s a sense of pride within my unit. It doesn’t matter who you are or where you came from, you are eager to volunteer, sacrificing yourself for the greater good and helping carry people through the illness.
When COVID’s pace accelerated and overwhelmed New York, anxiety rose among the ranks of our staff, who were frantically dealing with regular calls and 911 calls and transferring patients out of the health system’s hospitals to balance the load. At the height, we moved seventy-five to a hundred patients daily, which isn’t surprising considering Northwell Health has treated more COVID-19 patients than any other health system in the United States. There were a lot of sleepless nights.
Then I became ill—a health scare like I’ve never had before, and I consider myself relatively healthy. Having COVID-19 curbed everything I knew of living, especially breathing. And despite being hospitalized for five days, afraid to sleep at times and now considered “recovered,” I have reentered the battle against this deadly virus.
Why? Because working in emergency services is more than a profession. It’s a calling. If my family—wife Connie and two boys, Elijah (twenty-one) and Christian (nineteen)—is my world, then my CEMS brothers and sisters are my oxygen. Returning to work was never a question in spite of my family’s reservations . . .
I was exposed and unknowingly contracted the virus during a patient transport on Monday, March 23. Back then, I put aside my administrative duties as regional director to assist in the field. We covered overnight shifts to help facilitate transfers. There were a lot of sick patients, all of whom seemed to need to be ventilated.
For me, the coronavirus started as a dry cough. Nervousness immediately settled in, and four days later I tested positive. Literally every known symptom had emerged. The fatigue was the worst. Every two minutes I needed to sit still and catch my breath. COVID-19 was as debilitating as advertised.
Ultimately, I quarantined myself in my basement, away from my family and our typically busy household. I went to the hospital twice. After the first visit, I was diagnosed with pneumonia due to COVID-19 and was released. That night, I was extremely frightened, blowing through seven oxygen tanks just to breathe. I wasn’t sure if I’d make it and refused to sleep.
My wife was nervous. My boys were scared. No one and no family should experience this.
The next day, I was admitted to North Shore University Hospital, where I stayed for five days, participated in a hydroxychloroquine clinical trial, and was treated with prednisone, oxygen, albuterol, and other medications. Breathing was my main issue, but it improved, and I was discharged on Easter morning—a blessing to watch a streaming service at my church before heading back to the basement. It was good to be home and feeling better, which is when I realized I needed to recover as fast as I could and get back to work.
That day came on Tuesday, April 21, just one month after testing positive. It’s been slow progress. Toward the end of each day, my energy level tends to run down—the lingering effects of the virus. I’m immensely proud of the way our department has responded. Our team has protected themselves and helped thousands of people through this crisis, risking exposure during every COVID call.
I’m now mostly performing administrative duties and yearn to be back in the field . . . I’m still in uniform, though, and want to join everyone out there, ready for battle with my Band of Brothers.
Elisa Vicari, LCSW, is a social worker in the Intensive Care Unit at North Shore University Hospital.
As a social worker in the Intensive Care Unit at North Shore University Hospital, I’ve become immune to people passing away. Death is an unfortunate part of the job because we are treating the sickest patients.
COVID-19, though, was quite different for me and my colleagues.
During the patient surge in late March, we were caring for otherwise healthy twenty- and thirty-year-olds who were unaware of their surroundings and had no business being intubated. These are previously independent individuals who have been abruptly put on life support. This is the heartbreak the coronavirus leaves.
Adding to the complexities of this situation, visitation was restricted, and patients in our unit were unable to speak to their families. This didn’t sit well, so I adapted my practice and refocused my efforts to find a solution. A quick Instagram post asking my friends and followers for one iPad donation turned into more than twenty and about eleven thousand dollars in community support—the true power of social media. Their assistance has allowed us to set up every unit within the hospital and other facilities in the area with iPads, which have been critical to helping us connect with families.
Not everyone is comfortable going into patient rooms. It’s a personal choice that must be made, one that I did not struggle with. A social worker’s role is to connect and assist, and the iPads have opened new roads to make important video calls where we could show not just a patient’s condition, but the entire room and care team.
In the ICU, patients are mostly intubated. Finding close connections has been challenging. Instead, we have grown closer to families, FaceTiming with them every other day for status updates, learning nicknames and favorite songs, and hearing about their pets who await them at home. They’ve sent pictures so we can build collages and fill their rooms with love. I feel like I’ve become a part of these families just by holding the screen for them . . .
In some end-of-life circumstances, visitors have been allowed to see their loved ones in their final moments. We’ve been there to help them with PPE, addressing their fears and coping with their situation. Some are able to hold their family member’s hand for the first time in weeks. We are also assisting with funeral arrangements, which are very different than usual with increased wait times. It’s overwhelming, physically taxing, and mentally exhausting. But it’s worth it. I couldn’t imagine being on the other side, watching the terrible images on the news of beds with patients lined up and packed into places nearly on top of each other like wartime scenes. Showing families that our patients are in private rooms and we are helping them has given them tremendous comfort.
When patients fail, I feel it more than I used to because I’ve grown closer to them and their families. Our conversations aren’t just based on medical concerns, but rather on vulnerable situations that I’ve now been welcomed into.
It’s bittersweet. When things go well, they go well. But when they don’t, it’s devastating. At the heart of it, we deliver personalized, patient-centered, and compassionate care, pandemic or no pandemic. COVID-19 may have tested our mettle and capabilities, but we have survived thanks in part to the camaraderie between us and families. We have all met this challenge with innovation, compassion, and integrity. I really admire the people I work with who have stepped up. Teamwork is everything, knowing we will get through this together.
The angel of environmental services: John Baez works in the Environmental Services Department at Staten Island University Hospital.
In environmental services, we go above and beyond to make our patients feel comfortable and keep a clean environment. During COVID-19, we became their loved ones when their families couldn’t be there and helped comfort them in their final moments. I’ve faithfully worked for Staten Island University Hospital for eleven years, and travel three hours each way from my home in Yonkers on public transportation to help care for patients.
I’m not a clinical care provider, but my dedication to patient safety in the Environmental Services (EVS) Department is what I strive for. My coworkers and I are at the top of our field when it comes to bedside manner and being spirited patient professionals. Unfortunately, our team is no stranger to a crisis. We saw the hospital through the evacuation ahead of Hurricane Irene, the aftermath from Superstorm Sandy the following year, and even the Ebola crisis in 2014.
But COVID-19 was something entirely different and something we never faced before. It put the EVS team on the front line to help contain and eliminate the virus, which tested all of our abilities. When the crisis was at its peak, I remember seeing one case after the other. People begging for their life, “I can’t breathe, I can’t breathe.” Before coronavirus, I would always try to befriend and comfort the patients. During the crisis, I showed them love when their loved ones couldn’t be at their bedside.
There was one day that would change me forever. It was a regular day, and then one of our patient care associates (PCAs) told me that this person is going to pass away. I knew the patient. I’d met her days earlier. It was the end of my shift and I was ready to take my first bus home, but I said to myself, “I can’t let this woman pass alone. I’m going to be there for her.”
I walked into the room and leaned over the patient and said, “It’s me, John. If you hear me, squeeze my finger.” She did. I told her, “I want you to go with God. I want you to relax and once you see the light, I want you to go to it. I’m going to hold your hand until you go.”
The PCA cried alongside me. I told the patient I would pray for her. On her third breath, she passed. The doctor came in and checked her vitals, and confirmed what I already knew—she was gone.
I took the two buses and three trains home, replaying the day in my head. It’s always going to be with me, the sadness that she couldn’t have a loved one with her, but I couldn’t let her die alone.
I did what many health-care heroes battling COVID-19 did: make the patients their second family and be their loved one. During this crisis, my mother was begging me to quit because we’re dealing with something that’s new and scary. But we all have to be here. It’s our job. It’s what we signed up for.