Lauren Edmonds ’10, a native New Yorker, is a nurse in the intensive-care unit at NewYork-Presbyterian/Weill Cornell Medical Center.
When you hear hooves, think horses, not zebras. It’s a common phrase among medical professionals. Basically, when diagnosing a patient, start with the most common, most basic, most likely diagnoses — not the exotic disease seen in less than 1 percent of the population. A sneeze is seasonal allergies, a cough is the common cold, a stomachache is the expired food eaten the night before. However, in the time of COVID-19 all the rules have been thrown out the window. It is a zebra.
For nurses, the elusive zebra has transformed from the rare to the omnipresent. COVID-19 is dominating our patient population, our supplies, and our psyche. It has invaded hospitals and overwhelmed the health-care system to such an extent that no cough is benign and no symptom innocuous. It’s difficult to maintain perspective. I remind myself that I work in a hospital where I’m accustomed to treating the worst cases and that the virus is in fact not everywhere and everything. In actuality, there are thousands more people exhibiting symptoms that are too mild to warrant a hospital admission. But it’s difficult to keep your fear in check when you are standing in the middle of a COVID unit as a doctor tries to MacGyver a face shield out of a gown. It’s a struggle not to panic when the patients are younger than what you’ve heard on the news and much closer to your own 31 years. It’s nearly impossible not to get overwhelmed when your colleagues’ PPE-donned faces have been reduced to their eyes — and yet it’s still not enough to mask their concern and worry.
People have every right to be afraid. The unknown is a terrifying thing; it’s uncomfortable and unfamiliar. However, nurses have a very different kind of COVID-19 fear — a fear of the known. COVID-19 is not just a virus that may or may not land you in the hospital, where it may or may not kill you. It’s a series of cascading events with a complicated hospital course. Each step of the hospitalization, from intake to recovery, is a well-known reality to nurses, with nuances that are met with worry about their patients, loved ones, and themselves.
As a nurse, my experience during the time of COVID-19 has been heightened and magnified because of my knowledge and familiarity of the hospital and patients battling the virus. The fear is in the details: the alarming number of droplets released during an intubation, the half-life of the sedatives and paralytics administered to maintain ventilator compliance, the numerous pressure points created when you flip a patient over onto the stomach for hours to improve lung function.
Each fact releases its own flurry of anxieties, which makes it difficult to process the gravity of the situation. Despite all of this, there is a certain level of composure required to be an ICU nurse even in the face of two contagions: COVID-19, and fear of the known and unknown.
PAW reached out to alumni who are on the front lines of the COVID-19 crisis or are affected by it in different ways. Read their essays here. More will appear in our next two issues and online over the next few weeks. Write to us at email@example.com with your own story.