Robby Klein
Kristin Nguyen has worked in the ICU at Vanderbilt Medical Center for nine years and says no two days—or in her case, nights (she works from 7 p.m. to 7 a.m.)—were ever alike. But she couldn’t have imagined how different things were about to become.
On March 12 VMUC admitted their first COVID patient and opened their COVID-only ICU on March 23. Nguyen was reassigned to that ward. We asked her to share how much her job—and her life—have changed in her own words.
What does a typical day at work look like for you now?
My daily routine has changed a lot since COVID-19. I now work in hospital-issued scrubs, a scrub cap, and (of course) a mask at all times. I wear full PPE when in a patient’s room: gown, gloves, and PAPR (a powered air-purified respirator on a belt that is attached to a hood by a hose). I have been an ICU nurse for nine years and COVID ICU patients are the sickest patients I have ever cared for. They stay critically ill for weeks and often require multiple pieces of medical equipment to sustain their life. These patients were not allowed any in-person visitation for the first several months because we were still trying to understand the transmission of this virus. We have started allowing for very limited “through the glass” visitation for a couple hours each day, but it is still hard for families to not be able to be at the bedside with their loved ones. Bedside nurses become everything for these patients. On top of routine nursing care, we are their sole source of comfort and human interaction. We become attached to these patients that we care for in every way for weeks. This only makes it harder when they don’t survive. Many of them have been my age or younger. It is emotionally demanding and draining on everyone. When I get home, I change in the garage and often shower before going to bed. Gone are the days of coming home and collapsing directly into bed. There is now a system of cleaning to protect myself and my family.
Can you share any stories from your experiences with COVID patients?
The first COVID patient we ever intubated at Vanderbilt walked out of the hospital and is doing wonderfully back at home. We always say his name with gusto (Bill!) and remember that he hated puns but loved cracking jokes. We smile when we talk about some of the patients that stayed on our unit for months, were so close to death so many times, but eventually left the ICU alive. We mourn for those who leave the ICU after months of critical illness and are not able to return to their normal lives. Many patients will never be as functional as they were before battling COVID. What most frontline workers want people to understand is that this virus is vicious. This virus does not discriminate. This virus is brutal. We still don’t know the long-term effects that COVID will have on people (like heart issues, kidney issues, neurological issues, etc). Most of our “success stories” do not feel like true successes because these patients will likely need specialized care for months and, possibly, for the rest of their lives.
Who inspires you?
My coworkers and my husband. While this pandemic has seemed to bring out the worst in society, it has brought out the best in my coworkers. The nurses, respiratory therapists, nurse practitioners, and doctors that I work with never cease to amaze me. Their adaptability and resiliency is impressive. They will pick themselves up, even after a death, and move on to care for the next patient with skill and compassion. My husband has been my rock. He can tell when I need to talk and when I need peace and quiet. He lets me vent when I need to vent. He understands those nights that I just want to curl up on the couch and watch Netflix for hours. He knows when we need to order comfort food (and he knows what my comfort food is). He understands that I find grocery stores uncomfortable now (because of the number of people and the refusal of some to wear masks) so he does most of the grocery shopping. He has stepped up in so many little ways that I have lost count over the last seven or eight months.
What have you learned about yourself since March?
I have learned that I am stronger than I thought. This past year has been challenging on so many levels, but I feel I have stepped forward and faced the uncertainty and new challenges head on. I have worked extra shifts to make sure the COVID ICU is covered. I have volunteered to pick up shifts in the COVID ICU for other nurses who may have high-risk family at home and don’t want to risk exposure. I have also learned that I have spent most of my life putting things off until later. Seeing what I have seen this year, I have begun to drink the good wine and not save it for a special occasion. I am starting to plan vacations to check things off my “bucket list.” But not until it is truly safe to travel.
What’s been the hardest part about this time?
The hardest part at first was fear and uncertainty. In the beginning we didn’t fully understand transmission of COVID. There was a lot of fear of taking the virus home to our families. That fear of contracting the virus is still there, but I have had a few negative swabs and negative antibody tests, so it seems our PPE is doing its job and I find that reassuring. The hardest part now is watching and hearing the drama play out on social media and in the news. Our response to COVID has become very politicized and polarizing. It feels as though health care workers went from being heroes in the beginning to feeling like villains now for encouraging masks and social distancing. I have been called a communist and a sheep (among other things) for encouraging masks in public and advocating for the flu vaccine and a COVID vaccine when it is safe and available. It’s very frustrating when all we want to do is protect people from illness. But the hardest part of all is seeing what this virus does to people who contract it and are sick enough to be in the ICU. It attacks the body in many different ways. Patients stay critically ill and medically unstable for weeks. Calling families to warn them that their loved one may not make it through the night is gut wrenching and we’ve had to do it countless times since March. If everyone could just see what we see every day in the COVID ICU, I am certain one hundred percent of people would be wearing a mask and socially distancing without complaint.