This Is How 10 Travel Nurses React When Asked, "Why Go To The Epicenter of COVID-19?"

When you ask America's most honest profession to show up during a global pandemic...well, we do. Even if that means leaving our homes and loved ones behind to travel to a different state, 

• Where we are essentially entering a “war zone,” - working in dangerous conditions that are most likely unsafe and understaffed.
• Where we may or may not have access to adequate protective equipment.
• Where we are working well over 12 hours per day, usually without a break at all.
• Where we will probably be placed in quarantine for 2 weeks, alone, in a new city and home that is not our own. 

For Nurses Week 2020, we caught up with some of these heroic nurses who traveled to Seattle and New York City to tackle COVID-19. We asked them a simple question - “what is your why?” - their responses were inspirational, powerful and raw. 

Travel Nurses - New York City, NY 

The epicenter of COVID-19 in the U.S. quickly shifted from Seattle to New York City. While New Yorkers were told to stay home, these heroic travel nurses traveled to the Big Apple to join in the fight against COVID-19. 

We asked them “why” they chose to run directly into the epicenter? These were their responses. 

Cam, RN @traumacam

It wasn't an easy decision, but like thousands of nurses across the country I was lured to NYC by the images of 

• Mobile morgues
• Statements by defeated nurses
• A staggering number of ill and dying people growing by the day

Meanwhile, as a per-diem ER and Critical Care Transport nurse, in California, I was begging for shifts. Social distancing and fear kept those who normally used the ER as their primary care away, and we saw those with life-threatening illnesses. One night, in mid-March, during a 12-hour shift, I had seen only six patients and discharged five. At one point, I had no patients for four hours. Mind you, this was no small community hospital, but a rather large level one trauma center. The lack of productivity only made me feel increasingly helpless, watching New York suffer from afar. I had the skills that were so desperately needed, and once I started hearing that nursing students would be graduating early to fill roles in the hospitals, I knew I had to go.

The decision was not completely selfless. I had 

• Bills to pay
• A resume to pad
• Goals I needed to be competitive

The pay per week was more than most nurses saw in a month in California, two months for those in places like the midwest. The lack of PPE, increased patient ratios, and demanding environments, no doubt, warranted the increase in pay. Yet, those who already worked weren't even receiving even half of what was being offered. Still, the opportunity was not one I could walk away from, and so I applied to numerous hospitals around NYC that needed help.

Ivette Palomeque, RN @nurseweehtx

I have always been a person that turns towards people in a time of need. Given this being a global pandemic and the fact that my clinical skillset--ICU/Critical Care is one of the most sought after right now, I felt it was the perfect opportunity for me to be of great service to the cause. 

Jenna LaFace, RN @jennalaface

Back in February, I was on a boat in Antarctica with spotty reception when I learned that the first diagnosed case of COVID19 was in Washington state. Not only in my state but just a few miles away from my home hospital. I remember hoping and praying that we'd get help, that nurses would answer the call and come to the rescue because we are already chronically short-staffed. When I got home, we had a small surge, but it became more apparent that our social distancing measures are working and that NYC needed help. 

My sister lives in NYC, too, and I felt by going, I am somehow by extension helping my sister. The best way to make sense of it is that all of those healthcare workers are somebody's family. That could be me, or you, struggling to take care of these critically ill patients. Everybody stands a better chance when we are all in it together..

Julia Eze, MSN, RN, NP-C  @thenursejulia

The outbreak in NY has been heartbreaking. Despite my initial hesitation, I wanted to help. The census on my home unit was low, so I felt my skills could be better used on the frontline caring for patients alongside fellow nurses. 

Everett M. RN @the_paramurse

I woke up one morning, and I saw a post on Instagram of the FDNY cheering and clapping for the nurses. I knew I had to come. I have a varied clinical background ranging from 

• Prehospital
• ER
• ICU
• Adult
• Peds

I felt I had something I could offer. I talked to my family and started preparing to leave. I've dedicated my whole career to making a difference in the life of another, and I wouldn't have it any other way.

Cassandra "Cassie" Marcelus RN, BSN @theflyrn

PW: How long have you been a nurse, and what's your specialty?

CM: I've worked in so many specialty areas. I started with Critical Care and ER. Did stints in Cancer Care, PACU, Pre-admission testing, GI, Outpatient services, Burn unit, School health, Med- Surg, and Hospice.

PW: Where do you live? 

CM: Atlanta, GA

PW: Why did you decide to go to NY to help with the COVID-19 crisis?

CM: Honestly, I wanted to come to NYC because we were heavily incentivized to do so. I figure if I'm going to be exposed, then I may as well be receiving well- deserved pay for my skill set. 

PW: How long is your contract? How did you find an agency? How did you prepare before being deployed?

CM: I work for Krucial staffing. I heard about the assignment on a Wednesday. It took me almost six hours waiting on the phone, to get through. A background check was done immediately. I was asked to be there on the next day but negotiated for a Friday arrival. I packed 

• Six sets of scrubs
• Nursing shoes
• Toiletries
• Stethoscope
• My juicer, essential oils, computer, chargers, oil diffuser, my NutriBullet, herbs, ginger, turmeric, lemons, and limes. 

PW: Do you have proper PPE? Does your contract stipulate that you have adequate PPE?

CM: Yes, I have PPE. It's readily available in the nursing office when we arrive and available on the floors. My agency had sent multiple emails stating that we are not to take assignments without PPE, and we should contact them immediately. 

PW: Set the scene for us:

1. What is a day like for you?
2. Are you on a COVID-19 unit?
3. What's the nurse: patient ratio?

CM: I'm on the night shift, so I sleep until about 4:30. The bus arrives to transport us to the hospital around 6:05. I head out about 15 minutes early to check the mailroom for packages and to pick up any company-sponsored snacks or grab bags. Once on the bus, we have a 45-minute commute, and I use this time to FaceTime my son, who is away in college at ORU in Tulsa, OK. 

• I work on a MedSurg COVID-19 Unit
• My patient ratio is 1:6

PW: Do you feel supported by your agency, the facility, and your coworkers? Do you feel safe?

CM: I feel very supported by my travel nurse staffing company. Email, texts, and WhatsApp connect me. Staff is always available via phone, being that it's a 24-hour operation. I'm assigned to North Central Bronx. A small 232-bed hospital. The nursing admin staff have been welcoming and engaging. This hospital isn't used to this type of traffic, so it's a major adjustment for them. Change of shift can be arduous. I'm a veteran, so I can rise above it. Younger nurses are struggling in this area. I think because of unrealistic expectations. This is a crisis assignment and not a travel assignment. 

PW: Do you feel prepared? 

CM: I feel more than prepared. If anyone is interested in coming to NYC, come with the mindset to work. Realize that we are visitors, and it's an honor to be here.

S. Nicole Hill MSN, RN @thenursenicci

PW: How long have you been a nurse, and what's your specialty?

SH: I have been a nurse for 17 years. My background is Critical Care and ICU; I currently work as a contract PreOp/PACU nurse in multiple outpatient surgery centers in metro Atlanta.

PW: Where do you live?

SH: Johns Creek, Georgia

PW: Why did you decide to go to NY to help with the COVID-19 crisis?

SH: My initial thoughts were, "It's an opportunity to help other nurses and patients in a crisis, and it gives me a platform to do what I do best and save lives." Also, I have to be honest, compensation played a part in the deciding factor. So I then thought, "I get to do what I do best and finally be compensated for my worth." This is nothing new for us; we're always on the frontlines. We're usually overworked, understaffed, and underpaid.

PW: How long is your contract? How did you find an agency? How did you prepare before being deployed?

SH: It wasn't really a contract. They asked us to complete 14-21 days. Nothing was really in writing. A nurse friend sent me the info via text. Then I also saw it in a Facebook group. I didn't believe it at first, but I called anyway. It was on a Wednesday. I didn't have much time to prepare. 

• They were asking us to leave the same day or the next day, but I told them that I couldn't leave until that Friday.
• I rushed to get things for my home and to get my daughter situated. 
• I also had to buy blue scrubs (as it was a requirement)
• Vitamins
• Some other travel items

PW: Do you have proper PPE? Does your contract stipulate that you have adequate PPE?

SH: They stated over the phone that we would get PPE once we arrived. Again, there is no contract, as much is not in writing. They told me that Rapid Responses are different. Definitely not organized. It was basically me taking a chance. I told myself that if I got there and there wasn't proper PPE, I would book one of these cheap flights and go back home. My assigned hospital had appropriate PPE in the PACU and ICUs.

PW: Set the scene for us:

1. What is a day like for you?
2. Are you on a COVID-19 unit?
3. What's the nurse: patient ratio?

SH: We head downstairs to begin our workday by loading the buses by 6:30 a.m. Then, we go to our assigned hospital. As you get near the hospitals you see the 18 wheelers--that are used as a morgue--as well as the makeshift morgue tent. We unload the bus and report to the administrator's office to sign in as well as clock in (by now, we've signed in three or four places). Then we're given an assignment.

There's no guarantee that you will be in the same department every day. Next, we report to our unit to get our patient assignments and report. It's chaos everywhere, and there is not much organization. I'm usually assigned two or three patients. It's a COVID-19 ICU, so everyone is:

• COVID positive
• Intubated and sedated (some even on paralytic)
• On multiple drips, accuchecks, tube feeding, etc 

All of the patients aren't elderly. Quite a few are in their 40s and 50s. It's like a revolving door. You may or may not see the same patients on the unit the next day. The unit is full of residents, and there is a provider. The providers don't go into the rooms, or at least I didn't see it happen. I did, however, see some residents, go to the glass door of the room and take a picture of the information needed. 

When rounding on patients, they all huddled outside of the room and wrote numerous orders, some that I questioned. Throughout the day, they would write more orders. Then they would constantly come and ask, "have you done this or that." Once I had to tell a resident, "if you want it done now, be my guest." 

My game plan includes getting all of my things together so that I could go into the room every few hours to minimize my exposure. So I would gather medications, tube feeding, lab supplies, ice, etc. Pretty much everything I needed. 

There's also the donning and doffing process. It has to be done before and after each patient, each time you enter and exit the room. It includes:

• An N95 mask
• Surgical mask, goggles
• Face shield mask
• Two surgical caps, gown
• Two pairs of gloves 

The process takes time, and wearing all of that PPE is very hot. The masks are uncomfortable to wear all day and cause my nose to be sore and irritated. It's a lot, very overwhelming! IV pumps are always beeping. The good thing about the IV setup is that the poles and pumps are outside of the room. They added IV extension sets on so that the tubing would reach from outside the room to the patient. This way, you didn't have to go into the room to change or hang a new bag. 

The units are very short-staffed. It gets worse by the day. They had quite a few nurses out that were COVID positive. Some of their staff are just tired. It's hard to take a break, get a drink of water, or even use the bathroom. Patients were dying pretty regularly. When I experienced one of my patients' deaths, it was horrible. They were a full code, but due to reasons, the providers chose not to resuscitate. I wanted so badly to jump in and start compressions or bag them or give Epi, but I couldn't do anything. 

You're talking about feeling helpless. As if that's not bad enough, no family present. They don't get the privilege of spending these last moments with their loved ones. The day goes on. You spend most of the afternoon into the evening playing catch up and waiting on the next shift to arrive. They are even more short-staffed. We then wash up, sanitize the things that need it, and gather our things. Then head to the admin office to clock out and then to our bus. We wait on the bus for all the nurses to arrive, and then back to the hotel. The first thing I do is shower, then order food if I feel like eating. I was drinking a glass of wine just to unwind, but they threatened to send us home if we were caught with alcoholic beverages in our rooms. Before I go to sleep I make sure to talk to my daughter, my parents, and a few other loved ones. The love and words from family and friends and my social media family is what kept me going. They are the best.

Nurse:patient ratio was 1:2-3. Probably the worst thing about it is that a lot of us weren't recent ICU or ICU nurses at all. They had MedSurg nurses in ICU. I, myself, had not worked in ICU in the past six years.

PW: Do you feel supported by your agency, the facility, and your coworkers? Do you feel safe?

SH: That's far stretched! I feel like we are just another body there to get the job done. I believe that that's all the agencies and hospitals want. They don't care who or how, as long as you can jump in. They ask us to be patient, be flexible, and be open, but we don't receive that back in return. As soon as we voice a concern or a complaint about the assignment or not feeling comfortable with the assigned department, we're quickly reminded of what we're here to do, and if we can't do it, there are thousands more waiting to come.

I do however feel supported by most coworkers. As travel nurses, we stick together and support each other. Most staff nurses were nice and appreciated the help. A few of them seemed like they didn't want to be bothered. I felt safe to a certain extent. I wasn't going to place myself in harm's way by not having proper PPE. However, I was a little uneasy about taking ICU patients. I did my best, though.

PW: Do you feel prepared? 

SH: No, I wasn't. Before coming to New York, I didn't realize that it was as bad as it is. Watching the news or reading an article does no justice in describing the magnitude of the effects of COVID-19 on these patients and these facilities.

Travel Nurses - Seattle, WA  

In February 2020, Seattle became the epicenter of COVID-19 in the USA. At that time, Washington State called hundreds of travel nurses to the frontlines. Nurses answered that call, in record time. Following, are three nurses who were the first to join the frontlines in a battle against the novel coronavirus.

Nurse Allen 

Allen came all the way from Little Rock, Alabama to Seattle and his story might make you cry.

He missed his son’s wedding and was one of the first ICU nurses to help at Evergreen Hospital in Kirkland, Washington. Though he was able to watch the wedding from work, on FaceTime, he says that being on the frontlines taught his children the importance of, “making a difference in someone else’s life.”  

Nurse Sarah

Sarah is an experienced travel nurse who was taking a break from the ICU to work in the PACU when the pandemic hit Seattle. As it became clear that the pandemic was not going away, Sarah chose to head back into the ICU to help where her skills were needed most - on the frontlines of COVID-19. 

Sarah says that at the time she thought to herself, “well, if I can’t contribute now then what have I been working for all these years or what did I even train for in school?” she continued, “this was one of the biggest opportunities for nurses to shine so brightly.” 

Nurse Chelsea

Chelsea is a new nurse who recently graduated and will soon be working towards her Doctorate of Nursing Practice (DNP) in Midwifery. In the time between her two degrees, COVID-19 hit Seattle, “it’s the reason I chose to become a nurse and I wanted to make sure that in a time as important as this I was able to serve my community.” Above all else, Chelsea chooses to “serve with love” and says, “if we’re not serving with love, I don’t know how much we’re really helping.” 

Honoring Seattle Travel Nurses 

Nurse.org is based in Seattle and we wanted to do something to honor these three travel nurses who showed up to help when our hometown needed them most. With the help of their staffing agency, NuWest Group, we surprised them over zoom with a gift fit for a healthcare hero. 

• Figs scrubs donated personalized scrubs
• Clove shoes donated each a pair of shoes made with love for healthcare workers 
• Nuwest and Nurse.org gifted them $1000 each

This was their reaction, 

 

Portia Wofford is a nurse, writer, content manager, and nurse consultant. Spending her nursing career creating content and solutions for employers that affected patient outcomes, these days Wofford strives to empower nurses by offering resources for mental wellbeing--while helping healthcare organizations and entrepreneurs create engaging content that connects and converts. Follow her on Instagram and Twitter for her latest.