Denise M. Kresevic, PhD, RN, APN-BC, FGSA, FAAN, reflects on her professional journey and finds that the current pandemic reminds her of a different time in her nursing career. Dr. Kresevic explains that while some things are different, the core of how nurses face each challenge remains the same.
The COVID 19 pandemic has made me think a lot about an earlier time in my career.
In the 1980’s I was a new Clinical Nurse Specialist working at University Hospitals of Cleveland. I was responsible for “clinical education” through teaching, role modelling, and mentoring. One day one of the infectious disease physicians asked me what I knew about “AIDS”. I remember telling him I had read about it, but didn’t know much. Well he responded I need you to learn lots quickly and teach others. Learn, I did, quickly, calling hospitals and nurses in California to help me understand the care of these patients so I could teach others. Those nurses were trailblazers, a great source of support and knowledge. I taught what seemed like a million classes, wrote policies, and helped care for patients.
The COVID crisis is in some ways similar, but in many ways different. I remember hearing about this coronavirus in China in December of 2019, again from my infectious disease colleagues. At that time, they were comparing it to other infections such as MERS and SARS. I don’t remember feeling afraid. Now I was still a Clinical Nurse Specialist at UH but I was also an educator and Nurse Practitioner at the Veteran’s Affairs (VA) caring for older veterans. Then the TV reports started to talk about the “crisis” in Italy. Seeing refrigeration trucks with dead bodies every night on TV, I started to pay more attention. In March, the nightly news began to feature the number of infections and deaths in New York. Ohio started to close businesses. I remember hearing the virus had come to Ohio. I felt frightened. Many of my friends and colleagues began to retire. I just didn’t feel ready to “throw in the towel,” but I was worried. I was not the single young carefree nurse I had been during the AIDS pandemic. I was a mother and I was a boomer. I remember telling my son that he might need to move out of the house. We decided to live in separate parts of the house. Again, I starting reaching out to my colleagues on the East Coast, only this time they had little information to give. Each day there were conflicting reports--masks or no masks, only dangerous for older people/dangerous for all. The numbers have continued to climb.
Each morning as I got dressed I worried about catching the virus and bringing it home. Most of my VA patient visits were now by phone. Very few people came to the office; they were working from home. On days I went to UH there was lots of planning going on. I was convinced early that the virus might be airborne, so I tried to convince all nurses that masks were important. Driving to work, I thought about the possibility of getting sick. However, when I arrived at work these thoughts seemed so far away.
I remember walking down the hall and hearing a woman sobbing. When I went in her room she said ”I am so weak I can’t pull the covers up or hold the phone.” She needed a nurse and that is who I was and still am. She was recovering from the virus having left the ICU. She was what we now call the” long haulers,” those who are suffering for months after the infection with “brain fog”, nightmares, PTSD, and incredible fatigue and weakness. I have been moved by the diverse symptom of this virus. Some patients have none or a few days of “cold” like symptoms. Other patients have severe confusion, delirium, profound weakness, and cognitive deficits that have persisted.
What is similar about COVID is that nurses have been right there on the front lines--new nurses, old nurses, ICU nurses, floor nurses, emergency room nurses, home care nurses. They are in patient rooms holding patients hands when families can’t visit, talking with very anxious families who can’t visit, making things “better,” and doing as Dorothea Orem recommended--whatever the patients need and cannot do for themselves.
Again, I remember why I became a nurse and I am again very proud to be a nurse.