On the Other Side of the Rails
COVID-19: When It Hit Me, It Really Hit Home
Holly Watson, RN, MSN, TNS
The Morning Routine
Not long ago, my morning routine started with grabbing a cup of coffee and logging onto my computer. It was quick and effortless. I had coworkers and employees in my office regularly for casual conversations, and I followed the recommendations for social distancing and masking. The days spent planning for an influx of COVID patients were long and busy. Trying to get our emergency department fully prepared for something we knew so little about was tough, and I tried to fill the gaps of what I didn't have the answers to by just being present and available for all, answering questions from our staff and helping as much as I could.
That was before I contracted COVID-19.
My morning routine still includes coffee—let's be real, I work in the emergency department—but it now also includes wiping down my desk, mouse, keyboard, door handles, and cell phone with sanitizer before even logging onto my computer. I'm even more vigilant about using hand sanitizer, washing my hands, wearing a mask, and keeping an appropriate distance when possible. I wear a mask from the minute I leave my car until I return to it in the evening. I limit the length of visits in my office and scrub surfaces afterward.
Younger People Get COVID-19 Too
I'm 37 and healthy. I washed my hands until they were raw and wore the appropriate personal protective equipment (PPE) at work and in public. I followed all the rules and I still got the virus. I don't know how or where.
That's the scariest part. There's still so much we don't know about COVID-19.
But here's what I do know: Take this thing seriously.
When COVID-19 Arrived in More Ways Than One
Our community's first case came through the emergency department. I remember clearly thinking "Here we go; it's really happening and it's what we've been preparing for." I felt oddly calm. I worked my shift and went home. I was tired. I had been putting in longer hours helping all of the staff understand rapidly changing guidance and remaining visible on each shift. Like many of us, I was in overdrive and had been for some time.
On Friday, March 27, 2020, we were starting to see community spread, though the number of confirmed cases remained very low. I got home from work late and was exhausted. I ate dinner, watched some TV, and fell asleep only to be awakened by horrible gastrointestinal upset. It was like nothing I had ever experienced. It came out of nowhere and just slammed me, lasting for a few hours. I texted one of my good friends, who is also an emergency nurse, because my thoughts went to, "Haven't they said diarrhea could be a sign of COVID...?" She was equally as concerned as I was, but there's nothing you can do besides wait to see what happens next. I finally fell asleep and woke up a couple hours later with terrible chills and a fever of 103 oF (39.4 oC). I knew the chances were very good that it could be COVID-19. I had been reading everything about the symptoms to ensure my staff were informed, and I was looking like a textbook case. In the morning, I called our employee hotline, and they told me what I was dreading: "You need to go to our employee testing site to have a swab done."
Testing and Results
The swab really hurt. It's nothing like I had told countless patients over the years. "Oh, it's no big deal, it's quick, easy, but a little uncomfortable." I was wrong. It really hurt! I left with tears running down my cheeks, feeling miserable, and I was getting really scared as reality continued to set in. The wait for results felt like forever; the next day our chief quality officer called me personally to tell me I was positive.
The Panic and My New Reality
Like all other emergency nurses, I knew too much about the worst things that happen to COVID-19 patients. I jumped to the worst conclusions, as I'm sure we all do when we suddenly become the patient. My mind immediately thought about the cases of acute respiratory distress syndrome (ARDS) that were happening in young, healthy people. People like me. I also thought about patients who were in an intensive care unit on a ventilator and prone for hours, with their medical team desperately trying anything to get some lung function back again. I was so scared I was going to be one of those stories, as I struggled to breathe.
An Explosion of Questions
Questions whirled in my head. Whom had I seen recently? Whom else did I expose? Where did I get it? What did I do wrong? I had this overwhelming sense of embarrassment, and I was ashamed that in some way I had messed up. I also kept thinking, "Who's going to take care of our team?" I had been so careful. As far as I knew, I did everything right to prevent exposure, but here I was. I felt so vulnerable. With COVID-19 being so new, I recognized that there was so much we still didn't know about the virus.
COVID-19 Hit Me Hard
For 9 days, I had a fever that would only break for a short time, then it was time to take acetaminophen again. I felt very stuffy and used an inhaler for some relief. I had no appetite and no interest in drinking any kind of water or juice. On day 5, I began having chest tightness and feeling like I couldn't take a full deep breath; it was like I had a thick band around my chest that just kept getting tighter. I didn't want to take a deep breath because it hurt and took so much effort, but I also knew I had to. I knew that deep full breaths could be the thing keeping me from getting pneumonia and ending up in the worst-case scenario. I really started to worry during days 5 through 7. Just getting up to go to the bathroom and getting back into bed took everything I had in me. I asked my boyfriend to get a pulse oximeter if he could find one. He did, and my suspicions were right. Walking less than 20 feet into the bathroom and back to bed, my heart rate was in the 150s, and my oxygen saturation was 90%. I was really sick. I'm still not sure if knowing the pulse oximeter readings helped me to feel better or if it made me worry more. On top of all this, I lost all sense of taste and smell, which finally came back about 2 months after being sick.
As an emergency nurse, you see and take care of it all. You don't really fear getting sick because you've already been exposed to everything. But this was different. It's funny how we don't listen to our own advice. If a patient were telling me the severity of symptoms I was having, I would have told them to go get checked out. I knew what I needed to do, but frankly, I didn't want to do it. I simply did not have the energy and did not want to expose anyone, especially not my own ED staff. I was terribly ill, and yet, I didn't want to burden my own team with taking care of me.
I had daily monitoring by public health and the employee hotline. An emergency doctor and colleague assessed me virtually, guided me through the symptoms I was having, gave suggestions for things I could try, and asked for updates. I forced myself to breathe slowly and deeply a few times a day when I had strength because I knew that was best for my recovery.
Groundhog Day in April?
It really felt like Groundhog Day—living the same day over and over with no end in sight. I remained isolated in my bedroom for 11 days. I did not see anyone, including my dogs. My boyfriend would leave PowerAde and snacks outside the bedroom door in hopes that I might actually eat or drink something. My family, coworkers, friends, and even strangers reached out with cards and care packages. One of the best things that happened was my boyfriend setting up a TV in our bedroom, working his magic so I could watch countless hours of "Friends." It was very sweet, and every time a new card or care package showed up, it was the best feeling knowing my friends and family were cheering me on from outside that room I was stuck in.
Re-emerging into the World
Finally, on April 4, 9 days later, my fever broke. Seventy-two fever- and acetaminophen-free hours later, I spent my first day outside on my porch, wearing a mask, staying 6 feet away from my boyfriend and dogs.
A month later, I returned to work half-time with continued monitoring and safeguards in place. Now, 3 weeks later, I still struggle with shortness of breath and reduced energy. I know I still can't fully relax.
Questions still fill my head. Can I get it again? What else can I do to keep safe?
My new normal includes an almost hour-long ritual cleansing before I ever enter my home. I keep a bag in my garage with my work clothes and shoes. I wash my hands at a special station, and I shower in the basement before I greet my family. I think it will be a long time before we can return to the way things were, and this new normal will be around for the long haul. However, as I settle back into a routine and feel better every day, I am hopeful that we are one day closer to being back to normal—and I know I am lucky. I am back to work, something for which I am incredibly grateful. I feel fortunate to have an idea of what our patients are experiencing and feeling, and I help explain the experience to staff to make it something to which they can more easily relate. I hope that I am able to create a positive outcome from a scary situation.
Holly Watson, MSN, RN, TNS, CEN
Holly Watson is Director of Emergency Services at Carle Foundation Hospital. Holly’s nursing career began in the Emergency Department at Barnes Jewish Hospital in June 2006. She worked in this department as a staff and charge RN for seven years. She then moved into leadership and worked as an Assistant Nurse Manager for two years and the Clinical Nurse Manager for four years. She completed her MSN in Nursing Leadership at Webster University in Saint Louis, MO. She also holds her Trauma Nurse Specialist certification. This piece is a personal story of her experiences while ill with Covid-19.
How to contribute
We encourage submissions from any reader who has been touched by the healthcare system. Some contributors may be involved directly in patient care and might want to share the impact a patient, family, or colleague had on them. Others may want to write about life “on the other side of the rails” …those moments when the caregiver becomes the patient…or maybe sees healthcare from the vantage point of a family member. Inquiries can be sent to [email protected]
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