My Encounter with COVID-19 - Rachel E. Spector, RN, PhD, CTN-A, FAAN
“It happens to thee, and thee, and thee; but never to me”
I learned this little axiom many years ago as a young nurse; it generated the grit to care for people with countless communicable diseases – polio, tuberculosis, hepatitis, and so forth – without fear. Now, as a much older nurse, I confronted the coronavirus with the same attitude. I carefully followed the CDC mandates – mask, gloves, distancing 6 feet, and hand washing, etc, but felt no fear of ever getting it.
YET
Tuesday, April 28, 2020 – I lost interest in daily events.
Friday, May 1 - added a low grade fever and a dry, non-productive cough to the mix.
That afternoon, a COVID-19 test was administered on the roof of the physicians’ office building parking lot - the “swab”- with results to be available in 3 days.
Saturday, May 2 - spent in a chair – restless, sleeping, and not eating.
Sunday, May 3 - woke up feeling poorly but walked around, did not eat breakfast or lunch and slept most of the day.
Around 6 pm I became confused but remember being placed on a stretcher and being whisked away. I really could not pay too much attention to the event because I had developed a high fever –104 – was coughing, and sleepy. The EMT told me we were going to a Boston Hospital. I faded in and out of consciousness.
When we arrived at the emergency room, I remember being given oxygen via a nasal cannula, and the nurses making me wear both a mask and the cannula together. This made breathing nearly impossible. When privacy existed, I slipped the mask down and took some real breaths.
Suddenly the EMTs arrived and informed me that we were going to another hospital as there were no beds in this one.
Just as I was falling asleep after admission to the second hospital, another set of EMT’s arrived and whisked me off to yet another hospital – (3 different hospitals in 5 hours). When they told me where I was, I wanted to bolt – my good friend had died here and I did not want to stay. No choice, I had to stay. I saw a huge deep hole in front of me. I said, “I ‘m scared.” My friend appeared with her arms raised and pushed me back away from the hole, said “don’t be scared,” and disappeared. The doctor asked, even though they had a copy of my signed DNR and DNI forms, did I want to be on a vent. I remember saying abruptly – “NO.”
The following is the admission summary statement: “On presentation she was confused and inattentive, was satting at 94% on 6 liters of oxygen, with a fever of 102.8 and a blood pressure of 200/90. After defervescing and BP control her mentation improved.”
Monday, May 4, 2 am - I remember being moved into a bed in a COVID-19 recovery unit and hooked up to an intravenous infusion, oxygen, and monitors. Around 3 am I was given my first dose of remdesivir and received this medication every early (3am) morning until 5/11. Remdesivir is an antiviral drug that is given by intravenous infusion in the hospital and is being tested in carefully controlled environments. It has been seen as effective in patients who were newly diagnosed with COVID-19 who were not placed on ventilators. Every day there is more information. A long awaited study was published in the New England Journal of Medicine on 5/22. Essentially it reported that the drug was effective!
I believe the combination of remdesivir, oxygen, Lasix (used to treat the pneumonia), Lovenox (used to prevent blood clots), highly skilled nursing care, and sheer determination brought me to a point where on the 6th day in the hospital I was up and out of bed on my own.
May 4 – May 7 – days 1 - 4: I silently put on my “nurse’s persona” and observed an interesting progression: The first night and day I was often confused and slept. By day 3, I was more alert. From the beginning, I knew that the nurses were with me; first every 2 hours, then 3, then 4 – as they checked my blood pressure, orientation, intake and output, and so forth. They also followed the monitors, watched, and communicated with me via an iPad from the other side of the closed door. I was totally isolated and not allowed visitors. Everyone who entered the room was wrapped up in protective equipment – gown, mask, plastic face shield, and gloves. I missed smiles and sometimes hearing words was difficult.
My appetite gradually returned. I was given a menu that initially made no sense due to my confusion, but by the 4th hospital day I mastered the art of finding outstanding food. My daughter, who flew in from California and my son, who flew in from Nevada, dropped off treasured treats each day.
May 8 – 10, days 5 – 7: Brought an increasing awareness of improvement and freedom. The physical therapist taught me several exercises for getting out of bed and walking. The nurses trusted me to be on my own to go to the bathroom and walk around my room. The cardiac monitor and then the nasal oxygen cannula disappeared.
Monday – May 11, day 8, home! The discharge for the most part was easy, with instructions for strict isolation and other aspects of homecare discussed. My husband was not tested along with me and we did not know if he had had the virus. Therefore, we could not be in the same room, or use the same bathroom and shower for the first few days I was home. My husband had been stranded home alone while I was in the hospital, and he was overjoyed to have noise in our home! He is not a medical person and the information he was given, especially in the early hours, was overwhelming.
Follow up – nursing and physical therapy were arranged with the Visiting Nurses.
The nurses – I cannot think of one negative thing to say. They were phenomenal. Every time they entered the room, they efficiently and quietly did what needed to be accomplished. Not a single nurse left without a reassuring word, asking if I wanted anything, and if I was comfortable.
The other members on the team – physical therapists, dietary, laboratory phlebotomists, physicians, and so forth, were also highly skilled, and kind. The team members for the most part are young, committed, and kind. I feel a profound sense of pride in our nursing profession, our colleagues, and members of the team.
In closing – there is one important thing to be said: Decide NOW if you want CPR, to be placed on a ventilator, etc. If your choice is NO, complete the necessary papers and be sure you know where they are.
This was my confrontation with COVID-19 as well as I can remember. I know that too many people have not survived and feel profound joy that I am still here to tell this story.