Alison Kamikawa ’13, a registered nurse at NYU Hospital in New York City, is only nine months into her first year as a nurse. Yet, she now finds herself working at the forefront of the COVID-19 crisis in New York City, one of the world’s epicenters of the outbreak.
She spoke to Team Up podcast editor Allen Murabayashi ’90 about her experiences trying to save lives during the midst of this global pandemic. Listen to a podcast of that interview (above).
AM: I’m curious what drove you into nursing in the first place?
AK: I always wanted to help people, and I know that’s a very common answer. I was always interested in bio and health sciences, and I thought nursing was a good culmination of helping people directly and also putting science as part of my career.
AM: You just became a nurse, a registered nurse, nine months ago. I’m wondering in all of the classwork or the clinical work that you did, did you ever discuss the possibility of a global pandemic at all?
AK: No, not at all. It’s enough trying to learn all the new skills and understanding the medications and learning, just getting your workflow, your day-to-day workflow. But now that everything is just changing in the hospital day-by-day, and it’s just something that you can’t predict at all. I didn’t expect all of this to just happen within my first year. Every day, we’re getting emails, updates on practice changes because we don’t have enough masks or gowns and things, and we’re changing practice guidelines. For example, when someone’s in restraints, we are supposed to check their skin breakdown and check their mental status every half an hour. But if someone is COVID positive, we now check it every two hours because we can’t be wasting and using masks and gowns every time to go into that room every half an hour.
AM: NYC is a hotspot, as a lot of people have read in the news and yesterday at a White House briefing, officials have said that the virus, what they’re calling the attack rate, is five times higher than anywhere else in the United States, so one in a thousand people have it. Twenty-eight percent of the tests are coming up positive compared to the national average of eight percent. What is going through your mind as all of this unfolds?
AK: I just find it – I find it so crazy. It all happened so fast. It’s like our unit, we became a cardiac unit, because we designated other units in the hospital as COVID-designated units. We started getting a lot of cardiac patients, but now my unit is just becoming COVID overflow, so half my unit is now COVID patients. Every day you’re seeing more and more COVID patients, because less and less people are actually coming to the hospital for non-COVID reasons. PACU and Periop nurses, because there’s less and less patients that they’re seeing, they’re being floated to my unit because staff is calling out sick, nurses are getting tested COVID-positive. We’re just being short-staffed, and we just need more and more help every day.
AM: And the cases that you’re seeing of COVID patients, is it running the gamut of severity or is it pretty light? What’s the status?
AK: I’m only trained in acute patients, so they’re relatively stable. I’m not in the ICU. The ICU is where you hear a lot of the ventilator patients, and you hear a lot about the shortage of ventilators and how we’re going to need to be making more ventilators. But I don’t see all of that because mine are pretty stable. They’re on nasal cannula, oxygen, so that’s the one that you see the two prongs in your nose, the least invasive form of oxygen a patient can get. We kind of just like slowly titrate down their oxygen while they’re on my unit, and once they’re off oxygen, we’re discharging them. We’re getting them out of the hospital, trying to empty beds. I had a patient that was still having fevers, and fevers 102, 103 on room air, no oxygen, and that patient was discharged the next day because we’re just trying to pump out the patients and get them home, telling them to self-isolate at home because fevers are expected. But in normal circumstances, that’s not stable enough for patients to be discharged.
AM: We’re hearing about constant shortages of PPEs, the personal protective equipment. Can you explain outside of this outbreak, what would be normal for going through PPE during the course of the day and what you’re doing now in the face of the shortages?
AK: All of these masks, all of these gowns, everything, they’re meant to be one-time use, so once you go in the room and you leave, you take it off because you’re interacting with other patients. But since we are so short on any protective equipment right now, we are given one mask that we are expected to use indefinitely, and we’re storing it at work in brown paper bags, because we don’t know when the next shipment of masks will be available for staff. But that’s what is expected of us because of the shortage.
AM: I’m curious what conversations you’re having with your classmates at this point. You guys are about 25 years old. It’s supposed to be the most carefree time of young adulthood, and yet, here we are. So what is the Class of 2013 saying on your chats and your Zooms?
AK: I’ve received a lot of texts. I even received Venmo money from a lot of friends who are just reaching out and are wondering what it’s like in the hospital. But for most of my friends, they’re fortunate enough to be able to work from home, but they are saying that it is boring. They’re just wondering when it’ll end. They want the inside scoop, and I was like, “I don’t know too much more than you do.” I personally would love to travel home. I was hoping to travel home during the summer at least for a week or two. I don’t know when that will be, because we’re still going to receive, so I’m still going to be caring for so many COVID patients, and I don’t know when that will stop.
AM: What do you think the kind of community at large or the community or even your friends can do to sort of support medical professionals like yourself during this time?
AK: Yeah, I mean honestly the easiest thing is just to social distance. I can’t believe that’s an actual term now. But yeah, just to stay at home. I know it gets a little boring, but keep yourself at home, because you don’t know if you’re a carrier and can easily spread it to a parent, a family member or just someone elderly in the community. I’ve had patients that are COVID positive on my unit that are ranging from 30 to 60 that are COVID-positive requiring oxygen. I mean, I can’t speak for the ICU, but at least on the acute floor, there are a lot of young ones with no past medical history.
AM: Are your parents freaked out about you being in New York right now and working as a nurse?
AK: So before it escalated, they were like, ‘Oh yeah, you should come home for Easter,’ because I had Easter weekend off and a whole chunk of days off. Once Governor Ige was saying the city’s shutting down, you have to quarantine and all that, they’re like, ‘Oh, that’s probably not a good idea.’ And when I was telling them about the masks and everything, they’re pretty concerned. They’re telling me to make sure I get enough rest, because I’ve honestly been picking up a lot of overtime shifts, because there’s a lot of overtime opportunities with the lack of staff. I’ve been honestly working quite a bit. My parents are telling me, ‘You should take care of yourself. Rest, treat yourself. Go buy some takeout and delivery from some local restaurant, support the local businesses out there.’ I actually ordered takeout delivery for dinner tonight.
AM: I’m curious, I talked to an ER doctor the other day, and I posed this rather somber question to him, but I’m going to pose it to you as well. When you talk to other nurses and doctors, are you just operating under the assumption that you’re going to get infected at some point?
AK: Yeah, I do. Now that since I’ve worked with COVID patients I am actually a lot more cautious about practicing social distancing, staying at home, keeping that distance between me and other people if I do need to grocery shop or whatever. It just all hits you all at once, and you’re just so unprepared, but you just have to adjust, because you don’t really have an option. It is your job. You do have to grind it out and keep going, knowing the circumstances are there and the possibility of you getting COVID is very real.
AM: What scenario are you fearful of in the next few weeks given that the infected population is doubling every three days in New York?
AK: Oh my goodness, I don’t even know. I’m just honestly wondering how long this will continue for. My unit, at this point it’s half COVID-positive, but I’m pretty sure soon within the next week or two, we’re going to just be a full-on COVID unit. And just the lack of protective equipment honestly is pretty fearful for me, and just being able to be well-protected in this time, and just all the uncertainty around the disease. You want to be well-protected, just because you don’t know how it really is transmitted. There’s not enough data. I’m not as anxious as far as catching COVID, but just the unknown is scary to me.
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