‘We know it’s coming’: A local ER nurse shares her workday, worries over COVID-19

"Nurses will always go to work and we'll always take care of patients."

St. Elizabeth's Medical Center in Brighton.
St. Elizabeth's Medical Center in Brighton. –Pat Greenhouse / The Boston Globe

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This story was told by Ellen MacInnis, who is on the board of directors for the Massachusetts Nurses Association and works as an emergency room nurse at St. Elizabeth’s Medical Center in Brighton, and has been transcribed and edited from a conversation with Kristi Palma.

My name is Ellen MacInnis and I’m a staff nurse in the emergency department at St. Elizabeth’s Medical Center in Brighton. I’ve been in the ER for 20 years or so. I work 36 hours a week, three 12-hour night shifts.

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This is the most significant challenge that we’ve had, I think, in healthcare — certainly in my lifetime. It’s something that we think about almost constantly while we’re at work. We think about the challenges involved with giving the best possible care to our patients in view of shortages of equipment. At St. Elizabeth’s, we’ve had most of the supplies we need. The last time I worked, I didn’t have an N95 mask but, fortunately, I had saved one from a previous shift.

It’s been a challenge identifying who’s at risk. I took care of a patient recently whose only complaint was some flank and abdominal pain. She was not febrile. She had none of the risks for COVID-19. She was a relatively young person. I spent hours with her. And then a day later a radiologist made an incidental finding of bilateral pulmonary opacities, which are the hallmark of COVID-19 infection. She’s since been tested. The last time I was at work, the results weren’t back yet. But that was a little bit frightening. I thought that I would know when I was at risk, and now I know I don’t know. I don’t think anybody has a good handle just yet on all of the indicators for who is COVID-19 positive. At this point, we just have to assume that everybody is COVID-19 positive.

Getting ready to take care of a patient who is a potential COVID-19 patient or a diagnosed COVID-19 patient requires a lot of resources and a lot of time. We know from the Ebola outbreak that we’re most likely to contaminate ourselves with the offending organism when we’re removing, or what’s called ‘doffing,’ our protective equipment — that is, our gown, our gloves, and then our face shield and our mask. That’s the highest risk of exposure at that time. Now, if I’m donning and doffing for every single patient, I’m using lots of PPE and we now know that there’s a finite supply of that. And also, it takes a long time to do it all properly. I’m concerned that when the volume increases, I won’t be able to take the time that I need to take the best care of my patients that I can. And to keep myself safe.

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I think, for the most part, patients have been very appreciative and understanding. One of the things that’s really troubling us is that we have so many walking well — people who aren’t sick but they want to come to the hospital and be tested just to be on the safe side. It is a tremendous waste of resources. Don’t come to the hospital to be tested. You are exposing yourself to people, you are exposing yourself to a place where there is an absolute incidence of COVID-19. And you’re using up precious resources. I’m having to use PPE two times to take care of a patient who is coming in just to be on the safe side.

I’m also concerned for the environmental services people. They are working like dogs to keep everything as clean as possible. They work nonstop. It can take a half hour, forty-five minutes to thoroughly clean a COVID-19 room.

Originally, we didn’t have scrubs, we were wearing our own scrubs. One day, I actually brought a bed sheet to work with me. When I left work, I put the bed sheet over the seat of my car, I drove home, and when I got out of my car, I cleaned everything that I could, I walked in through my garage, and I threw everything into the washer. And I left my shoes. And when I was going to work that night, I put on everything fresh and then I sat down on my front steps to put on my shoes. I didn’t even want them in the house. Then for a couple of days we had scrubs. Then we ran out of scrubs. So I’m wearing my own scrubs to work tonight, so I’ll probably do the same thing.

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We used to be able to go out and get food or order food in. And some places just won’t deliver right now. And I understand that. And a lot of restaurants are just closed. So that’s a bit of a challenge. So I’m sort of scrambling around and bringing food in with me because 12 hours is a long shift. We’re very grateful to the restaurants that are still open and delivering. We’ve had nurses whose families are sending in buckets of snacks and stuff like that to keep us going through the shift and that’s really nice.

The toughest part of this right now is, we know what’s coming. We watched what happened in Washington, we are watching what’s happening in New York and we know what’s coming. We call it pre-traumatic stress syndrome. It’s like waiting for the other shoe to drop. We know it’s coming. We know that we’ll look back on this in two weeks, we’ll look back on today and say, ‘Those were the good old days.’ We know it’s going to get very tough. Nurses will always go to work and we’ll always take care of patients. We don’t know how to not do this.

The saddest thing for me — I’m trying not to cry — is I can’t see my kids. I have two adult daughters and two grandsons and I can’t see them. I’m not venturing out to the stores any more than I absolutely have to. My younger daughter, when supplies start to run low, she said she will go and get supplies and drop them off to me. But I won’t get to see her.


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