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As the COVID-19 crisis continues to unfold, the medical staff at Mount Sinai Brooklyn is providing regular dispatches about the daily experience fighting the virus. Alex Inkhamheng is an ICU nurse based in Texas who came to New York to volunteer during the COVID crisis. As an Army veteran, Inkhamheng is used to dealing with trauma, but he had never experienced anything quite like this. His dispatch:
This is my first time in New York. The locals here tell me this isn’t New York. And I get it; it’s like a ghost town. Everyone’s walking around with a mask. It’s really weird.
As soon as we got here, we did an orientation, and then the next day, we were supposed to shadow the staff who were already there. But that day only two nurses showed up; all the others were out sick. And it was a 12-bed ICU. Typically, you want to a ratio of one nurse to two patients, and the ratio that day was one to six. So we started saying, “Just start giving us patients.” It was kind of like baptism by fire.
There was one really bad day, April 12. We were having codes back-to-back. We were trying to keep this one patient alive who had been dying all night. Then she was coding. We made it a short code, to not be cruel. And then right afterward, her next-door neighbor coded. Literally, I go from one to another. I run in, and I take over for chest compressions. Nobody knows who anybody is, we’re all wearing masks, we’re all wearing goggles.
Typically in the hospital, they’ll bring in a tripod and put an iPad on it so the family can see the patient. It turns out that right as this patient was FaceTiming them, his heart stopped. So we run into that room, and I accidentally hit the iPad so it fell facing the wall. I had no idea at the time that his family were on there. Meanwhile, we’re coding this patient, I’m doing compressions, giving him meds. Finally they call the code, time of death. I walk back around, I’m smoked, I’m tired, and then I see the iPad and I realize the family’s still on there. There are three or four people on the call. I’m like, Shit, it’s still on. The doctor then sees that too and then he goes over and gives the bad news that their family member had passed. And I just hear them scream. Screaming, wailing over FaceTime. And then I walk out of the room and I have to go back to my other two or three patients.
Looking back, it’s like you have to remind yourself that it really happened. I find a coping mechanism is we try to block out stuff. I’ve been keeping a diary, which kind of helps me — it helps me not forget. Before all this, I was in the Army, in a frontline infantry unit. Some of the strategies that they use in the military to help deal with stress I continue to use. I keep in contact with my wife, and tell her some of the stuff, and try to express kind of like how bad it is. Some of my friends, I tell them what’s really going on. Because in Texas it’s not bad yet like this. I see social media, and it kind of makes me mad because there are people out there who still don’t believe it is how it is in New York.
One thing I miss about my job back home is talking to my patients. All my patients now are COVID patients, so they’re intubated. But I talk to their families on the phone all the time now. They’re always asking, “How’s my mom doing? How’s my dad doing?” I tell them they’re stable right now, I’ve been with them since seven this morning, and I’ll be with them all day. Usually they’ll ask if they are getting better, and it’s tricky. I try to have a little grace when I tell them, but at the same time, as a nurse, you have to be honest too. You don’t want to give them any false hope because then you’re lying.
The first week, there was a patient I was taking care of. I’d talk to his daughter; she called a few times to check on her dad. I’d tell her, “He’s about the same, he’s getting dialysis today, his kidneys are shutting down, we’re keeping him comfortable, he’s sleeping right now.” They’re so grateful. A lot of the families I talked to, they’re so grateful. They tell me “Thank you for everything you do, and God bless you.” It’s just trying to tell the family that they’re not alone, because I think that’s the hardest thing — trying to let them know that they weren’t there alone.
I come back the next week and I check my chart and I see his name and it says deceased. And I just think back on the conversations with his daughter. It sucks.
My contract here is until about June. Honestly, if they start opening things back up, it’s probably not going to stop. I get it: People need to work, people have to make money, and if you don’t have money saved up, you really don’t you don’t have options. They’re talking in the news about all these meat-packing plants that are being forced to stay open. My city, Amarillo, Texas, actually is in the top five right now when it comes to outbreaks. You have all these beef-packing plants, where you have thousands of people all in one place working together, so now they’re having their outbreaks there. So I’m starting to see it back home. And I know Texas at least is opening things back up and I see it on social media, like: Oh, we have to get back to work, the cure can’t be worse than the problem. But they really don’t know. They don’t see what’s going on here. And from just from a medical perspective, when you see people dying back-to-back-to-back, it changes your perspective.
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