Treating Patients Like Family

Deirdre Rogers at HSS went from working in the post anesthesia unit to a COVID-19 ICU

30 Apr 2020 | 02:55

When she’s done working a twelve-hour shift caring for ventilated COVID-19 patients at the Hospital for Special Surgery, RN Deirdre Rogers changes into a fresh pair scrubs before leaving the building, and carpools home to her apartment. When she gets in the door, she changes out of the clean scrubs, and gets straight into the shower before doing anything else. Afterwards, she has about an hour to hang out with her fiancé, have dinner, or watch some TV before it’s time to go to bed and start all over again the next day.

“I think I’m doing okay, but who knows,” says Rogers, a Johns Hopkins graduate who’s been working as an RN for over four years now. “I think I feel as if I haven’t really had time to really process my emotions. When I come home — I know the right thing to do is talk about it and deal with your emotions, but you’ve had such a long, 12-and-a-half, 13 hour shift and you have to go back to work in less than 12 hours — it’s hard to kind of process all of your emotions. I’m sure once this is all truly over and we’re starting to go back to elective surgery I’ll start to really think about what has happened these past couple weeks.”

A Major Shift

Her routine and work day are much different now than they were pre-pandemic. Prior to the COVID-19 outbreak, Rogers was working on the Hospital for Special Surgery’s PACU, post anesthesia care unit, which used to see about 85 patients daily, recovering from a variety of the orthopedic surgeries HSS is known for.

“Some patients would go home the same day, some patients would have to stay in the recovery room for pain management, cardiac observation, medical observation,” explains Rogers. “Most of the time, because it is an elective surgery, you’re working with patients who don’t have a lot of comorbidities.”

That all changed a month ago.

The Hospital for Special Surgery proactively suspended all nonessential surgeries on March 17 to make bed capacity, supplies and staff available to help neighboring hospitals. As the strain on New York’s health care system grew, HSS enacted a surge plan to treat overflow patients from NewYork-Presbyterian, converting ORs into ICUs and training nurses while on the job to provide care to COVID patients.

"Life and Death Scenarios"

The hospital started taking on overflow from NewYork-Presbyterian on April 1. As of April 28, HSS has taken in 260 patients, with over 80 being COVID-19 positive.

Rogers is now treating patients on the 9th floor, which had been converted from operating rooms to ICUs for COVID-19 patients on ventilators. She estimates she’s had about 20 thus far.

“To go from dealing with a relatively healthy 50-year-old male waking up from a total knee replacement — to go from that to really sick, really a lot of comorbidity patients that are dealing with life and death scenarios was pretty extreme,” says Rogers. “But we had a lot of team members to make that transition really easy ... it was really a huge shift as far as what our day-to-day tasks were, to working as a team with all of these new roles. It’s been amazing so far, the teamwork and everything I’ve witnessed among all of the different providers.”

Rogers confirmed that she was fully trained, certified, and equipped to work with COVID patients. Prior to the pandemic, she had experience working with ventilated patients recovering from spine surgeries.

Despite the stressful changes and work days, she describes herself as being lucky: lucky to live in Manhattan, and have a friend to carpool to and from the hospital with; lucky to be able to stay in her apartment with her fiancé when she knows health care workers who have had to separate themselves from their homes and children; lucky to have access to PPE.

But it hasn’t been easy.

“I have had to deal with my first patient death and that experience, and postmortem care,” says Rogers. It’s something she never thought she’d experience as a nurse whose job was mainly treating patients coming out of elective surgeries, such as joint replacements. “Now you have to deal with it at work. It’s your new normal.”

Calling Families

Since her patients are all COVID-19 positive, they can’t have any family or support system visiting in-person, for the safety of patients, family, and hospital workers.

“That’s hard too,” adds Rogers. She and her coworkers, despite incredibly busy schedules, do their best to coordinate zoom and FaceTime calls with families to keep them updated.

“I’ve had experiences calling families and having such joy out of it, seeing that their family member is getting better,” she says. “And obviously, there are those calls to say their final goodbyes and their final wishes for their family members.”

“You really have to be there for them because no one else can really be there for them physically.”

One thing she wants non-healthcare workers to know?

“Even though you can see a decline in the numbers as of late, it’s super important to really adhere to all of the guidelines,” says Rogers. “Stay home, wear your face covers.”

She fears that the itch to get outside, combined with the thought that the worst is over, will lead to a new surge in COVID-19 patients.

“Especially working in the ICU, you’re really working with life and death scenarios. I really don’t want to take care of more patients with this because it’s so sad,” she emphasized.

New and Old Normals

For now, the OR-turned-ICU is Roger’s new normal. She ignores the rumors circulating about when her hospital will be able to shift back to taking elective surgeries.

“Every day it’s something different,” she says. “I try not to focus on when that will happen, otherwise I think I would drive myself crazy. I just take it week by week, day by day, because I truly don’t think anyone does know.”

Until then, she’s dedicating herself to providing her patients with the best possible care, and treating them like family.

“The most rewarding part of my job is being there for these patients at their most precious point in life. Being there for them when no one else can be there for them. I often think about — if that was my mother, or my best friend’s aunt, or my cousin — what would I want for them?” says Rogers. “I find it really humbling ... to have the opportunity to give people the best care possible when they’re in that stage of life.”

On her days off, she’s been wrapping up grad school coursework for the semester. She began taking courses in NYU’s nurse practitioner program in January, right before the coronavirus pandemic hit.

“I cannot wait until I’m off on a Tuesday and don’t have to do a paper or a test or a quiz,” she said.

But most of all?

“When I’m no longer working with COVID patients, I can’t wait to see my family.”

The most rewarding part of my job is being there for these patients at their most precious point in life. Being there for them when no one else can be there for them." RN Deirdre Rogers, Hospital for Special Surgery