?You?re Not Alone?: How One Nurse Is Confronting the Pandemic

Becky Cherney is one of those nurses and this is her story.Since November 2014, Cherney, 32, has worked as a nurse on floor 8D of University Hospital, a moderate care unit that serves patients who are too sick for general care but not quite sick enough for an intensive care unit. From one shift to the next, 8D became a pop-up ICU and Cherney became a temporary ICU nurse, adjusting on the fly to cumbersome protective equipment while learning how to care for acutely ill Covid patients. It is the reason she spends nearly all of her free time sanitizing and packaging face shields, fumbling to respond to texts from donors with numb fingers and fogged lenses, and helping to organize deliveries all over southeast Michigan and beyond.It is the same look Cherney saw in the eyes of the phlebotomists, janitors, and fellow nurses in March before 8D became a Covid unit, when the floor was serving as a waystation for “rule-out” patients who were sick enough to be hospitalized but still waiting for Covid test results. Hospital workers were still learning how to don and doff protective equipment and familiarizing themselves with constantly changing protocols for avoiding infection.Cherney glimpsed the new fear for the first time in late March when she requested a blood draw for a possible Covid patient. “It was so brand new,” Cherney says. After five-and-half years on 8D, Cherney is a seasoned hand, someone whom the younger nurses look up to in the same way that she had looked up to more experienced nurses like Danielle Lueck when she was new. “She had a presence,” Cherney says. She was fast, witty, and extremely smart.” Lueck was one of several mentors, including Sam Judkins, Cherney’s current nurse supervisor, and Deb Eastman, 8D’s clinical nurse specialist, who helped her acclimatize to the tempo and the intensity on the unit. “We didn’t know how bad it was going to get, if one of us was going to get intubated or super sick.” On Thursday, March 26, the hospital relieved some of the tension when it released its new Covid visitation policy: dying patients would be allowed two visitors, not one.In 2015, long before Covid took over her life, when Cherney was fresh out of orientation and new to the rigors of nursing on 8D, she learned just how lonely and frightening it can be to care for the sick. “My nurse instincts could tell something was wrong,” Cherney says, “but all of his vitals and his oxygen saturation levels were fine and stable.” She would never downplay her instincts again.Around midnight, the man began to cough blood. “I have already seen the worst,” Cherney reminded herself, looking back on the disaster she lived through in her early days on 8D. “Time to get creative.” Cherney jumped into the discussion under Leeser’s posts, and a few days later, Operation Face Shield was born.By the time Judkins’ emails arrived, Cherney had assumed a leadership role in Operation Face Shield, helping organize the logistics of a homespun PPE operation that was already fielding requests from all over Michigan and across the country, from states as far away as New Jersey and Louisiana. In seven weeks, Operation Face Shield and its partners have churned out and delivered 25,000 reusable face shields to medical facilities, homeless shelters, ambulance companies, grocery stores, and nursing homes—all without charging a dime.For Cherney, Operation Face Shield has been much more than an exercise in goodwill—it has been an outlet for energy that might otherwise consume her.“It made me realize who I was again,” she says.As fortune would have it, Cherney’s worries of being sidelined at the hospital were short-lived. When Cherney returned to work on the afternoon of Tuesday, March 31, she and her fellow nurses rushed to prepare carts outside the rooms with the materials necessary to put in IV lines and to make sure dispensing machines were stocked with the array of sedation, paralytic, and blood pressure medications essential to caring for ventilated respiratory distress patients. By the end of the first week of April, all 20 beds on 8D were full—some with severely ill non-Covid patients transferred out of the normal ICUs to clear space, some with Covid patients at varying stages of illness.Cherney was unfamiliar with some of the new medications, but she was prepared by years of experience with delirious patients for the moment when her first Covid patient panicked and tried to pull out his endotracheal tube—a dangerous event that can release a bloom of virus-laden aerosols into the room and leave the patient gasping for oxygen with no secure airway.Watching through the window as the man grasped at the tube stretching from his mouth to the ventilator, Cherney resisted the urge to rush in as she carefully donned her protective gear. A few eternal minutes later, she attached the ventilation hose to a hole in the back of her PAPR mask unit and switched on the fan.“Right before I went into that door,” Cherney says, “I was scared.” She paused to make sure air was circulating in her hood, then stepped into the room, alone.“The first thing I did was look into his eyes,” she says. “I don’t know if he was listening,” she says, “but it just felt comforting for me to talk to him.”“I’ll pray for you,” she told him just before she let go of his hand, “and you pray for me.”Caring for elderly patients who are fearing for their lives has forced Cherney to relive the most painful chapter of her own life. Humanity mattered to me.”For years after her father’s death, Cherney kept the Scooby Doo scrubs in a wooden drawer with a gold-plated handle under her bed, along with the pillow she bought him at the gift shop.“I think that’s why sometimes I can understand loss,” she says. Without proper suctioning, a patient’s breathing tube can become clogged, depriving them of oxygen, and harmful bacteria can proliferate in the tube and in the lungs, which can lead to pneumonia.“A lot of people are afraid to suction their loved ones because it can initiate a cough response,” Cherneys says. “I had a lot coming at me at once,” the woman told Cherney. She turns on soothing music for deceased patients and talks softly to them as she prepares them for the morgue.As for the living, Cherney tries to care for them with the same devotion that she showed to her own father, as if she is still living out the pledge she made by his bedside—“I’m your personal nurse now.” Seeing elderly patients written off as an “at risk population,” somehow less worthy of care and concern, fills Cherney with a blend of anguish and rage. He makes no sound when he mouths the words, “I love you.”When Covid delivered respiratory distress patients with tracheostomies to 8D, Cherney’s pulmonary care expertise and her ability to carry a heavy load of emotional stress became invaluable. Her headache persisted and she was unsure whether to chalk it up to dehydration (masks make it difficult to drink water), to rebreathing her own CO2 all day, or to the early stages of Covid.“Don’t let the fear get to you,” Cherney tells herself before one nursing shift. Cherney and her colleagues spend hours of their shifts tending to the banal aspects of patient care—charting, bathing, feeding, “code browns.” These chores are the nursing equivalent of filling sandbags, stringing barbed wire, and digging latrines—the unromantic labor that is the purest essence of the job, even at the front lines. “She responded to me when I said her name!” Cherney told a nurse practitioner on the care team. “I asked if she was in pain and she nodded her head yes.” Cherney gave the woman some Tylenol and left the room feeling a little lighter herself.This time, she could wonder, “Did I save her?”As of May 15, Michigan Medicine had discharged 473 Covid-positive inpatients and only 59 remained hospitalized, a low not seen since March 26. “However, it is just as concerning to us that people may be delaying appropriate care and getting sicker as a result.”Some of those patients will inevitably make their way to 8D, where Cherney and her colleagues will hear their names for the first time during a morning or evening shift report. “This is due to logistical reasons and to avoid disruptions as patient care ramps up services in the days and weeks ahead,” reads the message from Michigan Medicine.That characterless room has become a repository for some of Cherney’s most intense memories. On March 3, she left the hospital on sick leave, uncertain about when she might return.On April 20, a day off from the hospital, Cherney took a break from Operation Face Shield to drive to the Karmanos Cancer Center in Detroit, where Lueck had been hospitalized for two weeks for a clinical trial.