Nurse recounts Covid-19 experience

Donna Foster, RN, a travel nurse for four years, enjoys taking assignments in different areas of the country. Earlier this year, she decided to take a travel nurse job at a large hospital in a suburb of Washington D.C. so she could see the cherry blossoms in bloom.

“Instead, I inherited Covid-19,” Foster said. “My Mother’s Day included taking care of an eight-year-old who died that day from Covid-19. It has been a nightmare. There is a real sense of fear in the mid-Atlantic.”

One of the reasons the hospital was hit so hard so fast is people were driving down 1-95 away from Covid hotspots in New York and New Jersey to find hospitals to care for them. Her hospital was getting people from Queens and Brooklyn.

“It was a matter of going down the interstate and overwhelming every hospital imaginable,” Foster said. “We also have issues with disparities. It is the elderly, African Americans and Latinos who are most likely to die from this. In the Latino culture, old and young family members live together and are often afraid to seek care because they fear deportation. We have strong, healthy, Latino 30-year-olds come in very ill and in respiratory distress. These disparities are so wrong, very wrong. Everyone deserves care.”

Foster said the disease doesn’t only cause lung problems; it affects every system in the body. Losing the sense of taste and smell are some of the first signs of the disease, along with a lack of appetite and exhaustion. It can also cause blood clots or severe internal bleeding caused from inflammation and fever disrupting blood vessels.

Not all patients have the same symptoms, so during the assessment Foster said they work to be extremely thorough.

“We have had 20-year-olds come in with strokes that are covid-positive,” Foster said. “We’re learning on the fly what this virus can do. There are strange-looking infiltrates in the lung. Normally, when you have pneumonia, you see long thread-looking infiltrate, but covid has a square infiltrate. It is the strangest thing.”

Foster couldn’t even estimate how many covid patients she has treated. The eight-floor hospital has turned four floors into covid units, a tent was set up outside to triage patients, and ER nurses have had to double as ICU nurses.

“We were overwhelmed with sick, sick people,” Foster said. “Usually 5-6 patients on vents are housed in the ER because the ICU is full. Covid is not only highly contagious, but when a patient is hypoxic with a lack of oxygen, they have altered mental states. Sometimes they physically fight us. It becomes physically, emotionally and mentally exhausting.”

The disease can progress quickly. One minute, patients are talking and 30 minutes later, the ER team is intubating them to put them on a ventilator.

Foster recently finished what was supposed to be her last tour at this hospital. But after a two-week rest in Eureka Springs, she is going back.

“I’m going to have covid-19 anywhere I go to work in the country,” Foster said. “So, why not stay with the people who gave me two weeks off to rest and heal, and work with nurses who now are experienced taking care of covid patients?”

Foster has high regard for her fellow nurses. “We are leaning very, very heavily on each other. We talk about our stresses to each other. We just clench our jaws. We do it for the twelve-and-a-half-hour shifts.”

One of the hardest parts for her has been looking at the fear in the eyes of patients before they are sedated and put on a ventilator.

Covid pneumonia can develop into acute respiratory distress syndrome, as no matter how much pressure is applied pushing oxygen into the lungs, they begin to stiffen.

“We try a lot of interventions before we get to that point,” Foster said.

There have been shortages of antibiotics, PPE and even swabs to take samples to test for Covid-19. If there are more major outbreaks, supplies will become even more scarce.

“We were having to do covid tests with strep swabs because we are out of proper testing swabs,” Foster said. “Do you realize how uncomfortable it is for a large swab to tickle your brain? We are trying to be creative with a minimal number of tests and PPE. It would be nice if the current administration would not hold grudges against states that have obtained important supplies elsewhere. We wouldn’t have had to do that if the federal government had done its job.”

There is a huge emotional toll in doing this kind of work, which includes seeing patients who die alone because family members can’t be allowed to see them due to contagion risk.

“Now we have our town open and all these people are coming in from other states,” Foster said. “These visitors don’t seem to know what is happening and are taking no precautions at all.”

Eureka Springs had a large number of tourists Memorial Day weekend, nearly all not wearing masks downtown. Similar behavior has been reported across the country in vacation areas. Because of such behavior, Foster fears the virus is going to spread widely in the U.S.

Foster is not a fan of people not respecting others enough to wear a mask.

“Why can’t they protect people from what they spew out of their mouths during a cough, sneeze or just having a conversation?” she asks. “It is just an inconvenience. It is not like we are asking people to give up their liberties. And yes, masks are hot. But you should see what nurses wear. It is just a small thing to do. I don’t understand why there are so many complaints. It’s a highly contagious virus. I don’t know why people don’t get this.”

It also bothers her to see so many people in town who think Covid is a hoax or that it’s over.

“We have meatpacking plants here so our low number of cases is not going to hold,” Foster said. “If you look at a map, the darker colors showing the highest number of cases are where industries with no distancing are.

“Covid is slow moving and its sits. It has sat on New York since March but is showing signs of easing. It has sat on us in Maryland with a new spike in Washington DC. If I have any message at all it is, please take this seriously. Viruses are invisible. But when it does show up here, it will be scary. People don’t get what we are facing. That is why I use Facebook the way I do. I’m trying to warn people. There will be more waves of this and people need to be educated and prepared.”

Some younger people may not be following recommendations because they think it is more likely to kill older people and those with serious underlying health problems. But Foster has seen healthy young people with no underlying health issues die, and people in their 90s survive it.

“The information about this virus is spotty because we are learning something about it every day,” she said.

Covid is much more dangerous than the flu.

“No way is this like the flu,” she said. “Flu comes on really quick. You get a high fever and feel like you have been run over by a truck. Covid takes weeks. Usually when a patient suffers a cytokine storm, an overall inflammatory response, it can be a 10-14 days afterwards they test positive. We have had to learn what medications make things worse and better. There are drugs we cannot give because it exacerbates the situation.”

Nationwide, about 98,000 Americans have died from the virus as of Memorial Day. Some say the death rate is overstated because so many people have mild cases and recover without being tested. Foster disagrees.

“The numbers of deaths and positives are underreported because we do not have enough tests, period,” she said. “On the death certificate, if it says ‘probable Covid,’ they are not counted. Only deaths with positive tests are counted. And the number of states showing few cases don’t have the tests to prove that they are truly in the low numbers.”

At home, Foster has frequently found herself crying, but sometimes it is because of the support of the community here.

“I can’t thank enough Jane M Tucker, Ermilio’s, Brandon and Donna at LeStick and Kelli J Zumwalt and Sarah S. Niazi for food and kindness beyond what I think I deserve,” she posted on Facebook.

Foster, who is married to international herbal consultant Steven Foster, believes she has stayed well because she is careful with using personal protection equipment and takes a number of supplements and herbs.