An Intensive Care Unit (ICU) nurse for Northside Atlanta Hospital, Jenny Accarino has a perspective on the impact of the COVID-19 pandemic like few others. From coming face-to-face with the deadly disease to postponing her honeymoon trip, Accarino gives us an insider’s look at the frontlines of this global crisis.
How are nurses being affected by COVID-19?
“ER and ICU nurses are being hit particularly hard as a result of this crisis as they primarily take care of intubated patients. That’s why there’s such a shortage for everything. A lot of the other nurses are not trained in working with intubated patients, and unfortunately it can take months to be trained at a level where you could effectively deal with these situations. That’s why, when they say our ICU nurses are getting worked, we are getting worked.
We adopted a triage work environment [because] there are so many patients. I can normally take two vented sick patients, but now we’re doing “team nursing” —other specialty nurses, such as Med Surg, PACU, and OR nurses, are helping me and assisting with care — giving certain medications, assessing patients, and performing other basic tasks. Having the additional hands is great, but the caveat is they also need masks, gloves, shoe covers, hats, etc.
When did COVID-19 start appearing at your hospital? What were those early days like?
Around early to mid-March, because March 17 was St. Patrick’s Day and that was when everything started shutting down. [It picked up at] the beginning of April. Now, our entire ICU is COVID-only.
I was actually one of the first nurses to take a COVID patient. It was very scary in the beginning because we didn’t know if [our patients] had it. We assumed they were positive until we could get a “rule-out,” but sometimes [that took] 3-4 days. Those patients were then stuck in isolation during that period.
How did you become an ICU Nurse?
I graduated from Auburn’s business school; however, while I was finishing my last semester of classes, I knew that I potentially wanted to be a nurse, so I started taking science classes with my electives. While everyone was taking fun classes like bowling, I was taking biology. In 2008, when the market crashed, I wanted to try to see if I could get in-state tuition for Auburn for their nursing program. In order to get in-state tuition at that time, you had to work, I eventually worked and lived in Auburn for a total of 9 years.
Troy University Montgomery, where a lot of my friends also enrolled, accepted me into their nursing program, so I ended up enrolling there. After completing my nursing degree, I accepted [my current position]. I’ve held a variety of nursing positions here since 2014.
Tell me about the photo of you in the Auburn jacket.
That was from 2014, the night of the “Kick-Six” game. I was at the hospital and I rushed home just in time to see the Kick six play; I didn’t even change out of my scrubs, I literally grabbed my keys and drove to Auburn to roll Toomer’s Corner. [Hospital ID] badge still on, scrubs on, I saw it on TV and went straight to Auburn.
What is the process like when you come into work every morning?
All of us are screened before we walk into the hospital. Other nurses screen us by asking ‘do we have any fevers, chills, shortness of breath or cough,’ and have we been in contact with anybody we suspect has COVID. Those are the main questions they ask us first. Most of us say no, unless we feel we are, though usually I assume that if a nurse is feeling chills or shortness of breath, they have probably already called their managers to stay home.
Then they take our temperature. We get our temperature checked every time we walk into the hospital. We also hand-sanitize before we walk into the hospital as well. All of us are on mandatory orders to clean our hands.
Now, I arrive at the hospital earlier, because we change into clean scrubs that we wear only while on the unit. We change our scrubs daily in case something contaminated us. A lot of us wear masks going into and coming out of the hospital.
What’s the difference between a surgical mask and an N95 mask?
Surgical masks are to protect YOU from ME giving you something. If I’m asymptomatic and I don’t know it, I wear this mask so that I protect you. Everyone should be wearing these masks.
N95 masks keep out 95 percent of virus particles. You have to be fit-tested for these because they come in different shapes and sizes. They put [the mask] on, they put something over you and test you to see if you’re smelling a certain smell — if you are, that means you might have to try a different mask. N95s are to protect ME from getting the virus. That’s why medical professionals need these masks, because we are in close contact with known COVID patients.
Now, people also have handmade masks. Handmade masks are good; however, they have to be non-permeable, meaning they are thick enough to wear when you cough and cover your mouth. There’s a way you can test this, actually, it’s been going around the internet: Light a match, blow as hard as you can. The match should not go out.
How have you adjusted to the Coronavirus pandemic at home?
I got married [to Michael Plunkett] in February, right before this hit. Literally, the week we got back from Charleston was when it hit the fan; we were supposed to have our honeymoon in May. We’re obviously going to reschedule.
One of the best things, too, for Michael and I, we had a discussion early on whether we wanted to isolate, because we didn’t know how severe it was. We didn’t know if we should be alone in separate areas of the house.
One of the things we do [to stay safe] is make sure the house is extremely clean; we’re very diligent. I have a whole procedure when I come home — from the car, to my shoes, my clothes are immediately in the wash, my shoes are cleaned, my car handles are cleaned — anything that I wore or potentially touched, Michael goes around behind me with a Clorox wipe and wipes it down. Even the shower handle, when I open it, he wipes it down.
A lot of healthcare workers are so nervous about bringing it home, but I feel like we’re pretty diligent about keeping things clean, because we know how it spreads
Are you ever scared to go to work? Do you wonder if today is the day you’ll be infected?
No, I’m not scared. I’m not scared to treat the patients; I’m scared of them dying and scared for their families not being there. The night when I wrote that Facebook post, I had a patient for 4 days and they were getting better. I really wanted to be there for that patient, so that night I was struggling to see if I could come in for the fifth day in a row, but my body was literally saying ‘no you cannot, you are too tired. You can’t do it.’ So, I was very sad that I couldn’t come in, but that’s why I wrote that post, because I really wanted to be there — it’s not about me, it’s about them.
There are a lot of nurses who think the same way as me, they want to be there for their patients, but they’re scared. If you have a bunch of kids at home, I would be scared too. I’m scared for Michael, of course.
How are your friends who are also medical professionals handling the crisis?
I have a friend who just took a travel assignment to New Jersey last week, and within 15 minutes of meeting her first patient, they died.
In New Jersey, New York, Connecticut, all those places are struggling. A lot of us are on nursing forums online, plus we have friends who are traveling all over, so we stay informed of what’s going on.
The nursing community is like a family — much like the Auburn family — there is a lot of camaraderie and people have really stepped up to be there for each other.