The coronavirus pandemic is surging through the Southeast, and some of the nation’s worst clusters have been in parts of Florida, Louisiana, and Texas, where hospitals have reported nearing or even reaching full capacity in their ICU wards.
For some nurses who work in those ICUs, the sight has been horribly familiar. During the early days of the pandemic in April and May, nurses from around the country traveled to New York to help out with its urgent need. After a couple nightmarish months, the pandemic subsided in the city, and the nurses returned home with the hope they would leave the experience behind them. But now, as states that seemed to have been spared in the early days of the pandemic have reported weeks of near-record numbers, nurses have come to fear a repeat of New York.
One of those nurses is Kristina Ng. For five years, Ng had worked in the operating room of an ophthalmology practice and as a home-care nurse in Houston, where she was born and raised. When the pandemic hit, Ng traveled to Brooklyn to work in a hospital there for a little over a month. When she arrived home, she decided to carry on her work as an ICU nurse, treating COVID-19 patients. Slate spoke to Ng to learn what it’s like to work in two hot spots, months apart and halfway across the country.
Molly Olmstead: What took you to Brooklyn?
Ng: The practice that I work for is all ophthalmology, and the majority of the cases are elective. Because of the crisis, the state of Texas had stopped all elective surgeries during that time. That meant that I wasn’t working for over a month.
I told myself before this quarantine happened, I was done with ICU. I had my son, and I didn’t want to work the long 12-hour shifts anymore because I wouldn’t have time with him. But I felt like I really needed to help. I was trying to find a job back in the hospitals here in Houston, but everywhere, there was a hiring freeze. A lot of hospitals were not taking admissions, unless it was related to COVID or suspected COVID, because they were trying to keep those beds open in case there was this influx of COVID coming in. So they just didn’t need all those nurses, with all these empty beds.
My husband works, but he also has an internship for school, and I didn’t want him missing out on his future career to just go to work somewhere. I said, “I want you to finish school and focus on your internship, and I’ll just do anything [I need] to do.” I thought to myself, “What better place, if I’m going to go back to the ICU to help, than the epicenter of where it’s happening?” I needed to go and help where they needed it the most.
What was it like in Brooklyn?
I was assigned to a very small community hospital. It was a very old hospital. My first day, two nurses and I, we opened up a brand new unit to become a COVID ICU. And we didn’t get training. We were told that we weren’t going to get an orientation because there was just no time. We got there and they said, “OK, you’re going to go to the second floor.” So we’d go there, and it’s a completely empty unit, and they’re like, “OK, we want you guys to turn us into an ICU, we’re going to start getting patients in three hours.” We don’t even know where the bathroom is.
The hospital was being run pretty much by residents. There weren’t very many attending physicians with, you know, 15-, 20-plus years experience running around. And a lot of the things that people were saying, like, “OK, this new medication is great for COVID, or research currently shows that this has some success”—we weren’t doing any of that, at least in the hospital that I was at. Like proning, turning a patient on their stomach to get the lungs a break—they weren’t doing that as often. Here in Houston, they are keeping up with current research and studies.
Why was that the case in Brooklyn?
I really think about that a lot. I think the clinical education people who are typically there to help educate about new and upcoming ways of doing things were still in quarantine. [And]
I think there was also a lack of resources. We didn’t have the right equipment. They had an old pediatric unit, and we were opening it up as a COVID ICU. Whatever you find in the supply closet, you just have to make do with what you have. So we found a bunch of IV pumps. And we thought, “Oh my God, this is great.” But what we shortly found out a few hours later was that those pumps are set for pediatric patients. So when we take adult patients that have to be maxed out on lifesaving IV medication through a pump, we couldn’t always max them out.
What sticks out to you in your memory from that time?
Of all the patients I took care of in New York, I only had one survive. And she’s not the model patient that you would think. She was 91 years old. She had all these other comorbidities, so she wasn’t the healthiest. I did not think that she was going to make it when she came to me on my first day in New York. She was not responsive, she was on a ventilator, she did not look good. But towards the middle of my time in New York, she started to wake up. She really surprised all of us. When I first arrived home, I had been keeping in touch with her. And to my knowledge, she’s still doing very well.
What was it like coming back to Houston?
I went into quarantine for two weeks. My son has congenital heart defects, so I chose to quarantine at a hotel close to the house. While I was there, I had a lot of time to think. My experience in New York really changed my mindset, because working there made me realize how much I missed the acute care side of things. I felt more comfortable when I felt like I was really helping.
When you returned to nursing, how was it treating COVID patients for a second time?
It’s like night and day. First of all, the hospital is clean and up-to-date. There aren’t COVID patients literally laying around everywhere. Everybody has their own private room. And you have experienced doctors and nurse practitioners at your disposal whenever you need them.
[But] my first week at this new hospital, I did a terminal withdrawal on two different patients in one week. And they both had COVID. You’re used to dealing with death and dying and the grieving process, and you’re used to having these really hard talks with family, but when you do it so often, it gets even more stressful than you would imagine. But it hasn’t been as crazy [as New York] here in Houston, at least not where I’m at. My fear is that when the people here continue to not take it seriously, it’s going to head that way.
Were there any parts of it that have been harder in Houston?
The hardest thing is the fact that these patients that I’m taking care of since I’ve been back in Houston are really alone. I mean, that’s not something new or different from New York, but I think because it’s my home state, my home city, it hits home a lot more for me than it did in New York. This hospital that I’m working at is literally down the street from where I live. And it just becomes very real that it could be my neighbor, it could be my own family member that this is happening to. And it’s that, I think, that will make me remember all of this: just the normalcy of it, if that makes sense. That it could just be anyone.
Are there any lessons you brought from New York to make Houston easier?
To be honest with you, I had a really hard time in New York. Death doesn’t bother me, but when I was in New York, I was dealing with it every few hours. I couldn’t even make my patients comfortable when they were dying. I just started thinking, this is the best that we can do. I started changing to, like, war-zone time. You can only save the patients that you can, and if you did your best, then that’s all they can do. And it did get easier. So now that I’m back home, I have all these resources, and I’m very grateful for that. But I also know how to try and make it work if I don’t. I’m more adaptable now.
What do you want people in Houston to know?
The units are completely full. I can tell you that the vast majority of the patients in my unit are COVID-positive patients. It’s very bad here, a lot of Houston is not taking it seriously. And I noticed that when I first came home from New York and I was in quarantine, a lot of people thought, “This is not as big of a deal as what happened in New York,” and “they’re only showing you the bad things on TV.” But the bad things are real. I have an older co-worker who is a nurse practitioner here in Houston—he worked in the ICU, and he himself now has COVID. And I can guarantee you that he wore the best PPE available to health care workers. He is the best NP I’ve ever worked with. And he’s fighting for his life. He’s not doing well. So when I see people here talk about how this is a hoax or make it political—it really is an insult to a lot of health care workers. We see people dying all the time.
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Correction, Aug. 11, 2020: The caption on this photo originally misstated that it was taken in Brooklyn.
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