Health care workers are coming unglued. Every day, they struggle to protect their patients, their communities, and themselves from the coronavirus, many working 24-hour shifts in overcrowded hospitals, sometimes without the appropriate personal protective equipment. “We all feel really burned out. We just want our patients to be well and for this pandemic to be over,” says Val, a medical-surgical and critical care nurse working in a New York City unit caring only for Covid-19 patients. “After almost every shift now when I go home, I break down into tears from all the stress I felt during the day all hitting me at once.” Their work environment is dangerous and exhausting, and some medical professionals don’t even get to go home.
While many Americans self-quarantine and socially isolate to avoid even a chance encounter with someone or something carrying Covid-19, health care professionals willingly expose themselves to the pandemic every day. They don’t begrudge the threat to their own well-being, but many are concerned about transferring that risk—and, potentially, the novel coronavirus itself—to those around them: their coworkers and patients, yes, but also the families and friends waiting for them at home. With limited official guidance, health care workers have been making tough calls about how and how often it’s safe to move between hospitals and clinics and homes full of people who might otherwise never be exposed to the disease. “I feel very guilty for not being there for my husband and child,” says Laura, a nurse in Portland, Oregon, whose son is 5 years old. (Laura, like Val, asked that her full name not be used.) “But I don’t want to put them at risk or, God forbid, get them sick.”
Hospitals, like most workplaces, have a say in what their employees do on the job, but less of one when it comes to what they do once they leave. But in the case of Covid-19, what health care workers do during their shifts impacts the people they interact with when they’re done. “We know hospitals are reinforcing infection control protocols that help keep providers safe, like hand hygiene and appropriate donning [and] doffing of protective gowns,” says Akin Demehin, the American Hospital Association’s director of quality policy. According to Danielle Zerr, division chief of pediatric infectious disease at Seattle Children’s Hospital, management has also been reinforcing that health care workers should be monitoring their health closely and getting tested for coronavirus. Those in charge also offer practical advice for limiting exposure, like switching from contact lenses to glasses so workers don’t have to touch their eyes, or tying back long hair so it doesn’t need to be adjusted.
Still, the smallness of these measures in contrast with the enormity of the problem has left some workers anxious, especially since Covid-19 tests and personal protective equipment aren’t always available. “The hospital talks about what the expectations are for wearing protective gear at work, but that’s always changing because of what supplies we have,” Laura says.
The one family-safety measure all health care workers agree on is extreme hygiene. “I live with my pregnant wife, son, and two dogs. My wife is also a nurse. We try to strip down as soon as possible when coming in the door, clothes straight to the laundry,” says an emergency department nurse who wished to remain anonymous for fear of workplace repercussions. “I’ve been spraying off [my shoes, pen, and badge] with disinfectant, and then it’s straight to the shower.” According to Laura, many of her coworkers are using this strategy as well, though she points out that it works best for people who live in bigger homes. “Some people are isolating within their houses, with a special bathroom and a special bedroom,” she says. “I only have one bathroom, so that’s not an option.” So Laura, like many other health care workers, just doesn’t really go home at all.
Laura is living in a pop-up truck camper in the hospital parking lot and, more recently, a room meant to house families whose children are being treated, which the hospital recently made available to essential staff. “It’s like a hotel room, but I don’t want to overuse it, so I only request it on the days that I’m working. Then the rest of the week I’m going to go back to sleeping in the camper,” she says. Living this way is a strain on her and her loved ones. “I happened to have a three-day weekend, so I was really excited to maybe come back and spend that time with my family,” Laura says. “But I had a conversation with my husband, and he was saying to me, ‘What are we doing? We can’t do back-and-forth. Is this a serious enough situation where you need to isolate, or can you come home?’” Laura didn’t get to go home that weekend and has found herself struggling emotionally.
Other doctors and nurses have moved into hotel rooms or sleep in their cars. Some are working 24-hour shifts to reduce the number of times they move between the hospital and home. Some have sent their children and families to stay with friends or grandparents rather than risk exposing them to the virus.
And these are the measures they take when they think they’re healthy. What happens to those who do contract the disease is another matter. Some hospitals are offering accommodations for employees who test positive, but others are recommending that their employees quarantine at home, which concerns many health care workers. “They haven’t said anything about how they would support us if we did get the virus. There is no mention where we would quarantine,” says Laura. “A lot of us are wondering where are we supposed to go and [with] what financial resources, if and when we do get this.” The ambiguity of it all has left many health care workers feeling helpless and emotionally exhausted. “When this is all over, there are going to be a fair amount of people who are looking to get out of hospital nursing for a little while,” says a nurse who wished to remain anonymous. “I have a feeling there will be health care providers who end up with a PTSD diagnosis when this is all said and done.”