Nurses are the underappreciated heroes of this crisis. One, normally the coolest of heads, checked in to the department after her shift. “I am anxious for the first time in my life,” she said. “I’m usually the face of calm. I tell family members of patients, ‘Look at my face, when this face gets worried, then you worry.’ ” Our department’s nursing leadership led the charge by working with hospital administrators and the disaster-preparedness team to set up, within hours, a screening tent outside our two San Diego emergency departments. This newly created care area offloaded many cases that would have entered the emergency department, endangering others and burdening our inner system.
If you wonder who actually sticks the swabs into the noses of worried patients, it’s the nurses. They’re on the front line, face-to-face, in the 6-foot danger zone. They are collecting the data that epidemiologists use to track the outbreak.
Moving in and out of negative- pressure rooms, putting protective equipment on and taking it off, nurses are caring for elderly patients who are severely ill and sometimes crashing. The nurses marinate in risk as they spend the greatest amount of time with the patient. They draw blood, obtain samples, provide oxygen, and steadfastly tend to their patients’ needs. They are by the doctors’ side as we intubate patients struggling to breathe. Once that patient is transferred to the intensive-care unit, it’s the nurses who do the mundane and the heroic to make sure the patient survives the illness or dies more comfortably.
How critical are nurses to the capacity of the health system? The number of nurses staffing the hospital determines its capacity. An absence because of a sick call or child care closes three beds. Understaffed floor beds result in boarding in the emergency department, and that creates a waiting-room backup.
I thank everyone who’s working to help get through this. I commend the scientists at big pharmaceutical companies who are developing better tests and vaccines. I thank the teachers setting up remote classes and the managers making tough business decisions. Everyone is playing a part — but none are more important than the nurses.
Dr. Dohrenwend is assistant chief of emergency medicine at Kaiser Permanente San Diego.
