Elden Cox, BSN, RN, CCRN, CNRN – TNCC Unit Supervisor at Our Lady of the Lake Regional Medical Center

What’s so weird for me being a Trauma Nurse is that I’ve seen everything. I can be neck-deep in blood working a trauma with our team and walk out to the next room and eat a full meal.

This is so different. I don’t know why. When I was giving a report to the day nurse and was instructing her on what to do (her first day at work since the apocalypse), she said, “Oh, no. That’s not how I nurse. I can’t do that. I’ve got to turn my patients every two hours, hold their hand and give them water.” I feel like what a soldier must feel like on the battlefield. Dodging “the virus.” Wondering if it’s creeping in somewhere through my PPE while touching the patient. When we go into a room the rule is to get in and out as fast as possible and go in very minimally. You have a buddy watching to see if you need anything handed to you through a crack in the door while you’re in there. Your buddy watches but then he may have to run check on a drip. You look out and bang on the window to get anyone’s attention. You very quickly open and close the door. We constantly watch each other to make sure under all the stress that no one breaks isolation protocol. We yell at each other across the unit if anything deviates from the norm. We’ve got each other’s backs—more than ever. When you go in, it feels like when you’re snorkeling, and you hold your breath to dive deep down to get a glimpse of the coral on the bottom. You try not to breathe too deep in fear of sucking in the virus through an unknown crack.

We’ve become engineers, fixing and creating new ways to get the job done, with safety being #1. Our IV pumps are now on the outside, so we don’t have to make unnecessary trips in to hang fluids, vasopressors and sedation. I saw nurses high-fiving last night because one of them came up with a brilliant idea by brainstorming.

At any one time, you may look across the unit and see the sudden motion of the team donning PPE to rush in to intubate. The unit is in constant motion. These patients crash faster than any I’ve ever seen. Ever. Our unit looks so different. So much equipment everywhere because we took our only two storage rooms for two more beds. We’ve sent equipment to other areas to share and we’ve literally built ICUs overnight out of scrap.

We got word last night that we had a patient coming from a unit down the hall. This is a unit where the more stable ones are. Our unit is the highest level of care and the most critical so when they tank, they come to us. I can’t get the image out of my mind seeing them rushing this woman in to be intubated. I was running across the unit as they wheeled her by me and I caught eyes with her while trying to concentrate on what I was doing and it was as if I was in a slow-motion movie watching the fear in her eyes. My eyes followed her. She was sitting high in the bed breathing rapidly and was FaceTiming her family because they cannot step foot in the hospital. This is horrific for my hospital because this isn’t what we do. We cater to the patient and their family, or at least try to. I watch these patients’ expressions and it must feel like they are being wheeled into a gas chamber, not knowing what’s next. The staff is running around, faceless. They see the constant rush as they pass by all of the equipment, which to them looks like the inside of a spaceship or a science-fiction movie set. The horror is unsettling. We can’t stay and hold their hand or wipe their forehead. We have to get them intubated, get a central line in, an arterial line in and a catheter in and get out, only to look at them through the window. I’m not used to not having 20 people around the patient working on them. Our amazing Trauma Team. Now it’s only one MD, one nurse and one respiratory therapist in the room at a time, or we try to keep it to two. This woman’s nurse told me she was giving as much comfort as she could in that short time while she was FaceTiming her family. I can’t imagine how that family felt. This is so barbaric but necessary for everyone’s safety in this time of disaster.

I can’t imagine how it feels when that phone goes blank on the family’s end. I can’t imagine how the patient feels when they say goodbye before being sedated and intubated not knowing if they will ever wake up. No matter how strong you are, it’s frightening. Very few of our patients are conscious, but the few that are, they helplessly look at you through the window when you walk by. In all this, which is now the “national or world norm,” and because we are operating in “disaster mode,” rest assured that this phenomenal team keeps your loved ones updated on the phone. The doctors and nurses make regular calls to keep your families updated in the most compassionate way possible.

Lastly, I’m so proud of my hospital and team. No hospital can be prepared for a catastrophe this large, but we were. I’ve never seen such precise execution of a disaster plan. Equipment and supplies appeared out of nowhere. I’ve never seen so many disciplines work so hard together in my life—the pharmacy, the lab, nursing, biomed, maintenance and housekeeping! Everyone has pulled together to pull this off and it’s amazing to see every department work so hard and be so kind and cooperative together. Emotions have run high, but everyone has been amazing and kind. Administration has held constant briefings around the clock to keep us informed. Our new Nurse Manager has been handed something many couldn’t handle, but she has been amazing, even though I’ve seen her cry a few times—but that just shows she is human. She has been such a pillar for us to lean on. I feel very safe. Our hospital stresses both patient and staff safety year-round. Throughout this disaster, they have catered to us. It has been amazing. I feel we have sufficient PPE at the moment. We are a very large hospital and normally stock large quantities of PPE, but come on, people, how can you expect a hospital that may normally have 20 or maybe even 50 isolation patients to be prepared for something of this magnitude? We can’t stock warehouses of PPE for hundreds of people. I can’t blame any hospital for this. One thing I can say is the staff has been amazing at conserving our PPE and other supplies. Everything we pull out of a kit, someone says something like, “Save those extra parts—we can make masks out of that if we have to!” I’ve seen nurses saving things we normally throw away.

I wish everyone could see what is going on behind the scenes. It’s nothing short of a miracle at my hospital. Our ICUs now look like an army battlefield ready for what comes our way.

I know this is so stressful, but we have to make the best of a catastrophic situation.

Rest assured, if you come our way you will be very well taken care of, both physically and emotionally. I’m so proud of everyone and the quick response with the swift adaptation to changing needs in this very trying time.

Stay safe and stay away!


Now it’s your turn! Click here to submit your COVID story!