Annie Quasnitschka was supposed to start her new job in March. She’d left her job at JPS Hospital in Fort Worth, and was planning a new life as a traveling freelancing nurse anesthetist. She’d landed her first contract. Then, all elective surgeries were cancelled.
“When the elective procedures were canceled, so was my job. So we came up here,” she said. “I made the decision and within 18 hours I was on a plane.”
Up here was New York City, where she and her partner – also a nurse anesthetist – have been working since late March. By that point, it had become the epicenter of the coronavirus pandemic in the U.S.
As the infections spread and communities started hunkering down, healthcare workers have been faced with twin realities: while some prepared for an onslaught of patients, others were furloughed, sidelined or laid off. Some traveled to COVID-19 hotspots to help out.
Quasnitschka arrived just as cases there began to peak. The small community hospital in Brooklyn where she’s been working was not prepared for the flood of COVID-19 patients and was completely overwhelmed, she said: Hospital staff were stretched to the max, exhausted, and many were unable to work, already sick with the disease caused by the coronavirus. The entire hospital was crammed with patients struggling to breathe.
“People [were] on stretchers, leaning against the wall, in wheelchairs, in nooks and crannies and hallways, on oxygen, coughing,” Quasnitschka recalled. “Alarms [were] going off, and you didn't know if they were going off, or who they belonged to because everyone was sick and everyone was dying.”
The 12-hour shifts were grueling and grim. Quasnitschka said the training that nurse anesthetists have is widely applicable to the care COVID-19 patients require. They complete an advanced training program to become a Certified Registered Nurse Anesthetist after earning a bachelor’s degree in nursing and practicing in a critical care setting for at least a year, according to the Texas Association of Nurse Anesthetists.
Nonetheless, Quasnitschka’s day job before the coronavirus pandemic involved caring for surgery patients, keeping them stable while they’re under anesthesia and then waking them back up a few hours later. But with COVID-19, she said so many of the patients put on respirators never wake up.
“After a patient passes away we try to have 30 seconds of silence to honor them and speak their name, because there’s no family there when they die,” she said.
During the peak, she said patients were crashing so frequently that even 30 seconds to observe a death was often impossible.
Now, things are calmer. But she said every day is still exhausting, still a grim crush of patients.
“From one hour to the next, I don’t remember what I did,” she said. “I don’t remember how many patients I’ve done CPR on in the last two days. It was a lot though. I don’t know how many family members I’ve called to tell them their loved one died.”
But there’s always another patient to get to, and that leaves her little time to dwell on the macabre. She said she can do this work every day because she and the rest of the hospital staff are in it together. Who will care for their patients, if they don’t?
At the same time, she said the layers of personal protective equipment (PPE) and the deteriorated condition in which patients arrive makes this experience different than the kind of very personal caretaking many healthcare professionals are used to. Nurses write their names on their face shields because they can’t recognize each other under all of their masks, gowns and other protective equipment. And the patients come in completely alone, and by the time she sees them, many are already intubated.
“I’ve never made eye contact with many of them. I can’t touch their skin,” she said. “In fact, one of my coworkers told me that she saw a patient without any PPE on and held her hand and realized that that was the first time that she touched a patient in months.”
Quasnitschka said she misses her dog, back in Fort Worth. She watches "Star Trek: The Next Generation" to get her mind off of COVID-19 for an hour every night.
On days off, she and her partner stayed in their hotel room in Times Square. It’s eerie, she said, empty. The lights are still on, but the Broadway billboards advertise shows canceled weeks ago. Some of the LED signs now beam messages of thanks to frontline healthcare workers.
“It does feel good,” she said, “but the biggest thank you is for people to just stay home, to not give us more work and more sick people who never leave the hospital.”
Quasnitschka doesn’t know how long she’ll be there. After she’s done, she’ll probably head to the next hotspot. With so many states and counties pushing to re-open, she thinks there’ll be plenty of work to do taking care of patients with COVID-19.
Texas Public Radio's Petrie Dish podcast has an entire episode dedicated to nurses and the coronavirus.