Philadelphia Nurses Tell All: I’m Afraid I’ll Infect My Family

Rhonda Browning is an ER nurse at Penn Presbyterian Medical Center. Courtesy photo / Courtesy

“Philadelphia Nurses Tell All” is a weekly series that features stories from healthcare professionals about how they are working to combat COVID-19. If you are a healthcare professional and would like to share your story, please email qmuse@phillymag.com.

In just one week, the number of positive COVID-19 cases in Philadelphia rose from nine to 175, according to the latest data from the Philadelphia Department of Health on Monday. The city now has more positive cases of the novel coronavirus than Montgomery County, the first area in Pennsylvania to go on lockdown.

As the number of positive cases continues to rise, all eyes are on our local healthcare professionals — the global shortage of face masks and other protective gear could cripple their ability to provide critical care. The shortage is so extreme that the  CDC suggests that professionals construct homemade masks from bandanas and scarves “as a last resort.”

Philadelphia nurses say they are hoping for the best and preparing for the worst. Ultimately, they fear they won’t be able to protect themselves or the vulnerable people in their families. We talked to three Philly-area nurses about how their hospitals are preparing for the influx of patients they expect to see in the weeks ahead. Their stories illustrate how we are still in the calm before the storm.

Monica Phann, Hospital of the University of Pennsylvania

Monica Phann is a nurse at the Hospital of the University of Pennsylvania. / Courtesy

“Healthcare providers are terrified of possibly exposing themselves to the virus, but regardless we have to put our nerves aside and provide treatment,” said Monica Phann, a registered nurse at the Hospital of the University of Pennsylvania (HUP).

Over the past few weeks, Phann has seen several coronavirus-related changes that have altered her day-to-day routine. In addition to all employees being required to have their temperatures checked at the hospital’s entrance, nurses like Phann have stepped in to assist with COVID-19 testing in various hospital units. Overall, fewer and fewer patients are showing up at the hospital, likely because they want to avoid potential exposure to COVID-19. Phann said she’s also seen a decrease in blood transfusions being performed in the hospital because there has been a shortage in blood supply and many providers are only ordering blood transfusion when it’s absolutely necessary for a patient’s plan of care. Blood drives are being held to combat this issue.

Phann said she’s felt most burdened by seeing her co-workers wrestle with the triple challenge of caring for patients, protecting their own health, and continuing to protect and provide for their families.

“Many of my co-workers have to plan childcare, stock up on food, and clean themselves before entering their homes because they are terrified of possibly exposing their own families.”

Phann’s aunt was recently hospitalized for health issues unrelated to coronavirus so the issue hits close to home. In addition to working 12-hour shifts caring for patients at HUP, Phann’s work continues at home where she serves as her aunt’s primary caretaker. Despite her worries, Phann remains hopeful.

“It has been incredibly exhausting and emotionally hard to have to be in nursing mode 24/7, but I feel extremely blessed that I have the knowledge to help my family and to provide medical help during a crisis like this,” Phann said.

“It is hard to go to work and save people’s lives when it seems as if there is a possibility that things may not be getting better. I am worried about possibly contracting the virus and exposing my loved ones. I am worried that people are being misinformed and healthcare providers are not being given the correct amount of personal protective equipment to protect ourselves as we are working on the frontlines of healthcare. Through all of these worries, I know that the good work we do will all be worth it one day.”

Rhonda Browning, Penn Presbyterian Medical Center

Rhonda Browning is an ER nurse at Penn Presbyterian Medical Center.

Rhonda Browning has been working as a nurse in the emergency department at Penn Presbyterian Medical Center for 16 years. She’s been a nurse for 30 years, and she says she’s never seen anything like the sweeping changes the coronavirus has caused.

“We’ve had some scares. We’ve seen a lot of different things come through, but this is probably one of the most trying things I’ve ever seen,” Browning said.

According to Browning, her team goes through yearly training to prepare for outbreaks like this one, but now the training has a very real possibility of being applied, and soon.

To prepare, care teams at Penn Presbyterian are attending daily meetings to stay updated on the latest coronavirus cases, they’re being refitted for N95 masks and other protective gear, and they’re being trained to identify the ever-changing criteria for identifying coronavirus symptoms in patients. Browning says the constant updates and training have given her confidence that her team is ready for what’s to come.

“We all know it’s coming. We’re expecting it. If it doesn’t come, that’d be great. But we’re expecting an influx, and I think we’re prepared for it,” Browning said. “A lot of times we think we’re never going to use the training that we get, but we’re about to now. We’ve trained for this. We’re ready.”

While prepared, Browning says this is still a very scary time for hospital employees like herself who go into work every day not knowing whether they’ll encounter something that’s going to put their own families at risk. As an extra precaution, Browning has resorted to removing her work clothes before she enters her home to avoid bringing any germs inside.

“We are just as nervous as everyone else. We wash our hands and change our clothes often. We’re all taking precautions for our own lives and we are hoping that everybody else is taking the same precautions,” she said.

In an effort to limit healthcare workers’ potential exposure to coronavirus, last week Penn Medicine prohibited visitors at all of its hospitals except under a few special circumstances. It’s a tough policy to enforce when emergency patients are still coming in. Under the policy, even the mother of a young gunshot victim would not be able to enter the emergency room with her child. Browning says she and others on her team have had to go out of their way to put patients’s family members at ease when they can’t be with their loved ones.

“You don’t realize how big of a thing it is until your family is brought into the ER and you can’t go in with them,” she said. “Our staff has been committed to stepping in to help families communicate through phone calls, or FaceTime, or any method we can use to help them see each other and know what’s happening with their loved one.”

When patients start showing up in droves, that’s when Browning predicts the true test of preparation will begin. They haven’t yet had to resort to the more extreme measures nurses in other cities have taken to protect themselves from COVID-19 but over the weekend, Browning said her hospital’s supplies began to diminish. Healthcare workers began reusing masks and goggles, and some staff resorted to buying their own protective gear, raising new concerns.

“Besides our concern of bringing this virus home, we now are concerned with protecting ourselves,” she said.

Dash Hightower, Fairmount Behavioral Health System

Dash Hightower is a registered nurse at Fairmount Behavioral Health System. / Courtesy

“Things are hectic at times because not only do we as employees have to change many things about our workday, our patients have to change their routines as well,” said Dash Hightower, a registered nurse at Fairmount Behavioral Health System. “When you’re dealing with psych patients this isn’t always easy. They don’t always understand or care about the ‘whys,’” she explained.

Fairmount has not reported any positive cases of COVID-19, but Hightower says preventative measures are already having an impact on her and her co-workers’ ability to provide patient care as usual.

One of the biggest changes to nurses’ routine at Fairmount is that they’re now required to bring meals to each patient instead of allowing them to eat in a communal setting. Hightower says this and other COVID-related disruptions to patient’s schedules have been difficult to manage among a particularly delicate patient population.

“Now that patients are not getting down to the cafeteria, they are not experiencing free time in the gym due to the protocols put in place,” said Hightower. “This time is usually used to pull medications without the hassle of patients hurrying you.”

Fairmount’s heightened security is also a major change for Hightower. To ensure that all employees and patients are screened before walking into the building, every entrance except for the front entrance of the hospital has been locked. Anyone entering the building must have their temperature taken and is required to respond to a series of questions about their wellbeing and recent travel. Once inside, nurses must ask similar questions of any new patients or visitors seeking entry into the building.

Hightower says she remains cautiously optimistic that should any COVID-19 cases arise at her facility, she’ll have the protective gear and support that she needs to care for her patients.