ICU Nurse Kim on working the frontlines during the COVID-19 pandemic and the importance of self-care

meet kim,

an ER and ICU nurse working the frontlines during the COVID-19 pandemic. Kim is one of the kindest and most compassionate people i’ve ever met. she leads by example, and not just at work - Kim reminds me to take care of myself, to make the most of each day, and to be mindful.

to be completely honest with you, watching the news and scrolling through updates doesn’t impact me in the same way that personally talking to someone about their experience does. that’s why it was such an honor to hear from Kim about what life has been like for her during this past year.

it is my hope that this conversation gives you insight into what life is actually like in the COVID-19 unit, how we can all do our part, and why it’s so important to not only take care of each other, but ourselves, too.

How are you? I miss you. And working out with you.

I miss working out with you, too. This morning I woke up super early because I bought a Peloton bike, so I got on that and I rode for like forty-five minutes and then I got my day started, but I’ve been so busy with work I haven’t had time to exercise like I want to. When you’re working out, you feel good and you feel energetic and it’s just, it makes your day so much better. And earlier, I went to Trader Joe’s - and you know they have the best flowers - so I went there and I got two things of roses and I bought four orchids. And I want to like, go home, clean my house, put all my flowers out, you know, it just makes me feel good.

You are so good at that - making the best of every day. You know that phrase, “Save it for a rainy day?” You’re like, “No, today is just as good.” Something I really admire about you is how you make the most of each day, and you really do treat yourself. 

You have to. Because you don’t want to find yourself in a slump. It’s easy to fall into depression when you have to stay at home and that’s a thing people don’t talk about. Because, you know, people are staying at home. You’re not around people you love, and then it’s like, people are afraid to hug people or shake their hand or be around them. It kinda takes that human touch away and now you’re alone by yourself. So you have to make the best of it. 

Right? For those that don’t know, you’re a nurse and you work in the ICU and ER, which we will get into, but like you said, the mental health aspect is so important and not talked about nearly enough.

I didn’t actually realize it until my job came out with an email, maybe about a week ago. In the email, they put a hotline for healthcare workers and it said, like, “Hey, we’re with you. We know that you guys are feeling tired and burnt out,” because the thing about it is, we’re seeing death more and more. It’s an amount of death that no one should ever have to see. And I’m starting to see younger people now, which is very sad. I thought that was very big of the hospital to come out and create a hotline that anyone could call if they needed to. Because even though you see your coworkers on a regular basis and we’re all smiling and we’re laughing and, you know, there’s times where we’re serious and we’re working because we are on those front lines, but you don’t realize that your coworker might actually be going through something. And you have no idea that they’re going through that.

People can be so good at kind of faking it or putting on a smile. Or it’ll be the end of the day and something will hit them out of the blue. Things like depression and anxiety don’t have to be a 24/7 thing to be real and be heavy. How have you and your team been doing? Do you think it’s bonded you guys? 

For sure. I spent so much time at the hospital and they were already my work family, but now it’s like even more of my work family. Like, if I go to Costco and buy groceries for my house, I’ll pick up stuff for work. Like, “Oh, let me pick up soup and a salad,” and things like that, because there’s a lot of us at work and you don’t get time to sit down and eat lunch. It’s kind of grab and go. The nurses over in the NICU, because they deal with the babies and there’s hardly any coronavirus over in the nursery, did something for my department; I thought it was the cutest thing. They created this box and then they put a bunch of goodies inside, like sparkling waters, granola bars, gum, chips, cookies, snack packs, things like that. It’s a box and it just says, like, “We appreciate you,” and it’s a grab and go type of thing. So when you’re feeling depleted or you just need a snack, you can go to that box and get a little snack out of there and have something in your pocket. I thought that was cool.

That’s so cool. What is the situation like from your eyes? Los Angeles is the new epicenter, and you’re a little bit south of that. 

Honestly, it’s been so busy. I had a couple of days off and when I came back, there was nowhere to walk. It was so busy. There were patients wall to wall, and now I’m starting to see it taper off, and I’m so grateful for that.

I just want people to remember that just because things are opening back up, it doesn’t give you a pass to go out and live your life the way you were living it before the pandemic. You still have to be cautious.

You still have to wash your hands, wear your mask. Keep your distance, because I’m seeing younger and younger people come in. 

Exactly. Thinking about younger people, anyone young feels invincible; that’s true for so many of us. But I think if you’re young and don’t live with your parents, you’re maybe more likely to be a little less cautious.

I think each generation is different because the millennials, they’re more tech-savvy and they’re on social media, and their whole life is posting. It’s, “Where are you and what are you doing?” It’s always the next thing. Versus someone my age, I‘m used to not having social media. I’m used to not posting or saying where I was or, “Look at me, I’m here with my friends.” I think for younger people, this pandemic really affects them and they want to be out. But at the same time, you have to be out with caution.

How has COVID-19 affected how you feel about what you do? You said all your co-workers were so much closer now, but do you feel different about what you do? 

I’ve always had a passion for what I do, but I feel now even greater at what I do. Sometimes there’s no visitors at the hospital and in the beginning, the hospitals didn’t allow any family to come – no matter if you were on comfort care and that was end of life care. So we are their family. We are the people that are holding their hand when they’re having their last breath. I just feel closer to my patients as a whole, because they don’t have anybody. You know?

Yeah. I think, for me, I’ll look back on March 13th as the day that everything changed and got serious, because that’s when the schools closed. As someone working in the hospital, did you see it coming at all, or was it overnight as well? 

I saw it start to pick up being busy ICU beds being taken up and patients being placed on the ventilator, but in the beginning, it was more older people, so I didn’t really realize the degree of the virus at the time. Going back to March 13th, I actually had a couple days off. And I was calling my job like, “Hey guys, how’s it going there? Is it busy?” They would keep me updated and they would say, “Hey, it’s really busy.” When I went back to work, I was mind blown. It was just something that I had never seen before. Right now, there’s not visitors in the hospital, but if someone were to come into the hospital and just take a look, you would think that we were in a warzone. It was so bad - so bad. We were just making due with whatever we had. 

To the point where you were running out of supplies and equipment. Some people had more in their private homes than you did in the ICU.

It was so, so bad. In the beginning, I contacted a paint company - they have painter jumpsuits you paint in - because we ran out of proper PPE. So I ordered a box and I would keep the box in my car, so if my co-workers didn’t have protection or I didn’t have protection, we could just keep those suits up and work our twelve-hour shifts in those suits. I would change my clothes in my garage, you know, just.. life was just so different.

I can’t imagine. You’ve been a nurse for a while now. Obviously, studying is different from doing, but did you think it would ever be real or something you would have to deal with in your career?

No, never. 

That’s what’s crazy to me. This phrase is a meme now, but we’re really living through history.

It’s true. I work at a hospital that has two locations. They set up a command center. I would call that command center and I would say,  “I’m out of ventilators.” And then they would say, “Okay. I can have a ventilator there within an hour.” Or I would say, “Hey, I’m out of masks. I’m out of PPE.” And the good thing is they work so well with our campus. They created this command center so we could communicate between the two hospitals because we were getting so overwhelmed. So we would say, “Hey we have more patients than we have staff. Can you take twenty patients?” And they would say, “Okay, we’re on our way.” 

What is it like now? Are you both maxed out? 

No, we probably have 15% bed capacity right now. We’re not totally maxed out, so we’re a little bit under our threshold of where we would like to be. But things are getting better. The main campus is really good about coming over and taking patients so we won’t feel overwhelmed. Because we are, I believe, a 106-bed hospital. But the main campus has 700 beds. 

What does a day in your life look like right now?

I’m in charge, so I come in at 6 o’clock, and I kinda get a rundown from the day shift about what happened - how many patients are on a ventilator, how much staff I have. Then I divide each section of the hospital into staff members that can care for certain patients. We all go to our area that we’re in, but after that, it’s an emergency after an emergency after an emergency. Because I’ll have Code Blue here, Code Blue in the emergency room, Code Blue in the ICU. So I’m intubating one patient while I’m doing CPR on another patient next door that just coded.  There are no lunches or no breaks, because we don’t have time for that. There has been no lunch and breaks for quite some time. And it’s okay, because that’s just the flow of things. During the entire twelve hours, I’m basically putting out fires. That’s how my twelve hours go right now. I’m putting out all the fires, I’m keeping patients stable, making sure they get meds, and keeping them safe at the end of the shift.

Oh my gosh. I think the media has kind of said it so many times that it’s kinda lost its touch, but a ventilator is a very serious thing. 

And the thing about it is, in a twelve-hour period of time, if I have fourteen patients and they’re on ventilators, we are proning these patients. Proning is when a patient is on their stomach, and we put them on their stomach for sixteen-eight - that’s the time. Sixteen hours on your stomach, eight hours on your back. Proning is on your stomach, and supine is on your spine. With these patients being this bad, we have to prone them because what happens is, although you’re on a ventilator, you still are not oxygenating very well. And you need blood to get to those lungs in your body and other parts of your body, so that’s why it’s important to prone these patients. And that is a lot of hard, labor intense work. To prone one patient, it will take six or seven nurses on our teams together to prone one patient. It’s very back-breaking work. Because some patients, you might have a patient that’s 5’5, 180 pounds, and then you might have a patient that’s 6’, 275 pounds. 

And it’s not like they can help you in that process. 

No, they can’t. It’s dead weight.

And you’re doing that over and over and over again. Whereas before the pandemic, that wasn’t a common procedure, right?

No, it wasn’t a common practice at all. 

Doing what you do and having such difficult shifts, one thing I want to ask you about is the shutdown aspect of the pandemic. Businesses are closing, and we’ve seen the governor kind of flip-flop on regulations and what can be open and when and why. I think you really see all sides of it, because you are so great at supporting small businesses. What are your thoughts on the whole shutdown process?

I think that there’s a lot of businesses that are being displaced in this pandemic and that is the people’s livelihood, their business. At the same time, I’m busy in the hospital, but I don’t wish for anyone to lose their business. I feel that if a business owner can take responsibility and proceed with caution, limiting the amount of consumers that they have in their business and how they did business prior to the pandemic, then yes, I don’t see why they can’t open up. Bars and restaurants and things like that, I think that it still needs to be outside for now, until we get a handle on things. But if I am a consumer and I’m shopping at someone’s business and I’m wearing a mask, and they’re wearing a mask, and there’s shields to protect each of us and we’re keeping our distance, we can’t let our lives stop because of the virus. I just think that there has to be precaution taken and that people have to take this virus seriously. If they don’t, it’s never gonna go away.

That’s the big thing for me. Will it go away? 

With herd immunity, I’m hoping that we can get back to normal, but I feel like the same way that we talk about the flu shot or the flu season, I think that COVID will be here to stay because you are gonna have those people who are not vaccinated. And it’s their right; it’s their choice, you know? So you will always have those people. But I think the magnitude of it will be on a lesser scale than it’s currently on. 

I think it’s really naïve to admit now, but I didn’t see this getting as political as it’s gotten. I didn’t think this would divide people. There’s anger on both sides. 

I didn’t either, and I really thought that there were a lot of politics behind the virus. I consider myself a free thinker and I just feel that you have to question things and you have to explore the answers that you get. And if something doesn’t make sense, you need to ask why. You have to look into it for yourself.  

You do. As a result of that, I’ve seen some of my friends aren’t following all of the safety protocols. Has that happened to you at all?

Yes, I have, and those types of people I keep my distance because I have a family at home that I love. I cannot hang out with that type of person and have them in my circle when I know they’re being inconsiderate, and there’s a possibility that I can bring something home to my family. Those types of people, I just have to love from a distance. And it’s hard. It’s so hard to do that because you don’t want to have a disagreement with people you love. My husband gave me an analogy last night because we were talking about the coronavirus. And he said, someone told him, if they were vaccinated and someone else not vaccinated, they didn’t want to hang out together. It doesn’t matter if you have a mask on and getting vaccinated; there’s still a possibility that you may still have the virus because although you get vaccinated, the vaccination protection is 95 through 99% effective. Nothing is 100% effective.

Right. And like you said, you have family at home and your loved ones. How has the pandemic affected you as a person?

I have spent so much time at home. I’ve gotten into puzzles, I’ve gotten into adult coloring. My family has a Zoom meeting every Saturday now, because I don’t see my mom or my sisters as often, so that’s good. I spend so much more time with my husband. I’m not a television watcher, but I have found myself watching so many movies with my husband and I think we were already close, but I think it just brought us closer. It’s made me more of a homebody, for sure. And I really enjoy being at home. 

Me too. When you have time off or you’re not at work, do you ever trouble separating yourself from what you do?

Oh, yes. I can tell you what happened to me last Saturday. I was at home; it was my day off. I was cleaning and cooking in the kitchen, and I got a call from my co-worker. She and I are very close, so it wasn’t an unusual call. She said, “Kim, I know you go back to work on Sunday night, but before you go in, I have to tell you something. I didn’t want anyone else to tell you; I wanted to be the person to tell you.” And so I said, “What’s going on?” And she said, “I just wanted to tell you that one of your favorite patients passed away.” And when she told me that, I just broke down crying. And I just… I could not believe that he passed away. And she said, “Kim, I know how much that man meant to you, so I made sure that he did not pass away alone.” I thanked her for that. And I told her, “Thank you for calling me and letting me know,” because if I would have gone to work and found out that he passed away, I don’t think I would’ve been able to contain myself. I was thankful for her that she called. Let me give you the backstory of this patient. This patient came in with covid back in September, he didn’t know how he got it. He was admitted to the hospital, and he was a young guy and he did not look good at all. We were working with him for two months, just trying to get him stronger, get him better, keep him off of a ventilator, he was in a unit where he saw other patients being placed on a ventilator, he came to me one day and he said, “Hey, I don’t want that.” And I said, “You don’t want what?” And he said, “That thing over there.” So he pointed to the ventilator and I said, “The ventilator?” And he says, “Yes.” He said, “If something were to happen to me, I don’t want that.” Because he saw what people really go through. So he talked to the doctor and we got everything in place. We knew that if something were to happen to him, he wanted to pass peacefully and he did not want to be on a ventilator. We worked with him for months, and he was in what we call MPU Unit - that’s like our COVID unit. Now in this unit, there’s no windows – not one window. There’s numerous patients in this unit separated by a wall or a curtain, and there was a clock on the wall. One day I went in there to see him, and I was so happy and cheerful. I went in there and I would always put both of my hands on his face and I would like shake his face a little bit, and I would say, “Aren’t you happy to see me today?” I would always tell him that, and he said, “You know what, I’m tired. I’m tired of looking at the clock. That’s all I have to look at is the clock. I’m so tired of looking at the clock.” He was so frustrated. And I said, “Okay.” I told another co-worker, and I said, “We have got to get him out of this unit.” She said, “I know. He’s been here for quite some time.” So then, he had ended up giving it to his wife and his wife got admitted. We put their beds by each other, so that he could be in the same room with his wife and they could be together. His wife stayed for a couple of days, she got better, and she went home. When she left, he started to deteriorate. So, I told my coworker, “We have got to advocate for him to get him out of this ward.” She said, “Okay,” so I knew she was working on it on the days that she was at work, and I was trying to work on it on the days that I was at work. I called the hospital supervisor and I said, “Hey, I really need a favor.” And he said, “What?” I said, “I know you’re busy and you have a lot on your plate, but if you can give me a room upstairs with a window and a television, I will owe you forever.” And he said, “I’ll see what I can do.” Then I had a patient on the third floor who unfortunately passed away from coronavirus. I called the house supervisor again and I said, “Hey, a room just became available. Can my patient have it?” And he said, “Well, I don’t see why not.” I said, “Okay, I’m gonna go downstairs, pack up all of his belongings, and then we’ll roll him up.” I was so excited. I went down there, packed up his belongings, and I told the patient, I said, “Hey, I found you a room! Aren’t you excited?” And then he said, “You keep saying that and saying that.” He lost all confidence in me. And I said, “No, it’s gonna happen.” And then everyone came in to move the bed to take him upstairs. He went to that room, and it had a window view; he could watch the hot air balloons from Temecula in the morning time, and it had a television, too. He was so happy, and I was so happy for him. Then he said, “Hey, can I take this oxygen that I’m on, home with me?” I said, “Well you can, but right now you’re not ready to go home. But we’ll see what we can do.” I was off for a couple of days and I saw him when I came back, and he was still doing great. And then I had a day off and he passed away.

That’s so sad.

I know. It’s a bittersweet thing. I’ll never forget him, but it made me feel so good that I was at least able to help him see the sunrise and the sunset before he passed away. Because he was in a room for three months with no sunlight, and just a clock on the wall. So if I could bring him just that little bit of peace, to see the sun rise and the sun set, I felt like I did my job and I was happy that he got to see that. You know, he was getting tired, and I can tell he was getting tired. He was losing the fight that was in him, and he just couldn’t do it anymore. I can tell, and you know, he was just done.  He told me before he died, “You know, I want you to know that I’m okay.” And I said, “You’re okay?” And he said, “Yeah. If something happens to me, I’m okay. I just want to tell you thank you for everything.” That made me smile, and I told him, “Don’t talk like that!” You know, because I didn’t want anything to happen to him. But unfortunately, he passed away. 

Do you see any of your coronavirus patients where you know that their way of living will never be the same again, even if they do make it?

Oh, yeah, most definitely. Even if they were to overcome the Covid  discharge from the hospital, those types of patients have a very long road ahead of them. They will forever be a respiratory patient, and they will forever have lung issues. 

This virus changes everything.

It’s so crazy because you’re such a healthy person. You might be into fitness and exercising; I’ve had some patients like that. You get this virus and it completely shuts your body down and now, months after being testing negative, you’re still experiencing lung issues and shortness of breath and inability to breathe. It’s just like, how could a virus – an invisible virus – do so much damage to so many people?

I know. Through that story, though, you bring up a good point about how you advocate for your patients. Being a nurse is so much more than the medical side, the technical and things like that. What do you wish people knew about nurses?

That we’re people, too. We can’t fix everything. And I don’t want to take anything away from doctors, but we’re the people that are at the bedside 24 hours a day. Sometimes I feel that, especially respiratory therapists and nursing, they don’t get enough credit. 

They don’t. Nurses are everything.

Sometimes when patients come in, they want to see the doctor and they want certain things, and that’s fine, but you know what, the person that’s going to advocate for you, get you what you need, order certain things that you need, it’s going be those nurses and respiratory therapists. There’s plenty of times where I had a doctor say, “Oh no, let’s not do this,” or, “Let’s do this,” and I say,  Why aren’t we doing this? This patient needs this.”

It’s almost a weird title thing. Because at the end of the day, nurses are there for you the majority of the time. When patients come in, though, you see them at their worst, essentially. No one goes to the emergency room for fun. Seeing what you see, what do you wish people knew?

When a patient passes on, it affects us. It’s sad. we have a brave face but inside we’re hurting too. 

I agree. That being said, what is one thing everyone should know how to do? 

CPR. Because you can really save a life. 

Right. Another thing people should know about you is that you’re the queen of life hacks. You always have the best advice for everything. One tip I remember is that if you have a stiff neck, put Icy Hot patches all over – like a lot – and do a cycle of that and it’ll loosen up. What is another one of your go-to tips?

Falling to sleep with meditation. I love that, every night. Last night, I played it for my husband. For the first, like, two minutes, he complained that the guy’s voice was not soothing, next thing you know, I turn over and he’s snoring. So, I love to fall asleep to meditation. I have a Peloton bike so I use Peloton meditation. That is my go-to. 

You’re also the self-care guru. You always remind me to make time for myself. What advice do you have for someone who keeps making excuses to not make themselves a priority?

Start with a journal. When you wake up in the morning, list one thing that you’re grateful for, two things that are productive and that you want to achieve for the day, one thing that you’re going to do for someone other than yourself, and to end it, a prayer. I love self-care. You can never have enough self-care.

What inspires you to stay consistent with it? 

My mom taught us to always be grateful for everything. And then I just kind of incorporated self-care into it.

because if I’m not taking care of myself, how can I take care of anyone else? I mean physically, mentally, spiritually. I have to be grounded in those aspects to take care of someone else, to give of myself to someone else. We all do.

Lastly, what has this time of life taught you about yourself?

To slow down.

seven questions with kim mays:

I can’t go a day without… tea.

Everyone should read... Comfortable with Uncertainty by Pima Chodron.

Life is better with a little…Cheddar Cheese 

Everyone in their 20s should… Travel 

One insider thing to do in Palm Springs… ride the tram.

What the world needs right now is… kindness.

One way to spread love is… random acts of kindness. I love those things where you go to, say to a fast food place or you go to Starbucks, and the people purchase your food behind you, and then you pay it forward, and the next person does it. I love that.

All photos courtesy of Kim.