YSN Student on COVID-19 Front Lines in Detroit

May 21, 2020

Erin Micale ’21 DNP is a float RN working in the Ascension Healthcare systems in Detroit, Michigan. She also teaches psychiatric nursing, medical-surgical nursing, health assessment, evidence based practice, and immersion clinical courses at Madonna University. She is also a recipient of the prestigious Yale School of Nursing Gruber Nursing Fellowship. In addition to her work being affected by COVID-19 (coronavirus disease), she is also recovering from the virus. 

This is part of an occasional series of YSN community members sharing their COVID-19 experiences.

YSN: How is COVID-19 affecting your daily work right now?

I currently work two different jobs, one as a nursing professor and the other as a float nurse at the hospital.

They changed many hospital policies to accommodate the pandemic, so it made our work responsibilities more bearable during this time. Generally, I’ll have an average of 5-7 patients, but since the start of the pandemic I have had a maximum of three. Originally, they were anticipating that each nurse would have up to 10 patients to accommodate the surge and changed our charting and assessment requirements to be less because of that. Thankfully we had many nurses come from throughout Michigan, Texas, and Ohio to support the surge, so we were never short-staffed, and we never had to have that many patients. Thanks to the help of the nursing community, working at the hospital has actually been much easier than usual. 

During the surge, they had turned over half of the hospital into COVID-19 floors and were more selective about what “non-COVID” patients they were admitting. When I last worked, they had already turned 5 or 6 units back into “non-COVID” floors, which was reassuring that not as many people were getting sick from COVID-19 or needing hospitalization.

My other job—as a nursing professor—continued as usual with the exception that everything was changed to online instead of in-person. That was a bit of an adjustment, but we were all able to get done what we needed to and many of the students were very patient and accommodating with that. The main way that COVID-19 has affected that position is the students are no longer able to complete their clinical hours in the hospital setting, so we had to transition to virtual simulations and are waiting to hear when the students can return and finish up their semester. 

YSN: What has surprised you about operating in this pandemic environment?

I think that the thing that has surprised me the most is that health and safety has suddenly been defined as “COVID” or “non-COVID.” The whole world shut down, and everything changed because of the virus, and it seems like we all suddenly forgot about so many other things that are important to health and wellness.

In nursing education, we teach the students that a person’s health is defined by 8 dimensions of wellness: physical wellbeing, social support, intellectual stimulation, emotional wellness, spiritual wellness, environmental safety and appeal, financial security, and occupational status. During this pandemic, people have been so consumed by the physical aspect of wellness that the government, the citizens, and even nurses have seemed to forget that we are holistic people, and we still need to do things to care for the other aspects of our health. 

Suddenly we’re seeing an increase of death at home from heart attacks and other illnesses because people are afraid to go to the hospital; or they can’t access their medications; or their medical appointments, surgeries, and diagnostic testing have been cancelled in response to the governor’s mandates to slow the spread. We’re seeing an increase in depression and anxiety, drug overdose, and suicide attempts. We have restricted visitors, so people are dying alone. Women are giving birth to their children without the presence and support of their partners, and while I understand that we don’t want to spread disease, something about it seems so inhumane and neglectful and against everything we learn about providing good, holistic nursing care.

It’s been a very hard adjustment and really hard to process and accept. I don’t know what the answer is, but I think that is my biggest surprise: how we suddenly forgot how to be humane and how quickly we put aside so many fundamental aspects of nursing to prevent the spread of COVID-19.

YSN: If you could tell the public one thing about this pandemic, what would it be?

“Remember that everyone is having a different experience with this, and nobody’s experience is wrong.” 

Some people have lost jobs and can’t support their families or secure housing and they may feel the need to protest the stay at home orders—and that’s okay. They aren’t stupid or dumb or idiots. Some people may have lost family members or may have high risk factors and don’t want to get the disease—and that’s okay. They are not stupid or dumb or idiots. Everyone has different resources to help them through this: some more, some less, and we need to be cognizant and compassionate to everyone’s stories and situations, not just our own. So stop the hate—this is a time to love and accept one another. We need to meet people where they are at, and make sure that we are taking care of each other in every way we can!

YSN: How can people and institutions best support nurses, midwives, and other front-line healthcare providers?

By continuing to take care of yourselves. Go for a walk if you need to. Reach out for support if you need to. Sleep if you need to. Ultimately, when this pandemic is over, we may see an influx of hospitalization for so many other things—suicide, substance abuse, other communicable diseases that we usually build up immunity to but aren’t because we’re isolating. So get your rest, eat healthy, love and support one another, and let’s try to prevent another overload of hospitalization.

YSN: Are there any habits you’ve established during COVID-19 that you anticipate maintaining after the pandemic threat recedes?

I am kind of a workaholic, and during this pandemic, I have been forced to rest and sleep more than I have in years. I think I would like to maintain part of that. Making sure I am not overloading my schedule and responsibilities. Give myself time to rest and take care of myself.