Every day when she gets home from work, Rachel Spray parks her car inside the garage of a home she hasn’t entered since early April. She takes off her shoes and leaves them in the backseat. In flip-flops, the nurse and mom of three walks away from her driveway, covering about 100 feet, and comes to a camping trailer with swooping beige and brown designs across its front door.
It is an RV, on loan from her parents. It is her home in exile.
“Before, I’d come home, I’d help take care of the kids,” says Spray, a nurse at a Kaiser Permanente Fresno Medical Center. “I was always helping with the homework, we’d have dinner together.” These days, she adds, “I go home, and I go straight to the RV.”
This kind of story isn’t just playing out in an RV in Fresno.
Spray is among the untold thousands of nurses and health care workers who have found themselves on the frontline of a the fight against a global pandemic. Across the country, nurses and medical workers are shouldering the burdens of medical systems strained to their breaking points.
From an RV in Fresno to an apartment in Chicago to a pregnancy ward in Boston, mothers on the frontlines of the coronavirus outbreak spoke to Patch about what they’ve seen — and sacrificed.
“Boring, Lonely And Hot”
The RV in Spray’s yard was never meant to be a guest house. In its former life, it was towed by Spray’s parents on road trips to Arizona, Oregon and Idaho, the vehicle a veritable living room on wheels, complete with a sofa, recliners, a kitchen and bedroom. Unfortunately for Spray, what it doesn’t have is a cooling system that can handle Fresno’s triple-digit heat.
“It’s boring, lonely and hot,” Spray says, summing up her state of isolation. “It’s like 100 degrees inside, and if I use the air-conditioning too long it pops the breaker.”
When she’s not at the hospital, Spray says she fills her time by journaling, watching TV and talking with her family by phone. When her kids come to visit, knocking on the door with homework questions, they don’t enter the RV. They talk outside, at a 10-foot distance.
“The way for me to get through this is to keep taking care of patients; I’ve never picked up this many extra shifts since I’ve worked there,” she says. “I’ve never been one to take extra work. I usually spend time off with my family.”
For Spray, the decision to move out came in April. She says she began hearing about nurses getting sick, and she grew alarmed after hospital staff were instructed to reuse their N95 masks between patients, contradicting the previous safety policy. She stopped feeling safe at work. She couldn’t bring that danger home to her kids.
“My girls, both have pretty bad asthma,” she says. “They’ve had pneumonia at least half a dozen times each. One of them has been on a ventilator before. I fear that if they get it it’s not going to be good.”
Since March, more than 9,000 U.S. medical workers have been infected with coronavirus, the federal Centers for Disease Control and Prevention reported, while National Nurses United reports88 nurses have died amid nationwide shortages of protective gear. If the hospital wouldn’t, or couldn’t, protect its nurses with sufficient supplies of protective gear, Spray reasoned, she would had to take action to protect herself.
She was caught between obligations — between her duty to patients at Kaiser, and her love for her children and husband waiting for her at home. Spray split the difference — by moving into an RV in her yard.
“I miss my family,” Spray says, though she notes she’s not the only nurse in her unit to self-isolate. One nurse is living out of a hotel room. Another moved in with a second nurse, but eventually moved back home to take care of her young children.
“It’s already hard on our kids,” Spray notes. “They’re dealing with the stress of being pulled out of school. My daughter was supposed to graduate this year. And then mom leaves.”
“It’s tough,” she adds. “It’s tough all around. “
“I Can’t Bring This Home”
It started with one patient.
It was early March, and Falguni Dave, a charge nurse at Stroger Hospital in Chicago, noted the symptoms with increasing alarm. The patient had appeared in her unit at 9 a.m. By noon, he was feverish, in the ICU and intubated.
Could it be coronavirus?
At the time, hospitals still didn’t have access to quick testing. Dave remembers reading through the patients’ charts one last time before leaving her shift that day. She thought of her husband, who is diabetic, and her elderly mother-in-law at home.
“I decided, after that day at work, I wouldn’t go back to my family,” Dave recalls, “until I figured out what was going on with the patient.”
It was a time of confusion. Dave spent the next four days in a hotel room, but decided to return home after the patient’s test results came back negative for coronavirus, despite seeming to show the major symptoms.
Slowly, and then quickly, the coronavirus was spreading throughout the country.
On March 16, Illinois passed 100 cases, and Falguni says a hospital administrator called her in for a meeting: Her unit, Falguni was told, was being converted to COVID-19 care for detainees at the Cook County Jail.
She had one day to prepare, and spent one last night at home. The next day, on March 18, she rolled a light-colored suitcase into the apartment her daughter, a sophomore at the University of Illinois-Chicago, had vacated after in-person classes were canceled. This was her new home.
“We’re constantly in front of these COVID-positive patients, in and out every day. We’re picking up their meal trays, taking the garbage out of the room,” she says. “I told my husband, ‘I can’t bring this home.’ “
The first week in the apartment was the hardest.
It was the first time Dave has lived on her own, and she says she found herself crying, “randomly, for no reason,” in the empty space, missing her daughter, her son and her husband back at home. And while they stay connected through calls and the internet, it’s not the same. And for Dave, it’s not enough.
“You want to see your loved ones face to face,” she says. “My husband, he comes to visit, and he’ll stand on the street, about 12, 13 feet away from me with a mask on, just to see me. We’ve been married 25 years, we’ve never been apart this long in our entire lives of knowing each other.”
She knows other nurses are making similar choices.
One rented a studio apartment in order to have a clean place to change her clothes and sanitize before returning home to a newborn baby. Another is living in a hotel across the street from a medical facility. Another dropped her 4-year-old daughter off at a relative’s house for the foreseeable future.
At the same time, Dave has seen the ravages of the disease up close, her sickened patients shackled to the hospital beds. To date, more than 800 Cook County detainees and jail staff have been infected; seven detainees have died.
Despite the risk and ongoing shortages of protective gear, Dave says she can’t stop being a nurse. Not at a time like this. Her patients need her, and even though nurses are told to limit their time with the infected, Dave will sit next to their beds, hold their hands, and let them cry until they’re ready to talk.
Later, she goes home alone. It’s been nearly two months. But she’s not thinking about giving up.
“Everybody has a reason to walk away from hard situations; they have the right to do so, I can tell you that myself,” she says.
“But,” she adds, “I signed up for this, because I truly wanted to care for the sick, and I chose to work at a specific facility that serves the underserved in Chicago. Underneath all my PPE getup, I try to be the person that I am, what I signed up to do.”
“Admiration And Awe”
Years before she became the director of nursing in the labor and delivery unit at Beth Israel Deaconess Medical Center in Boston, Elizabeth Kester was a patient, pregnant and going through a difficult birth with her first child.
“I just felt such admiration and awe for nursing, particularly the maternity nurses,” she says. “I remember thinking, ‘I can’t believe these people do this every day.’ “
She’d soon believe it.
The experience ultimately changed Kester’s life, not just in that she became a mother, but in that the moment of admiration led her to cut ties with a long career advertising. In 2007, she became a nurse, and by 2013 moved up to leadership role in a pregnancy ward, managing nurses just like those who had had inspired her.
Of course, while most hospitals have halted or delayed non-critical surgeries and have converted resources into units treating the outbreak, pregnancies aren’t taking a break.
The hospital’s pivot to a primary mission of infection containment, she says, “has pulled me out of a lot of work that I found really meaningful, and it’s totally changed the focus of my work.”
Indeed, while Kester’s normal day-to-day duties would involve close monitoring of the unit’s 120 nurses, she’s embroiled in the vast sea of logistical planning required to keep those nurses protected. On a recent day, finalizing which color of protective gowns go in which bin for cleaning was a multi-hour ordeal.
And for a pregnancy ward, the sight of an empty waiting room is reminder of the painful sacrifices being made by patients. There are no crowds of waiting family members eager to see the new mother and coo over the blanket-wrapped baby.
“This is a tough time to be giving birth in a hospital,” she says. “A lot of patients envision their birth experience going a certain way, the same way people grow up thinking about their wedding day. Having to redefine their birth experience is hard enough.”
As a director, Kester isn’t on the clinical frontlines of coronavirus response. But she watches those who are. Recently, she says, she’s noticed a new kind of greeting shared between heavily PPE’d nurses as they pass each other.
“When the nurses are in a mask, goggles, cap and gown, it’s really hard to connect; you’re just looking at set of eyes,” she says. “In the last few days, you walk down the hallway, and everybody has a mask on, and you hear, ‘I’m smiling at you.'”
Soon, one hopes, the need for masks will disappear. Families will welcome babies to the world. In Chicago, Falguni Dave will see her husband again, and in Fresno, Rachel Spray will sit down for dinner with her kids.
On that day, after all the sacrifice, their smiles will be self-evident.
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