When the Provider Becomes the Patient: What I Learned From COVID-19
My world changed on December 22, 2021. It is a day I will never forget: the day I tested positive for COVID-19. For nearly two years, all while caring for patients with the virus, I avoided contracting it. I prided myself on mask-wearing, handwashing, and social distancing, but what we know all too well is that COVID-19 does not discriminate.
As a fully vaccinated and boosted young person without any comorbidities, I expected to make a quick recovery after the test showed I was positive. I had mild symptoms the first two days, but they worsened after Christmas, especially my breathing. My oxygen saturation was around 90%–92%, my cough was productive, and I couldn’t taste or smell anything. I finally decided to see a doctor when I couldn’t brush my teeth without falling short of breath.
Because I was COVID-19–positive, I scheduled a virtual appointment about a week after my initial diagnosis. The doctor saw my vitals, heard my cough, and prescribed antibiotics and steroids. But despite following the treatment, I wasn’t feeling better. I had minor improvements and stopped having fevers, so I returned to work with the hope of improvement, but my brain was still in a fog and I would forget routine things like the room numbers we used for a clinic. As my mental strength slowly returned, my lungs couldn’t keep up, and that made me nervous. I struggled to walk to my train, and once I got home, I went straight to bed with extreme fatigue.
On January 14, 2022, sitting at my desk, I turned to my colleague and said, “My chest feels tight.” I started coughing and wheezing. She looked at me and replied, “You need to go home. Something is wrong.” I went home and tried a nebulizer treatment, but my oxygen saturation hovered at 82%, and my nursing knowledge told me that I needed emergency care. I called my fiancé and said, “Okay, don’t freak out, but I need you to take me to the hospital now.”
The emergency department (ED) placed me on a nasal cannula with no improvement. My family has a history of pulmonary embolism, and COVID-19 infection increases your risk of blood clots (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377993/). The ED physicians wanted to rule out an embolism, but they couldn’t use a BiPAP machine (bilevel positive airway pressure) because I was unstable. My fiancé may become my proxy and would have to make medical decisions for me. We discussed my wishes and that I wanted full care. I was going to fight.
My experience reinforced the importance of advance directives. I never expected to need one at this phase of my life, but my story illustrates how even a healthy young adult with no comorbid conditions may encounter a situation that requires a healthcare power of attorney. As oncology nurses, those kinds of conversations with our patients are critical, no matter the stage of their cancer journey. ONS has an advance care worksheet (https://www.ons.org/clinical-practice-resources/advance-care-planning-worksheet), video (https://www.ons.org/videos/advance-care-planning-video), and podcast (https://www.ons.org/podcasts/episode-21-normalizing-use-advance-directives-cancer-care) to help you approach those discussions.
COVID-19 took a lot from me, but it was not going to take my nursing-honed ability to handle an emergency situation. I wanted to prove to my fiancé that I was strong and not scared. I wanted to show my colleagues that I was a nurse and in some way that COVID-19 wasn’t affecting me. I think I never accepted the fact that I could become as sick as I did, and that’s one reason I delayed seeking care.
Thankfully, I was able to slow my breathing in the ED after high-flow oxygen and steroids. I also had a computed tomography scan that showed no evidence of blood clot. The ED physicians admitted me to monitor my oxygen, but I begged to be discharged the next day with the promise of aggressive, self–pulmonary rehabilitation at home.
The weeks at home were rough. The one thing I needed was rest, Steroids (https://link.springer.com/article/10.1007/s40121-020-00338-x) were my frenemy (https://www.merriam-webster.com/dictionary/frenemy) and resting and relaxing are not my forte. I idolize Clea and Joanna from The Home Edit (https://www.thehomeedit.com/), but I couldn’t even use my downtime to organize my closet because I would get short of breath just brushing my teeth. And my clothes felt different as my body changed while I was too short of breath to spin with Cody on Peloton (https://www.onepeloton.com/instructors/bike/codyrigsby).
The steroids really affected me. I was crying because I was so hungry and gaining weight like crazy, all of which I knew were some of the side effects, but because they also gave me anxiety, I couldn’t cope. Looking back, that experience helped me better relate to my patients because it showed me how medications really can alter a patient’s personality and that side effects are real. As nurses, we need empathy for our patients because emotional struggles are just as important as physical.
Although the physical barriers during my COVID-19 recovery were extreme, mentally, I never felt stronger. I am fortunate to have a great support system. My friends, family, and coworkers were incredible to me, and a few people and medical advancements saved my life. My nurse coworkers helped me get to the hospital quickly, and the physicians and nursing staff at the hospital, my friends, my family, and my fiancé are why I am alive and recovering. I would not be here today without them or the vaccine (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/about-vaccines/index.html?s_cid=10493%3Acdc%20covid%20vaccine%3Asem.ga%3Ap%3ARG%3AGM%3Agen%3APTN%3AFY21).
How Being a Patient Influenced My Nursing Practice and Advocacy
Now when I see patients in the clinic, I feel like I can relate to them more. Because I’ve never had a medical issue like hypertension, diabetes, or cancer, I didn’t have a way to connect with them on that level before, but now I can truly understand and say, “I know what you are saying. I know exactly what that feels like.”
I’m now adamantly advocating for COVID-19 vaccination (https://voice.ons.org/advocacy/share-these-resources-to-increase-covid-19-vaccination-rates) and using my story to overcome barriers (https://voice.ons.org/advocacy/how-public-health-can-stop-the-pandemic-hint-its-covid-19-vaccination) like personal beliefs, political views, and apprehensions. My physicians have told me that I would not be here today if I had not been up to date on the vaccine.
And I also now recognize nurses’ critical calling to promote education and awareness (https://voice.ons.org/advocacy/nursings-new-role-public-health-information-advocate)—among our patients, communities, and colleagues. I delayed seeing a physician at my diagnosis, but if a friend, family member, or patient ever came to me with the same symptoms, I would have them seek medical care immediately.
Nurses must learn to care for ourselves as they care for others. It is so difficult to remember that, but after my COVID-19 experience, I’ve learned to not take my health for granted and to take care of myself so I can care for my patients. I am following that advice every day so I can continue to be the provider instead of the patient.