#nurselife: National Nurses Day + Indian-American Nurses in the COVID19 Response

“On a rainy Sunday morning last weekend, we had just finished breakfast. I was happy that I was able to make Appam and egg curry (a traditional south Indian delicacy) for breakfast after many months. I sat on the couch and was checking the messages on my phone,” Mary (the names of the nurses have been changed for this report), who is an RN at a large hospital in the state of Connecticut, recalls. “I was shocked to learn that a 41-year-old male patient I had admitted and had taken care of for over a week has come positive for Covid-19, the deadly virus that has affected over a million people in the United States alone.”

This is not the first patient Mary had worked with for weeks/days, not knowing that the patient had hidden symptoms of Covid-19 since the pandemic broke out over two months ago. The fear of being exposed to the symptoms while serving patients who are not diagnosed with but carry the virus, has been devastating.

Mary does not work on a unit assigned to work with Covid positive patients, but has been unknowingly caring for many such patients, risking her own life and that of her family.

Mini, on the other hand, was called to work on the Corona units, which have now come to be occupying entire five floors in addition to the ICU/EDs in her hospital because of an overwhelming flow of people diagnosed with the deadly virus.

The lack of adequate tests for corona virus leads to the healthcare professionals, who are the heart and soul of healthcare delivery system, being exposed to and being infected themselves and endangering the safety of their loved ones at home. “It’s a nightmare going to work,” Mini says. “Seeing my colleagues one by one falling victim to this virus has made me nervous about going to hospital every morning.”

“A vast majority of the nearly two dozen clinical staff on my unit have become positive for the virus,” Mary reports with anxiety and fear. “One of my colleagues, with whom I have worked for over a decade has been in the ICU for over two weeks now, struggling for her life. Another colleague, and everyone in her family have been positive for the virus. Many others from my Unit are still recovering or struggling recover from the deadly virus that has taken away nearly 60,000 lives in the country.”

Mary herself had shown symptoms that go with people diagnosed with Corona virus, and has been self-quarantining for the past six weeks, mostly isolating in her room after work and with minimum contact with her husband and their three daughters.

The experiences of nurses who are in the frontline caring for patients have been traumatic to say the least. Sumana Gaddam, Indian American president of IANA-North Carolina, says, “Nurses are the life and soul of the healthcare profession, providing comfort, kindness, and care to patient’s every day. It’s indeed a challenging job that requires hard work, dedication, and a very thick skin. Nurses are the ultimate healthcare monitors – vigilant observers and problem solvers, poised to take action whatever the challenge. Our mindset is one of preserving the unique attributes of our roles while embracing the progress that helps us excel.”

During this pandemic, the role of nurses has become even more challenging in every possible way. Ciji, an ER nurse at a local hospital in Connecticut, says, “When I first heard about Covid-19, I never in my wildest dreams thought it would be this bad.”

The challenges of working with the Covid patients is not limited to work alone. “Since the first day of caring for Covid patients, I had isolated myself at home. I am very concerned about the safety of my family as I could bring this virus home any day with me. I have my kids, husband and, more importantly, my elderly parents who are vulnerable to this virus. I want to keep them safe.”

Describing her work and the challenges at work, Ciji says, “The stress level at work is unprecedented. We work hard to keep people alive. It’s painful and traumatic to watch my patients die without being allowed to see their loved ones even at death bed. Working in ICU wearing N95 mask for 13 hours gives me terrible headaches. I get home and cry in the shower because I don’t want my family to see it.”

Experiencing this self-isolation for weeks takes a toll on Ciji and the entire family. “I wish to hug my kids but I can’t. My 3-year-old daughter knocks at my bedroom door but I can’t open the door to let her in. You will only be able to understand this pain when you go through it,” Ciji says with tears rolling down her eyes.

Ciji’s experience is shared by numerous colleagues around the nation and world. Shyla, who works in the medical ICU at a leading healthcare facility in Connecticut, says, “In the past few weeks, the entire unit is filled with only COVID patients now. The large ICU has been turned into exclusively for treating COVID patients, calling it now Covid-ICU.”

Describing that all the patients with are “extremely sick, and most of them are on the ventilator for weeks now, it is very depressing to work with patients during this pandemic,” Shyla says. “We are working hard all day and night, don’t see the progress in several patients.”

Kavya, from Long Island, New York who works in a Rehabilitation Unit at a local hospital, says, “Now we are treating only post-Covid patients on my unit. Among all the patients and negative news about the losses, I was glad to discharge a 68-year-old patient home last week. He had come to the hospital for kidney transplant, and had subsequently developed Covid and was faced with several complications.

There are several nurses who have sacrificed their lives while caring for patients with Covid 19. Aleyamma John, 65, a registered nurse at a New York City Queens Hospital Center, passed away on April 7. She began her career at Parker Jewish Institute for Health Care and Rehabilitation, before moving on to the NYC Health + Hospitals system in 2003.

“We honor Aleyamma’s record of service to the patients of New York, and her career spanning record of National Association of Indian Nurses of America membership and participation,” Agnes Therady, RN, and currently serving as the president of NAINA, the foremost organization for all professional nurses of Asian Indian heritage in the U.S. since 2006, said.

These nurses are among the thousands of Indian American Registered Nurses in the New York Tri-state area and around the nation who have been in the forefront providing professional nursing care to thousands and thousands of COVID-19 patients. 

As U.S. health care facilities struggle to fill current registered nurse staffing vacancies, a more critical nurse undersupply has been foreseen over the next few decades. In response, many institutions are doubling their efforts to attract and retain nurses, and many more nursing schools are opening up and the existing schools are expanding their programs accommodating more students. In the interim, foreign nurses are increasingly being sought, creating a lucrative business for new recruiting agencies both at home and abroad.

Nurses who migrate from India to the U.S. undergo both socio-cultural and workplace adjustments. They deal with loss, change and sacrifice. Workplace adjustments include communication issues, dealing with a new healthcare system and adapting to an expanded role of nurses. However, in a very short time, they adapt and master the skills and shine as the best among the nursing community.

Nurses from India and born in the U.S. have made an impact on the patients they care for. In recent decades, the U.S. has been looking to India to alleviate its shortage for nurses as Indian schools are churning out professionals matching American standards. “India is now being recognized as an area which offers bachelor-degree nurses and a good health care system with an abundance of nurses,” Mary Prascher, HRD manager at Texas-based Triad Hospitals, was quoted as saying by the Dallas Morning News

Indian American nurses, like the physicians serving millions of patients in the U.S., have come to be known for their compassion, dedication and clinical skills, touching thousands of lives daily. Nurses educated in India make up one of the largest groups of internationally educated nurses in the United States. Internationally educated nurses from India is the third largest group of internationally educated RNs serving patients in the country.

Nurses such as Mary, Shyla, Ciji and Kavaya continue to play a critical role in alleviating patients of their illnesses, especially during this time of pandemic. They are showing the way for many others from India and other nations to come and continue to provide critical care to the patients in this country. While they are in the forefront treating patients and impacted by the struggles of the patients, and being isolated in their own homes, away from their loved ones, for fear of bringing home the virus from the hospitals they are committed to serve, they are hopeful and are satisfied that they touch so many lives daily, giving them health and hope.

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