Work is changing, probably forever, as are ideas about whose labor counts. Clocking In is a series where we talk to workers of all kinds about a single day in their lives.
Dana’s alarm goes off at 5:00 a.m. on a Wednesday, in her home—a short-term rental in Minnesota. It’s the morning of her third scheduled shift out of five that week; she snoozes the alarm and doesn’t get out of bed until about 5:25. After washing her face and brushing her teeth, she puts her hair into the low bun that she favors. It fits under the surgical cap she wears all day at work, to keep airborne particles from nestling. Once the dog is walked and the coffee is made, she grabs her lunch and a few snacks, along with some water. Later she tells me she doesn’t even know why she bothers with the coffee most of the time. Over the course of her shifts at a designated covid-19 hospital in the Twin Cities, which last between ten and twelve hours, she only ever really gets to have a few sips.
As a travel nurse, Dana is used to reshaping her life every few months. But adapting to pandemic care can be draining, even for someone who has been practicing emergency medicine for years. Dana was finishing up a job at a hospital in Louisiana when the state logged its first batch of covid-19 cases. That contract ended April 6th. Weighing a set of internal variables, she chose to take her next eight-week stint here. She’s always proud the be working as a nurse, and appreciates that the profession has been valorized over the last months. “I used to get comments like, ‘It must be nice to sit around and do paperwork all day,’” she says. But she has no illusions about why she’s making so much more money than she has in the past. “It’s what the military gets,” she says. “In case they die.”
“It’s what the military gets, in case they die.”
The commute from Dana’s temporary housing to the hospital is about twenty minutes. She lives in a townhouse split into two apartments, both occupied currently by nurses. Dana, who is in her early 30s, has been a travel nurse on and off for nearly a decade, working short-term contracts in emergency rooms in 20 different cities and states. She likes the work. It pays well, and she’s been able to see a lot of the country. You can stow away an awful lot of savings if you’re flexible and interested in moving around.
Before St. Paul, Dana was in a hospital outside of New Orleans; before that, it was Detroit. A few weeks ago, she took a two-month contract to work in one of the Twin Cities’ only health centers catering specifically to patients who have tested positive for covid-19, a stately brick building that’s nearly a century old and was last used as a hospital in 1989.
“They don’t want to expose more nurses than necessary,” says Dana. “If you’ve already been exposed you might as well keep getting exposed.” Her weekly pay here is about two-and-a-half times as much as she’s made at former jobs, about the same as what nurses getting hazard pay in New York take home. It’s very good money, calculated for the increased risk. Dana keeps three pairs of shoes: One she wears only on the hospital floor, one she sanitizes regularly for commuting and going on walks, and one that she keeps in her temporary home. Caring for these patients is the hardest thing she’s done in the course of her career, she says.
Dana clocks in at the hospital at 6:49 in the morning. She’ll clock out 11 hours later with a half-hour for lunch. In the locker room, she changes into scrubs and the work shoes she says she’ll throw out when she finishes her eight-week term here. At the moment, there are two floors reserved for ICU patients, most of them on ventilators, and three for covid-19 patients who are doing fairly well. Dana says it’s a good sign there are more of the latter than the former, right now.
About half her current colleagues are in from out-of-state. The others are local nurses shouldering the increased risk. The health system Dana is working for furloughed scores of employees as most procedures and surgeries were canceled over the last months. According to the hospital system, the nurses who qualified to work in this covid-19 hospital, the ones with ICU or emergency experience, were not offered hazard pay to fill this particular need.
Yesterday, one of Dana’s patients had been moved from the ICU down to the lower floors, where he might have been discharged. She’d expected to start the morning working with new patients, helping out on the admitting floor. But now it’s Wednesday and “today is a new day,” she says. She starts her morning with a rapid response call; her patient has worsened. The team specializing in resuscitating patients moves in and he’s taken back to the ICU, where he’s in a unit close to his wife. The couples’ daughter calls for an update. Dana and a colleague talk to her about her family’s condition over the phone. “Everyone is very different,” when it comes to the progression of this disease, says Dana. “The patients are very delicate.”
“I couldn’t imagine having this conversation with my parents and keeping my composure.”
A patient is fighting a ventilator. The level of sedation needs to be fixed. Dana spends three hours in the room making sure his vitals are stable. Through the morning the phones won’t stop ringing. Nurses are requesting medications for their patients; the floor needs more IV drips, more sedative drugs. There’s an IV tubing shortage today—later in the week, it will be a shortage of ventilator filters—which means IV pumps can’t be placed outside a patient’s room. Every time a machine beeps, Dana must have on her N95 mask, washable isolation gown, gloves, and face shield. She’s very careful with the gloves. Often, when Dana is treating or admitting a patient, she’ll write supplies on a whiteboard and place it in the room’s window, so other nurses can get her what she needs from outside.
In the afternoon, a patient’s daughter wants to Zoom with her parents, both of whom are still in adjacent rooms in the ICU. Dana waits outside the rooms to sanitize the iPad between visits. The woman spends nearly an hour talking to her mom, and when she’s ready to talk to her dad, she puts the grandkids on. They tell him who is watching the dogs and how happy they are to see him opening his eyes. Dana cries a little bit, overhearing them through the wall: “I couldn’t imagine having this conversation with my parents and keeping my composure,” she says. The next day, Dana will comfort the daughter when she blames the excitement of the call for a sudden downturn in her father’s health.
At 4:00 it’s time for lunch. Dana never did drink that water, so she drinks it now, sitting in silence for about half an hour. When she returns she finds one of her earlier patients, stable all day, had gone hypoxic—a dangerous condition where there isn’t enough oxygen circulating through the blood. He’s spiked a fever, too. Dana and her colleagues pack him in ice and watch him slowly improve. Around 7:15, Dana walks out of her patient’s room and begins to take off her gown and shield, but a piece of machinery goes off. She suits back up and addresses the low blood pressure that sparked the alert. She sticks around to update the night nurse and speak to the physician’s assistant. By the time she clocks out it’s 7:40.
Originally, Dana had wanted to stay in New Orleans; she was working in a hospital there when the city reported its first positive covid-19 tests. But none of the hospitals called her back. She’d been offered positions in New York, but watching crews set up triage camps and hearing about the shortages of equipment, she wasn’t entirely sure she was ready for that. At least Minnesota has a strong union presence; like California, another popular destination for travel nurses, state laws mandate how many patients a single provider can see. Which isn’t to say this work isn’t gutting: “It’s devastating,” Dana says. “You see someone completely fine a week ago, and now they’re on life support.”
After she clocks out, Dana walks to her car. She blearily opens Facebook once she’s in the driver’s seat, mostly out of habit, but everything she sees is about the people protesting state lockdowns. “I can’t stomach any more of that,” she says. She listens to a true-crime podcast on her way home instead of the news. After sanitizing her shoes and everything she’s brought home with her, Dana takes the dog for a walk and washes her hair—something of a chore, but a necessary one every night she’s off a shift. Like most nights she’s working, she watches something mindless on TV to calm her nerves. It’s just after 10:00 and she’s hoping to fall asleep soon.
This story has been updated to clarify pay scales for local nurses working in this facility.