When Natalie Johnston walked into Swedish Hospital Issaquah in the first week of March, her workplace looked remarkably different. The nurse had been away for about two months, wrapping up rotations on First Hill and Cherry Hill for an RN ICU—registered nurse in an intensive care unit—fellowship, but the coronavirus epidemic had totally reshaped her workplace. She could immediately see that the unit’s layout had been revamped and new stockpiles of personal protective equipment (PPE). New faces greeted Natalie, staff brought in as additional resources.

“The whole way our unit runs had to be modified,” Natalie says. She quickly adapted to new precautions around PPE; she now uses temporary stations outside of patient rooms to quickly and safely don, then dispose of, her protective gear: gowns, gloves, N95 face masks, hair covers, shoe covers, and face shields.

Since she’s been back, the ICU is slightly more crowded, and not just from the extra staff. A rise in ICU patients divided the unit. Before she left Issaquah, Natalie would care for telemetry patients—ones that require cardiac vital monitoring—alongside intensive care patients. To make room for the Covid-19 patients requiring ventilators, most of those telemetry patients were moved from the ICU to a different part of the hospital. Now, Natalie’s focus is primarily on caring for intensive care patients, some with the virus.

Pre-Covid-19, Natalie’s RN fellowship took place alongside an active social life: concerts and happy hours, time with friends and family, and fitness, including skiing. The crisis brought all that to a halt. No longer seeing family face-to-face hits her the hardest, but was a no-brainer when she considered the long-term risk of exposure as a nurse. For now, her attention is in the ICU: “It’s just the nature of my job to take care of the patient,” she says.

When Natalie goes home for the day, that’s changed too. She tries her best to limit exposure to her roommate, though sharing an apartment makes it difficult to separately self-quarantine. But Natalie takes as many extra steps as she can: changing her clothes at the hospital, showering immediately when she gets home, and of course, incessant cleaning around their shared space. “Indirectly… by her living with me, it has affected her life.” Natalie says. Regardless of those extra steps, she knows her roommate deals with extra risk too: “She’s chosen to stay away from family and limit exposure to people."

Back at the hospital, all the changes brought Natalie and her unit much closer together. Even when she considers the stress and uncertainty, she calls it an honor to come together to provide care to patients. A nurse’s natural instinct, she says, is to make a positive difference.

The community helps. Local restaurants and organizations support the hospital staff with lunches and regular treats. “Little pick-me-ups are nice reminders that people are looking out for us,” says Natalie.

With her fellowship complete, Natalie now takes things day by day, knowing that the Covid-19 situation continues to evolve. She looks forward to slowly getting back into a normal routine but knows that the pandemic will affect her even after the wave of virus patients ends. “As things start to calm down, they don't just [go back to the same] either,” she says.

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