Braving uncertainty during uncertain times

Written by: Cassidy Toben, Assistant Nurse Manager, Emergency Department, Lenox Hill Hospital

Northwell Health is proud to spotlight our front line health care workers. See how Northwell clinicians – doctors and nurses – are responding and working on the front lines of the COVID-19 pandemic. Read their stories here.

Cassidy Toben, RN, finds a new niche as COVID-19 forces health care workers to shift roles

As an assistant nurse manager, I’m lucky to have the opportunity to inspire and motivate our nurses and staff, really coach them through their nursing journey. And during the COVID-19 crisis, my role has shifted, transitioning into even more administrative responsibilities.

I’m not always in the rooms with COVID patients, and there’s a sense of guilt that comes with that. Togetherness and camaraderie are built within nurses. It’s our calling — caring for another as if we are the patients we are restoring to health. Leading my team is also a calling, one that I’ve relished during this situation.

Since COVID-19 reached our doors at Lenox Hill Hospital, we’ve bundled care, limiting the number of people and trips in and out of patient rooms. What you might do in a few trips, you do all at once now.

On tough days, and there have been many, one of my nurses will need me to serve as a sounding board to vent about harrowing experiences, or to cry with them about a lost patient. Being this support system is critical to their well-being. We all share the burden and have a stake in this.

I went into nursing to save lives and to help people. But, you realize quickly that you can’t save everybody. That’s really humbling.

The scariest day during this experience came at the end of March. New York was just hitting its peak and COVID-19 patients arrived at alarming rates. One patient was talking to us and seemed pretty stable. About an hour later he coded. Everybody ran to his bedside. Then about 10 minutes after that, a patient on the other side of the emergency department coded — everyone ran to that bedside.

Then a third patient needed resuscitation.

I took a step back and, while watching every one race to the bedside, thought to myself, “Wow, the teamwork here is really inspirational.” The compassion that they showed to the patients, to each other, it eased my fears that day. We have each other’s backs and we support each other. We take care of our patients and we go home. Most of us go home alone. We don’t get to hug our parents. We don’t get to see our families. So, we’re really in this together.

But worry does come over the staff. Patients begin to remind you of your family — many times you’re acting as their family, with visitation suspended in hospitals. And then you worry about your own family, and then yourself.

(Deep breath)

My first symptoms started on March 26, a curious cough that would lead into fatigue and shortness of breath. My husband and I decided it would be safer to stay together than risk exposing anybody else in my family. Still, the thought of getting him sick caused so much anxiety that I started having nightmares. I dreamt that I got him sick and he was dying, because that’s what we were seeing each day. And any health care worker can tell you that they have that exact same fear. It’s not about me. I can handle me. But I don’t want to hurt the people I love.

After two weeks of being ill, I returned to work. I still struggle to sleep, but now it’s our patients that I worry about. It’s also really rewarding to see that our staff has risen above a lot of the challenges, remaining positive at every corner. So, even on days when I’m operating on little sleep, I come into work feeling like we can succeed. We are together and we’re going to get through it.

Luckily, the situation has improved — the volume in the emergency department has slowed. People are staying home, and we’re now on the right part of the curve. Devastation has turned into hope. We’ve lost a tremendous amount, people we know, grandparents, friends. So, we must remember those who are lost and work through each day with positivity.

In a time where it’s hard not to think about yourself and your family and worry about getting sick, people are still thinking about each other here. That is just absolutely incredible. It makes it all worthwhile, providing purpose and an unrelenting desire to help another.

That’s what nursing is truly about.

Cassidy Toben, RN, is an assistant nurse manager in Lenox Hill Hospital’s emergency department.