Ciana Boardman's job as a nurse in the intensive care unit at CHI Health Good Samaritan in Kearney, Nebraska, was stressful before she learned the trauma center would begin taking on COVID-19 patients in late March.
Pre-pandemic, Boardman, 24, would typically work at least three 12-hour shifts in the ICU, treating patients for everything from heart failure and respiratory distress to traumatic injuries. She'd treat one to three patients per shift, depending on their level of severity. "It was not uncommon to be caring for a neurological patient and another in septic shock," Boardman says.
Those were all challenges that Boardman was familiar with. None of these conditions are communicable, therefore they don't pose a threat to Boardman or her co-workers. COVID-19, caused by the highly infectious novel coronavirus, was something else. "I remember feeling very uneasy. It was scary, hearing about the number of people dying," Boardman says, of the moment she learned she'd be treating patients with COVID-19. "When you don't know what you don't know, it's anxiety-producing."
Talking with some of her fellow nurses -- who were also worried -- helped her get past her apprehension.
"We knew we have to figure out how to take care of these patients and take care of ourselves," Boardman says. "That was our mindset: This is scary, but we're stepping up to the plate and we're going to take care of these patients."
Caring for COVID-19 patients can be frustrating, Boardman learned. She recalls one patient who deteriorated quickly and had to be put on a ventilator. Patients can suffer multiple organ failure while struggling to breathe. "They felt like they were drowning," she says. "That was really hard. You're doing so much to help them, but there's only so much you can do."
Her hospital has done plenty to keep clinical personnel safe, Boardman says.
In addition to surgical masks, gloves, gowns and hair coverings, the hospital gives Boardman and her colleagues impermeable "bunny suits" that cover the wearer head to toe.
About a month after the hospital began treating COVID-19 patients, the facility made a fitness locker room with showers available to clinical staff. "That definitely brought down a lot of anxiety about bringing COVID-19 home to our families," says Boardman, who is married.
While her anxiety level has gone down, her level of exhaustion, physical and mental, has increased.
"If I worked three days in a row, the first day off would consist of a lot of sleep," she says. "With all of the PPE, it was difficult to stay hydrated throughout the day. Our team did the best it could to give each other breaks, but during our busiest weeks, it was challenging at times. On one of the busiest days, I remember only being out of my PPE for a total of one hour during my 12-hour shift."
Dealing with the COVID-19 crisis is also mentally taxing.
"Working all day with COVID-19 patients who we would fight so hard to help and then come home to hear more about COVID-19 on TV and see posts on social media became exhausting and discouraging at times," she says. "Some shifts were worse than others. Some patients would deteriorate quickly, and the loss of patients was really hard to see. It often felt lonely because the only people who could really relate to what I was feeling were my co-workers. It definitely helped us form an even tighter bond with one another and we leaned on each other to get through the toughest shifts."
Medicine runs in her family. Boardman's mother works as a speech-language pathologist. One sister is a research speech-language pathologist at Georgetown University Medical Center in the District of Columbia and another is a pediatric nurse at Children's Hospital & Medical Center in Omaha, Nebraska.
Nationally, some 30 states have reported rises in COVID-19 in recent weeks. Some states -- like Arizona, Texas and Florida -- are experiencing dramatic spikes in the number of cases. On July 1, health authorities throughout the U.S. reported more than 50,000 new infections nationwide, according to a tally kept by Johns Hopkins University.
Compared to other states, the number of infections in Nebraska has remained steady. However, CHI Health Good Samaritan is in a county flanked by two of the three counties with the state's highest levels of COVID-19 patients, a consequence of outbreaks in meatpacking firms in those jurisdictions, according to the Omaha-World Herald. The rate of COVID-19 cases in those two counties is 15 times higher than it is in the rest of the state, the newspaper reported. It's also more than five times higher than the national average.
While Hispanics comprise just 11% of Nebraska's population, they account for 60% of the state's coronavirus cases, according to a report in the World-Herald.
Nationwide, young people are driving the dramatic new rise in COVID-19 cases. As states have eased up on stay-at-home orders, many people in their 20s and 30s are returning to bars, restaurants and attending parties without wearing a mask or practicing social distancing. That's led to a huge spike in COVID-19 cases among younger people, public health officials say. In Texas, the majority of newly infected people are younger than 30 in several counties. A spike in infections among young people has driven the median age of coronavirus cases in Florida down to between age 33 and 35.
While the vast majority of younger people who become infected do not become seriously ill, they could spread the virus to vulnerable people, including individuals age 60 and older and those with underlying health conditions, like asthma, diabetes and obesity.
Boardman expresses frustration with members of her generation who aren't taking the novel coronavirus seriously. She wishes teenagers and people in their 20s and 30s could see the suffering COVID-19 causes and that she sees on a daily basis: the patients struggling for breath; the ones who stay in the hospital for weeks; the family members who, unable to be at the hospital because of the risk of transmission, call multiple times a day to check on their loved one.
The pandemic is also exposing gaps in the health care system and disparities regarding who is most affected by COVID-19. Black and Latino people -- many of whom work in jobs that don't allow them to work from home -- have been disproportionately affected. Some people who work low-paying jobs in supermarkets, big box stores and warehouses can't work from home and are at greater risk for contracting the virus.
"We feel invincible because we're young, we're healthy and we don't have diseases," she says. "I wish young people would take it more seriously. I think if people my age saw what we see, we wouldn't see as much selfish behavior. Although it may not affect you, it may affect a family member or someone else who's vulnerable."
Boardman's advice to young people: "Think of others, think of your older family members. While you may have your night of fun, you may contract the virus and potentially end someone's life by spreading this terrible disease."