UNC-CH Hillman Scholars work on the front line of the COVID-19 pandemic

As general care floors in hospitals turned into COVID-19 triages, students became practitioners and classroom education shifted to the grim reality of treating the victims of a pandemic. Students in the UNC School of Nursing have spent the last year consumed like the rest of us by the coronavirus — but running toward it rather than away.

“I think there was definitely this sense of camaraderie like, ‘We can do this. This is what we went into the nursing profession to do,’” Elizabeth Myer, a doctoral student in the School of Nursing said.

As a registered nurse at UNC Hospitals, Myer typically worked with geriatric patients while she pursued her doctorate in nursing. But once the pandemic struck, Myer’s floor quickly became a COVID-19 floor, and she had to learn how to treat a deadly new virus while avoiding contracting it herself.

It’s a common story among nursing students, many of whom work at UNC Hospitals in some capacity while pursuing their degrees.

Ebahi Ikharo, another doctoral student, worked as a critical care nurse before the virus broke out. Since then, she’s been floated from floor to floor, treating COVID-19 patients and whoever else she can help.

Treating the virus

After doing what they could to protect their families and themselves, UNC’s nurses were thrown into the frontlines of treating a virus the world had never seen before. Safety guidelines changed frequently, personal protective equipment was scarce and tests for the virus could take a week or longer to return.

Many nurses, wary of the unknowns of the virus and their proximity to it, had to make difficult choices to keep their families safe. Becky Hoover, a doctoral student who worked on UNC Hospital’s oncology floor, said she sent her two children to live with her elderly parents once the virus hit.

Before Hoover treated a COVID-19 patient for the first time, she said she stood outside the door with an epidemiologist and an infectious disease specialist. In exacting detail, they told her how to don her PPE, what surfaces to touch and which to avoid and how to sanitize the room.

But what she wasn’t told, she said, was how to answer a terrified patient’s questions.

“I think it’s just sort of sharing in this unknown moment between the patient and myself,” she said. “Typically, a patient comes in and (I say) ‘I’m going to give you chemo and these are going to be the side effects and this is how we’re going to combat the side effects,’ and (now) I have this person going like, ‘Well, what’s going to happen?’ and I don’t know.”

In the early days of the pandemic, when nurses were often unable to give clear answers to patients about the virus, Ikharo said compassion was essential.

“I think the biggest thing was just having to help ground patients and be like, ‘We’re right here right now, and at this moment you’re still alive,’” she said. “At this moment, things could be worse, but it isn’t, and so we’re just going to help you get through this shift. And we’re going to take it shift by shift or hour to the hour.’”

With visitors unable to see their loved ones due to COVID-19 restrictions, nurses often had to be the ones to establish a line of contact between sick patients and their families. Holding up iPads, nurses projected familiar faces to their patients, watching as they did their best to comfort one another.

“What surprised me is they were so elated to be able to just see their loved one,” Myer said. “Even if it was through a camera screen.”

Juggling virtual classes

The coronavirus took a toll on the nurses outside of the hospital as well. Doctoral students spent around six hours a day on Zoom after long shifts at the hospital. Meanwhile, their undergraduate counterparts — those pursuing their bachelor’s of science in nursing — had to begin fulfilling their clinical hours online in virtual classrooms.

Professors had to get creative in giving students hands-on experiences when in-person instruction wasn’t possible — such as learning to insert an IV over Zoom.

“We mailed students their kits, and we had them practice on teddy bears and family members,” Louise Fleming, associate dean for undergraduate studies in the School of Nursing said.

After PPE became more readily available and COVID-19 cases stabilized, undergraduates were able to return to in-person clinicals with extra precautions.

“It makes a world of difference,” Chloe Winebarger, a junior in her first year of nursing school said. “Seeing it in person, getting to do things hands-on and practice your skills and make everything come full circle from classroom teaching to lab to clinical and then to real world nursing.”

Coping with mental health challenges

In addition to the physical toll of fighting a pandemic, nurses had to cope with the severe emotional strain of treating an overflow of critically sick patients.

“I think a lot of nurses in general are able to compartmentalize,” Hoover said. “So you just sort of would, for lack of a better term, pull up your scrubs and walk in and be like, ‘I’m here for this patient. I’m going to be everything they need me to be, and then when I go home, I’m going to try to shut it down.’”

Ikharo said her stress from working in healthcare and pursuing her degree was compounded by her experiences as a Black woman after the police murder of George Floyd.

“There was quite a bit of burnout from school,” she said. “But also as a Black woman, just an exhaustion from a lot of the constant trauma porn that I was seeing and experiencing when the pandemic hit.”

This trauma was only amplified as she witnessed the racial disparities in those impacted by COVID-19 firsthand.

“I felt like I was getting it from all ends, so to speak, in terms of going to the hospital, taking care of patients and seeing that it’s my people constantly being in this space,” she said.

On top of all this, nurses had to deal with the contingent of Americans who refused to believe the virus was real or adhere to safety precautions such as wearing a face mask.

Ikharo became disillusioned with the constant “thank-you’s” from strangers and politicians, calling healthcare workers “heroes,” which sounded, to her, closer to “martyrs.”

“Yes, I said I want to be a nurse,” Ikharo said. “But no, I did not say I wanted to feel this level of emotional and physical burnout due to a pandemic, which in my opinion, did not have to escalate to the level it escalated to because we had people in power who did not want to take responsibility.”

The future of nursing 

Despite the difficulties, or perhaps because of them, Fleming said this pandemic has been an essential learning experience for students.

“It’s been a really powerful time for our students to see how important nurses are in our society,” she said. “I think they feel pride in the profession they’re going into. So although it has had a lot of challenges, a lot of death, a lot of sadness, I think for most of our students it really confirmed their desire to be a nurse.”

With healthcare workers vaccinated and COVID-19 cases decreasing, nursing students have been able to retain some small sense of normalcy. Hoover’s children are back home, Winebarger is back in clinicals and Myer’s floor has returned to regular medical care.

Ikharo said she hopes society learns something from the struggles nurses have endured throughout the pandemic.

“I just truly hope that we actually get to show nurses how much they are truly valued financially as well as just the air and environment in which we speak about nurses,” she said. “Because we deal with a lot of things that I think a lot of (people) are not aware of. And at the end of the day, I think we are at the center of care for our patients.”

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