Alison Geissler pulled out of the driveway of her suburban home on the outskirts of Tampa, with tears streaming down her eyes. For six years, she drove the 30 miles from her home in the quiet community of Lithia to St. Joseph’s Hospital in Northwest Tampa, where she was a nurse in the cardiac intensive care unit. But this Saturday in late May it would be her final shift at the hospital.
She’d accepted a job in Baltimore where she’d move with her 8-year-old daughter Brooklyn to be closer to her family. But that meant leaving behind her fellow nurses in the midst of a global pandemic.
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There are roughly 208,000 registered nurses working in the state of Florida, according to the Florida Center for Nursing. They are predominantly women (80 percent), in their 30s, and reflect the ethnic demographics of the state.
Nurses have been on the frontlines of the coronavirus pandemic, putting themselves in harm's way through the direct treatment of infectious patients or simply by working in a hospital that puts them at a high risk of exposure. More than 729 healthcare workers have died from coronavirus in the United States according to Kaiser Health News and the Guardian, their series is called Lost on the Frontline.
Alison wanted a career in healthcare since the early days of her pregnancy back in college. I know this because Alison and I went to Hofstra University in Long Island together, where we became close friends before she moved down to Florida to attend nursing school.
I’ve always been inspired by Alison, and her cheerful attitude despite the challenges of raising a daughter as a single mom — while working in an incredibly demanding profession.
Alison recorded a radio diary during her final weeks at St. Joseph’s Hospital. Over the course of those two weeks in May, Florida was slowly emerging out of the economic lockdown, allowing hospitals to start elective procedures.
Her hospital received its share of coronavirus patients and there was a risk she would be required to treat some of them. St. Joseph’s developed a lottery system to rotate nurses into the COVID intensive care unit as needed, to prevent staff burnout and illness.
“For me I felt fairly safe because I’m not (normally) up there. I’m really not super exposed. But the idea of having to go up there, and everyday you’re like ‘Oh, it's going to be me?’ That’s scary.”
Below is an edited transcript of Alison’s diary entries over those final two weeks.
Friday, May 1, 6 a.m.
I could not sleep for anything last night. I’m kind of getting sick of this no sleep thing. I think it’s my anxiety and all the thoughts in my head, that are definitely catching up to me. It makes everything a little bit more difficult when you can't really sleep. I'm curious as to what I'll be walking into. It's been three days since I was in the hospital, so you never know how quickly things change. I'm kind of curious about the electoral procedures, especially because that will affect our unit probably quite a bit.
I'm curious how this transition phase is going to go, because I think that Florida is starting to work its way out of lockdown, moving into the next phases of transitioning back to what will be our new normal. So definitely curious to hear what changes have been made. Over the last month, it's been kind of tough because each ICU definitely has a different kind of set of patients.
And in general, we definitely get end-of-life patients, but not to the extent that we've been getting on our unit. And on that note, it's been incredibly tough because families aren't allowed to visit their loved ones. I think that not being able to see what's going on with your loved one is incredibly terrible. Do we facetime? Do we call every day? Do we try to update our families as much as possible? Yes. But It's obviously not the same. And I think that expressing what's truthfully going on with their family members, especially towards end of life or things that we just can't fix, is very difficult for families to grasp without seeing.
So on both ends, this has been a long month for everybody, for the families, for the visitors, for the nurses, for the doctors. So I'm really curious to see what we walk into today and what we'll be changing in the upcoming month.
Saturday, May 2, 7:45 p.m.
It was certainly a busy day. I’m definitely hurting more than usual. I stayed in my cardiac unit today because I was plenty busy. But I found out we got 27 COVID positive patients from the nursing home. Turns out there were actually almost one hundred from nursing homes that were dispersed amongst our hospital system and we got about 27 of them. Couple thoughts on that right now, we're actually fairly well staffed, obviously, well enough that I didn't have to get floated, that they needed me on my unit as is. But also, I’m thinking about the fact that these people living in nursing homes, they’re going to need to test negative twice before they’re able to go back to their nursing home to keep everyone safe.
So who knows how long that will be. So being able to staff them on the right floor. And we are going to be starting elective procedures on Monday. I’m wondering if we will peak in the next week or two or if it will be exactly how we planned. I definitely had on more PPE than normal today because I had to intubate a patient and that’s part of the COVID protocol. You feel like you have a sauna on your nose and mouth during the day, definitely starting to bother my ears. So definitely the first thing I want to do is shower as soon as I get home.
Monday, May 4, 7:21 p.m.
So it's Monday evening. What I'm noticing and a lot of our coworkers and doctors have been noticing is that people come in very sick now. You know, nobody wants to come to the hospital when they need to and they usually know something's wrong because they're more afraid of getting COVID at the hospital than what's actually going on.
I've had my second patient now who likely waited too long to address his heart attack, and unfortunately, he will likely pass this evening. We were able to kind of put him on comfort measures. This morning, we had a nice Zoom call with his family. So that was really nice to be able to help facilitate and try to keep the family in constant communication. And they were actually able to come in and talk to the doctor and be at his side.
I've had a couple of "COVID" nurses come down to our unit. They're lucky because up until recently with these nursing home patients, they haven't been super slammed. So I think that's definitely helped the burn out. Luckily, a lot of the nursing home patients that got admitted aren't in the ICU. They're mainly on our watching unit just for some supplemental oxygen and being able to watch them more frequently. But it's definitely gonna to take some time before a lot of these nursing home patients can return, because they have to have probably two negative before they're allowed to return to their homes. So I think a lot of them will be hanging out with us for a little bit, which would be good, because then we can watch them through the course of their illness and help them get through under a close watch.
Wednesday, May 6, 12:30 p.m.
Alison: Alright Brooklyn, you can take a 20-minute break until your Zoom class.
Brooklyn: Good, because those were like the most difficult ones ever. I mean I didn’t get anything wrong in the second half but in the first half I was really stressing so Gammie had to help me out.
Alison: I’m really glad Gammie was here and was able to calm you down because sometimes Mommy isn’t a very relaxing teacher is she.
Brooklyn: No, but I still love you.
Alison: I love you, baby.
Thursday, May 7, 5:45 p.m.
Today went pretty well. Obviously good enough that they actually are sending me home early. I generally don't complain about that. It seems like we have generally been overstaffed and now that we are safe to say that, you know, there's not a surge coming in at this moment, we don't need the staff for an hour before they weren't letting anybody go home early.
We did have a couple of elective procedures today. It went well. There’s a good amount more next week, so that’s exciting to see we are getting back into our normal routine. All in all it was a good day.
I was thinking back to a funny story to someone that was orienting me. We were elbows deep in quite a bit of a mess. We were elbow deep in poop. Nurses understand, most people don’t think that’s such a great dinner conversation. We were cleaning the gentleman up and she looks up at me and she says, “This should be a PSA movie they play for nurses on their first day. Nursing isn’t some glorified job. There’s terrible emotions involved, you see people on their very worst day and you have to give somebody dignity in those moments.”
One of my favorite things about nursing is just that it's one of the few jobs where not only is touching required for the assessment of your patient to see how they're doing, to see how their skin temperature is, to see how they're feeling. There are so many times that it's so much more than a job. It's that simple handhold when you can see that somebody is about to lose it. It's the fact that no other job, do you get to be that close and intimate with somebody.
And with that comes so much power, so much respect that you are trusted enough to to be that close with somebody. When they don't have their family and want to hold your hand and that sometimes just being able to touch them and know that they're human and that they're not just, you know, a body in a bed or a room number, that you see them like you see your family. I love these people. I have so many great memories of just holding somebody's hand and seeing the worry leave their eyes.
Saturday, May 16, 8 p.m.
So, today's my last day at St. Joe’s. I'm definitely feeling a mix of emotions. At the moment, I'm mainly just sad. I'm definitely excited to be taking the steps that I want to be taking. But I've been in that hospital for quite a while now. Both on the float team and on my unit, and I've made a lot of really amazing friends and role models. You know, I was pulling out of my driveway this morning and I look behind me and I saw my daughter's car seat. I was thinking back to when she was two and I used to drive her here to go to daycare every day with me. It's just crazy to see how much she's grown and how much I've grown.
You know, emotionally, career wise and in so many ways, I matured so much here. I've learned so much here and I've made some really longstanding friendships. I have so many stories from this place, so many great memories, so many terribly sad memories. It's just a lot to process. It's like closing a chapter for a book. But I look forward to hearing everybody from, you know, my work from my unit stories as they move forward and learn more and potentially grow in all of their next steps. I really look forward to keeping in touch. Just going to be a really weird feeling pulling out of the garage today. I can't believe it.