My fellow nurses and I test hundreds of patients each day at our drive-thru facility—and I still feel safer there than when I'm out in public.

By Elizabeth Bigos, MHA, BSN, RN, as told to Leah Groth
May 12, 2020
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Elizabeth (Bitty) Bigos, MHA, BSN, RN, chief nursing officer at ProHEALTH, has been on the front lines of the COVID-19 pandemic at a drive-thru testing facility in Long Island, New York. Since the COVID-19 pandemic started, the 34-year-old healthcare worker, along with her fellow nurses, has been testing hundreds of potentially infected individuals daily.

Each morning, I wake up alone during the COVID-19 pandemic. My boyfriend, who's currently staying at his home, isn't beside me to give me a good morning kiss, nor is my dog, who is staying at my parents' house in New Jersey because of the long hours I work. I haven't seen any of them—my boyfriend, my parents, my dog—in over a month because I'm a nurse; I come into contact with the coronavirus every day, and the risk of exposing them is just too high. I couldn't bear to be the reason someone else got sick, especially a loved one, so as hard as it is to come home to (and wake up in) an empty house right now, it's the only option.

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Before the pandemic, I was the chief nursing officer for ProHEALTH, a health care company with more than 300 locations across Greater New York. I educated staff on the latest evidence-based medicine, made sure that all of our offices maintained the highest of safety standards, and acted as the liaison between my clinical team and the executives. But once the pandemic started to surge in New York City, I knew that I had to work on the front lines—it was important for me to stand alongside my fellow nurses and put my nursing degree to good use.

My days now involve testing potential COVID-19 patients at one of the drive-thru testing centers we have set up around the area. Lately, I've spent most of my time at ProHEALTH's Riverhead Urgent Care location, which opened less than two months ago—that’s how quickly we have had to adapt to this virus; standing up full urgent care facilities in a matter of weeks to meet the needs of the community. Our focus has shifted from treating patients in a clinic setting to keeping them as far away from the hospital as possible.

The drive-thru testing locations are popular and necessary—but sometimes the setup makes my job even harder.

Each morning, instead of just throwing on a pair of scrubs, my new uniform requires full personal protective equipment (PPE): a hazmat suit, an N95 mask, a surgical face mask on top of that, and a face shield. Each day, it feels like I'm starring in one of those end-of-the-world pandemic movies, not just getting dressed for another day of treating patients. 

The PPE—though it protects me, my fellow nurses, and our patients—makes it almost impossible to express emotions to my patients and give them the support they deserve. (Right now, my patients can only see my eyes, and we're not allowed to comfort them with any physical contact.) One of the hardest parts about nursing through this pandemic is that the majority of us who got into nursing, believe our careers were actually a calling—something that we have always known we wanted to do because we love interacting and forming relationships with patients. 

The drive-thru setting is also another hindrance: While we see over one hundred patients a day per location (there are eight different drive-thru locations across New York), and we are able to protect them by not having them come into an office setting, it makes our jobs as nurses even harder. Even though it's currently May in New York, it's still pretty cool outside—so much so that we noticed our equipment wasn't working properly from the temperature. Now, we have tents and propane heaters so that has helped keep both us comfortable and our equipment working.

The patients are a little confused at first in drive-thru settings, and many of them try to speak to us through their car window with their masks on. It’s their way of protecting us, but it's really important for the nurses to talk to them with the window down and their mask off. For me, I need to see how hard they are working to breathe, I need to listen to the strain in their voices—all of those things that are muffled while behind a mask or car window. Plus, the exam is still very physical. Every nurse has to take oral temperatures, auscultate lung sounds, check pulse and oxygen levels—all of which are hard to do, even through a fully-opened window.

Right now, my main mission—and that of the other nurses I work with—is to keep patients out of the hospital.

Even in a drive-thru setting, my job as a nurse goes way beyond administering a test and sending someone on their way—I try my best to give patients the necessary education and information to keep them healthy and at home as long as possible to decrease the stress that's currently being put on our health care system. Symptom management is key, and only those who are very ill are sent to the hospital.

While patients are sent home with discharge instructions, it’s still really important to make a connection with them while they are in front of you. I tell my patients to expect a phone call from a ProHEALTH provider within 2-3 days with their test results—and that they absolutely should stay home and limit contact with others during that time, even though it can be difficult. I also remind them of the importance of hand hygiene; to increase their fluid intake which can be depleted by a high fever; to eat good, whole foods when they are hungry; to take fever reducing medications; and to just let their body rest.

And even though the main objective is to keep patients comfortable and home and out of the hospital, there are situations when it's essential to seek advanced medical care. Everyone wants to know what the cutoff point is for when they should go to the hospital, but even that is hard to pinpoint since every patient is different. My advice: If you're feeling extremely short of breath, even while doing everyday activities like walking up a set of stairs, or if your skin starts to turn bluish-gray in color, it's time to see a doctor in an emergency setting.

Outside of work, even as a nurse, I feel more comfortable in my clinical setting right now than when I'm out in public.

A lot of people ask me if I am afraid to go to work every day, where I come into contact with COVID-19 regularly. I'm not—I'm much more in control of my surroundings when I am at work. It’s when I am food shopping or out trying to get some fresh air and I see hoards of people getting together or not following social distancing at the stores when I feel uncomfortable. I am not afraid to come to work. It’s when I am not at work that I don’t feel safe.

Just a few days ago, for example, I saw a group of adults and teenagers congregating on a boardwalk near my home—packs of 10-15 people just socializing. At first, I felt reserved in those situations—I don't normally like to correct someone who's wearing their mask incorrectly or not practicing proper social distancing (the six-foot rule is not an arbitrary number, it's a specific, calculated distance to reduce disease transmission), but now, I can't help myself. I've started speaking up because everyone is special to someone, and I want others to be smart while they're out so they can keep protecting those they care about.

I miss my family and my personal life too, but all of the sacrifices I am making—that most of us are making—are worth it to help save lives. It’s hard to be asked to come to work every day, facing life-or-death situations, only to see people outside of work not following the guidelines that are in place. It’s heartbreaking. It feels like it is negating everything that health care professionals are working so hard to accomplish. We're trying our best to eradicate this disease, but others aren't doing their parts.

I'm going to keep doing my job regardless, but I want everyone to know that we, as a society, need to take this virus—and all the suggested social distancing and prevention methods suggested by the Centers for Disease Control and Prevention—seriously, for our own personal health and the health of our communities. 

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.

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