A Patient in My Own Hospital

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I would tell nurses to know that they leave a palpable impression on the people they are caring for and never lose sight of the impact and value they add to patients’ experiences as they restore them back to health or help them when they’re transitioning through death.

Kevin Browne

For Kevin Browne, deputy chief nursing officer at Memorial Sloan Kettering (MSK) Cancer Center in New York City, contracting COVID-19 was an experience of trust and faith.

Like so many other healthcare workers, Kevin’s risk of exposure to COVID-19 increased when cases surged in his region and, therefore, his hospital. Ultimately, he developed symptoms and tested positive for the coronavirus. But when the symptoms began to worsen, Kevin knew he had to make a difficult call – he would need to be admitted into his own hospital.

“I had two systems down when I arrived in MSK’s Urgent Care Center,” he recalled. “I already had COVID pneumonia and had sustained an acute kidney injury. I had a high fever, I was desaturating, and I was hypoxic and not doing well.”

As a nurse for 33 years, Kevin had a strong critical care background and knew that delaying treatment could be deadly.

“As part of the MSK executive staff, I was intimately involved with surge planning in the three weeks before I got sick. So, as deputy chief nursing officer, I was involved in making decisions about clinical operations and delivery of care. I had just approved a guideline that after nasal cannular oxygen up to 6 liters, the next step was intubation. I knew when I got there, the likelihood of intubation was highly likely. In my best clinical judgment, knowing what was happening with me, that I most likely would not come off the ventilator, I made a decision to not be intubated.”

Critical care nurse Valarie Lucas remembered when Kevin arrived at the hospital. She held his hand in order to provide reassurance since his family wasn’t at the bedside.

“I wasn’t going to let him feel alone. After initially speaking with him and leaving his room, I remember doffing my PPE and breaking down in tears. It was one of the most challenging conversations I ever had in my five years as a bedside nurse,” Valarie recalled. “We had to transfer Kevin to the primary ICU, but I felt compelled to continue providing support beyond the expected duty on my unit. Because we had developed such a strong bond over the course of a few hours, I requested to remain his primary nurse in the primary ICU to continue comforting Kevin during his escalation of care.”

Critical care nurse Andrea Ogbonna-Egbuna admitted Kevin to the ICU during the peak of his symptoms.

“Observing him in that state, air hungry, unsure of events that may occur, caused me to experience numerous emotions,” Andrea said. “Emotions such as fear, worry and hope. Fear and worry initially because my goal in conjunction with the ICU team of trying to oblige his wishes of avoiding intubation. However, I also felt hope because Kevin’s optimism and faith in God really stood out.”

For Kevin, there came a point where he had to let his colleagues care for him.

“It’s kind of like that expression ‘let go and let God.’ I had these men and women who knew me professionally, who I attended meetings with, who would see me walk around the building and check on them. I was now being helped with basic needs: toileting, repositioning (proning) and being washed. My whole human dignity was now at their mercy. What they did to preserve that, knowing my role, my position in the organization; they took care of me like you would not believe.”

Following a SARS treatment option, for which he was given steroids, Kevin could finally catch his breath and stabilize.

Reaffirming the Role of a Nurse
Kevin’s experience as a patient informed him, as a nurse leader, about the unknowns that nurses must face every day when treating patients with COVID-19.

“I love being a nurse, even though I’m a nurse executive. This experience made me reaffirm, which I never really lost, but it really reaffirmed the value of a nurse and the return on investment of a nurse. These men and women went into those rooms every day to face a silent killer. They couldn’t see it, they couldn’t taste it, they couldn’t smell it, but they were coming in and they never lost their humanity. I never felt their fear. When they came in the room, they were fully game on and they were all there for me.”

During his three weeks in the ICU, Kevin’s condition often fluctuated, but his care from the nursing team remained strong.

“We have a large portion of our nurses who are certified in their specialty,” Kevin said. “We have cultivated a team of nurses who use a relationship-based care framework to deliver care in a very meaningful, humanistic way – never losing sight of the whole person. That’s what makes a nursing service successful. It’s that connectedness; it’s that one-on-one.”

“From the time I have known Kevin, I can describe him as an individual that is humble, selfless and an advocate for nursing,” Andrea said.

After three weeks in the ICU, Kevin was finally stable enough to leave the care of his trusted nursing team.

“It was emotional; it was humbling,” he recalled. “My colleagues were at the nursing station, cheering me on as I came out of my room. The lobby was full; the sidewalk in front of the hospital had employees all the way up to the ambulance that was taking me home. I think it was what they needed. They needed a save, they needed some good news, and my story then became a story of hope.”

“The takeaway for me from this experience reaffirmed that small acts of kindness are impactful and vital for healing,” said Trish McTague, a nurse leader at MSK. “As a colleague and friend, I was proud to be able to make a difference in Kevin’s recovery.”

Remember Your North Star
Now, several months after discharge, Kevin is feeling stronger each day, although his heart and lungs still have some issues. Kevin’s advice for nurses navigating the pandemic is simple:

“I would tell them to not lose sight of their North Star. I would tell nurses to know that they leave a palpable impression on the people they are caring for and never lose sight of the impact and value they add to patients’ experiences as they restore them back to health or help them when they’re transitioning through death. I think if they just continue to use that as their North Star and guiding light, they can’t go wrong. Thank God for nurses; they continue to run toward the pandemic.”