Bare Bones Nursing in the Wake of COVID-19

Updated: Sep 18

This week in our new series: Nurse's Spotlight, we hear from one of our own RNs: January Plantage on what it's like to be a travel nurse today.

Here is her story:

Right now I’m travelling, not exactly because I wanted to be traveling, but more because we got relocated because of my husband’s job. At the time I took an assignment thinking I’d do this sort of work up until I graduate, but then it became more of a “no, I actually need this job,” because I felt uncertain about my future as an advanced practice nurse provider.

I feel like a lot of people go into travelling thinking “Oh, I’m going to make all this money and I can’t wait and I’m going to see the world!!!”

My Motivation for Becoming a Travel Nurse

Partially because I’ve been a traveler before (back in 2015), I didn’t really get into it for the financials and started traveling again because I knew it was a good way to get into a hospital quicker– just more of: I needed a job and I needed something else to keep me busy while also finishing school. I honestly thought I’d do my 10 weeks and be done. But then the pandemic came and all of a sudden it felt like the smart thing to do was to take another assignment, given some rumors I’d heard that hospitals were going to decrease their patient load in order to prepare for an increased census in COVID patients.

Getting that next assignment was a pretty quick process too. I interviewed, and they basically offered me the job the next day, and I started the next week. I also know when I started this current contract, there were a lot more travelers than there are now. I’m not 100% sure why they’ve kept me on? Perhaps because I’ve been with this hospital for longer or I’m more established with the unit? I’m really not sure. But I’ve definitely had those moments where it was questionable whether or not I’d have a job at the end of the day because the patient volume dropped so dramatically. But honestly – it’s just week to week these days. For example, this week, patient volume jumped up because they re-introduced elective surgeries. Just, you never know with this whole COVID thing.

A Lack of Resources and Bare Bones Nursing


While my current contract isn’t technically a COVID contract, it certainly feels that way with COVID being so prevalent in nursing today.


What I mean by that is that the entire dynamic of nursing has changed in just a few short months. I’ve been experiencing what I can only call “bare bones nursing.” If you’ve been a nurse for as long as I have, which has been almost 10 years, then you’ll automatically know what I mean by that statement. For those that haven’t been in nursing that long – what I mean is back before COVID, nurses had a ton of resources on their units that they no longer have in addition to the fact that the stakes are higher. “Am I donning and doffing correctly?” “Will I get COVID?” “Will I pass COVID on to my family.” These are the questions that go through my mind daily.

What do I mean by “resources”? Because hospitals are trying to limit exposure to patients and clinical staff they’ve downsized tremendously. So, housekeeping can no longer go into the patient's rooms, the nurses are expected to be the housekeeper. Dietary staff can no longer enter the patient's rooms, the nurses are expected to take in all the food trays. And our techs have limited access to patient rooms because of the need to limit exposure to the virus. Even with regards to phlebotomy, nurses are now drawing their own blood. It really feels like Florence Nightingale type times where you literally do everything for your patients. From feeding them, to cleaning their sheets to taking out their trash. It’s way beyond standard nursing care where you give a patient their medications, check their vitals, and assess them. There’s a lot more depth to this type of nursing. Even going in and out of rooms takes a lot longer. It’s not just like walking in, checking something really quick, and walking out. I mean you’re garbing up, garbing down, garbing up, garbing down in between each patient and that takes up time.

The New Mental Component to Nursing and No Room For Error


There’s also definitely a mental component to all this because you think to yourself “there’s no room for error,” “I don’t want to bring this home,” “I don’t want to infect myself,” and “I certainly don’t want to infect my family.” This mental component affects how you get through you day. You’re always worried about if you’re being safe enough, meticulous enough with your movements and how you do things throughout your day. It’s an added element to my job, that I’ve never seen before and I’ve worked in a ton of specialties including Med/Surg, Tele, Surgical ICU, Trauma ICU, Neuro ICU, Trauma Step-Down and Orthopedics. It’s interesting, just how the structure of my day has changed dramatically because of the pandemic.

Working in a COVID-19 Rule-Out Unit

Right now, I’m technically working Telemetry, but it’s more of a COVID-19 rule-out unit where I’m usually tasked with 3 to 4 patients at a time. But the hospital also has to play around with the ratios a lot, so each day is different. But it’s tough. For example, in the COVID rule-out unit there could be 4 patients who are all rule-out (meaning: we’re waiting for their COVID test results), but there’s still a chance that one or two of them have COVID. And my job is to go room-to-room-to-room all day long with a patient who may or may not have COVID and possibly exposing another patient to COVID. But we all treat every patient like they have COVID, whether or not their waiting on test results. So for this reason – I think the hospitals are working really hard to keep those nurse to patient ratios down.

What the Future of Nursing Will Look Like


When looking towards the future, I think hospitals are going to change a lot and I don’t think we’ll ever go back to no masks. It’s kind of like gloves. Just like HIV introduced us to gloves I think COVID is going to introduce us to facemasks and I think that is going to be a big element in nursing. I also think the whole having visitors is going to change a lot too. Like whether or not a patient can even have visitors. You just don’t know where a visitor has been and there’s that increased risk of exposure I don’t think hospitals will ever take a chance on again.

As for a return to “normalcy” I’m not sure we’ll ever go back to where we were – and I think hospitals will continue to change and adapt as we become more familiar with this virus. I also don’t think anyone really knows what’s going to happen with 100% certainty. Just consider the fact that Fall is just around the corner. And with the Fall season comes all the upper respiratory illnesses we normally see in a given year. So unless we truly have a vaccination or something – we just aren’t going to know what the future of life after COVID will look like– and for now hospitals are going to be pretty strict with their precautionary measures. And as nurses we’re going to have to adapt day-to-day, month-to-month, maybe even hour-to-hour as the environment around COVID changes, as hospital census’s change, as the need for more medical equipment and PPE changes, as government policies change and as hospital policies change as a result.

Advice for Current and Future Travel Nurses


For all you staff and travel nurses out there the only bit of advice I can give to you is to be open to the opportunities that are presented to you. I’m thinking about things along the lines of continuing your education, if time allows, and being open to working in minute-clinics or urgent care clinics or looking into your community and seeing where your skills might best fit the needs of that community. And also keep in mind that nothing is guaranteed. No assignment, no staff job is permanent.

I think sometimes we’re put into a position as humans, where we’re not dealt the cards we thought we were going to get dealt but you can absolutely play your cards to the best of your ability. If anything, COVID has taught us that being flexible is really the way we’re going to get out of this and hopefully come out as a better people, and better communities. I guess what I’m trying to say is that everything is temporary, and even if things are hard right now, even if that assignment sucks right now, it’s temporary.


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