As Told To: What It’s like to Be a Boston ER Nurse Right Now

Photo via Getty Images/Ge JiaJun

When Megan Esch first started work at Tufts Medical Center in January 2010, she couldn’t have predicted that the hospital—like so many others—would be battling the wrath of a global pandemic a decade later. Yet, for the Boston emergency-department nurse and clinical instructor who now treats COVID-19 patients while serving as the onsite education liaison for unit staff, facing uncertain and dire medical cases is what she has trained for her whole career. “As emergency-room nurses, this is what we do,” she says. Here, in her own words, Esch shares what it’s like to do her job during the outbreak.

During the week, my nine-month-old daughter wakes me up around six or seven. I start checking in with work email and communication just because of how dynamic and evolving the situation is. My organization has been excellent as far as daily and shift-by-shift communication regarding what’s going on with patient volume and changes in policies and guidelines.

I try my best to eat well and make sure that I exercise every day. I’ve probably been the most diligent about that since this has all started. After, I’ll touch base with my director in the emergency department, our nurse manager, as well as our staff, again, just to see how the day is going.

A large portion of us in healthcare are dealing with some sort of childcare difficulties at this time, whether that’s due to school being closed or childcare centers being closed. I am very lucky that I have a spouse who works remotely. It’s a balancing act every day, but I will be with my daughter until about two or two-thirty, and then he’s able to take over at that time.

When I’m home, I think being present is certainly important. Especially for your own emotional and mental health. At the same time, I would say that what we’re going through right now with this pandemic is an extraordinary circumstance, and I am in a position where I need to keep myself updated constantly. So I acknowledge and I accept that that is a part of my role: to be available when necessary and to stay in the loop.

I usually will get into work around 3 p.m. I’ve been working evenings mostly lately, so three to 11, or I’ve been working six in the morning till six at night. It kind of changes week by week based on what the need is. I begin with checking in for updates, making the rounds to check in about patient volume and make sure that the staff has the resources they need. We’re also trying to do our best to cross-train tiers of backup staff in the event that healthcare workers do get ill and are out of work. So staff from other departments have been coming to the emergency department to cross-train in the event that they might need to be drafted to assist.

For us in the emergency department, it’s business as usual. We are used to taking care of sick patients, we are used to dealing with the unknown with patients that come in through our department, and we are used to dynamic changes in the volume of patients. I’d say what has changed of late is that we are in constant communication, as information that we are learning about the COVID patient population is constantly changing day by day and hour by hour. So our focus has been on ensuring that our lines of communication are always clear and up to date.

The current volume that we’re seeing at Tufts Medical Center’s emergency department does not appear to be at the surge level. So we are anticipating that surge and are preparing for it, but we have not currently seen that volume in our emergency department yet. The rooms and the equipment that we have are well capacitated to take care of these patients currently. And I am grateful to be in a facility that currently has all of the medical equipment and personal protective equipment to take care of our patients. I’m also grateful that there’s been a lot of proactive thinking at the medical center. There’s been quite a few people involved in planning and anticipating future needs.

As a nurse, it’s in your nature to run towards catastrophe or people that are in need of help. And I think having to pause to take the moment to be cautious, and to make sure that you’re donning your protective equipment, purposefully, but mindfully is a change. Because we are definitely a “jump right in” kind of department. It’s what we do.

We are all combating a level of fear and anxiety. Particularly for our families a lot of times more than ourselves. But this is what we signed up for; this is our call to arms. We are certainly being cautious but courageous. So as long as we have the resources and the equipment to take care of these patients, I personally am confident and not fearful.

I wear a different set of scrubs while I’m working at the emergency department than what I wear in my travels home. Then when I get home, I shower immediately. We’re all following the guidance that’s been put out by the CDC and adopted by our facility. All workers are also checking our temperature frequently and monitoring our own symptoms and health for the safety of our families and the patients we take care of. We’re in the medical field so we can recognize chest tightness, shortness of breath, congestion, sore throat, things like that. There’s been a focus on trying to make sure that the workforce in the emergency department is staying healthy. And if we have opportunities to get staff home early, we’re taking those opportunities now to ensure that people are able to take care of themselves because they will be needed.

I have been truly floored and humbled by the outpouring of support in our area and at Tufts Medical Center—whether in the form of homemade mask donations, food, or letters of encouragement—that has truthfully been incredibly heartwarming and humbling. I’d encourage everyone to educate yourself, stay home if you can, wash your hands, obviously, and respect the guidance that’s been put out there by the CDC and the World Health Organization. Meanwhile, we are in the business of taking care of sick people, and we will continue that. We’re up for the challenge.