Life as a Nurse Educator During COVID-19

By Sarah Sattler

Nurse educator Sarah Sattler shares her experiences during early phases of the COVID surge at her facility.

I have been on the front lines during this war called COVID-19.

Yet I am not the one in the trenches fighting the war first-hand. I stand beside and support those who do. My title is 'Corporate Nurse Educator' and my role is to provide clinical education and professional development within a health system in Western New York.

My background and passion in nursing is critical care. I obtained my CCRN certification a few years ago. Today, that certification is worth so much more than I originally expected. Patients with COVID-19 present with very acute, very severe symptoms, at best. Therefore, their treatments and interventions change rapidly, and their needs are far more advanced at times. These patients often require immediate intubation, heavy sedation, use of paralytics, pressor support and proning therapies.

How do I get nurses from outside critical care ready for this?

I may not be delivering direct bedside care during these trying times (at least not yet), but I am facing challenges of my own: providing advanced critical care education to nurses who may never have imagined themselves doing this work during their career. I’m tasked with preparing non-critical care nurses to care for critically ill patients, overnight.

Preparing redeployed nurses for COVID-19 care

When it comes to COVID-19, preparing nurses from various backgrounds and different levels of nursing (both critical care and non-critical care) presents additional complexity. Some nurses perceive the education as useful, whereas many others are overwhelmed and anxious about providing this level of care to their patients.

This is where I come in. I am in the ‘red zones’ along with many of these ‘deployed’ nurses who are now caring for critically ill patients. I am there as a resource, to help nurses with various levels of experience take care of these patients. I provide just-in-time education, to supplement the previous ‘crash course’ many of them received just a few days ago. I am there to help them prone their first patient, to initiate their first vasopressor, to teach them how to zero an arterial line, to help them through their first train-of-four peripheral nerve stimulation and to help them provide oral care to their first intubated patient.

And while I am not the one fighting this disease first-hand, I am there to support the nurses who are – to help them provide the best care they possibly can after just a three-hour ‘crash course’ on ICU education. I am there with them seeing the awful progression of this virus in so many different types of patients. I am also there to see the positive outcomes that bring a glimmer of hope during this scary time.

Heightened anxiety around PPE and equipment shortages

PPE shortages are an added burden in this fight. Although my own health system hasn't experienced too many hardships with PPE, we are being proactive in planning for what the future may bring. We are reusing N95 masks up to 5 times – or eight straight hours of wearing – then ‘recycling’ them through a sterilization process. However, such actions and measures bring another level of fear to those fighting on the front lines. They’re asking ‘Why do we have to sterilize used N95 masks?’ and ‘What happens when we run out of PPE?’

The scarcity of essential supplies and ventilators is also a challenge we are beginning to face. Up to now, we haven’t had to consider doubling up patients on the ventilator, but it has definitely been talked about among the leaders of our organization. For weight-based titration medications, we have back-up plans if we run out of pumps that involve utilizing dial-a-flows that will have set rates for titration.

All of these triage strategies are counter to the norms of critical care nursing and, therefore, present additional educational challenges – even for many experienced critical care nurses.

I hope sharing my experience helps shed light on a different angle of critical care nursing during this COVID-19 war. Thank you and God bless.

Sarah Sattler is a corporate nurse educator at Kenmore Mercy Hospital (Catholic Health System) in Western New York. Her eight-year nursing career includes experience in both ICUs and progressive care units, which has served her well during this pandemic.