Deployment isn’t normally a word associated with nursing. But Ashley Juste, a Las Vegas nurse practitioner and UNLV alumna, just finished an “eye-opening” stint at Kings County Hospital in Brooklyn, New York. As part of a COVID-19 crisis response program, she was temporarily dispatched to one of the areas hardest hit by coronavirus outbreak.
Her 21-day deployment ended this week. She only had 2 days off in those three weeks. But she hasn’t lost the drive to help others — something that was forged during her studies. “In nursing and in the nursing school, you start developing a certain sense of service, so you feel like if you are capable and blessed with the skills, you answer the call.”
Juste says her deployment feels like Groundhog Day. “You literally go to work, go to sleep for a few hours, get up, and just do it all over again.”
Her long days would start and end with a 40-minute commute. The staffing company that coordinates the deployment program has four hotels in Manhattan to house the 600 to 800 out-of-town nurses to 11 different hospitals in the New York County hospital system.
“I’m used to some pretty rough places, but this really takes the cake. It’s so mentally, physically, and emotionally taxing," she says, "but I’m happy to be here and help.”
Juste notes a difference in social distancing in each area. “The city is empty. No one’s in the street. You’ll occasionally see someone walking their dog or jogging. Times Square maybe has a total of eight people taking pictures at a certain time. But when we make our way across the bridge into Brooklyn, there are more people outside in parks.”
More than a quarter of all COVID-19 cases in the United States are in New York state alone. Population size is one issue: larger crowds and more public transportation lead to more chances for the coronavirus to spread. Juste also believes not enough people took the threat seriously at first, and did not isolate when they probably should have.
She hasn’t had too many new patients in her ER, but the ones who are admitted are so sick they stay in the ICU for weeks. “I think people are scared. They don’t want to step foot in the hospital for whatever their issue is until probably too late, because they’re scared to catch [COVID-19] if they don’t think they have it already.”
For all the social distancing associated with the coronavirus outbreak, the situation is ironically bringing people closer together, particularly nurses. Juste says it’s easy to bond with the other deployed nurses. “You have to be more team-based to help take care of people. You can’t always do everything by yourself, especially when someone’s crashing or you need to turn to someone to provide care.”
It's a situation that she's unfortunately been in before. She was a nurse practitioner at a clinic the night of the Oct. 1 mass shooting in Las Vegas. She went down to Sunrise Hospital to volunteer, knowing her fellow nurses needed that support.
“Healthcare is a hard job on any given night. Then you put something like tragedy and crisis on top of that, you feel for those nurses and the only thing you can do is try to offer your help.”
Building Strong Relationships
Juste recently treated a 31-year old pregnant woman with COVID-19. She had already been in the ICU for a few days before Juste took over her care. Hospital staff performed an emergency C-section because of the mother’s respiratory distress. The baby tested COVID negative. The mother, however, kept showing respiratory issues, so she was put on a breathing machine. Juste said she made sure to check in on her every night.
Juste: “She was very appreciative of that because it wasn’t something that would necessarily happen [when a patient is relatively stable],” she said. “I don’t think there was enough time for it with other shifts. I was fortunate enough to go and make a little bit of difference in her life.”
This patient went on to praise Juste on social media, but Juste says she’s just glad her patient is home with her baby. “I try to always handle my care that way, or my patient rapport very down to earth. I talk to patients just like I talk to my friends, because, in my opinion, I think that’s what builds a true and honest relationship with people, when you’re more down to earth, you’re more relatable.”
East Coast Challenges
Juste admits even during her short time in Brooklyn, she’s noticed cracks in the New York healthcare system. “I think they overwork the nurses and there’s a culture of burn out, and they don’t really recognize it or maybe offer people the opportunities to transfer or relocate that may bring back that passion in nursing or whatever their healthcare field is.”
She says in her previous trauma ICU experience, nurses and doctors work together as a team. But she feels a greater sense of hierarchy in New York. “It’s almost like the nurses are more tasked to do things, and they’re not encouraged to critically think and help push and advocate for patients as far as treatment or what they anticipate could happen.”
The nursing deployment program, however, helped increase positivity and reduce burn out, she says. The passion is what she says is critical to keep moving and stay focused, not just for nursing, but for anyone feeling stagnant in their jobs. “Sometimes we spend too much time in one place, because we think can we advance or we get comfortable. But if your outlook is already jaded, you just don’t have that passion to care anymore. Find something else because you want to be able to keep that."
After her 21-day deployment is over, Juste returns to Las Vegas, goes into quarantine for two weeks before starting her new job with at the Veteran’s Administration hospital.