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Annabelle Moore
Arriving at the general adult COVID unit at 7:15 a.m., East parent and nurse Brenda Kotar’s patient assignments are thrown at her while she stands among a swirling pool of night nurses, rushing to check their patient’s breathing one last time, or send them to a ventilator.
“Nothing prepares you for this,” Kotar said. “Nothing.”
20 different patients’ call-lights are going off, and the night nurses handing their patients off to the day shift have lost sight of what it feels like to sit down and take a break. That will be Kotar in 12 hours.
A line of COVID-positive patients engulf the halls of the unit at Jacobi Medical Center in the Bronx, NY, waiting for someone like Kotar to check their breathing, hook them up to an IV or get them on some oxygen. Chaos. Absolute chaos.
Being a nurse during this pandemic is miserable, and as a deployed nurse from Kansas City, Kotar had never seen anything like the four large tractor trailers waiting outside Jacobi ready to be filled with dead bodies, victims of COVID-19. The trucks remind her why she’s there, so maybe next week there will only be three trucks, then two, then one.
After hearing from a co-worker about Krucial Staffing, a Facebook page dedicated to finding nurses to help during times of emergency or disaster, Kotar knew she belonged in a hospital in New York where the pandemic hit hard. Back home, she works as a pediatric nursing instructor at Metropolitan Community College. She’s young, she has skills in a hospital setting, she’s in good health and has supportive friends and family who will cheer her on for the 21 days she’d be gone.
She couldn’t make any final decisions without consulting her kids, aged 12, 18 and 21. They understood the importance of what she was doing, so she packed her scrubs and on April 5, she was off to New York City.
Kotar on her flight to NYC, posted on her blog
“Some people would be like, ‘I don’t know why she would leave her kids,’ but that thought never went through my head,” East senior Sophia Kotar said. “I was thinking, ‘She is a freaking hero.’ I could never imagine putting myself in harm’s way for people I don’t even know. That’s just something that she does every single day.”
The first week on the job was one of the hardest weeks of Kotar’s life. Her patient load was double that of what she’d ever experienced back home. Patients fill the hallways — not just the rooms — and Kotar treats everyone.
“I really never thought I would be reporting from the frontlines, I [had only] dreamt it would be from the eye of the storm in a hurricane, but here I am,” Kotar said in a blog she’s been keeping, called Being Brenda in NYC.
Despite Jacobi’s lack of essential supplies such as water cups and ice, they don’t have a shortage of PPE. To enter a COVID patient’s room, Kotar must have on the N-95 respirator mask that she’s worn all day. She gets a new one of those every three days, whereas most nurses back in Kansas City get a new N-95 every day. She doesn’t bother putting on makeup for work — the mask would rub it off anyways.
Kotar and her colleagues geared up to save New Yorkers from COVID-19
On top of the N-95 goes a surgical mask, face shield, a plastic gown over her scrubs, surgical cap, shoe covers and gloves. This process takes four to five minutes, but she hardly has that time when eight of her nine patients are calling for help.
In her unit, the general adult COVID unit, Kotar finds herself restlessly working despite the ‘breaks’ she’s supposed to be given. Someone always needs a bed change, a cup of water, more medicine or any of the supplies Jacobi is running short on. Kotar’s had times where she’s found herself having to get creative to make an oxygen mask with a latex glove, because they’re out.
It’s considered a slow day for her if she has time to use the restroom even once or make her way down to the lobby by the giftshop to eat a quick lunch. She says if she has time to do this, she comes back to the unit in a much better state, for herself and for her patients.
Kotar doing her laundry at her hotel in Times Square
Her patients mainly range from ages 20 to 60, but regardless of age, Kotar quickly learned to prioritize patients who are the sickest, even when she wants to treat everyone. Kotar said when she goes into a patient’s room, she hardly ever thinks about the risk she’s putting herself in. Instead, she looks forward to making her patient better and getting them out of there. Though if she were to get sick, Jacobi would offer her a test.
While over 9,000 COVID deaths have been recorded in NYC — up to 500 deaths a day — Kotar feels lucky none of her personal patients have died from the virus. Not the 82-year-old man restrained to a bed with a broken hip and dementia, or the 33-year-old Hispanic woman forced by the virus to be put on a ventilator.
“Some of the nurses have said they’ve walked in and their patients were already dead when they walked in the room,” Kotar said. “I’ve had nurse friends that have lost two or three patients in one day.”
Kotar makes a point of educating her patients with deep breathing exercises called incentive spirometer that will help to keep them alive. She believes the only way to keep them from developing COVID-induced pneumonia is by telling her patients the harsh reality: you either do the breathing exercises, or you could die.
Once, Kotar spent four hours in one of her patient’s rooms who went from feeling normal to immobile in minutes. Many patients fluctuate between moderate and severe conditions, so it’s paramount to keep constant tabs.
“You have to monitor them, because [this patient] was within four hours of me sending her to the ICU because her blood pressure was so low,” Kotar said. “We were hanging bags of fluid and starting more IVs and drawing labs and amping up her oxygen and all of that. And so in that time, that’s when it becomes really scary because it happens so fast and you have to put those other patients on hold — you have to prioritize and take care of the one who’s the sickest in that time.”
Since Kotar isn’t working in the ICU, she typically sends severely ill patients to the ICU before it gets especially bad. Given she has seen some disheartening sights, Kotar says discharging patients is one of the most rewarding parts of her grueling job.
Kotar will never forget the time she treated a COVID patient whose 11-year-old daughter was at home alone because there was no one to take care of her. The girl’s grandma was also hospitalized with COVID-19. Kotar said that discharging this mother to her child is what reminds her that she’s making a difference — she knows leaving her own three kids at home to care for families like this was the right decision.
“I wanted to hug her, but I couldn’t,” Kotar said. “But I wanted to.”
Most COVID nurses in New York are dealing with the dark end of the virus, one way or another. They’re exhausted. They’re getting sick. Their families are getting sick. Some nurses have even quit because they couldn’t take it anymore. Sometimes when Kotar is supposed to hand off her patients to the night nurse, the nurse just doesn’t show up. Kotar is then left rushing to write patient reports before the bus leaves at 7:30 p.m. for the hotel.
“I think it’s a lot harder for [the nurses that live here] because there’s not really a light at the end of the tunnel,” Kotar said. “[I’m going home on April 27], and that’s what’s getting me through it, because it is very hard.”
Kotar has found that the most important part of her job is balancing time and focus between work and home. When a patient is struggling or hospital beds are clearing up because people are dying, she has to be able to go back to the hotel and take her mind off of work. Reading a book, taking a shower or talking to her kids can usually get her mind off of the 12-hour shift she had and refresh her for the brutal 5 a.m. wakeup call the next morning.
When she had to work on Easter, her three kids sent her flowers. This made her cry, but also made her realize how good she has it. Even separated by thousands of miles, Kotar feels lucky to know her family is healthy and rooting for her.
Exhausted and hungry, Kotar finishes her shift around 7:30 p.m. She walks past the cheering crowd outside of Jacobi who hold signs of encouragement, ring cowbells and yell words of appreciation for doctors and nurses like her.
“You know [nurses] don’t do this job for attention, honestly,” Kotar said. “Sometimes we call it a thankless job because we don’t do it for attention, that’s not the point. I don’t need a bunch of attention for doing it, but it’s nice to be supported and it feels really good to be supported by your friends and family and I have that.”
“A prayer sent in our Nurse group text this morning” — from Kotar’s blog
Kotar is a single mom, currently working three jobs, with three kids back at home: her oldest daughter, 21-year-old Abby, has been taking care of 18-year-old Sophia and 12-year-old Owen.
Sophia says that life at home without her mom is a team effort. Abby is the one who gets all of them moving every morning, making Owen do his school work and keeping the house clean and organized. Sophia makes dinner and meal plans because she likes to cook, and says Owen is just a good source of energy. They also have a number of caring and supportive neighbors who have been bringing meals to the kids almost every day.
“It’s so helpful for me because I can’t do that obviously, and then I can be here and not be worried and stressed that they’re not getting dinner or whatever,” Kotar said of her neighbors’ efforts. “I call it the support for the support. It’s been really helpful.”
After working this job and leaving her family for a bit, Kotar says she will never take her normal schedule at home for granted again.
“It’s going to take me a long time to start complaining again about little things, just because I’ve seen some really terrible things,” Kotar said. “But, I would absolutely do it again — not right now, but if I had to do it over, I would do it again.”
Kotar and her colleagues in the adult COVID unit
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