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Lessons Learned from the Front Lines l RN Shares Care
Tabitha Tinsman, a Genesis R.N., shares her experiences as a traveling nurse working in an area hit hard with COVID-19 cases in the Washington, D.C./Maryland area.
Featuring:
Tabitha Tinsman, RN
Tabitha Tinsman, RN, a Newark native, chose to be a traveling nurse to gain additional experience. During the summer, she’ll travel to Alaska and will be tested for COVID-19 before returning to work at Genesis. Transcription:
Scott Webb: As the pandemic wears on it's natural to focus on our own lives and perhaps lose sight of the work our healthcare heroes are doing on the front lines to combat the virus and save lives. Joining me today to share her experiences as a traveling nurse, who's treated COVID-19 patients is Tabitha Tinsman. She's a Registered Nurse at Genesis. This is Sounds of Good Health with Genesis brought to you by Genesis Healthcare System. I'm Scott Webb. So Tabitha, thanks so much for joining me today. I'd like to start by learning a little bit more about you. Tell us a little bit about how you became a nurse and what exactly you do at Genesis?
Tabitha Tinsman: I have been a Genesis employee since 2015. I became a nurse that same year and started at Genesis on the cardiac step down unit. I worked there for three years and it really gave me a great start as a new graduate because it requires very in tuned and practiced assessment skills. So altogether I've been at Genesis for five years.
Host: You know, obviously COVID-19 is on everybody's minds. And I want to talk to you about that. And especially as it relates to your role as a traveling nurse, what have you learned about COVID-19 as a traveling nurse?
Tabitha Tinsman: My first travel assignment was to a COVID step down unit. And until that happened, I did not take COVID-19 as seriously as I did after that experience. And it really was because if you don't see something firsthand, whether it be you have it, or you're taking care of patients who have it, it doesn't mean as much. You know, I think what I learned is that you can be female, male. It doesn't your cultural background, your health status, anybody can contract COVID-19 if they are exposed to it, doesn't mean they will, but they can. And if people do, they can become very sick very quickly. Unfortunately they can even lose a life. I saw a lot of people who recovered in less than a week, people who had no preexisting conditions, but I also saw people who had no preexisting conditions who slowly deteriorated, ended up on a ventilator and eventually passed away. And I think that was the hardest thing of course, to see that. But it definitely made me be more sober regarding COVID-19 and wanting to educate people who were willing to listen that this is something to take seriously. It's inconvenient, to say the least, on people's jobs or finances or ability to interact with the family and friends have a social life, but the repercussions of not taking it seriously can hurt your loved ones and hurt yourself.
Host: Yeah, definitely. And that's all really well said. And I know that you've also cared for patients near Washington, DC and other locations. So I'd love for you to share what that experience has been like and really what you want the members of the community to know?
Tabitha Tinsman: I remember walking into my first COVID-19 or being a travel nurse, you're expected to have, you know, a day or two of training and then jump in feet first with your job role. And I walked into my first COVID-19 room. It was a new admission from the squad had just brought this patient up. He had no preexisting conditions and I'm being careful what I say due to HIPAA and privacy, normal body mass index. All of that. I ended up having him as my patient for three days in a row. He started off requiring a high amount of oxygen. Eventually with patients who require a large amount of oxygen, they tried to put them on a heated high flow nasal cannula. The difference with the heated high flow nasal cannula versus what you see on TV shows with the nasal cannula in the nose, and even a high flow nasal cannula, which delivers up to 15 liters of oxygen. So it is literally like the last resort to needing either a BiPAP or intubation. Well, after the three days of having this patient, he was weak. He was very compliant with, you know, keeping it on. I got a call to go down and get his room because they will considering intubating him.
Now I had just talked to him an hour beforehand. He was on the South end with his family. Of course, no visitors. He hadn't seen his family in a couple of days at least. We told him, we're putting you on a ventilator because it's going to allow your lungs to rest. Because right now you are burning up your respiratory drive, your lungs, you know, are working extremely hard to try to exchange gases. We explained it to him. He said, he understood, he consented to be intubated. He was on the ventilator. I want to say two weeks. And he woke up. Eventually I went over to the ICU to see him. And he had lines and drains everywhere because when somebody is sedated, they cannot do any of those things for themselves. So we do it for them. He did not know what was going on. He was very scared, very confused. You know, I thought maybe him seeing a familiar face since we had such a good rapport, maybe he would remember me and it would help him since he couldn't see family members. But I found out he ended up having to be intubated within 24 hours, spend another week or so on the ventilator and passed away.
And that being my very first COVID-19 patient in between, this person being on the ventilator, I had several patients, some who I actually got to help discharge home. Eventually I got to see some of them do better each night. I took care of them, decreased oxygen needs improved energy, improved appetite and others I was in a couple of different codes, where somebody's heart lungs stopped and we didn't get those patients back. It's very emotional being a part of that, but more so you think about these people who are experiencing it and the families who are experiencing it, and it really makes you want to do everything in your power to stop the spread of infection. And I just would like the community to know that there are people who get COVID and recover quickly. And there are people who get COVID and suffer and eventually pass away. And if we can do our part to slow transmission to prevent other people from contracting it, wash our hands, wear a mask, try to follow social distancing. It's a real saying, and we can help slow it down. And as cliché as that sounds, I do believe that.
Host: Yeah, I think you're right. And I'm just taking all this in. And I know nobody on the front lines in healthcare goes to work every day, feeling like a hero, never the beginning of the day, the end of the day. But the reality is so many of you really are and the emotions, the rollercoaster you go through of dealing with helping some patients and seeing them go home and doing everything you can for other patients and being unsuccessful in sending them home has got to be very challenging. And I wonder how specifically has COVID-19 impacted your life?
Tabitha Tinsman: I think the biggest thing is realizing that there are circumstances outside of your control, even though COVID-19 is different than the things we've been fighting. In my instance, over the last five years of my nursing career, whether it's congestive heart failure or myocardial infarction, heart attack or whatever, it may be it's different because we don't, we don't have research treatments available. Everything that we were doing is based on what's been used to treat other illnesses. I think the most difficult thing for me of how it affected me as a nurse is to realize that you can do everything in your power of what you know, to do based on your knowledge on let's say respiratory illnesses, prevention of infection and that sort of thing. At the end of the day, the power of life and death is not in your hands. And I think that is something that I really had to be reminded of a lot.
I did talk to a crisis chaplain, where I was in the DC area. At one point I was severely upset. I just felt like I had let my patients down. And even though in the back of your mind, you know, it's not true. In the moment when you've been taking care of a patient for 12 hours or maybe 72, if you have the same patient for four, three days or three nights, it feels like you let them down and you let those families down, but that's not the case. You can't bear that burden. And I think the thing was healthcare workers who care about the job and they really care about the purpose of helping people. They are going to take it home with them to some degree, you can't get around that. Some of that will go home with you. It's just knowing how to process it in a healthy way.
Host: Yeah, definitely. You know, and I'm just thinking about how difficult that must be in carrying that burden around with you and knowing that people need you to come back the next day, right? You need to go home, you need to be able to process what's happened. And then you got a strap on the PPE and get back at it the next day. And it's just so amazing that you're able to do that. Have there been any inspirational moments, any positive stories or positive effects that have come out of COVID-19 for you?
Tabitha Tinsman: Yes. There is one, a couple actually inspirational stories. I did have a paraplegic patient who was paralyzed from about mid chest down and he already had a lot to deal with being in the hospital in general, but he had COVID-19 as well. I think one of the best things that inspired me is how some patients, even though they were suffering, you know, they were having difficulty breathing. They were away from their families. There are no visitors whether they are there two days or two weeks to visit them that they could be so kind and so thankful to the staff for the most part, very polite patients, very kind. And they would, you know, ask you to tell them a story or ask you to just some questions about your life. They just wanted some human interaction and to feel like they were carrying on a conversation. And honestly speaking with that patient while I was doing ATLs, which is activities of daily living care for that person personal care, they reached out to me and said, I want you to know that what you're doing matters and what you're doing is very important and that God has called you to this.
And I just started crying right there in the room because, you know, I was about a month in being a travel nurse. You were away from your family too. You know, if people in their moment of need can try to provide help to others is amazing. But one of the coolest things, the hospital I was at that we got to see and participate in was our 100th COVID discharge. So even though we had lost patients, despite our best efforts, there were also a lot being discharged home. And this lady who was discharged home, English was not her first language. They did a great job of making sure interpreters were available and they got consent to video her and have a parade with us all in our PPE. She was discharged out of the hospital and her family met her in the emergency department parking lot. We wheeled her all the way out there. She was crying, waving her hands as everybody was clapping down the hallway, as she got discharged. The cool part about that to me, besides the fact that she got discharged and it was just like a little ray of sunshine and a lot of sadness or stress, is that I also took care of her husband.
Well, he had COVID and he would have me go over it with the middle of the night, whenever I had any downtime and go check on his wife because of course, for precautions, you can't leave your, so he couldn't go to the next hallway to see his wife, even though they were both in there together. And I would go over, I peek at her and I didn't give false hope or she was intubated. You know, I just said, nothing's changed. No change is good news. Right. You know, and he'd be like, thank you for checking. And they both got home. They both made it. They both recovered. That was awesome to see. And I know that everybody who helped take care of them also felt the same way.
Host: That is an amazing story. And I'm sort of emotional, just listening to you and you know, everything you've said today about, you know, following what we know, distancing masks, washing hands that, you know, COVID-19 is real, it's a real thing. And some people survive and some people don't, despite the efforts of healthcare professionals, I just want to give you an opportunity as we wrap up today, what else would you like to tell potential patients, members of the community? What else do we need to know about COVID-19? And maybe if you're optimistic that we're going to get through this at some point?
Tabitha Tinsman: From what I've seen on the news, from the articles that have been shared, the researched articles, it sounds like things could be on a down spiral for, in a good way of the COVID-19 numbers, as much as we can't predict that the fact that the longer any type of disease or virus is known. So once we have a bunch of people surviving it because we can trend how it affects people. How has contracted, what, what medications work, what don't work while I was taking care of those patients, they trialed and, you know, patients who also have this consented to almost any trial from what I've seen, they can send it to any trial drug, because they knew there was no known cure. The COVID antibodies contained in plasma, and we gave plasma transfusions. And from what I saw personally, which was a very small amount, you know, not like a case study ,those patients did do well with the antibody plasma. They're also trying what they call adjunct therapy, Zinc, Vitamin C hydration, broad spectrum antibiotics.
So, finding ways to treat the symptoms, which of course improve patient outcomes. But I'm also, I don't know if things ever go back to the way they were before. That's my perspective. And maybe that's a good thing, you know, because people were not as proactive about washing their hands, using antiseptics, keeping surfaces clean. Maybe what we've learned from COVID-19 is, is to do that, to prevent the spread of COVID-19 or even the common cold. And also I think the good things that have came from COVID-19 is that we've learned to appreciate our families and our friends more, and just the small things in life, instead of the rat race of doing all the time, we were forced to slow down and go out in nature because we couldn't go to the mall. I think there's some good that comes from having your normality turned upside down, which I know a lot of people experience. Most people did.
Host: You are, and I don't want to, you know, make you blush or anything, but you are such an inspiration your insight today, your expertise bringing it home, letting us know just how real this is and the struggles, the real human personal struggles, that healthcare workers, you know, healthcare professionals go through, whether it's wearing full PPE or Pappers or face shields, you know, for hours and hours on end. And everything you go through just to do your jobs, just to try to see people, and have those celebrations when people go home, knowing that some days, no matter what you do, it's not going to work out. It's not going to work out in their favor and dealing with that and processing that and getting back up the next morning and going to work is truly an inspiration. And I sincerely mean this. I hope you stay well. To learn more about how Genesis is caring for our community throughout COVID-19 go to Genesishcs.org. And thanks for listening to sounds of good health with Genesis brought to you by Genesis Healthcare System. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics of interest. I'm Scott Webb stay well.
Scott Webb: As the pandemic wears on it's natural to focus on our own lives and perhaps lose sight of the work our healthcare heroes are doing on the front lines to combat the virus and save lives. Joining me today to share her experiences as a traveling nurse, who's treated COVID-19 patients is Tabitha Tinsman. She's a Registered Nurse at Genesis. This is Sounds of Good Health with Genesis brought to you by Genesis Healthcare System. I'm Scott Webb. So Tabitha, thanks so much for joining me today. I'd like to start by learning a little bit more about you. Tell us a little bit about how you became a nurse and what exactly you do at Genesis?
Tabitha Tinsman: I have been a Genesis employee since 2015. I became a nurse that same year and started at Genesis on the cardiac step down unit. I worked there for three years and it really gave me a great start as a new graduate because it requires very in tuned and practiced assessment skills. So altogether I've been at Genesis for five years.
Host: You know, obviously COVID-19 is on everybody's minds. And I want to talk to you about that. And especially as it relates to your role as a traveling nurse, what have you learned about COVID-19 as a traveling nurse?
Tabitha Tinsman: My first travel assignment was to a COVID step down unit. And until that happened, I did not take COVID-19 as seriously as I did after that experience. And it really was because if you don't see something firsthand, whether it be you have it, or you're taking care of patients who have it, it doesn't mean as much. You know, I think what I learned is that you can be female, male. It doesn't your cultural background, your health status, anybody can contract COVID-19 if they are exposed to it, doesn't mean they will, but they can. And if people do, they can become very sick very quickly. Unfortunately they can even lose a life. I saw a lot of people who recovered in less than a week, people who had no preexisting conditions, but I also saw people who had no preexisting conditions who slowly deteriorated, ended up on a ventilator and eventually passed away. And I think that was the hardest thing of course, to see that. But it definitely made me be more sober regarding COVID-19 and wanting to educate people who were willing to listen that this is something to take seriously. It's inconvenient, to say the least, on people's jobs or finances or ability to interact with the family and friends have a social life, but the repercussions of not taking it seriously can hurt your loved ones and hurt yourself.
Host: Yeah, definitely. And that's all really well said. And I know that you've also cared for patients near Washington, DC and other locations. So I'd love for you to share what that experience has been like and really what you want the members of the community to know?
Tabitha Tinsman: I remember walking into my first COVID-19 or being a travel nurse, you're expected to have, you know, a day or two of training and then jump in feet first with your job role. And I walked into my first COVID-19 room. It was a new admission from the squad had just brought this patient up. He had no preexisting conditions and I'm being careful what I say due to HIPAA and privacy, normal body mass index. All of that. I ended up having him as my patient for three days in a row. He started off requiring a high amount of oxygen. Eventually with patients who require a large amount of oxygen, they tried to put them on a heated high flow nasal cannula. The difference with the heated high flow nasal cannula versus what you see on TV shows with the nasal cannula in the nose, and even a high flow nasal cannula, which delivers up to 15 liters of oxygen. So it is literally like the last resort to needing either a BiPAP or intubation. Well, after the three days of having this patient, he was weak. He was very compliant with, you know, keeping it on. I got a call to go down and get his room because they will considering intubating him.
Now I had just talked to him an hour beforehand. He was on the South end with his family. Of course, no visitors. He hadn't seen his family in a couple of days at least. We told him, we're putting you on a ventilator because it's going to allow your lungs to rest. Because right now you are burning up your respiratory drive, your lungs, you know, are working extremely hard to try to exchange gases. We explained it to him. He said, he understood, he consented to be intubated. He was on the ventilator. I want to say two weeks. And he woke up. Eventually I went over to the ICU to see him. And he had lines and drains everywhere because when somebody is sedated, they cannot do any of those things for themselves. So we do it for them. He did not know what was going on. He was very scared, very confused. You know, I thought maybe him seeing a familiar face since we had such a good rapport, maybe he would remember me and it would help him since he couldn't see family members. But I found out he ended up having to be intubated within 24 hours, spend another week or so on the ventilator and passed away.
And that being my very first COVID-19 patient in between, this person being on the ventilator, I had several patients, some who I actually got to help discharge home. Eventually I got to see some of them do better each night. I took care of them, decreased oxygen needs improved energy, improved appetite and others I was in a couple of different codes, where somebody's heart lungs stopped and we didn't get those patients back. It's very emotional being a part of that, but more so you think about these people who are experiencing it and the families who are experiencing it, and it really makes you want to do everything in your power to stop the spread of infection. And I just would like the community to know that there are people who get COVID and recover quickly. And there are people who get COVID and suffer and eventually pass away. And if we can do our part to slow transmission to prevent other people from contracting it, wash our hands, wear a mask, try to follow social distancing. It's a real saying, and we can help slow it down. And as cliché as that sounds, I do believe that.
Host: Yeah, I think you're right. And I'm just taking all this in. And I know nobody on the front lines in healthcare goes to work every day, feeling like a hero, never the beginning of the day, the end of the day. But the reality is so many of you really are and the emotions, the rollercoaster you go through of dealing with helping some patients and seeing them go home and doing everything you can for other patients and being unsuccessful in sending them home has got to be very challenging. And I wonder how specifically has COVID-19 impacted your life?
Tabitha Tinsman: I think the biggest thing is realizing that there are circumstances outside of your control, even though COVID-19 is different than the things we've been fighting. In my instance, over the last five years of my nursing career, whether it's congestive heart failure or myocardial infarction, heart attack or whatever, it may be it's different because we don't, we don't have research treatments available. Everything that we were doing is based on what's been used to treat other illnesses. I think the most difficult thing for me of how it affected me as a nurse is to realize that you can do everything in your power of what you know, to do based on your knowledge on let's say respiratory illnesses, prevention of infection and that sort of thing. At the end of the day, the power of life and death is not in your hands. And I think that is something that I really had to be reminded of a lot.
I did talk to a crisis chaplain, where I was in the DC area. At one point I was severely upset. I just felt like I had let my patients down. And even though in the back of your mind, you know, it's not true. In the moment when you've been taking care of a patient for 12 hours or maybe 72, if you have the same patient for four, three days or three nights, it feels like you let them down and you let those families down, but that's not the case. You can't bear that burden. And I think the thing was healthcare workers who care about the job and they really care about the purpose of helping people. They are going to take it home with them to some degree, you can't get around that. Some of that will go home with you. It's just knowing how to process it in a healthy way.
Host: Yeah, definitely. You know, and I'm just thinking about how difficult that must be in carrying that burden around with you and knowing that people need you to come back the next day, right? You need to go home, you need to be able to process what's happened. And then you got a strap on the PPE and get back at it the next day. And it's just so amazing that you're able to do that. Have there been any inspirational moments, any positive stories or positive effects that have come out of COVID-19 for you?
Tabitha Tinsman: Yes. There is one, a couple actually inspirational stories. I did have a paraplegic patient who was paralyzed from about mid chest down and he already had a lot to deal with being in the hospital in general, but he had COVID-19 as well. I think one of the best things that inspired me is how some patients, even though they were suffering, you know, they were having difficulty breathing. They were away from their families. There are no visitors whether they are there two days or two weeks to visit them that they could be so kind and so thankful to the staff for the most part, very polite patients, very kind. And they would, you know, ask you to tell them a story or ask you to just some questions about your life. They just wanted some human interaction and to feel like they were carrying on a conversation. And honestly speaking with that patient while I was doing ATLs, which is activities of daily living care for that person personal care, they reached out to me and said, I want you to know that what you're doing matters and what you're doing is very important and that God has called you to this.
And I just started crying right there in the room because, you know, I was about a month in being a travel nurse. You were away from your family too. You know, if people in their moment of need can try to provide help to others is amazing. But one of the coolest things, the hospital I was at that we got to see and participate in was our 100th COVID discharge. So even though we had lost patients, despite our best efforts, there were also a lot being discharged home. And this lady who was discharged home, English was not her first language. They did a great job of making sure interpreters were available and they got consent to video her and have a parade with us all in our PPE. She was discharged out of the hospital and her family met her in the emergency department parking lot. We wheeled her all the way out there. She was crying, waving her hands as everybody was clapping down the hallway, as she got discharged. The cool part about that to me, besides the fact that she got discharged and it was just like a little ray of sunshine and a lot of sadness or stress, is that I also took care of her husband.
Well, he had COVID and he would have me go over it with the middle of the night, whenever I had any downtime and go check on his wife because of course, for precautions, you can't leave your, so he couldn't go to the next hallway to see his wife, even though they were both in there together. And I would go over, I peek at her and I didn't give false hope or she was intubated. You know, I just said, nothing's changed. No change is good news. Right. You know, and he'd be like, thank you for checking. And they both got home. They both made it. They both recovered. That was awesome to see. And I know that everybody who helped take care of them also felt the same way.
Host: That is an amazing story. And I'm sort of emotional, just listening to you and you know, everything you've said today about, you know, following what we know, distancing masks, washing hands that, you know, COVID-19 is real, it's a real thing. And some people survive and some people don't, despite the efforts of healthcare professionals, I just want to give you an opportunity as we wrap up today, what else would you like to tell potential patients, members of the community? What else do we need to know about COVID-19? And maybe if you're optimistic that we're going to get through this at some point?
Tabitha Tinsman: From what I've seen on the news, from the articles that have been shared, the researched articles, it sounds like things could be on a down spiral for, in a good way of the COVID-19 numbers, as much as we can't predict that the fact that the longer any type of disease or virus is known. So once we have a bunch of people surviving it because we can trend how it affects people. How has contracted, what, what medications work, what don't work while I was taking care of those patients, they trialed and, you know, patients who also have this consented to almost any trial from what I've seen, they can send it to any trial drug, because they knew there was no known cure. The COVID antibodies contained in plasma, and we gave plasma transfusions. And from what I saw personally, which was a very small amount, you know, not like a case study ,those patients did do well with the antibody plasma. They're also trying what they call adjunct therapy, Zinc, Vitamin C hydration, broad spectrum antibiotics.
So, finding ways to treat the symptoms, which of course improve patient outcomes. But I'm also, I don't know if things ever go back to the way they were before. That's my perspective. And maybe that's a good thing, you know, because people were not as proactive about washing their hands, using antiseptics, keeping surfaces clean. Maybe what we've learned from COVID-19 is, is to do that, to prevent the spread of COVID-19 or even the common cold. And also I think the good things that have came from COVID-19 is that we've learned to appreciate our families and our friends more, and just the small things in life, instead of the rat race of doing all the time, we were forced to slow down and go out in nature because we couldn't go to the mall. I think there's some good that comes from having your normality turned upside down, which I know a lot of people experience. Most people did.
Host: You are, and I don't want to, you know, make you blush or anything, but you are such an inspiration your insight today, your expertise bringing it home, letting us know just how real this is and the struggles, the real human personal struggles, that healthcare workers, you know, healthcare professionals go through, whether it's wearing full PPE or Pappers or face shields, you know, for hours and hours on end. And everything you go through just to do your jobs, just to try to see people, and have those celebrations when people go home, knowing that some days, no matter what you do, it's not going to work out. It's not going to work out in their favor and dealing with that and processing that and getting back up the next morning and going to work is truly an inspiration. And I sincerely mean this. I hope you stay well. To learn more about how Genesis is caring for our community throughout COVID-19 go to Genesishcs.org. And thanks for listening to sounds of good health with Genesis brought to you by Genesis Healthcare System. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics of interest. I'm Scott Webb stay well.