COVID POSITIVE

It is a usual Monday in unusual times, and I begin my week in this altered world of the pandemic. COVID cases are soaring, and California is now experiencing crisis levels reminiscent of the spring in New York City. I feel fine and am very busy, but by midday, my world begins to change as I become acutely ill-nausea, abdominal pain, fever, profound fatigue-all the symptoms I have repeatedly heard described by frontline clinicians and news reporters as they chronicle the devastating cases of those who have entered the world of the COVID positive. I am immediately reminded of the latest statistics revealing that 3000 people are dying each day in the United States. Until now, I have managed to build a strong wall between "them" and "me"-me the nurse, the healthy one, not the patient.

I awake the next day after a sleepless, fevered night and need to face the inevitable. I need to go for a COVID test. I contact my health care provider and am directed to a drive-through screening center further from my home but designated to screen 10 000 people today. Within the first mile, I begin to feel worse and I realize there is no way I can endure the 45-minute driving time to this center; I redirect myself to a closer site but prepare for the possible several-hour wait. This dismal morning becomes worse as I then realize that this dreaded drive just became incredibly worse as I now encounter a serious California wildfire just a few miles ahead, creating dark skies and smoke so horrendous it challenges my breathing, even within the safety of my car. My car radio confirms the conditions I am living-COVID surges amidst multiple fires made worse by high winds.

I arrive at the screening location and begin the slow process of winding through the single line of cars. The closer I get to the screening, the more my anxiety rises. It must be COVID. But it cannot be COVID. I have too much to do. COVID would mean I cannot be with my grandchildren. COVID could mean that I am the tragic case on the news. No. I cannot think about this.

I drive slowly into the screening area where a young nurse approaches my car. I am trying hard to not cry as I am feeling less the nurse and more the patient. The nurse approaching me is a very young Latina woman who I imagine must be a very new nurse. For a moment, I try to remember when I was such a nurse, 43 years ago. As I roll down my window, this nurse approaches, looking very intently into my eyes. Her voice is calm and slow; her face is gentle. Despite the mask, gown, face shield, and gloves she wears, her intent eyes speak volumes. She explains that she will swab my throat and nostrils, all the while never taking her eyes away, although I feel tears forming in mine. She begins the swabbing as she gently tells me exactly what she is doing. I have a flashback to 2 months ago when I had another COVID scare and had my first screening, one I recall as an abrupt thrust of a swab that felt like an attack. I am struck by the difference today-the nurse's gentle touch, her slow movement, her calm voice that steadies me.

The procedure is done, and I sit paralyzed by the experience. It is an experience of feeling cared for. I am then startled by a man in front of my car who seems to be waving at me to direct me to begin driving ahead. I look back to the face of the nurse, and I tell her I am so grateful for her kindness. Her face has a gentle smile, and once again, she holds me in her gaze and then she says so intently, now with eyes that shine and such a dear heartfelt voice, "Oh, mamma, thank you." This simple term of endearment, "mamma," I often hear in my Latina friends and colleagues' voices, this endearing word spoken to me so genuinely.

I drive away. This site will screen 1500 people this morning, and this young nurse will undoubtedly perform several hundred tests, yet in this moment, it felt as if I was the only patient. I begin driving and realize that my screening is done, so I find myself resuming "palliative nurse" mode as I am now in full denial that it can possibly be COVID. Back to the wall of certainty, I am the nurse, not the patient. As I drive away, I think about how this young nurse had such an impact on me. What do we call this in palliative care? Empathy? Compassion? Was this expert communication? Presence? Caring?

And then it comes to me-it is called kindness. This nurse was kind. I am left to wonder: how do we teach kindness? How do we screen for it as we admit new nursing students or hire staff for our hospices and palliative care programs? I do not know. But I do know what it feels like to receive it. If I have COVID, please God let this nurse take care of me.

Three days later, my COVID test result is back. It is negative. My COVID testing experience[horizontal ellipsis]very positive.

Betty R. Ferrell, PhD, CHPN, FAAN, FPCN

JHPN Editor-in-Chief