A Broken System Revealed: Nursing During the Pandemic with Troy McMullen
In this week’s episode, Beth is joined by new nurse Troy McMullen, a nurse of three years who started just before the pandemic hit. Beth and Troy talk about his journey to become a nurse and what that meant when COVID took over the world. He talks about the various locations he worked as a travel nurse and how similar they all were in the frustrations he had with the system’s lack of proper care for the patients. Troy and Beth remind everyone that you have to know when to say no, even if that makes co-workers frustrated. It’s a journey you won’t soon forget.
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Intro/Outro:
Welcome to Don't Eat Your Young: A Nursing Podcast with your host, Beth Quaas. Before we get started, we have a few quick notes. Don't Eat Your Young is a listener-supported podcast. To learn more about becoming a member and the perks available to you for becoming a patron yourself, visit patreon.com/donteatyouryoung. You can learn more about the show, share your story to join Beth as a guest or connect with our wonderful community in our Facebook group. You can find all those links and more at donteatyouryoung.com. Now, on with the show.
Beth Quaas:
Hello, everyone, and welcome back to Don't Eat Your Young. I'm your host, Beth Quaas. Today, I'm excited to have Troy McMullen on the show. He's been an RN for three years, spent a lot of time in different places within the hospital, and now, he is a traveling nurse. I'm excited to have him on and tell us what he's experienced out there. Welcome to the show, Troy.
Troy McMullen:
Hi. How are you doing, Beth?
Beth Quaas:
I am doing great. I'm excited to have you here today and to hear all about your experiences. You're a younger nurse compared to some of the people that've been on here, so I'm excited to talk to you about how it's been, especially since COVID and you're traveling now. Why don't you tell us a little bit about yourself?
Troy McMullen:
I'm 29. I live in Upstate New York. I've been a nurse now for three years. Right now, I'm traveling, a traveling nurse assignment. Some of my background... I graduated nursing school, and I started working off in a cardiac ICU. I gained a lot of experience quick in that one year. I've always wanted to be an ER nurse. That was always my thing, so once I got my year down in the specialty that I was in, I decided to go further into the emergency department.
Worked in the ER for probably about six months, and I absolutely loved it. I love everything about nursing. I loved what I did. I enjoyed going to work. I was excited to go to work every day, and then, unfortunately, COVID happened. Being a new nurse at the time, I had to really not only adapt to being an ER nurse, but, holy crap, we're going through this pandemic that nobody knows anything about at the time. It was very scary to healthcare workers, to the public, and we were obligated to still go to work, and do our job as nurses, and take care of sick people.
Beth Quaas:
So how big was the hospital you were at that time?
Troy McMullen:
The hospital that I was at was a Level II trauma center, so it was a relatively large hospital. We had six floors for med-surg, labor and delivery. We had a neuro ICU and a normal ICU. We had a NICU, and then the emergency department operating was obviously... it was a very large... I went to nursing school there at the hospital that I worked in the ER at, so I was very comfortable working in that, in a large hospital.
Beth Quaas:
So how were those first few months of when COVID hit? Because you're so right. We didn't know what was going on. We didn't know what we were walking into every day we went into the hospital. Really, that was our job. Did you feel that you had what you needed from the hospital that you worked at, and how was it for you?
Troy McMullen:
When COVID first happened, like you had mentioned, it was a big shock to everyone, and we had to adapt very quickly because there was people that were sick. They were dying, and we had to do something, right? As far as protective personal equipment, I have to say that I was very fortunate to be provided the materials that I needed to do my job for the most part.
Once I started traveling, once I left the ER to travel around the state, that's when I really started to see, holy crap, there isn't enough PPE. I mean I worked in a long-term care facility. That was my first traveling assignment. I went to a long-term care facility to help out in the nursing home, and we were wearing the same gown all day. It wasn't your normal light yellow PPE that you're able to breathe and take off. It was this heavy... It felt like a mat that you just wore.
I mean I had CNAs passing out. This is in the middle of the summer. I had CNAs passing out on the floor right in front of me just collapsing because they were dehydrated, they were overworked, they were overheated from the PPE that they were wearing all day.
The masks were concerning. We had to wear the same N95s all day if you were lucky to get an N95. I feared for myself. I feared for my other coworkers. I myself am immunocompromised. I have asthma, and so I was high risk for... At the time, the variant that we had was very deadly. I was at risk to get that. Thank God, I didn't get COVID. I don't know how I didn't get it.
Beth Quaas:
Yeah, it is crazy who it hits, and who it doesn't, and timing. Well, I commend you for going in, and you didn't shy away from COVID. You went to where they needed you. How did you make that decision to travel and go to those places?
Troy McMullen:
At the time when COVID happened, like I said, it was a big scare. So the general public, they were afraid to come to the hospital for your normal aches, and pains, and other crap that you might see come through the ER. The med-surg floors were empty. They stopped ORs. They completely shut down the OR, so there was no surgeries.
The surgeries bring in a lot of money, et cetera to the hospital, especially your orthopedic surgeries. They weren't doing that, so they were calling nurses and saying, "Hey, don't come in today. There's not enough patients. We have too many nurses on. Take the night off," which was nice, but it got to the point where it was happening more frequent. We all have bills to pay. Costs of living is going up, and I couldn't just sit home, and get called off every day, and not get paid for it.
So there was a need down south in the New York state, such places like New York City at that time, where COVID really took over. I worked halfway between New York City and Syracuse at the time down in a small city called Binghamton. There just were no staff. They were hurting. There were really, really sick COVID patients at the time down in the southern tier of New York state. It didn't really affect the upper New York state at the time yet. I mean we still had a couple cases here and there, but I mean the southern part of New York state was absolutely just... Everybody had it. It was to the point where they were sending the National Guard in to help with staffing. Yeah.
Beth Quaas:
That is crazy. In this long-term care facility you went to, how was that? Number one, you hadn't done that really except as a student, right?
Troy McMullen:
Sure. Exactly.
Beth Quaas:
So how did that assignment go for you?
Troy McMullen:
It was the saddest thing I've ever seen in my entire life. These elderly people that have dementia, that may have a intellectual disability or developmental delay that are in nursing homes, they need their family. They need that support. They need to see a familiar face, and these elderly people were locked in their rooms. They weren't allowed in the hallways.
They weren't allowed in the recreational areas where they previously before COVID were able to go out and play bingo or they would have Thanksgiving dinners together and stuff. That all stopped. These residents could not come out of their rooms at all. They were confined in their rooms. If they came out into the hallway, "Hey, Ms. Grady. You have to go back in your room." This is their home. They live there.
What really bothered me is I don't feel they were protected. They weren't protected from staff that were COVID-positive, bringing COVID into the nursing homes. They didn't protect those residents' rights, and I felt that prisoners had more freedom than these elderly people. I mean their families could not come and see them. They would die alone with nobody, but these staff that they don't know. Yes, were we able to FaceTime and that kind of stuff? Yeah, but that's not the same as your son touching your face or, "Mom, dad, it's going to be okay." Those people died alone.
The elderly, they dropped like flies from COVID in the nursing home. I remember getting floated to specifically... I was an RN obviously in the nursing home, and there weren't very many RNs, so I did a lot of supervision-type duties, such as paperwork and supervision kind of things. I remember floating down to the COVID unit, and I don't know if you ever seen the old military movies, where it was people... They were bed to bed next to each other in a ward.
They took a cafeteria, made it into a... What do we call them? Isolation room. They made it into a huge airborne room in a cafeteria, and they had elderly patients, no privacy, bed to bed to bed, male, female mixed together. Didn't matter. Bed to bed to bed to bed to bed. They all had COVID. They were the sickest patients. They were confused. It was the hardest 13 weeks of my life.
Beth Quaas:
I bet. I can't imagine that. It brings tears to my eyes to hear that. Those people didn't deserve it, and I hope out of anything that we learned during this pandemic was how we don't want to do it next time. We can't do that to those people, to anyone. I think about the same in the hospital, the patients that come in, and didn't have family with them.
We knew if you were intubated at that time the chances of you recovering from that were very small. Families... I don't know if they knew that, but it was hard for us as nurses too to know what we know, yet we were everything to those people. We were their families. We were the people holding the iPads and the iPhones, and when there was time, letting people talk to their family. So I thank you for doing what you did, and I'm sure you have nightmares of that time.
Troy McMullen:
Absolutely. As nurses, we took an oath to be there, and take care of sick people, and cause no harm. I mean I know the nursing staff had no control over obviously what happened to these elderly folks, but I feel like the system failed them. Politics failed them. Those people didn't have to die.
Beth Quaas:
And if they were going to die, they did not have to die the way that they did. You're right. So many things came into play, and the nurses out there taking care of patients were doing everything they could, the best that they could with what they had at the time. We as nurses... I know we have the National Nurses March coming up, and we all need to come together and be part of the decision-making and what happens because we lived through it. You lived through it. You saw it better than anyone what happened out there. I think that is amazing that you're coming on here and telling people how it was. Where did you go after that assignment?
Troy McMullen:
After that assignment, I continued to travel. I took a COVID ICU position down in a local, southern part of New York state. That assignment didn't last very long. I was there six weeks, and I couldn't do it anymore. I was taking eight patients at a time in an ICU. We were giving them Decadron. Decadron can make people very mentally unstable to where they're very agitated. They're pulling their tubes out. It does weird things to the mind, right?
To stop these patients from pulling tubes, and getting out of bed, and et cetera, we had to restrain them. So I was doing restraint documentation, eight patients, managing drips, and I walked out of work every single day feeling like I just carried the whole world. I was so drained. I couldn't think. I would drive home and miss my exit to get home.
There were points to where I would be on the... I'm a grown man. I don't cry very much. I go to work. I've always been a worker. There was times where I would be on the ground at home on the floor crying because I didn't want to go to work, but I had bills to pay, and nursing is all I know.
Beth Quaas:
Absolutely.
Troy McMullen:
I've been a CNA. I've been a tech and now an RN. Healthcare's all I know. That assignment didn't last very long.
Beth Quaas:
Did you choose then to stop that assignment?
Troy McMullen:
I did. I did. I felt like my license was at risk, especially with the restraint documentation. It was very unsafe, and also there, the PPE that we had was very minimal. At the time, I was engaged and had a little girl at home. I didn't want to risk bringing anything home to them. It was really hard.
Beth Quaas:
Absolutely. Number one, no ICU nurse should have eight patients. Number two, restraint charting is impossible to keep up with. It is crazy.
Troy McMullen:
It is.
Beth Quaas:
For you to do that, plus you're also trying to save these people's lives and keep them alive-
Troy McMullen:
Right.
Beth Quaas:
Impossible to ask you to do what you were being asked to do. Was that because there was a shortage of nurses? Was it that there were that many patients? What led to that?
Troy McMullen:
There were that many sick patients, and I also feel like the staffing... There was just this big staffing shortage. Everyone was scared, and they couldn't keep staff. They just couldn't because nobody wanted to... not that they didn't want to deal with it, but they couldn't. They have a license to protect because if I get sued for something, I'm a traveler. I don't have a hospital or a union backing me up. I'm a young nurse, and I would like to keep my license for the rest of my career.
Beth Quaas:
Absolutely. What you felt and what you described is so normal for what people were going through at that time, and so I'm glad you realized that that wasn't sustainable and you walked away before your patients had a bad outcome, before you had a bad outcome yourself, before something happened to your license. We feel the guilt of taking care of patients, and waiting to be there for them, and caring for coworkers, but we have to take care of ourselves, so I'm glad you did that.
Troy McMullen:
Yeah. That's the thing that I always try to press too, especially the newer nurses, is that it's okay to say on. It's okay to say, "I can't answer that call bell." It's okay to say, "No, I can't help you turn that patient right now." It's okay. That other coworker, they might get upset with you, but you have to mentally take care of yourself at work. That's really the biggest thing.
Beth Quaas:
I am so glad you said that, and everybody needs to know that. Number one, it's you. It's you that you have to take care of first. Just like when you're on an airplane, they say, "If the mask comes down, put it on yourself first before helping others." We have to know that that's okay, that we can do that because sometimes I feel like nobody cares what's happening to us. Just take care of patients. Get the revenue. Keep the hospital running.
Troy McMullen:
Exactly.
Beth Quaas:
But nurses right now are suffering from all kinds of, call it what you want, PTSD, burnout, moral injury, compassion fatigue. It's all of those things coming together.
Troy McMullen:
Yeah, it is. Beth, the last time that I spoke with you, I actually had a really nasty cold last week before I went on vacation. I'll never forget this. I was working and the emergency department at my current assignment. This has been a pretty decent assignment. I've been with this hospital for, gee, six months now. I keep resigning my contract with them. It's a pretty decent assignment.
I was floating down to the ER, taking care of five patients, whatever. Normal nurse-to-patient ratio. I had a patient who was confused, kept pulling on his IVs. I had to put like three or four IVs in the poor guy. There was a patient next to him with a one-to-one sitter. Well, I've got other patients that I'm taking care of. We don't have bed alarms down in the ER, and so he kept going up to get to the bathroom.
I go out to the charge nurse. I go, "Hey, I really can't keep an eye on him every two seconds." I go, "I'm busy. I'm hanging drips, and this person's blood pressure's through the roof. I got to get them a CT," just that kind of stuff. He's like, "Okay. Well, have the sitter next to him pop the curtain open and cohort the sitter." I'm like, "Okay."I go out and let her know.
While I'm taking care of my patients, one of the techs comes to me and goes, "Hey." She goes, "I haven't seen the patient in a few minutes." I go to the sitter. I go, "Well, hey, where'd the patient go?" "Oh, I'm sorry. He got up and went to the bathroom again." Okay. Me and the tech go and knock on the door. No response.
Open the bathroom door. This man is on his back in the bathroom floor, so we started compression on him right in the bathroom floor. One of the techs brings the cart in. I'm screaming for help. I hit the code button. He's skin and bones, so we were able to lift him up off the bathroom floor and get him on the stretcher. I jump on the stretcher, and I'm straddling the stretcher, doing compressions as they're pushing the bed out to the bay. They bring the crash cart in, and we resuscitated him back.
That's the kind of thing that when I spoke to you last time is that these patients... They aren't only dying from COVID, but they are dying from the lack of staffing. They're dying from the lack of being able to be watched or monitored.
Beth Quaas:
It's a good thing you got in there and found him, but you were busy too. What are we going to do? I mean patients come in, and they want help, and it's not on you because you're busy doing everything else. Where do we change it? More staff? Is that what we need?
Troy McMullen:
We do. We need more staff. I was beating myself up pretty hard about it. I'm like, "Man, I should have been watching him more closely. That blood pressure could have waited maybe." Just those little things that I thought of, and I shouldn't have had to have those thoughts because I'm only one person. We need more CNA. Even for nurses, we need more CNAs. We need more techs. We need all hands on at this point because patients are dying from reasons other than just COVID.
Patients are waiting in the ERs for 16, 24 hours with emergent situations to where they need emergent surgery. They're dying from MIs in the ER. They're dying from just crazy things that shouldn't... They should have been addressed. Infections, sepsis, just dying in the waiting rooms. This isn't COVID that are killing these patients. It's we don't have enough staff. We don't have enough.
Beth Quaas:
Do you think patients still have the mentality that they shouldn't come to the hospital unless they have COVID or they're not coming because of COVID? Do you think that's still happening?
Troy McMullen:
Absolutely, I do. A lot of times I hear from my patients, "This hospital sucks. This place sucks. This sucks. These doctors suck. These nurses don't know what they're doing. Dah, dah, dah, dah." They get so angry. I understand what they're saying because I've been a patient before. I've been that patient that's waited hours. I get a little irritated when people aren't able to communicate with me.
I get that, but I feel like the patients maybe should also look at it from another perspective as these professionals are doing everything that they can short-staffed to take care of me, and maybe I don't need to hit that call bell to do something that I'm physically able to do at home. That's the thing that I see with patients, and we laugh about it as nurses now like, "Oh, they could wash their hair and brush their teeth before they came into the ER, but they got a bellyache, and they can't do it now."
I feel like patients really need to take a step back, breathe, and that nurse will be with you. That CNA will be with you. If they forget, we're sorry. We're swamped. It's beating up the nurses because we're wearing 10 hats.
Beth Quaas:
Right. Right. I think that's what this is about. I appreciate you telling this story because nurses know it. They're like, "Yeah, we know," but it's about letting the public know what's happening in the hospitals, and clinics, and anywhere you're getting your healthcare. We're running everywhere. We're doing so many different things. Plus, we're trying to chart. We're trying to take care of patients. We're trying to use all of these things without less hands, without less time. It's just get more and more done with little help.
I agree when you say if we could get more help from nurses aides, techs, pay them appropriately... because if I had the choice of either working at a convenience store or being an aide for the same amount of money... Being an aide is one of the hardest jobs anyone can do-
Troy McMullen:
Exactly.
Beth Quaas:
... and very thankless. They work hard, and if you have a good aide or you have enough aides, it can make your day go so much better.
Troy McMullen:
Oh, absolutely. Absolutely. I'm glad that you said that because really there's some days where we do have the aides, we do have the techs, and are able to grab our blood sugars or are able to grab those Q4 vital signs that seem like it's the end of the world for a nurse when their day's just chaotic or they're able to bring that patient down to CT. Those are the things that can make that 12-hour or 16-hour shift just a little bit easier. When we have it, I appreciate the heck out of it because it doesn't happen often. So it's good to go home after a long days of work and be like, "Okay, I had help today. It wasn't terrible."
Beth Quaas:
Yeah, it really does make or break our day when we have the right amount of help. We have a lot to do, and when we have somebody there that, like you said, can do those things, and remember to do those things, and keep an eye on the time, that helps us out immensely. We have a lot of reform to do.
Troy McMullen:
Yeah. Another thing that I'd like to point out that I see often is there's kind of a toxic relationship lately with nurses, and CNAs, and techs because there's might be only one or two techs on the floor if you're lucky. Those techs, they work hard. I remember being a tech. They do. They work hard. They answer call bells. They're flipping patients. They're writing. They have a lot going on too.
It doesn't benefit you as a nurse to be nasty to your CNA or tech because they forgot to grab a vital sign or they have to say no and say, "I can't help you flip your patient right now because I'm busy." I've seen nurses get very nasty with them. The techs will talk about the nurses, and the nurses will talk about the techs, "Well, they don't do anything. Well, they don't do anything." All that needs to stop.
If somebody's nasty and mean to me, I'm not going to want to help you. I'm going to want to walk away and go find another nurse that's nicer to me, and I'm going to go help them. It's so-
Beth Quaas:
That's human nature.
Troy McMullen:
It is. It is. Just like the nurses are burnt out, the techs are burnt out too, and I feel like the nurses also need to lighten up a little bit on aides because they're working their butts off just like we are.
Beth Quaas:
Yeah, they're going through the same things that the nurses are, so I totally agree with you.
Troy McMullen:
Absolutely.
Beth Quaas:
Troy, what are you doing now? Are you going to continue traveling, do you think?
Troy McMullen:
Until a reform is done to where they are willing to pay hospital staff that are doing just the same work as travelers. Until they are willing to pay the same. I mean why would I go work for a facility as a staff nurse, working my butt off, making half of what I am as a traveler?
Beth Quaas:
Doing the same job.
Troy McMullen:
Doing the same exact job.
Beth Quaas:
Even in the same hospital. You're right.
Troy McMullen:
And right now, I'm on a local contract, so I'm a traveling nurse, and I drive a half-hour from my own home to get to work, and I make double of what a staff nurse does who lives the same distance away.
Beth Quaas:
Yeah, I see it. People are leaving their jobs, and they're going to travel. You have to do what you have to do for yourself.
Troy McMullen:
It's not about putting a cap on travel nurse pay, okay? It's about paying your staff members what our travelers are making because nurses are worth way more than what we get paid.
Beth Quaas:
Nurses are retiring. Nurses are leaving the profession to not do patient care anymore. We're not going to have nurses coming in to go to school to pay the money for an education when you come out, and your job is impossible to do. So I agree with you. Pay is just part of it. Pay is a big part of it, but it's the schedule. It's while you're there on your shift, you have to have a manageable workload.
Troy McMullen:
Absolutely.
Beth Quaas:
So much needs to change, and that's why we need nurses just like you that'll come out and tell your story, let people know what's actually going on because we're not hearing it from administrators. And I don't think the media has the right story. I don't think they're talking to the right people right now.
Troy McMullen:
Exactly.
Beth Quaas:
I hope we can get your story out far and wide and let people know this is what's happening. This is going to affect your mother, your father, your sibling, your whatever. Family members are going to be affected when they come to the hospital with the way healthcare is right now. So I appreciate it.
Troy McMullen:
Absolutely.
Beth Quaas:
What else do you want us to know about you, Troy?
Troy McMullen:
I want you guys to know that I am a young nurse, very energetic, and I'm going to keep on keeping on. Know that there is going to be a light at the end of the tunnel, but we have to keep speaking. We have to keep advocating, and I think we can make this happen.
Beth Quaas:
I would have to say, Troy, you're a young nurse, but you are wise beyond your years.
Troy McMullen:
Thanks.
Beth Quaas:
Just listening to you talk, you know so much. You've seen so much. I hope that you're able to take care of yourself and not have the guilt of what you've seen in the past hinder you from moving forward.
Troy McMullen:
Thanks, Beth. I appreciate it, and I appreciate you doing this podcast and getting us out there, us nurses, who want our voices heard.
Beth Quaas:
It's not all doom and gloom. I don't want this podcast to be all doom and gloom. We do great care every day, and we take care of amazing patients. We are just working hard to make it even better than what it is right now.
Troy McMullen:
Absolutely.
Beth Quaas:
I thank you so much, Troy, for coming on and telling your story, and I hope that your career just continues to flourish.
Troy McMullen:
I think it will.
Beth Quaas:
I do too. Thanks, Troy.
Troy McMullen:
All right. Thank you, Beth.
Intro/Outro:
(Singing). Don't Eat Your Young was produced in partnership with TruStory FM. Engineering by Andy Nelson. Music by The Lighthearts. Find the show, show notes, and transcripts at donteatyouryoung.com. If your podcast app allows ratings and reviews, please consider doing that for our show, but the best thing you could do to support the show is to share it with a friend or colleague. Thank you for listening. (Singing).
