Emergency Room Nurse Recalls What It Was Like Working During Peak Of Pandemic

ER nurse Amanda McDaniel at Stony Brook Southampton Hospital. DANA SHAW

Amanda McDaniel was a fifth-grader in the Bellport School District when the September 11, 2001, terrorist attacks shook the nation. Despite her age, it had a profound impact on her.
Raised in a family of ambulance and fire department volunteers, she remembers her uncle, Mark Magnani, staying at Ground Zero for weeks with the Brookhaven Fire Department.

The experience sparked a desire to give back and honor the many volunteers and others who had died.

So she informed her family that when she graduated high school, she would enlist in the U.S. Marines.

They didn’t necessarily believe her at first — declaring intent to join a famously demanding branch of the military isn’t exactly normal for a preteen girl. But in October 2009, Ms. McDaniel started basic training and boot camp at Parris Island in South Carolina, followed by combat training at Camp Lejeune in North Carolina, hoping to become a combat engineer and to be deployed.

Instead, she was redirected to where there was a more imminent need: refueling jets, helicopters and other military aircraft, testing fuel for sediment and water, and helping set up fuel farms in far-flung locations like Okinawa, Japan.

In early 2011, she became pregnant with her first son and came back to the United States, working for a time at the busy Bogue Airfield in North Carolina. Ms. McDaniel, now 29, concluded her service after four years without achieving her goal of active deployment.

But that desire to be part of the action, and apply her skills in a high-pressure, combat-zone atmosphere, never left her. And the chance to fulfill that aspiration came in an unexpected way this past April.

When the coronavirus bore down on the United States with alarming speed and devastation, Ms. McDaniel was living in Tennessee with her sons, Charlie, now 9, and Payton, 7, working as an emergency room nurse.

States in the South and interior of the country had yet to feel the virus’s wrath, but Ms. McDaniel was closely following what was unfolding in her home state. Before long, she was headed north and east, on a sort of self-deployment, and wound up splitting time between Southside Hospital in Bay Shore and Stony Brook Southampton Hospital. At the end of June, she accepted a full-time position at Stony Brook Southampton.

Last month, Ms. McDaniel spoke about her experience working in the ER at the height of the COVID-19 crisis in the spring, giving a window into what life was like for many essential workers during that time.

Her account is a powerful reminder of those harrowing months, and is particularly poignant now, as the country is in the full throes of a new wave of the virus, with the holiday season and colder weather on the horizon.

Many health care workers at that time were making the kind of sacrifices more often associated with members of the military — isolating from friends and family for months, and putting their lives on the line while working under enormous pressure and ever evolving challenges.

It was not easy, of course, but it was the kind of work Ms. McDaniel said she felt called to — and prepared for, thanks both to her military training and what she faced in her early days as a nurse.

Upon graduating from nursing school in 2017, Ms. McDaniel immediately went to work at a level-one trauma center in Johnson City, Tennessee, where she was “thrown to the wolves,” she said. The experience confirmed her desire to be in the emergency department.

“I love the ER,” she said. “You never know what’s going to come in. Some of it is just a stubbed toe, but in other situations you have people actively dying right in front of you. Being able to stabilize them and make a difference — I like that feeling.”

Ms. McDaniel arrived back in New York on April 5, and her first shift at Southside was a sign of what was to come.

“Every patient was COVID — the hospital was overrun,” she said. Patients would arrive with low oxygen levels, and the medical staff would stabilize them, only to see them rapidly deteriorate within a matter of hours.

Many of the unprecedented challenges described by health care workers at that time were part of Ms. McDaniel’s experience: not enough medical equipment for the number of patients; not enough space to house them comfortably and with adequate privacy; and the enormous difficulty of trying to treat a novel disease that no one really understood.

“It was just really sad, because there were so many of them that I couldn’t treat them like normal patients,” she said. “I would just have to go as fast as possible and try to save lives. It was really hard to manage all that.

“The saddest part about it was that family wasn’t allowed. All I could think about was that the last time these families are seeing them is when the ambulance takes them away.”

Caring for critical patients was nothing new for Ms. McDaniel. She’d become relatively adept at compartmentalizing death. But those patients usually had a loved one by their side, or, at the very least, a nurse who could spare the time to comfort them. Trying to provide emergency medical care while spread so thin that she could not extend that emotional lifeline was hard, she said.

In moments when the enormity of the unfolding tragedy threatened to overwhelm her, Ms. McDaniel relied on her military training. “It really did help me,” she said, “to just keep going.”

She did that, working six or seven days a week from April until early July. During that time, she only saw her sons on FaceTime, but was grateful for the opportunity to work nearly every day, because it gave her less time to ponder what was happening and the physical and mental toll it exacted.

Of course, it wasn’t always possible.

“I tried to treat it like a deployment,” she said. “But I was exhausted, and there were some nights when I couldn’t keep it together, and I would just cry. As an ER nurse, I see people die all the time, but there are certain things that can eat away at you.”

Ms. McDaniel remembers one patient she treated in particular. She described him as an older gentleman who did not speak English. At one point, he was in respiratory failure and was panicking.

“Every time I would say, ‘It’s OK,’ and try to reassure him, he would look at me and smile,” she said. “We ended up intubating him, and he would wake up and reach for the tubes, and I’d say, ‘No, sir, it’s breathing for you.’ He would open his eyes and smile with the tube in his mouth and try to relax. I’ll never forget him, he was the cutest little old man. I don’t know what ever happened to him.”

That story is another example of the harsh realities of working in the ER — for every patient whose death Ms. McDaniel witnessed, there were others whose fate remains forever unknown to her. “It’s really hard not knowing,” she said. “But sometimes it’s better that way.”

Ms. McDaniel remembered another patient who had arrived from a nursing home, COVID-positive and sorely in need of a bath and teeth cleaning, tasks Ms. McDaniel took time to do with the help of another nurse’s aide.

“You still have to treat people like humans,” she said. “In the beginning, the entire thing felt very dehumanizing, the way we had to line patients up without much privacy. For some people, what makes them feel better is just sitting and talking to them, and it was really hard to be so overworked and busy that I couldn’t do that.”

Despite the long and arduous days and nights, Ms. McDaniel said she was buoyed by a strong sense of purpose during that time, which came in part from reconnecting with her roots.

“Just being back on Long Island, with people like me, I felt a sense of home there,” she said, referring to both hospitals, and speaking about the strong camaraderie among the nurses and other staff members at Southside and Southampton.

When the curve was flattened this summer, and the first wave of the virus was brought under control, Ms. McDaniel’s sons came to live with her in Hampton Bays. At the ages of 9 and 7, they understood why she had to be apart from them for several months, and she said she appreciated that her ex-husband and mother-in-law took care of them during that time.

“It was really hard being away from them,” she said. “They’re very smart kids and know that Mommy is a nurse and was going to help people. They think of this area as home, too.”

Ms. McDaniel’s aunt, Lynn Magnani, was not surprised that her niece made her way back north to help out in the spring. She remembers the fierce devotion Ms. McDaniel had to the spirit of service when she was young. There were books at home about the military, and Ms. McDaniel’s close relationship with her grandmother Emily Magnani, a nurse who volunteered for the ambulance squad in Brookhaven hamlet, was influential as well.

“I told her she was crazy,” Ms. Magnani said with a laugh, referring to her initial response when Ms. McDaniel said she would join the Marines. “But I was also very impressed. She followed through on her dreams.

“She’s very driven,” she continued. “I say to her, ‘You’re not even 30 yet, and you’ve been in the Marines, you got your nursing degree, you bought a house, and you’re raising two kids. When do you sleep?’”

As a military veteran and a nurse who worked on the front lines of a global pandemic, Ms. McDaniel knows that what she’s chosen to do for a living is frequently categorized as heroism. She has complicated feelings about that.

“I feel like the real heroes are the ones who volunteer their time when they’re off work and aren’t getting paid, and are giving back to their community,” she said, referencing her grandmother and other family members, and pointing out that her work in the military and as a nurse has always been paid.

But she said she appreciated the outpouring of support from the Southampton community in the spring, saying donations from local restaurants and food establishments meant there was always free, delicious food for breakfast and dinner whenever she went in to work.

“It was nice to feel appreciated, because a lot of times in this type of work, you don’t hear that,” she said. “Feeling appreciated is better than being called a hero. It was nice knowing I was helping someone and they appreciated my care.”

The staff at Stony Brook Southampton certainly appreciated that she cared enough to be there.

Ms. McDaniel spent more of her time in the spring at Southside, but as soon as she arrived back on Long Island, she made a phone call to Katrin Diana, the nursing director in the Emergency Department at Stony Brook Southampton Hospital. Ms. McDaniel had worked there as a nursing assistant several summers ago, and had formed a solid connection with Ms. Diana, who had worked alongside Ms. McDaniel’s grandmother more than 30 years ago at a different hospital.

Ms. McDaniel started working at Southampton during her days off from Southside in the first week of April. On April 14, Southampton experienced its peak in terms of COVID patients, with 54 cases: 36 confirmed positives and 18 “persons under investigation,” who were highly suspected and/or later turned out to be positive.

The hospital had expanded from 94 to 196 beds in less than 10 days, and the ICU, which typically accommodates seven beds, was expanded to 21.

What they were dealing with was “highly out of the norm,” Ms. Diana said, even for a hospital accustomed to dealing with surges thanks to the annual summer population boom. Having the additional help of a well-qualified nurse, someone they were already familiar with, was a gift, Ms. Diana said.

“We knew her and she knew us,” Ms. Diana said. “We weren’t taking someone unknown from another part of the country. It was a seamless re-entry, and she didn’t have to do that.”

“One of the things that’s so important about her is her adaptability,” Ms. Diana added. “Nothing flusters her, and she has a great, quiet calm about her. She just moves forward and is all about the patient and the task at hand.”

Ms. Diana added that she can see the effects Ms. McDaniel’s military training has had on her nursing work.

“My husband is retired from the military, so I can speak to how it impacts who you become,” she said. “The military teaches you that there’s a job to be done, and you’re going to do it and it’s going to be successful. I think she approaches her nursing that way.”

What health care workers like Ms. McDaniel and Ms. Diana have encountered at the tail end of the summer and the early fall has been far less reminiscent of a combat zone. The curve was flattened sufficiently enough that schools and many other businesses have been able to open, although anxiety is ramping up again as daily infection rates are soaring across the country in what is now a bona fide new wave.

Ms. McDaniel and Ms. Diana said they hope the public takes heed of lessons learned in the spring, and they remain cautiously optimistic that there will not be a return to the kinds of scenes Ms. McDaniel witnessed months ago.

Ms. McDaniel said she is now a firm believer in the effectiveness of mask-wearing, pointing out that she never donned a hazmat style suit at any point, instead wearing regular scrubs, gloves and an N-95 mask. She never got sick, and also did not test positive for COVID antibodies at any point.

She’s living in Hampton Bays now with her sons, and is hoping to stay in the area for the long term, continuing to work at Stony Brook Southampton. If a second wave does come, she will be ready to serve again, but the hope is that essential health care workers like Ms. McDaniel won’t need to experience what they went through a second time.

“Nursing and health care professionals sacrificed a lot during that time,” Ms. Diana said. “They were living in separate parts of their house, or in campers, decontaminating after every shift and not getting close to their family members. I don’t think people necessarily realized all that.

“We took care of people who were very sick, and we ran the risk of getting sick ourselves, and the impact it had on those families and their family life was huge.”