When COVID-19 ravaged New York City starting in March 2020, Valdosta-based family nurse practitioner Ashli Scruggs didn't know what would happen. But she says she knew she had to go.
She had been a registered nurse for 9 years in the emergency room before becoming an FNP, and all points on her resume listed "Georgia," from bachelor's to master's to work experience.
She reached New York April 3. In the weeks before that, "I had this feeling like I needed to go," she says. "When it started to get serious, I knew it was going to get worse and I needed to go. I was just waiting on the opportunity."
Worried? A little, she says, but not for her personal safety. "There was hardly any research at that time. I knew I just had to do my best and be cautious."
She touched down in Manhattan April 3, and started living at the Park Central Hotel, "smack dab in the middle of Central Park and Times Square." She was to work 21 days straight, 12-hour shifts, and then return to Georgia for two weeks of quarantine before resuming her ordinary FNP job.
She remembers even the single day she was assigned to Jacobi Hospital, a big place in the city that had transformed nine floors into ICU. When they ended up having enough help, she got unassigned and reassigned to Roosevelt Island Medical Center, referred to as RIMC for short. Originally a nursing home, the facility had been shuttered since 2012, when it was needed to cope with Hurricane Sandy victims. Now it was an emergency response medical center poised to combat the city's spike in COVID-19 cases.
"It was basically like a pop-up tent, a pop-up hospital for COVID response," Scruggs remembers. "When I first got there, there was nothing. No supplies, no crash cart, no medications, no respirators. All we had was beds and bodies and health care providers. Of course, by the time I left we had everything. When I left at the end of April, things had slightly started improving and hospitals had started catching up. But at first..."
Outside the makeshift hospital walls, it was eerie. Scruggs had visited New York as a tourist and had an affection for the Big Apple, but this was not like that. "It didn't feel real," she says. "Walking around in Times Square was the most surreal feeling I've ever had. The hustle and bustle of Times Square? That wasn't what it was like at all. I could walk in the middle of the street; there were no cars, no people, no nothing. I felt like I was in a post-apocalyptic movie."
Inside, it was frantic and also heartrending. She's understated when she describes it, but the sheer horror comes through. "Well, I was an ER nurse a long time," she says. "I've seen a lot of things from happy to horrible. There's nothing like holding someone's hand when they're
dying--when there's nobody there, when they have nobody to comfort them. And and that happened very often in New York."
She and the almost-instantaneous friends she made working at RIMC set up a decontamination station in her hotel. She says the group had plenty of personal protection equipment, and she was grateful, especially since the rule was that "if at any point you ran out, you got sent home."
Scruggs will tell you she is a country girl at heart. Now that she's back in Georgia, she can resume the "me time" she says is so important to nurses. "I get my dogs and go swim in the pond," she says. "Every day I make sure I'm outdoors. Every day, I'm outside touching the ground, barefoot, what some people call 'earthing.' I'm an outdoors person."
But as the pandemic started ravaging a faraway big city, she was drawn there. "I felt like my years in the ER and my training for disaster and pandemics and craziness in general prepepared me for that call. I knew I needed to help people in some way. I felt like I was just being pulled."
She also had a full time job that was supportive, allowing her five weeks of leave for both the work and the subsequent quarantine on returning to Georgia. "They just knew, too. I was like, 'Guys, I gotta go.' They pulled together for me, covered my work here so I could be there."
The experience reaffirmed her beliefs that nurse practitioners could be providing much-needed services if their work wasn't so restricted. "I feel like we're getting there, but we're behind," she says. "If they had loosened up the regulations on what duties NPs could perform even slightly, we would have more hands on deck, especially in rural areas. Prescribing medicine, calling time of death, I did that all the time in New York. That's something I'll never get to do in Georgia unless they change the law."
It wasn't that she merely wanted the experience of being in charge, she's careful to explain. "Freeing up a physician to go do something else and not having to be there, to, say, call time of death, that was really helpful in New York."
She also felt an added level of respect she'd never encountered before. "In New York, I was able to practice freely, and that was an experience in and of itself," she says. "I'd never worked as a provider in a state that allows you complete freedom. I felt so much more respected by the physicians. It was not, 'This peron is above this peron.' We were all a team."
And she says she would do it again, oh how she would leap at the opportunity. She didn't want to leave when her 21 days were up. Her services may be required in Texas, for example, and new hot spots are emerging constantly. She says she will respond when she can, and she knows other nurses will do the same. "It's on to the next one, it's what you do," she says. "That's our calling. If we stop doing it, who's going to?"
The New York COVID-19 response experience makes Scruggs one of the few in the world who has seen the pandemic do its worst in a major city, and will now work on the frontlines as it hits smaller communities in Georgia. When she left for New York in early April, COVID-19 had reached Valdosta. "It was always here," she says. "But we live in a rural area of the state so the numbers here weren't increasing at the time like they were in New York City. Our numbers rose way later.”
Now nearby rural counties are seeing a surge in cases and a rising death rate. "It's the same pandemic, but in New York, you've got 1,000 people in one building that all touched the same elevator button. It affects us differently in rural areas. The hospitals aren't as congested as they are there. It doesn't feel the same to me because we know more and it isn't as new."
Her city nurse/country nurse perspective didn’t leave her with a lot of advice for fellow nurses who are just wading into the fray of increased cases, just a couple of sentences about doing what they do best. “I know that we’ll make it through this,” Scruggs says. “Nurses are so resilient I feel like all I need to tell them is, ‘You got this, on to the next one.’”
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