(Photo: Alexa Shahrestani)

After witnessing the extreme stress on health care workers, you might wonder if the pandemic is discouraging prospective doctors and nurses from pursuing such careers. For Joanne Santiago, the opposite was the case. Santiago, a Brooklyn native, graduated from nursing school during the early stages of the pandemic, last spring. The challenges presented by COVID did not intimidate her, but rather catalyzed her to remember that such crises are what she and her peers had signed up to combat. With no second thoughts, Santiago began her first health care position as a registered nurse in the emergency department (ED) of Bellevue Hospital this past November.

In an interview that has been condensed, Santiago offers insight into what health care workers were thinking as they entered unprecedented territory in their first jobs.

Can you tell me what nursing school was like– early on, up until now– when they started talking about COVID?

I mean, nursing school is kind of a scary thing. Because when you speak to anybody who’s been in nursing school, it’s probably one of the toughest experiences you’ll go through in life. They’re not testing necessarily your knowledge and they’re not looking for memorization — you actually have to apply everything you learn. Now finishing nursing school, during a pandemic, it was a little hard, because I’m an older student. For me, this was kind of like my dream coming full circle. I was going to graduate, I thought I would get the pinning ceremony, which is traditional for nursing students. I didn’t get any of that. But in the end, I really just wanted to get out there and help and do what I could for people because I knew this was going to be life changing for most of us.

Santiago and her peers, pre-COVID, after running a simulation at a clinical site. (Photo courtesy of Joanne Santiago)

Did you always want to be a nurse?

I didn’t always want to be a nurse, I actually started college as a pre-med student. My husband and I had been together since we were 15. We got married pretty early and then we had a family early. I didn’t want to go to med school and give up that time with my family. And I soon realized that with my own kids most of your interactions are going to be with a nurse, and they can make things feel like it’s going well and help you feel better, or it can go the other way, too. There were a lot of great nurses who took care of my kids. And that’s when I decided I would go ahead and go to nursing school, because I felt like I would help more people as a nurse than anything else.

Did the teachers at the nursing school say anything to you all to inspire you when the pandemic started?

All of my professors, I have to say, were really great. But I have one particular one…she was really inspiring because, just as COVID was starting, she had a son who became ill. She was concerned, obviously–  she still came in to teach us, and this is before right before classes were moved to remote. I just remember that she was very adamant about when we’re out there, we have to care, we have to be present, we have to provide the care that we would want for ourselves for our loved ones. Then she ended up having COVID. She was really ill. But she still got better, she came back, she was teaching us again. We just thought it was the craziest thing, because you would think that she wants some time off. She just really wanted us to be able to finish. She wanted us to be able to get out there. She wanted us to know the risks, but to understand that we were needed.

How did it feel knowing that you were about to enter the frontlines?

It was definitely scary. Initially, I just kept thinking to myself, I just need to take every precaution because I have my children, I have my husband and I want to be very careful. We have been following all the guidelines, obviously. It was something I really had to consider and make sure that I understood the risks, and how to mitigate those risks. But once I started working, I just felt like this is where I belong. I knew that I wanted to be out there doing everything that I could. The fear kind of decreased, especially since we’re seeing the acuity is not as bad as it was back in like March and April.

(Photo: Alexa Shahrestani)

Have you seen anyone in the hospital who doesn’t follow the COVID guidelines?

Absolutely. Every single day, from the moment people walk in there, while they’re in the ED. We have patients who come in who may be not coherent. But we’ll take the time to explain to them. People will come without a mask, you’ll have groups of people sitting together, and we have to tell them to distance. You’re constantly having to remind them all day, every day about all the guidelines that we have.

How does that feel as someone who has seen people in critical care for this, and then people come in and don’t do what they’re supposed to do?

It’s frustrating, especially when you have the people who don’t have any sort of mental health issues or who are completely coherent and then don’t want to wear the mask. We’re just like, you’re exposing yourself by not wearing the mask and exposing others by not wearing the mask. You’re coming to the hospital to basically get sick instead of get help.

(Photo: Alexa Shahrestani)

Have you had the chance to get COVID vaccinated yet?

I did. I got both doses.

Did you have any apprehension about the vaccine?

Initially I did. Our head nurse is really great because she kind of sat us down and just talked with us about it. She asked us what our concerns were. But the one piece of advice she gave us, which I really took heed was: go ahead and do the research. Weigh your options and then you decide for yourself. So I did that. I read a lot of the research on the way the vaccines were developed. It just makes sense to me because on the one hand, you have COVID. And I’m never going to know how if I got it, how I would react. Am I going to do well? Will I be asymptomatic? Or will I be one of the people who needs a ventilator. And even if nothing happens to me, if I bring it home, who in my home is going to have that? Who else could I expose it to? So COVID is like the unknown. But with the vaccine, even if you think the worst thing that could possibly happen with the vaccine is anaphylaxis. Anaphylaxis, the extreme allergic reaction, we have treatments for that. We can give you an epinephrine, we get you to the hospital. We put some antihistamines in and you’re fine. It’s a scary experience, yes, but it’s treatable. We know how to treat that. And so I was just like, I can get treated for the worst possible thing getting a vaccine, or I could do the unknown, possibly die, or cause someone else to die from COVID. It just made sense to get the vaccine at that point, because really the risks don’t outweigh the benefits.

Has any of the staff not gotten vaccinated?

Pre-COVID, Santiago with her nursing school first-semester clinical group and clinical professor. (Photo courtesy of Joanne Santiago)

Actually quite a few have not gotten vaccinated. Since I had the second dose a lot of people were asking me: How was it? How do you feel? I did have side effects. And that’s okay. That happens sometimes. But it lasted for four days and now I’m fine. I still have not tested positive for COVID. So for the most part, it’s working. I know a few people have scheduled themselves. I also know that we ran out of vaccines, and there were people who were trying to get vaccines that couldn’t. And that the city is also having the same problem. But I think more and more of the staff is gearing more towards getting vaccinated.

Do you think that there are any positives that we can take from COVID?

Yeah, I think there are quite a few. Even though this has been a really scary experience for everyone. I think that one of the most important things that we all have learned to appreciate what we have, number one. The other thing is realizing that the people that you didn’t think were important ended up being the most important people to have around. Nobody thought the guy working at the grocery store was going to be important to them until you had nothing else but to try and get food, or there weren’t enough supplies for something. Or, you didn’t appreciate the housekeeping worker in the hospital, who keeps the floor clean, and makes sure that the surfaces don’t have COVID on it. I think the biggest lesson other than appreciation is understanding that we all have value.