A Tale Of Two Fronts: What One Critical Care Nurse Saw In Vermont, New York City

May 12, 2020

Lt. Andrew Kehl has been working the frontlines of the COVID-19 pandemic  – on two different fronts.

The 33-year-old critical care nurse lives in Hinesburg and has helped treat patients in the intensive care unit at the University of Vermont Medical Center. He was also recently called into his native city, New York, where he helped treat people at the Javits Convention Center when it was turned into a 500-bed makeshift surge hospital. He is currently self-quarantining at a location in New Jersey.

VPR’s Mitch Wertlieb spoke with Lt. Andrew Kehl via Zoom about his experiences at UVM Medical Center and at the surge hospital at the Javits Center in New York City. Their interview has been edited and condensed for clarity.

Lt. Andrew Kehl: At the Javits Center, we didn't have traditional patient rooms. But we did have what we call individual patient cubicles. The level of care that we saw at the Javits Center was much less acute than what I saw in the medical ICU. But our main purpose was to take these patients that were in what we call the convalescent phase of the COVID-19 disease and get them essentially primed up so that they could successfully be discharged home.

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In terms of patient severity, it really depended patient to patient. But we saw patients that were able to walk around with minimal assistance and just needed help with the oxygen tanks, to patients that were on very high levels of oxygen and for whom anytime they moved, their oxygen saturation levels would withdraw.

Mitch Wertlieb: Did you have the kind of training that you needed to go into a situation like this? Because this is an unprecedented situation.

I think that having the civilian ICU experience really helped, especially being in a medical ICU. Most of the army training and focus of medical care is on trauma patients in a much younger patient population. We were seeing medical patients that were older in age. So I think that being able to bring in my civilian experience in the medical ICU really helped me with being medically prepared to care for these patients.

I would say in terms of emotionally prepared, it was hard to know what we were getting into because this is really the first time that the Army Reserves has stood up to help in this type of mission. When I first entered the Javits Center, I was kind of in awe of the fact that we were able to set up 500-plus beds in a matter of essentially a week – less than 10 days. Those five hundred beds? That is essentially the size of the University of Vermont Medical Center, so just seeing that all in one place at one time, that was definitely a change and a major surprise.

So your record now in New Jersey, how are you feeling physically, mentally, emotionally after that experience?

It's hard to process the last three weeks in such a short period of time. But I feel that what we did was definitely something that can be modeled for future pandemics. At the Javits Center, they had a very extensive donning and doffing process for putting on personal protective equipment and then also taking it off. That whole process was instituted prior to our arrival. So when we arrived, we were arriving into a very safe situation. And at no time did I ever feel that we were at personal risk.

Lieutenant Colonel, what's next for you after you get out of quarantine? What are your plans?

Return to Vermont and then I will be working with my hospital to see what they need me to do in order to get back on to the floor.

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While you were working, either in ICU in Vermont or at the Javits Center, did you see people pass away from COVID-19?

At the Javits Center I did not. Within the medical ICU at UVM, we did have patients pass away.

What was that like to know that there were some people you just couldn't save?

Unfortunately, with a pandemic of this magnitude, the fact is that there will be people that will pass away. I think the main thing that keeps me going on is that we have other patients that will be coming. And with the knowledge that we have learned from these prior patients, we can use that knowledge to help future patients.

What are you going to take away from this experience? I know you're still in this and you may be asked to do more when you get out of quarantine. But just from your initial exposure to all of this, what do you think you'll be taking away from this?

When I was at the Javits Center, the connections that I found most meaningful weren't necessarily the medical connections, but it was actually connecting with individual patients. It was trying to figure out what the barriers to discharge were. These were primarily lower-income or patients for whom English is a second language. So they had concerns of food and security, they had concerns about housing and security. And some of the patients, in fact, didn't want to leave the Javits Center because of those issues. The fact of the matter was, no one ever address those issues.

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So on the night shift, I would make it a point to sit down with these patients and ask them, “What are your concerns about getting discharged?” And then that's when I learned, well, they don't have a place to go or they don't have someone to bring them food. And then those issues I could push up to our case management team, who would be able to address them. And then we were able to successfully discharge the patients.