Amid the chaos, fear and danger of the COVID-19 crisis, a Lovell native has plunged into the heart of the pandemic, taking a position as a traveling nurse in New York.
Jeri Lynn Tippetts Angal, a 1997 graduate of Lovell High School, started a position about two weeks ago at New York-Presbyterian Brooklyn Methodist Hospital, a 651-bed acute care hospital in the Park-Slope section of Brooklyn.
It’s the latest stage in a career that has taken her from office work in Cody to nursing in Billings and now New York.
The daughter of Les and Connie Tippetts of Lovell, Angal started her career in the medical field working for Dr. Jimmie Biles at his Yellowstone Sports Medicine office in Cody for several years before deciding to go into nursing, starting nursing school in 2008.
“They (nurses) were having all the fun,” Angal joked. “I was doing most of their billing and stuff and I thought ‘You guys are having a lot more fun than I am.’”
She earned her nursing degree at Northwest College and went to work as an RN at St. Vincent Hospital in Billings in 2010, commuting from Lovell. She worked for “St. V’s” for about 10 years, working first in a float pool as a resource nurse, which gave her experience in a variety of departments.
For about eight years, she said, she worked directly in critical care, primarily in the ER/ICU area or in cardiology.
She is married to Alan Fleming, though she kept her married name from her previous marriage due to certification issues. Son Justan graduated from LHS in 2019 and in June is scheduled to be deployed to Afghanistan with the U.S. Army. She and Alan also have a 4-year-old daughter, Katherine Fleming.
“She’s my little pistol,” Angal said.
After many years at St. Vincent, Angal resigned to take a new career path as a traveling nurse. She had worked at North Big Horn Hospital for about six months in 2018, as well, and was still working part-time at St. Vincent when she decided it was too much for her.
“I was kind of in a transition period where I was moving from critical care float directly into ICU (at St. Vincent), so I kind of hit a time where I didn’t have any schedule set up. They needed so much help here (Brooklyn) and we’ve been over-staffing (in Billings) and we’ve had more help than we need. So I decided that I would just come here and work here.”
Angal reached out to an agency that sets up opportunities for travel RNs, and she liked the flexibility of the program.
“I pick my assignment and I travel around wherever I want to go and where they will have me, and I can work in whatever hospital,” she explained.
She applied and was accepted at NYP Brooklyn Methodist Hospital, starting the week of April 20.
“I’m finally getting used to the charting system, and it’s definitely a different nursing world, for sure,” Angal said.
The situation on the ground
Angal said she has specifically gone to New York to deal with the COVID-19 pandemic, which has hit the New York City region hard, with thousands of cases and hundreds of deaths per day.
“That’s what they brought me on for, to help with the COVID patients,” she said. “Typically your ICU nurses are (working with) people who are on ventilators or are intubated. Usually they have one nurse to two patients, sometimes three, but not very often. But here they were taking five and six patients, which is way too much work for one nurse to try to keep up with.
“These patients are so critical and so fragile. They’re so fragile that even just to turn them in bed will set them back. Doing that kind of movement will set them off, and they’ll start to decline. They’re very fragile, very fragile people. It’s very scary.”
Angal is working 12-hour night shifts, four per week, from 7:30 p.m. to 8 a.m. (including a meal break).
“I’ve done night shifts for probably the last eight years (in Billings), so yeah, I’m definitely a night girl,” she said.
A crucial need
Angel said NYP Brooklyn Methodist and other New York hospitals were overwhelmed by the pandemic and were very much in need of some relief.
“At orientation they told us that this was the first week that they’ve actually had some relief,” she said. “They have brought in quite a number. Roughly 60 to 70 traveling RNs have come in this week to help out.
“This is a very large hospital. They typically have about 30 patients on ventilators on an average day, but since the COVID started they ramped it up and have 120 people on ventilators on a daily basis. That’s just in this hospital. Within a mile radius there are probably four or five hospitals the same size, and they’re all facing the same numbers. It’s about triple what their normal volume is as far as critical patients go.”
For New York, the crisis is very real, Angal said.
“From what I understand, they’re experiencing from eight to 20 deaths a day, and usually they have another 20 people who actually code and they have to resuscitate or revive on top of that.
“So it’s a very hectic time, very crazy, and super busy.”
Asked about the stress of working in a situation like the coronavirus pandemic, Angal said it’s difficult to answer because critical care in general is already stressful.
“Working in the medical field in the emergency room or even in ICU is stressful, period, in any place, even on a good day,” she said, “but it is, I think, significantly more so (in New York) just because, for me personally, I’m in a new place working with new software, new equipment, different models of things than I’ve worked with, so I’m kind of having to re-familiarize myself with a lot of the equipment they use and the routines and the things that they do. So I have that added stress on top of it.
“Your patients are super critical, and every time you turn around they’re declining. So it’s very stressful.”
Asked what she does to keep her sanity, Angal said she lives about a mile from the hospital and must walk to and from work since she doesn’t have a car in the city. She uses that time to de-stress.
“I love it. That is my unwind time,” she said. “Especially in the morning it’s a beautiful walk. There’s not a whole lot of people out because everybody’s on lockdown. It’s kind of nice that way. I’m not fighting crowds to get where I need to be.
“I usually have my scrub pants on when I’m walking home, so they cut me a pretty wide berth. Everybody is very terrified of getting the COVID here.”
Angal said the influx of traveling nurses has stabilized the nursing situation at NYP Brooklyn Methodist – and just in time.
“Right now we’re back to our standard two-to-one ratio, so it’s nice; it’s much nicer,” she said. “It’s amazing how the hospital adapted for this influx of patients. They ended up actually closing down some of their units like the psychiatric unit and the pediatric unit and a couple of coronary care units and sending those patients to another hospital. They modified those units as temporary ICU units. It’s amazing how they adapted for that. That’s how they expanded the hospital to accommodate that.”
As for the hospital’s main nursing staff that had to deal with the initial COVID firestorm for weeks, Angal said the nurses are completely burned out, adding, “They’re shell-shocked. There’s going to be a lot of PTSD with this. They’re tapped out.”
Supplies holding up
As for COVID-19 supplies from ventilators to personal protection equipment, Angal said the hospital seems to have acquired enough ventilators to meet the need. The odd thing is, almost every room of the hospital has a different model because of the way they were obtained or donated.
As for PPE, Angal said it depends on the unit a nurse is working in.
“Some have plenty, others not as much,” she said, adding that the staff is trying to conserve as much as possible.
Normally, she said, a nurse wouldn’t go from room to room with the same mask or gown on, or reuse them at all, discarding them as she leaves the room. But with the general shortage of PPE a nurse will likely use the same N95 mask for an entire shift, covering the N95 mask with a surgical mask to keep as much exposure off the mask as possible.
“We’re trying to stretch it as far as we can,” Angal said, noting that a gown might be used again if it is in good shape as far as cleanliness.
“That’s not super awesome or ideal, but you have to do something,” she said. “The other thing I love is that the hospital is providing scrubs for all of the nurses to change into so we’re not wearing our COVID stuff home, which is wonderful as another bit of protection to keep your family safe and not keep spreading it through the community. They’ve also provided us with face shields, which we have to sanitize at the end of each shift and re-use.”
Angal said she is scheduled to be in Brooklyn for eight weeks but said it will depend on the need. If the cases taper off quickly, she said, there’s a chance she could be sent home early. There’s also a chance her work could be extended.
Once she returns home, she will have to self-quarantine, she said, joking, “I’m going to the mountains for two weeks by myself. I’m going to go hiking and fishing for two weeks like a vacation. I couldn’t ask for a better one.”
She said she could be off for a few weeks, but if the coronavirus shows another surge, as expected, and nurses are needed back in New York or somewhere else, there’s a chance she’ll go right back into action. If not, she plans to take a month or two off, noting, “I’ve earned a break.”
Comparing NYC to Wyoming
Angal said it is difficult for people in Wyoming to understand how serious the situation is in New York, noting, “In Wyoming and Montana we’re very lucky, we’re very sheltered from a lot of it. A lot of people cannot grasp the reality. But when you come to a city like this where people are so close and live in close quarters together, it is very real, and it is very scary watching your friends and neighbors dropping like flies. It’s frightening. You can’t walk down the street here without hearing somebody talking about COVID. The fear is so real here. But yeah, we are super sheltered.
“It’s hard to know what you’re dealing with unless you’re in it. It’s something you can’t see, it’s something you can’t smell. It’s not like it’s obvious that there’s this infection. It’s really hard for people to wrap their heads around the safety features, like making sure you keep your social distancing and making sure you’re washing your hands – and wash your hands and wash your hands and wash your hands – and don’t touch your face. We’re very sheltered and very lucky. It’s not a bad thing to be sheltered like that. We’re very lucky.
“It’s absolutely unbelievable (in Brooklyn). All the cabs have plastic put up between the driver and the passenger. Everybody has Lysol in their car so they can spray it down as soon as the passenger gets out. It’s very, very real, and people are very, very terrified of being the one who gives it to somebody else, not just getting it, but giving it to someone else, especially someone close, like the older people who are affected most.
“This is just not something they will recover from. So most people are terrified. Little Johnny wants to go visit Grandma, but he could also kill her doing that. People understand that, if I go and visit Grandma, I very well may be the one who kills her if I have something I didn’t know I have.”
New York nurse urges people to take COVID-19 seriously
In a follow-up conversation via text, Lovell native Jeri Lynn Tippetts Angal stated that she wants people in North Big Horn County to understand the serious nature of the COVID-19 pandemic.
“This city is so incredibly devastated by the loss they have seen,” Angal wrote. “Everyone has at least one person they were close to who was taken by the COVID virus. People are torn up, and we are fighting like mad to save anyone we can.”
“We are very lucky in Montana and Wyoming to have the amazing healthcare that we have at our disposal. This pandemic is absolutely not a joke or a myth, just a complete and utterly heartbreaking tragedy.”
Angal followed up later: “You have to let them know that they need to take precautions to practice good hand hygiene and wear a mask while out in public even though it seems silly. The wave has yet to hit Montana or Wyoming, but it will come. This virus isn’t about how the young or healthy people are affected, it’s about who they might unknowingly pass it to: their grandma, their grandpa, their mother, their father. It’s the people in their lives that mean the most that will pay the price if they don’t take some consideration.”
By David Peck