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Volunteers Rushed to Help New York Hospitals. They Found a Bottleneck. Volunteers Rushed to Help New York Hospitals. They Found a Bottleneck.
(3 days later)
When Gov. Andrew M. Cuomo called for medical workers around the country to come to New York last month and join the fight against the coronavirus, Bevin Strickland was ready to help.When Gov. Andrew M. Cuomo called for medical workers around the country to come to New York last month and join the fight against the coronavirus, Bevin Strickland was ready to help.
Ms. Strickland, a former pediatric intensive care unit nurse in High Point, N.C., spent hours trying to submit her volunteer application online, and then emailed city and state representatives. She never heard back.Ms. Strickland, a former pediatric intensive care unit nurse in High Point, N.C., spent hours trying to submit her volunteer application online, and then emailed city and state representatives. She never heard back.
Frustrated, she reached out directly to Mount Sinai Queens hospital in New York City. A manager told her to use a private recruiting agency, which the hospital had used for years to bring in temporary staff.Frustrated, she reached out directly to Mount Sinai Queens hospital in New York City. A manager told her to use a private recruiting agency, which the hospital had used for years to bring in temporary staff.
Within two days, Ms. Strickland, 47, received her assignment. She started this week in the hospital’s emergency department, making about $3,800 a week for three 12-hour shifts instead of doing it for free, as she had initially wanted.Within two days, Ms. Strickland, 47, received her assignment. She started this week in the hospital’s emergency department, making about $3,800 a week for three 12-hour shifts instead of doing it for free, as she had initially wanted.
“I don’t feel like I should be walking out of this scenario with any money,” said Ms. Strickland, a doctoral student in nurse anesthesia. “It feels wrong. I don’t want the hospital paying the recruiter for me.”“I don’t feel like I should be walking out of this scenario with any money,” said Ms. Strickland, a doctoral student in nurse anesthesia. “It feels wrong. I don’t want the hospital paying the recruiter for me.”
As of Wednesday, more than 90,000 retired and active health care workers had signed up online to volunteer at the epicenter of the pandemic, including 25,000 from outside New York, the governor’s office said.As of Wednesday, more than 90,000 retired and active health care workers had signed up online to volunteer at the epicenter of the pandemic, including 25,000 from outside New York, the governor’s office said.
Putting them to work, however, has been a different story.Putting them to work, however, has been a different story.
New York City hospitals have only deployed 908 volunteers as of Wednesday, according to city health officials.New York City hospitals have only deployed 908 volunteers as of Wednesday, according to city health officials.
The urgent need for medical personnel is colliding head-on with the immovable bureaucracy of hospital regulations and a health care system that has been taxed in unprecedented ways. Several volunteers described a confusing process of navigating glitchy websites and slow responses.The urgent need for medical personnel is colliding head-on with the immovable bureaucracy of hospital regulations and a health care system that has been taxed in unprecedented ways. Several volunteers described a confusing process of navigating glitchy websites and slow responses.
Adding to the confusion, the state, city and individual hospitals each have their own portals for volunteers to sign up.Adding to the confusion, the state, city and individual hospitals each have their own portals for volunteers to sign up.
The governor’s office said it had assembled a team of 175 lawyers and other people to check the volunteers’ licenses and disciplinary history before connecting them with hospitals.The governor’s office said it had assembled a team of 175 lawyers and other people to check the volunteers’ licenses and disciplinary history before connecting them with hospitals.
State officials said the volunteer portal, which was built from scratch, was initially overwhelmed by the response, but has since connected about 10,000 volunteers to hospitals in New York State within two weeks.State officials said the volunteer portal, which was built from scratch, was initially overwhelmed by the response, but has since connected about 10,000 volunteers to hospitals in New York State within two weeks.
Dr. Jim Malatras, the president of SUNY Empire State College who is assisting Mr. Cuomo in the effort to deploy medical personnel, urged volunteers to be patient. Some volunteers were so eager, he said, that they showed up to hospitals without receiving specific assignments.Dr. Jim Malatras, the president of SUNY Empire State College who is assisting Mr. Cuomo in the effort to deploy medical personnel, urged volunteers to be patient. Some volunteers were so eager, he said, that they showed up to hospitals without receiving specific assignments.
“We deeply appreciate these people who have gone above and beyond the call of duty,” Dr. Malatras said in an interview. “This is a marathon, not a sprint. It may not be this week, but three weeks from now we may need people to help out.”“We deeply appreciate these people who have gone above and beyond the call of duty,” Dr. Malatras said in an interview. “This is a marathon, not a sprint. It may not be this week, but three weeks from now we may need people to help out.”
Dr. Malatras said only a few hundred potential volunteers out of 90,000 were screened out for disciplinary problems.Dr. Malatras said only a few hundred potential volunteers out of 90,000 were screened out for disciplinary problems.
Mayor Bill de Blasio said last week that “relatively few” of the volunteers had started working at hospitals because many were not qualified to work in intensive care units, which are overflowing with coronavirus patients. He has called for a national draft of doctors, saying the city needed 45,000 more medical workers.Mayor Bill de Blasio said last week that “relatively few” of the volunteers had started working at hospitals because many were not qualified to work in intensive care units, which are overflowing with coronavirus patients. He has called for a national draft of doctors, saying the city needed 45,000 more medical workers.
After the state connects hospitals to volunteers, the hospitals are then responsible for credentialing and training them.After the state connects hospitals to volunteers, the hospitals are then responsible for credentialing and training them.
The challenge of screening so many medical workers has opened an opportunity for the dozens of established private agencies that place temporary nurses and doctors at hospitals nationwide — like the one Ms. Strickland used.The challenge of screening so many medical workers has opened an opportunity for the dozens of established private agencies that place temporary nurses and doctors at hospitals nationwide — like the one Ms. Strickland used.
The staffing agencies, an $18 billion industry, say that unlike the state, they already have the technology and infrastructure in place to quickly check credentials for health professionals. In normal times, hospitals hire them to fill short-term staffing needs, such as during a regular flu season.The staffing agencies, an $18 billion industry, say that unlike the state, they already have the technology and infrastructure in place to quickly check credentials for health professionals. In normal times, hospitals hire them to fill short-term staffing needs, such as during a regular flu season.
“As great as it is that the state is trying to help, it’s a very complex process to staff a clinician,” said Alexi Nazem, chief executive of Nomad Health, a health recruiting agency based in New York. “There are dozens of documents to verify. Our company has spent years building those systems.”“As great as it is that the state is trying to help, it’s a very complex process to staff a clinician,” said Alexi Nazem, chief executive of Nomad Health, a health recruiting agency based in New York. “There are dozens of documents to verify. Our company has spent years building those systems.”
Mr. Nazem said one New York City hospital last week asked his agency to immediately provide 300 nurses, about 30 times more than a typical request.Mr. Nazem said one New York City hospital last week asked his agency to immediately provide 300 nurses, about 30 times more than a typical request.
To ensure patient safety, new staff members at hospitals usually complete a long checklist of requirements, including drug tests, work references, malpractice history and skills certifications.To ensure patient safety, new staff members at hospitals usually complete a long checklist of requirements, including drug tests, work references, malpractice history and skills certifications.
Mr. Cuomo has waived some regulations to speed up the process, including allowing health care workers licensed in any state to practice temporarily in New York without a New York license.Mr. Cuomo has waived some regulations to speed up the process, including allowing health care workers licensed in any state to practice temporarily in New York without a New York license.
Hospitals pay the recruiting agencies, which take a cut, then pay the rest to the medical workers. The agencies typically provide housing and travel stipends, along with health and malpractice insurance.Hospitals pay the recruiting agencies, which take a cut, then pay the rest to the medical workers. The agencies typically provide housing and travel stipends, along with health and malpractice insurance.
Now, some hospitals are offering to pay “crisis rates” of up to $130 an hour for nurses, more than double the typical rate, recruiters said.Now, some hospitals are offering to pay “crisis rates” of up to $130 an hour for nurses, more than double the typical rate, recruiters said.
New York City’s public hospitals had used private recruiters to bring in about 3,600 new medical workers as of late last week and were seeking to hire 3,600 more, according to the mayor and a city spokesman.New York City’s public hospitals had used private recruiters to bring in about 3,600 new medical workers as of late last week and were seeking to hire 3,600 more, according to the mayor and a city spokesman.
One of those recruiting agencies, NuWest Group, began contracting with the city less than two weeks ago. Since then, the agency has secured hundreds of nurses and respiratory therapists for city hospitals, with some positions paying more than $10,000 a week, a spokeswoman for the agency said.One of those recruiting agencies, NuWest Group, began contracting with the city less than two weeks ago. Since then, the agency has secured hundreds of nurses and respiratory therapists for city hospitals, with some positions paying more than $10,000 a week, a spokeswoman for the agency said.
Agencies, who negotiate the rates with hospitals, say that without the high pay, there would not be enough qualified clinicians willing to take jobs at the front lines.Agencies, who negotiate the rates with hospitals, say that without the high pay, there would not be enough qualified clinicians willing to take jobs at the front lines.
The pay rates reflect the hospitals’ desperate scramble to attract nurses and doctors trained to treat critically ill patients, exacerbating the hospitals’ financial strain at a time when other medical appointments and surgeries have been canceled.The pay rates reflect the hospitals’ desperate scramble to attract nurses and doctors trained to treat critically ill patients, exacerbating the hospitals’ financial strain at a time when other medical appointments and surgeries have been canceled.
Hospital staff members say they are grateful for any reinforcements, but some residents and nurses have expressed frustration over the pay disparities.Hospital staff members say they are grateful for any reinforcements, but some residents and nurses have expressed frustration over the pay disparities.
Updated June 5, 2020 Updated June 12, 2020
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
A nurse at a NewYork-Presbyterian Hospital said she and other nurses had asked for hazard pay on top of their $56 per hour salary as they managed an increasing number of patients stricken with Covid-19, the illness caused by the coronavirus. The hospital system last week announced a one-time, $1,250 bonus for staffers.A nurse at a NewYork-Presbyterian Hospital said she and other nurses had asked for hazard pay on top of their $56 per hour salary as they managed an increasing number of patients stricken with Covid-19, the illness caused by the coronavirus. The hospital system last week announced a one-time, $1,250 bonus for staffers.
“It’s better than nothing, but still seems low compared to agency nurse pay,” said the nurse, who spoke on the condition of anonymity for fear of losing her job.“It’s better than nothing, but still seems low compared to agency nurse pay,” said the nurse, who spoke on the condition of anonymity for fear of losing her job.
As more front-line health workers fall sick, hospitals have pulled out all the stops to replenish their ranks. They are reassigning other doctors to work the emergency room, while medical students are graduating early to help.As more front-line health workers fall sick, hospitals have pulled out all the stops to replenish their ranks. They are reassigning other doctors to work the emergency room, while medical students are graduating early to help.
Still, tens of thousands of eager volunteers are waiting on the sidelines.Still, tens of thousands of eager volunteers are waiting on the sidelines.
Julia Ruiz, a nurse at a private plastic surgery practice, lives in Manhattan’s Upper East Side, a 10-minute walk from the nearest hospital.Julia Ruiz, a nurse at a private plastic surgery practice, lives in Manhattan’s Upper East Side, a 10-minute walk from the nearest hospital.
She responded to three emails from New York State with the same volunteer questionnaire. She signed up again last week after the mayor sent an emergency alert to cellphones in the city asking for medical personnel. On Wednesday, almost three weeks after she initially applied, a state representative called to ask about her skills, including whether she could intubate patients.She responded to three emails from New York State with the same volunteer questionnaire. She signed up again last week after the mayor sent an emergency alert to cellphones in the city asking for medical personnel. On Wednesday, almost three weeks after she initially applied, a state representative called to ask about her skills, including whether she could intubate patients.
She still does not have a volunteer assignment.She still does not have a volunteer assignment.
Private recruiters have bombarded her with paid openings, she said, as rates around the country have gone up and competition has increased for qualified workers. One told her that, for tax reasons, the company could pay her more if she took an assignment further away, in a state like Tennessee instead of New York.Private recruiters have bombarded her with paid openings, she said, as rates around the country have gone up and competition has increased for qualified workers. One told her that, for tax reasons, the company could pay her more if she took an assignment further away, in a state like Tennessee instead of New York.
“I’m trying not to do this to profiteer,” Ms. Ruiz, 38, said. “Put me to work. I could not be closer. Do I just show up to the door?”“I’m trying not to do this to profiteer,” Ms. Ruiz, 38, said. “Put me to work. I could not be closer. Do I just show up to the door?”
Dr. Dennis Gray, a private-practice anesthesiologist in Atlanta, started volunteering on Wednesday at Woodhull Medical Center, a public hospital in Brooklyn. The city arranged a free flight and hotel for him.Dr. Dennis Gray, a private-practice anesthesiologist in Atlanta, started volunteering on Wednesday at Woodhull Medical Center, a public hospital in Brooklyn. The city arranged a free flight and hotel for him.
While waiting a week for his placement, a recruiter offered him a contract job paying $3,000 a day at a Queens hospital.While waiting a week for his placement, a recruiter offered him a contract job paying $3,000 a day at a Queens hospital.
“It’s going to be such a difficult experience that I don’t think you could do it for just income,” he said.“It’s going to be such a difficult experience that I don’t think you could do it for just income,” he said.
Ms. Strickland arrived in New York on Sunday night. In her first two days at the hospital, she said, two other out-of-state nurses quit, overwhelmed by the job.Ms. Strickland arrived in New York on Sunday night. In her first two days at the hospital, she said, two other out-of-state nurses quit, overwhelmed by the job.
Before leaving North Carolina, she tried to comfort her 16-year-old twin sons. One said he was worried she would die. If that happened, she said, she wanted them to know she had already lived a full and blessed life.Before leaving North Carolina, she tried to comfort her 16-year-old twin sons. One said he was worried she would die. If that happened, she said, she wanted them to know she had already lived a full and blessed life.
“I do believe this life is more than just about serving ourselves,” Ms. Strickland said. “I think about all the nurses who don’t have a choice but to show up. If I can help them not feel so worn out, I will feel like coming up here was worth it.”“I do believe this life is more than just about serving ourselves,” Ms. Strickland said. “I think about all the nurses who don’t have a choice but to show up. If I can help them not feel so worn out, I will feel like coming up here was worth it.”