A Wilson nursing student spends his senior year on the COVID-19 frontlines. By Darrach Dolan
The COVID-19 pandemic has touched millions if not billions of people worldwide and continues to exact a toll. The stories of loss and suffering are numerous and have dominated the headlines. However, in the midst of this global calamity there have also been uplifting stories of kindness and humility, of giving to others and providing for and protecting your loved ones.
This is one such story. It’s about a Wilson nursing student who spent the year balancing full-time studies, full-time work, parenting, having a chronic condition that made him more susceptible to the virus, and doing what Wilson students have always done — persevering, working hard, and helping others. This is the story of Aaron Welper, who earned his Bachelor of Science in Nursing this year and is proud to call himself a member of the class of 2021.
His path has not been without hurdles. So much happened during his senior year at Wilson that graduation felt at times more aspirational than achievable.
Welper remembers vividly the day that COVID-19 went from a novel virus affecting people in a faraway country to one that would turn this country and the whole world upside down.
In March of 2020, he and his fiancée, Sue Cerifko (they were married in June this year), were visiting Niagara Falls on a long-planned and much-needed break from their stressful home and work lives. It was the first vacation they had taken together as a couple without their children, and they had imagined it would be a romantic way to recharge.
COVID-19 had other plans for them.
On March 15, 2020, ominously, the Ides of March, the couple crossed the border to the Canadian side of the Falls, where they planned to spend the next several days. As luck would have it, that very day, the Canadian government announced its intention to shut the border with the United States due to the spike in COVID-19 cases on the U.S. mainland. Not wanting to get trapped, the couple hastily retreated to the American side. Two days later, the U.S.-Canada border closed to non-essential travelers and has remained closed until recently.
Back in Pennsylvania, the couple returned to a changed world. Schools across the state had closed, meaning Welper’s 10-year-old daughter would attend school online from home (he shares custody with the girl’s mother 50-50). Cerifko’s employer asked her to work from home (she has worked from home ever since). Shortly after this, her son’s college went to fully remote learning, and he came home to live and study online. And Welper, because he had traveled outside of the state, was put on precautionary administrative furlough for two weeks from his nursing assistant job at York Hospital.
To put this in the context of how rapidly things changed for everyone: the couple’s ill-fated vacation was just as the pandemic got a foothold in the U.S. On Feb. 24, President Trump Tweeted, “The Coronavirus is very much under control in the USA.” The first reported death from COVID-19 in the country was on Feb. 29, less than two weeks before the couple went on vacation. On the day they arrived at Niagara Falls, the federal government restricted some travel between the U.S. and Europe — as it turned out, this had little effect as most of the first-wave cases in this country were traced back to Europe and community spread was already occurring here. By March 26, shortly after the couple had returned from their vacation, the U.S. had already recorded 100,000 cases and 1,000 deaths.
For Welper, suddenly, there was a lot to worry about. “It was very stressful at the time,” he said. “Not least because I have a chronic medical condition.” As a child, Welper had been diagnosed with Type I diabetes, and, even at this early stage in the pandemic, medical authorities had identified diabetes as increasing the risk of a severe course with the virus. “My daughter was born prematurely, so I was concerned for her because she had respiratory difficulties as a baby. She had outgrown that, but there was still a high possibility that it could affect her too. And my fiancée has chronic medical conditions too.”
Welper is soft-spoken, and when he talks of the events of this past year, it is with a calmness that belies the stress and sadness he has endured.
When he returned to work at York Hospital after his quarantine, the changes in response to the pandemic were clear and impactful. While the hospital had few patients with symptoms of COVID-19 at the time, they had to change their safety protocols for dealing with all patients to protect staff and patients alike. The most obvious change was the mandatory use of personal protective equipment (PPE) regardless of the unit the medical staff worked on and even if they didn’t have direct contact with patients.
Welper was assigned to the nursing resource team. “It’s like a float pool of nurses and nursing assistants who go to whatever ward or floor that needs extra help — we help fill staffing shortages,” he said. In practice, this meant that he could be moved from one unit or floor to another on any given day. At first, his biggest gripe was that each floor or unit had a slightly different way of putting on or using the PPE. So, with each transfer, he had to learn how that particular team wanted things done. It was a minor hassle, one he remembers complaining about, but nothing compared to what he would face when cases began to spike.
It wasn’t long before this happened. By the end of April, the hospital saw a rapid rise in the number of COVID-19 patients. “Because of the nature of the float pool and the rising needs in the COVID-19 units, we tended to float to the COVID-19 units more often than not,” Welper said. He was now unambiguously working on the frontlines of the fight against COVID-19. And, because he was interacting every day with patients who had the virus, he had to worry not only about his patients’ welfare but about the risks to himself and his family too. “I was very concerned for my family and didn’t want to bring anything home.”
Given the uncertainties at the time about how the virus was transmitted, staff at the hospital were fearful of carrying the virus home on their clothes or bodies when they left work. Welper developed a routine that he has stuck with since the beginning. “When I come home, I come in through the garage and take my clothes off there,” he said. “I leave the clothes in the garage with the doors open to air them out. The bathroom is just across the hallway inside the door. So, I take a shower immediately. Then I put on gloves and take my clothes to the washer and wash them. I’ve had a year of this.”
As the only member of his household who worked or went to school outside the home — he was attending Wilson online as a full-time student throughout — the family decided he would take on the grocery shopping and all the other chores outside the home to minimize the risk of exposure. “We didn’t go anywhere or even order in because I knew there were people out there who were asymptomatic, and you couldn’t tell who had it.”
Meanwhile, in response to the spike in COVID-19 cases locally and across the country, the hospital suspended elective surgeries and most other non-emergency procedures. This was at the height of the first wave of the pandemic, which affected the East and West Coasts of the country disproportionately. The nightly news broadcasts showed images of overwhelmed health care facilities and elderly patients on ventilators.
Welper was surprised by the discrepancy between who he was seeing admitted to the COVID wards and the depiction of the typical patient as elderly or unhealthy on the nightly news. Of course, most were elderly or in poor health, but “many of the people [admitted with COVID-19] were normal healthy people, and you would never have thought it would have affected them the way it did,” he said. “And it affects people differently — nobody the same. It’s crazy how a virus can do this to people.”
If the workload and anxiety were heavy burdens, the staff had the added heartbreak of watching COVID-19 patients die alone without family or loved ones present. “It’s difficult because these patients are by themselves,” Welper said, “because at first, they were not allowing anyone in the room with them to say goodbye, and they had to do it by Zoom.” Even for staff used to patients passing as a normal part of their work, this was hard to bear.
Welper took to heart a lesson he learned in one of his first classes at Wilson. “Professor Buffenbarger said, ‘Never let a patient die alone. They may not know or acknowledge you are there because they have already started that dying process, but never let a patient die alone.’ What she said really stuck with me then and even more so now with COVID.” The philosophy of “do not let them die alone” became the attitude that everyone working the COVID-19 units took on board at the hospital. The staff — doctors, nurses, medical technicians, and nursing assistants — provided these patients with as much human contact as possible to ease their passing. And when a patient was in the “active state of dying,” at least one staff member would try to remain in the room with them.
Welper, true to the values he learned at Wilson and the compassion most medical professionals have, has remained with patients as they passed and hopes he helped in some small way make the transition easier for them. He goes quiet after recounting this and doesn’t say any more on this subject. But his eyes become glassy, and the pain of these memories is clear.
Late in the summer, the number of new cases dropped, and the hospital opened once more for elective surgeries. There was a brief period of normality — if you count wearing PPE all shift and having to wash yourself and everything you’ve worn before you see your family as normal. Then the second wave hit, and the staff were once again struggling with a surge in COVID-19 cases.
When Welper’s colleagues began contracting the virus, despite all the precautions they were taking, it felt to him like no one was safe from this virus. One of the doctors, an otherwise healthy man, contracted it and had to be hospitalized for more than twenty days. His disease course was quite severe, symptoms lingered, and six months after his release, he is still recovering and has had to relearn how to walk. Not only was it difficult to witness colleagues succumb to the virus, but their absence on the floors, even if only quarantining for two weeks after potential exposure, meant increased workloads for those on duty. For Welper, who was already trying to balance parenting, full-time study, and a full-time job, the stress was getting to him.
One of the more taxing assignments for nursing assistants at this time was to be a “sitter” for patients admitted with acute psychiatric conditions. Patients who tested positive for COVID-19 could not be admitted to the psychiatric unit until they were no longer infectious — the unit didn’t have the capacity to isolate and care for them. Until they were cleared to enter the unit, they had to have a sitter remain with them 24/7 for their safety. Under normal conditions, a sitter would not sit with a patient for a whole shift, and others would take turns sitting. However, with the staff stretched so thin by the number of cases they were seeing, sitters often spent an entire shift with a single patient.
For Welper, the last straw came when he was a sitter for 11 out of 12 twelve-hour shifts in a row. Of course, he got lunch breaks and bathroom breaks, but sitting with a patient for that long is both tedious and stressful. In full PPE, you get uncomfortable, yet you cannot let your guard down because you know the person within arm’s reach is both infectious and unpredictable. Even something as simple as your mask shifting means you have to change your gloves before you can adjust it. Imagine how many times this happens over a twelve-hour shift? And while some of the patients can hold a conversation with you to pass the time, some cannot, and others are in such distress they require constant reassurance and help.
By the end of his twelfth shift as a sitter, Welper knew he was burning out. Not only was the work getting to him, but his studies at Wilson were suffering, and he was in danger of failing. Something had to give. He spoke with his fiancée about the situation. She agreed that he had to look after himself or he would do himself permanent harm. They sat down and discussed their financial situation and figured that he could go part-time at the hospital and focus on his studies full time.
Welper requested to be reassigned from the nursing resource team to the emergency department. It is a measure of the times that the emergency department of a busy hospital is less stressful than the mostly COVID-19 units he had been working on. He still saw a lot of COVID-19 patients present themselves at the emergency department. And he could often tell after a few basic questions about their symptoms who had the virus and would test positive. The confirmation was often frightening for the patients, but the hospital was having more success treating and caring for the new cases, and the prognosis for patients was much better than it was at the beginning of the pandemic.
Welper’s employer, WellSpan Health, offers its employees counseling to help deal with the emotional and psychological stress of the pandemic. Welper is happy that it’s available but hasn’t needed to avail of it himself. He says that self-care is important, and he is conscious of maintaining both his physical and mental health. After every shift, he and his fiancée would talk about his stressful day without getting into specifics of patients, and this helped him process mentally and emotionally what he’d experienced. The fact that he was working fewer hours and his academic performance had improved helped a great deal as well. At the time of this interview, he was looking forward to graduating in May, getting married, and working full time as a nurse — all of which he has since achieved.
As he spoke about his experiences, the only time he displayed any anger was when he talked about the people he would see in the grocery stores or other public places without masks. Having witnessed so much suffering and death caused by this virus, he cannot understand why people don’t heed the clear message that masks reduce transmission. “People feel they are entitled to socialize, and they don’t care if they are spreading it or not. People don’t want to listen to regulations, and I don’t think even the regulations are being enforced,” he said.
When he reflected on the year he’s had on the frontlines, he is philosophical. He thinks the worst, if we’re lucky, is behind us. If enough people get vaccinated, and the rate of transmission is low enough, hospitals like York Hospital can get back to regular business, and the staff will have the time and comfort to take a deep breath and get on with their work without the added trauma of a virus wreaking havoc. However, his optimism is tinged with caution. He worries that the vaccines may not protect people against some of the new variants of COVID-19 or that the virus is here to stay, and it will be a cat and mouse game between the vaccine manufacturers and the ever-mutating virus. Even so, he thinks we have the upper hand now, and things will not get as bad as they did in 2020.
He reflects on the year as one in which he learned a lot about himself and what he values. He learned that compassion is every bit as important a skill in nursing as the clinical skills you are required to learn. That he learned both at Wilson is a reflection of the College’s nursing program and one he’s grateful for. He also learned the value of family and community and how we can overcome even something as enormous as a global pandemic if we work together.
Welper never talks of his contribution or sacrifice in personal terms or as if he did something extraordinary. Instead, he is sanguine and describes himself as just one member of the medical fraternity doing what he can for his patients and his family. When the interviewer suggests we owe him and others a depth of gratitude, he shyly shakes his head and says he was just doing his job and deserves no more credit than the person who delivers groceries to an elderly neighbor or the parents who found themselves working from home and doing algebra with their kids around the dinner table at the same time.
Welper’s story may not be extraordinary, but it is the story of a pandemic bringing out the best in a caring and good human being. And we are grateful for all the Aaron Welpers who have given so much over this difficult period in our history.