PARIS — Senior year for most students is a combination of making plans and contemplating the start of adulthood. What schools or training to attend, where to work, where to live. Not to mention, maybe how to get through school when they can’t go to school.

OHCHS student Tiana James of South Paris launched her nursing career before the start of senior year. Supplied image

Tiana James of Paris made quick work of those routine challenges and has taken on much, much more during her senior year than most adults have to worry about.

Facing COVID-19

Last July, at the age of 17, James passed the exams and completed the requirements to become a certified nurse’s assistant, a step towards her eventual career as a nurse specializing in women’s health. The first thing she did was apply for a job at a local hospital to gain experience and earn a paycheck.

Since then she has worked at the hospital’s COVID unit, working at least five – sometimes seven – days a week caring for those most impacted by the pandemic.

“Last summer I was working 50 or 60 hours a week. Now I still work almost every day,” she said in a Zoom interview last Friday. “I’ve always had a strong work ethic. I focus on school work Tuesdays and during my free periods. I do school from 7:30 a.m. until about 1:30. Then I go to work until about 7 p.m. Sometimes I don’t get home until 8:30 at night.”

When able, James attends Oxford Hills Comprehensive High School in person on Mondays and Tuesdays. The other days she is remote and works in Lewiston. Saturdays she puts in a 12-hour shift at the hospital. Her schedule does not leave much free time, but when she is not working she said she manages to hang out with her two best friends.

She works at the same hospital as her mother; her father works at another nearby, giving her a strong support system to help with the pressures of caring for very ill patients.

“I’ve learned to manage,” she said. “When I come home, I take off my scrubs at the door and put them in the wash. My mom and dad are very supportive. We don’t get out much, it’s pretty much the three of us right now.

James usually clocks in at the hospital about 2:45 p.m. and starts her shift by reviewing her patients’ reports. By 4 p.m. she is taking their vitals and bathes them or helps them eat. She might spend up to 90 minutes with each patient.

COVID patients can be anywhere from stable to not at all and she sees the toll the virus has on them.

“We’re very careful between rooms. We have to wear face shields, N95 masks, gowns, hairnets, booties on our feet and I double glove,” she said of her hospital routine. “The patients tend to feel bad for us that we have to wear all that stuff. They feel like they’re a burden. But I reassure them that I am there to help them get better. The gear protects me and them.”

Each patient on the COVID unit has a designated nurse and CNA. Their doctors check on them at least every other day – if their treatment is going well and they aren’t experiencing distress. Unable to see their families, often their nurses are the only people they have any contact with during the day. A stay in the unit might be a week, it might take a month.

“I’ve worked a few times in the ICU with people on ventilators. The ICU is not my favorite place because I just lost my grandmother to COVID,” she said. “She was 69. She lived in Alabama. She had a heart problem and she got better. We were able to visit her in July. But then she got COVID.”

James believes that people outside of healthcare do not realize how many patients go into the hospital with COVID-19. While unable to cite specific numbers, she confirmed that it can be multiple patients on a daily basis. She gets frustrated that even some people in her own family that don’t believe it.

“I want to tell them to walk through the hospital sometime,” she sighed. “If that’s your grandfather, your mom or dad in the hospital, on a ventilator, and you think you’re safe? You’re blind to what’s going on in the world.

“I have been the last person some people see before they pass, because of COVID. They can’t see their family, because of COVID. So for them, I’m the last thing they see before they go. It’s heartbreaking, but it’s reality. And still there are people who walk around with no mask on.”

Sometimes a patient’s family will call the hospital and want to speak with the people who take care of their parents, to find out if they are okay. James can talk with them and give updates about how they’re feeling or how their mood is that day. But she cannot go into details about their condition.

“I don’t have that scope of knowledge, it’s beyond my practice,” she said. “It takes a toll. There are days I leave and think that I don’t want to go back tomorrow. The 30-minute drive home from work, it gives me a chance to just breathe. Sometimes those four hours I’ve worked are the longest four hours. I get that time to process, and I can talk with my mom and dad although I have to be careful because of HIPAA. There is only so much I can say to them.

“But I love my job, I wouldn’t trade it. I come home, shower, eat dinner and try not to think about it. I try to leave work at work.”

As a healthcare worker, James was one of the first in Maine eligible for the coronavirus vaccine. She got her first dose after Christmas and the second in January. She had no reaction to the first injection and just some minor aches and a bump on her arm after the second. Some people advised the teen she should not be vaccinated.

“For me, it was like, ‘wow this is really happening,’” she recalls. “A lot of people said, ‘don’t get it, you’re young.’ But I got it for my patients, my family, for my community. It was a moment of … I’m not sure how to say it. It was unreal.

“I never thought in a million years I would be offered something so significant during this time. Almost all staff chose to be vaccinated [right away].”

Patient connections

One part of caring for COVID patients that stays with James are the stories they tell her. One of her patients, a World War II vet, loves telling her about when he was in the war.

“It is something that has definitely opened my eyes about life,” she said. “Since I’ve started working there I’ve learned that you can’t take any moment you have for granted. So many people wake up one day, and then three days later they’re gone.”

“Growing up I’ve always thought about the future – what am I going to do about this? What about when this happens? But since working at the hospital I’ve seen people who have lived life to the fullest and when they’re ready to go they can go. I want to tell my story like they’ve been able to tell me their stories, and be happy about it.”

She said working as a CNA during a pandemic has taught her to appreciate the time she has with her mom and dad, her grandparents and her niece, and to live for the day. And while recognizing it’s not necessarily for the best, she enjoys building relationships with her patients.

“I had one patient who didn’t make it and that was right after my grandma passed,” she recalled. “We had a bond. I had worked with them before they had COVID. They had made progress and then came to the hospital with COVID and then didn’t make it. It was almost like losing someone close to me.

“But it’s something you have to get used to. That happened, but at the same time I just had to put my face on and finish my shift because there were other patients who needed me that day. It’s not easy and I struggle sometimes.”

James plans to work at the hospital until next July, when she will move south to attend the University of Southern Alabama. She was accepted into the school’s nursing program with an in state tuition rate. Most of her father’s family lives in the area so her support system will continue. She hopes to continue towards her master’s degree and ultimately work as an obstetrics nurse.

School

James always knew she wanted to work in a hospital to help people but she found ways to help others first. She is President of her senior class and Vice President of the National Honor Society.

“I have always had a voice. I want it to be heard,” she said. “I took on a lot of leadership roles my junior year. I became class president and joined NHS. I knew going into senior year there would things we’d have to adjust and be ready for.”

Early in 2020 James partnered with other class leaders to successfully lobby the SAD 17 School Board to change their dress code to allow students to wear hats. The issue had become important to many and she wanted to help change it for them.

“I think about my classmates often, the ones struggling,” she continued. “I am grateful for my family. I’m grateful for everything I have. I have a car, my license, I have a job and I can go do things and have a lot of things that other kids don’t.

“I worry for kids who struggled before the pandemic. Some kids can’t learn from home. It’s not feasible for them. They dread those [remote] days from home. And for some, school was a safe place to be. They got to see people they love, get out of the house six hours a day. Now, it’s not the case. It’s difficult to help them during COVID.”

Tiana James has played as OHCHS’ girls varsity lacrosse goalie since she was a freshman. Supplied photo

One more experience James is hopeful she can enjoy before graduation is the spring sports season. She has been varsity goalie on OHCHS’ girls’ lacrosse team since she was a freshman. After missing out her junior year she is anxious to get that final season in.

“Right now, as an athlete, I get to look forward to lacrosse,” she said. “I’ve played since seventh grade. As goalie … I’ve taken a beating. It’s a physical and a mental game. You have to know the strategy.

“My work schedule will be probably Sundays only [when the season starts], which will make my paycheck close to nothing. But I don’t want to miss my senior season, and I’ve worked enough to save and be able to play. I’m ready to play.”

With her eye toward graduation in June, James said school administrators deserve props for seeing her and all her classmates through.

“It’s been a crazy year,” she said. “They have worked very hard and they’re doing a very good job to keep the class of 2021 happy, or at least as happy as we can be.”