The Nelson 5 Team
December 2020
The Nelson 5 Team
at The Johns Hopkins Hospital
Medical Progressive Care Unit
The Johns Hopkins Hospital




Prior to March 2020, Nelson 5 was an Intermediate Medical Care (IMC) at Johns Hopkins Hospital (Baltimore, MD). As news of the pandemic started to spread across the United States, Johns Hopkins Hospital realized that we would need special units to care exclusively for these patients. Our unit was one of the two units in the Hospital selected for this role. Over the last weeks of February and the first few weeks of May, new walls were built to maintain "negative pressure" on our unit, new protocols and workflows were developed, and nurses were educated on how to wear safety equipment and practiced putting on PAPRs. At the end of March, we officially accepted our first round of COVID-19 patients, and we haven't stopped since.
The changes didn't stop there though. Almost immediately, the Hospital recognized that we had an additional need for ICU-level nurses to care for these acutely ill patients. Many of the other ICUs in the Hospital were filling their airborne rooms fast, and national numbers were growing. So, Nelson 5 stepped up to the plate again - we started new staffing models, first "pairing" IMC and ICU nurses to work together, and then started upskilling our own staff. So, not only were Nelson 5 nurses learning about COVID, but they were learning new skills too! How to sedate and paralyze patients, how to monitor ventilator settings, run CVVHD machines, etc. Some of these nurses had less than a year of nursing experience.
Throughout this time, our nurses kept coming into work every day. People didn't start calling out, they didn't start looking for new jobs... they rose to the occasion, and just kept going. In the midst of all this change, they still found time to schedule Zoom meetings with their patients and their families. They decorated rooms with family pictures, and wrote patient likes and dislikes on their sliding doors. They made sure the radio station was playing a patients' favorite music before leaving the room. They got pressure sores from PAPRs, so bought colorful bandanas to wear underneath, and decorated their hoods with their names. They made sure that none of the patients who passed ever had to die alone - there would always be one nurse (if not more), in the room, holding someone's hand until the end.
I know that many nurses across the country rose to the challenge of COVID-19, but I think that these extremely special nurses on Nelson 5 deserve special recognition for their adaptability and dedication. Unlike others, these nurses were some of the very first to work with COVID patients, and also some of the most long-standing; they "went bio" in March, and are still going today. Recognizing the staff with a DAISY Award would help to give them the motivation to continue their good work, and would help to show them just how appreciated they are.
Thankfully, the COVID rates in many states are still declining, but for them, the fight isn't over, and probably won't be for a while yet.