She was fresh out of nursing school, new to Johns Hopkins Medicine, new to Baltimore, but Zhijie Zhou ("Jojo" to her friends and colleagues) was determined to help take care of COVID-19 patients.

"I just feel I’m a nurse and I should be there," she says.

Her father is a doctor in their hometown in China, just a couple of hours from Wuhan, where she earned a degree in business English at Zhongnan University of Economics and Law. Since the beginning of the pandemic, her father has worked on the frontlines daily, despite his age (late 60s), his own underlying health issues and a perpetual lack of even basic protective equipment.

"I have been so proud of him and of how doctors and nurses in China coped with this pandemic when nobody else knew what was going on," she says.

When the pandemic hit the U.S., Zhou was in nursing school in Chicago. She was frustrated that as an international student she was not allowed to volunteer on a COVID-19 unit. But after she graduated in May 2020, she obtained her work visa and was thrilled to be hired in August as a registered nurse on the progressive cardiac care unit at The Johns Hopkins Hospital.

"I was so excited," she says. "I wanted to help fight this pandemic."

After she completed her orientation, she started volunteering to work extra shifts on COVID-19 units that were sending out emails asking for help. The first was Nelson 4, a pulmonary medicine unit that had been converted to a high-level isolation unit to care for COVID-19 patients. "I was a little bit nervous because I didn’t know how to wear PPE [personal protective equipment]," she says. None of the N95 masks fit, so a senior nurse helped her order a powered air purifying respirator (PAPR).

"It covers your head like a helmet and you wear a special machine on your back to ventilate the air," she says. "You couldn’t take any of it off while you were on the unit, even to drink water." She had been assigned a "buddy" nurse, "and she was always checking in. ‘Hey, Jojo, how are you doing? Hey, Jojo, it’s been three hours. You have to drink. I’ll cover your patients.’ And she literally forced me to go outside the unit for a break, which was really, really helpful."

She learned there was a staff shortage because many pregnant nurses and nurses with chronic illnesses had left the unit. She learned how emotionally and physically draining the job could be. Wearing a PAPR for hours caused not only dryness, but severe headaches and pressure sores. She saw patients in great distress, including patients with delirium from being in the intensive care unit, "which is really heartbreaking and challenging for nurses." And all of that protective gear, plus COVID-19 protocols dictating how long nurses could be in patients’ rooms, meant little opportunity to bond with and comfort patients.

Zhou spent months floating to various COVID-19 units, and says she is enormously grateful for everything she learned and for the nurses who mentored and supported her. "And I have a deep, deep respect for the nurses who never left those units," she says. "They were truly amazing."

Read more nursing stories in the The Johns Hopkins Hospital 2022 Nursing Annual Report.