While messaging with one of my friends, a critical care nurse, she mentioned that “…we should be doing virtual community tours so people know about unvaccinated hell,” and then she told me she’d written about her experiences. I’d love to read what you have, I said.
I cried, reading about her experience, and then wrote back, “People need to hear this. May I share?”
She said yes, and now, after a bit of back-and-forth collaboration, here we are.
A Nurse’s Lament
I write about each of the Covid patients I care for in the Intensive Care Unit — just a short blurb jotted down in my personal Covid journal reviewing the major events of their progression, things they shared with me before they could no longer talk, and things their family told me about them. Initially, I did this as a way to remember them, to capture their struggle in Covid isolation that only the medical staff was witness to, and so I wouldn’t forget their journey, but now, eighteen months later, I realize I also need to do it out of recognition of my own trauma. Work feels different this second wave of the pandemic — so needless, as our ICU patients have almost all been unvaccinated.
Recently, when one of the families finally decided to stop the weeks of futile treatment on their middle-aged brother and son, they wept over our final video chat, asking me to please stay with him so he would not die alone.
“Of course,” I said. “I will be with him the whole time. My patients never die alone.”
I stopped his dialysis, unhooked the IV meds that were keeping his heart going, and disconnected the ventilator. His body hung on longer than I anticipated. I stood by his bedside, stroking his hair, holding his hand, periodically repeating the 23rd Psalm, and singing the hymns and lullabies that I sang to my children at bedtime. He never woke up, but if he had any awareness at all, he was never alone.
Later, I felt angry that I’d been put in that position, yet again: I bore the burden of his decision to refuse a life-saving, preventative measure at the cost of my own mental trauma. My own community has decided not to trust us — the healthcare providers who are also their neighbors, friends, and family, and who have their best interests in mind — and instead follow the inflammatory advice of radio and YouTube personalities, performers who are far more dynamic and entertaining than I am but who are woefully uninformed regarding medical treatments and evidence-based practices. And we — me and my fellow medical workers — must bear the brunt of the fallout.
Three days later I was once again in the same room, this time doing CPR on a previously healthy man in his 40s who’d been admitted the same day as my last patient, the one who had just died. Once other medical staff arrived to help, I got the patient’s wife on a video call and sat the iPad in the corner of the room to watch so she could make informed decisions about his care. “We didn’t believe in Covid,” she’d wept into the phone each time I talked with her in the days prior. By now, her husband’s organs had been ravaged by the clotting malfunctions of Covid and, after forty-five minutes of watching us attempt to save him, she requested an end. My heart went out to her, but my head just couldn’t comprehend — how is it we’ve been living in such different realities?
In Covid ICUs across the country, these scenarios are commonplace. The suffering is staggering. Covid patients are subjected to many hours of laying on their bellies to maximize viable lung tissue. Their faces and eyes swell due to the pressure from the face-down position, the excess fluid, and their stressed circulation. Because of the high-pressure ventilation required to recruit and maintain oxygen levels, their chest, neck, and arms fill with air directly beneath the skin, causing it to pop and crackle with every touch. They no longer look like the people their families once knew.
My coworkers and I watch as patients who are not yet at the point of needing a ventilator slowly wear out and give up. They cannot remove their oxygen devices long enough to eat, and their mouths are parched from the constant high-pressure airflow from the face mask. They struggle for each breath, and even though they hold as still as possible to reduce all demands on their bodies, they’re practically panting, breathing 30 or 40 times a minute. To help their families understand the dire situation, we try to carve out time for the family to video in — this is yet another distressing interaction that we must bear witness to.
Our ICU is on divert, almost continuously. We have some empty rooms, but there is not enough staff with proper training to care for the Covid patients, so sometimes patients are shipped several hours away in search of an available ICU bed. Beds open up when patients die. Does our community know this? Would knowing this help change people’s minds in favor of getting the vaccine? Would it make the unvaxxed a little more cautious? A little less invincible?
We have lost so many of our ICU staff, and I, too, have considered walking away in favor of lucrative travel nursing position, other less-intense hospital departments, maybe another career entirely. I understand why medical staff leave — this job is hard. But when I get the desperate texts from work for help and see the holes in our staffing matrix, I often say yes, mostly because I know how overwhelming it is to work with inadequate staffing. I don’t want to put my coworkers in that position. And yet I am so tired of sacrificing my own physical and mental health, and my time with my own family, for people who have declined, discredited, and denied our medical advice.
I have been working in these conditions for the last eighteen months. I am numb, angry, and heartbroken, sometimes all at the same time, and I am exhausted. I often go hours without a break to eat or drink. I have learned to make a quick run to the restroom before gearing up because it may be hours before I can go to the bathroom again. The bruise across the bridge of my nose and cheeks is painfully tender from relentless hours in my N95.
I see photos on social media and TV of people eating in restaurants, of packed college football stadiums, of full grandstands at county fairs, and I feel betrayed by my community where the vaccination rate hovers around fifty percent. Seeing these large gatherings, I feel both angry and teary, overwhelmed by the virus’s continued, unchecked transmission and hopeless that this will ever end.
I understand the deep desire for normalcy, but at what cost? Mine?
I want normal, too.
Thank you for sharing, friend. I am so grateful for the work you do.