Eleven years ago, I had both the honor and horror of being a highly skilled and experienced RN at the frontline of the swine flu pandemic. The winter of 2008-9 was the most difficult of my career. It moved me in the most profound way to become the ICU nurse I am today. I was called to pursue a degree in Public Health in addition to my BSN. I participated in every disaster drill my schedule would allow. I attended multiple FEMA courses on Disaster Management and Preparation. I made disaster management the focus of grad school. I created disaster plans for acts of biological, natural, and man-made disasters. I took and taught Classes on trauma readiness as well as lived mass casualty incidents in real-time at the level one trauma center where I worked for years.

Then COVID-19. It was terrifying to care for patients with a novel virus that has no cure, no vaccine, and little protection. The protection for the staff was minimal.  This was the first time I ever had to worry about my own protection from disease. There was never a moment in the swine flu pandemic that I worried for my own safety or the safety of my coworkers. In 2009, I wore a gown and mask in every room and threw it away after each patient encounter. Not one of my disaster plans included a lack of PPE. With the first wave last March, we were thrust into makeshift ICUs with makeshift negative pressure rooms. The patients were not makeshift. We were issued one mask at the door to the hospital for the next 12 hours. The same mask that I have spent the last 20 years throwing away after each patient encounter. The mask is still under scrutiny for its effectiveness for droplet/ airborne particle prevention. COVID-19 patients came in waves and they are very real. The moment came where I had to give myself a talk “this is it. The moment you were made for.” The choice was to either care for patients or turn around and leave forever. The overwhelmingly brave choice for us doctors, nurses and therapists were to choose life. Choose the lives of the patients entrusted to us.

My family told me they could not be around me for the unforeseeable future. Friends told me the same. No one wanted to be around a frontline worker. My neighbors would see me in my scrubs and turn around and walk the other way. At work, we saw an unbelievable tragedy. It made us closer to only have each other and yet we were still mandated to the social distancing of six feet.  It used to be we would sit next to each other and chart. During these moments we would either tell jokes or vent and debrief one another. There was no more hugging or high fives. Knuckles no longer touch. Nurses week when we needed it most was canceled. That would lead to social interaction. We worked so hard and long, that I could barely walk to my car in the morning. The amount of physical exertion that COVID-19 patients need to keep them alive is beyond explanation. I gained beyond COVID-19, 19 pounds. Multiply that by two. I have always been one to gain weight during times of stress, but for the first time in my life, I also stress ate. Eating seemed the only normal thing left to do. I sat alone on my couch month after month with my tacos, ice cream, and hallmark movies. Now that I realize the world is truly not ending, I stopped that. Looking in the mirror and zipping my jeans are reminders of the death I have seen. This is the most honest I can be; full-on survivor guilt.

I am no hero and none of us want to be acknowledged as such. Many of my coworkers stayed in their garages so as not to expose their families. Another coworker drove his family 1000 miles away to stay with other family members until the numbers dropped. Multiple times, our patients were us. Staff and family members of staff who contracted the virus despite the seriousness we all took with precautions. COVID-19 patients are the sickest l have ever seen. It is impossible to turn your back on them. They require the most complex mix of intellect, physical strength, and emotion I have experienced in my career. The rooms and garb are incredibly hot. We all learned “the look” and dive to rescue each other when on the verge of passing out.

One night I cared for one such patient that I literally could not leave. I titrated many lifesaving drips, administered oxygen, and fluid all night. I received him from the emergency room unconscious. Over the course of the night, he awoke. All of a sudden, he was talking and making perfect sense. “Am I going to die?” Not on my watch. “you are doing better,” I say. As I was leaving, I held his hand “can I do anything before I leave?” Pray for me. I don’t think I am going to make it. It was such an easy request to deliver. I called his wife before going to my car. She described her love for her husband of 42 years and how difficult it was to not be able to visit. I told her to bring his iPad and they could FaceTime. She said she would deliver in 20 minutes. I came back that night to find him no longer with us. He died soon after I clocked out. I realized his sudden wakefulness was what we in medicine refer to as a rally. The hardest part of caring for dying patients of any disease during COVID-19 has been watching them die alone. There has never been a time when we have had to shift from laboring scientists to the only bedside hand-holder as we do now.

Having whole families as patients from COVID-19 and not an accident or fire has also been new. How family members found the strength to get better while losing spouses or children has been amazing. I cared for one mom for weeks. When she was extubated and on the road to recovery, I asked her how she was coping. She explained to me that she knew she had to get better to go home and care for her daughter’s children now that she was gone. Another patient had also spent weeks on the ventilator with low blood pressure and high fevers as well as kidney failure. It was amazing and gratifying to FaceTime his family with him. We all cried. I hold on to those happy moments. Those families, those patients – they are the heroes.

In the beginning, the community-made us masks and sent us food. The support was appreciated even though we were a little bewildered by it. To say we are heroes is inaccurate. In the ICU, I have always said “it is a good day when we are still standing on this side of the glass.” Every nurse that I saw have their first assigned COVID-19 patient had the same initial reaction that I did. They would tremble and come to terms with their own mortality. “what if I die? I am a single mom. Who will care for my children?” Many have diabetes, obesity, or hypertension. Others have new babies at home. I myself have asthma and fall into a high-risk category. Your frontline workers are soldiers. The enemy is a germ we are fighting against with all that is in us. We do not want to be acknowledged as superhumans but quite opposite. We want to be acknowledged in our purest human form. Ordinary individuals assigned to the most extraordinary assignment. As we always do; we rise every day to face the battle for lives.

About Post Author

21st Century