Brie Gowen

Savor the Essence of Life

No One Understands What Nurses are Going Through

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“God’s got this.”

“He holds you in the palm of His hand.”

“None of this is a surprise to God.”

“Heaven, help us.”

These are the sentiments spoken in response to what critical care nurses like myself are seeing, and while these comments are absolutely true in my book, they don’t quite give me the reassurance I’m hoping for. It’s not that the thoughts and prayers aren’t appreciated; because, they are! My spirit thrives on them, and His strength makes all things possible. But after hearing the well-meant words of others, especially after a brutal day, it occurred to me what the human side of me really wants.

I want people to understand.

I can’t really blame them, though. Other than my spouse, I’m usually pretty nondescript when it comes to my day. When asked how it’s going during a pandemic, we’ll use bland words like “hard” or “bad.” Perhaps even “exhausting.” Yet those simple syllables say little to what’s really going on. I’m not sure if it’s too painful to rehash or just easier to say less. I think, for many nurses, after having close acquaintances, or even family members, act over the past year and a half like Covid is not a big deal, it makes you place a wall around yourself. To see folks neglect simple things like masks, or to chastise vaccines and science, it makes you crawl inside a hole. Then, later, when you need someone to understand how you’re feeling, they don’t.

They don’t understand.

Other than my spouse, and a few family and friends I’m comfortable enough to share the intimate aspects of my day, no one understands the pain of what I see. Deep down, I don’t want them to. I don’t want that for anyone. But sometimes, I just wish I could open a curtain into my ICU for the world to see. I think we wouldn’t have another record-breaking surge going on if I could. Maybe I wouldn’t feel like crying, like I did yesterday, all alone in my angst. Even when the tears don’t come, because I’m too afraid to let them loose, worried that I won’t be able to rein them back in.

As it stands, in lieu of a magic window, you’re left with the fact that no one understands, unless they’ve been behind the curtain with you.

Words like “hard“ don’t accurately depict what it’s like to watch people slowly die of a virus that takes away their ability to breathe. “Bad” isn’t adequate to describe the fear in their eyes of dying with a feeling of cruel suffocation.

When you hear the “numbers are going up,” you don’t see the numbers I see going down. The oxygen saturation numbers that keep alarming too low to oxygenate the blood and sustain life. They don’t tell you on the news (no matter the network) what it feels like to watch a person turn gray, and blue, and purple. They don’t describe the feeling of your hands when ribs crack beneath them during CPR, no more than they tell about the hopeless feeling in your heart when a family member asks you over the phone if the patient is getting better.

I’ve never fought such a losing battle, and it’s hard to put that into words. When you’re in the business of healing, Critical Care Covid doesn’t play by the rules, and it just ends up feeling like a bad luck streak that won’t break. Does anyone understand how hard that is on us?!

I can’t speak for everyone, but I know that personally my heart is broken. It’s excruciating watching people suffer. It’s beyond demoralizing when the majority don’t get better. I’m angry at people who ignore the suffering of others. I’m pissed that this is still happening! I’m frustrated at staffing problems, and I totally understand why nurses are fleeing the bedside in droves.

The thing is, I can write out all of the above, and most people still won’t understand. Not totally. Until you live it, until you can’t unsee the things you wish you had not seen, and until you spend your off days in a depressed daze, despite your best efforts, you’ll never understand. For your sake, I’m glad you don’t.

The Broken Heart of Nursing After a Pandemic

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Well, I guess that’s it, huh? CDC said we can go without masks (to the vaccinated), and you see businesses everywhere taking down their “masks required” signs. Disney World is taking advantage of our good numbers in the U.S., and while I’m just as excited as anybody to return to a normal, pre-covid world, I’m also having a hard time.

When mask mandates fall, plexiglass partitions are taken down, and social distancing requirements are slackened, it doesn’t just usher in the happy feelings of going back to the good ole days like I would hope. You see, it also feeds the wrong fires, and it perpetuates bad theory.

Who doesn’t know someone who thinks COVID-19 was a political ploy?! Like, I could probably count on both hands, and have to take off my shoes too, to total the Facebook friends who are certain the pandemic was an attempt at government control of its people; without them even noticing that a lot of the behavior in 2020 proved maybe a little government overreach was necessary. But that’s another topic. No wonder the Podcast I listened to earlier called social media “Satan’s cesspool.”

Point is, as the pandemic blows over, the chance of forgetting its seriousness flies away like the wind as well. It’s easier to lessen the virus when it’s not affecting anyone you know. When it’s a distant, news story from India, it’s fairly simple to blame the Democrats for going overboard to keep people safe. Heck, you could even believe COVID-19 was never really a big deal. Except… it was. To me, it was.

I am a critical care nurse, and in the year 2020 I experienced the worst year of my nursing career. I would even go so far as to say it was worse than my time in the military, in a post 9/11 world, watching scores of young men medevaced to my facility with only one limb remaining. At least the brave soldiers I saw in my stateside care lived. Not so with the Covid pandemic.

I personally saw hundreds in our facility’s care die. Not just old people, or people with multiple health problems. I especially remember the mother of three children who was younger than me. I tried to warn her she might die if she didn’t lay in a prone position. At the time, it was the thing that seemed to help those patients the most. The next day, she was intubated. A week later, she was gone. It was like that for way too many patients this past year.

I watched my coworker dress out in PPE to hug her husband goodbye before he died. I cried on the phone with more family members than my heart could take. I saw the hope go out of otherwise strong men’s eyes. Each day they fought in vain to breathe, the light in their eyes dimmed more and more. It was a fight they couldn’t win. And sadly it was a fight the nursing community couldn’t win either.

As a nurse, my job is to make people better. In my twenty years of nursing, I did a two year stint in Hospice Nursing. Y’all, I loved it. It was extremely rewarding to care for patients and families during a difficult end of life experience. I was able to prepare, support, and comfort them. All that to say, it wasn’t the morgue being too full to take any more bodies that got to me. As a nurse, I can handle patients dying. The problem with the past year was, they all died. If you came into the intensive care unit, you were only leaving in a bag! Back to the counting fingers… I can count on one hand how many patients got to leave my critical care unit alive. That’s bad odds.

Nursing care is about helping. No one wanted to die of COVID-19! They wanted to live! And when we became (like) Hospice nurses to patients and families who had not requested those services, it was debilitating to the morale. Y’all, I still have PTSD-like response from 2020. My actions, even now, as the virus statistics improve, are impacted negatively by the trauma I experienced watching patients die, over and over, every shift, day after day.

I am a woman of faith. When churches began to open back up, I didn’t take my family back. I had seen too much! It wasn’t fear winning out over my faith. It was my trauma response. But you haven’t heard the worst part. I still haven’t taken my family back to church, but it’s no longer the corona virus that whispers to me to stay at home. It’s a whole other form of PTSD. It’s the response of people that has given me a lasting trauma. With the vaccine, time, and herd immunity, I can move past COVID-19. But the careless words, hateful attitudes, and selfishness of some, fellow Christians has created a lasting trauma in my life. It’s hard for me to share in fellowship with people who laugh at a virus that made 2020 the worst year of my life as an RN. I’ve just been worshipping God at home with my husband. God, my spouse, and my fellow critical care nurses seem to be some of the few who understand why my heart was broken into pieces this past year.

*Insert sigh.

I’m glad we are returning to a life without a pandemic. I’m happy to see my patients transfer out of critical care, and on their way to recovery again! I want my children to play with other kids, and I want my loving husband to go back to striking up friendships with strangers. I miss his outgoing self! I think these things are possible. I know they are! But then there are the things that I don’t think can return to before.

I can’t forget the way people spoke so nonchalantly and uncaring about the death of >550,000 American citizens, or over 3 million people worldwide! I watched friends be more concerned with having to wear a piece of paper over their face for twenty minutes of shopping than they were for the possible health outcome statistically of their neighbors over 65 years of age. Citizens worried more about their “personal rights,” as they perceived them, than they were staving off the spread of a disease that had healthcare workers going beyond the possibility of what they could do. I remember reaching a wall of what I felt I could handle as a nurse in 2020. Then we busted right through that mother, to the point I recall in tears asking a coworker, “is this real life?!”

We were drowning, and no one cared! Our patients were dying, and no one cared! And now, things are getting better, causing some folks to say COVID-19 wasn’t a big deal. And no one seems to care!! Except me, my coworkers, and the families of the 3 million dead people. We seem to care. We seem to remember the past year wasn’t just a political ploy to oust Trump, reform gun control, or God-forbid, raise gas prices.

I don’t guess I have much more in me to say right now than that. It’s exhausting and it’s heartbreaking. Just when I think my heart is healing, callous words step on the broken pieces.

My husband told me earlier, “Brie, people just don’t know. They’re ignorant.”

To which I replied, “I wish I was too. I would rather be ignorant to the reality of a pandemic than have gone through what I did as a nurse in Covid Critical Care in 2020.”

So, if you see a nurse friend with a distant, haunted look while you discuss the government’s mishandling of the pandemic, try and understand why. It was so much more than you’ll ever know to those it touched personally. I do believe politicians play circumstances like a fiddle, and I know things were and are still mishandled in regards to COVID-19, but we have to be bigger than that. We, as human beings, have to rise above politics and the noise of this world to care compassionately about one another. If anything could return to normal after a pandemic, maybe it could be that.

I Will Never Forget the Trauma of COVID-19

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Numbers have been declining, face mask mandates rescinded, and I try to be hopeful. I haven’t taken care of a COVID positive patient in two weeks! I want this to end more than you know. I want life to return to normal. I want my outgoing husband to go back to ministering to strangers in love, and I desire for my daughters to play with other children without concern or worry. It’s not fear, you see, that drives me, but rather things I saw and cannot forget.

A few months ago I received my first dose of the COVID vaccine. I felt hopeful. In all honesty, I cried happy tears. I wanted an end to this pandemic more than anyone could ever imagine. I posted a picture to Instagram of me smiling with my vaccination card. A stranger commented about my lack of faith, and my obvious succumbing to fear. That broke my heart.

This morning my husband and I talked about it on the front porch. Before children wake, with coffee in hand, we’re allowed these private conversations. I mentioned how I wanted to see him engage with neighbors more readily, like he used to do. You see, the past year has not just impacted me. It had also scarred my best friend, my spouse who heard my pain after a long day at the ICU bedside. He knew the truth of it.

As we spoke of hope, of how things seemed to be getting better, I was taken back to this past summer. June and July of 2020. I had been working in a major, metropolitan area of Central Florida, and we had been hit brutally by the pandemic.

I said to my husband, “I remember reaching that breaking point where I knew we couldn’t take much more. There were more patients than we could handle. Every shift another person died. A woman my age with young children like us died. Then that man with daughters the same age as ours. Followed by the death of a coworker’s spouse. I took care of him. I helped her put on the PPE right before he died. I remember thinking that could be me, losing you.”

He listened in that understanding way of his. Then I added, “I think a part of my depression at the worst of it had a lot to do with public perception. I would try to escape to social media to take my mind off what I was seeing at work, but I was met with people who made light of the very thing that was breaking me.”

I had to take a big step away from the world during all of this. I didn’t fear a virus, but I did fear the way my heart was feeling towards others who could not fathom what I was going through. Here I was crying into the phone with family who couldn’t hold their dying loved one, and the rest of the country was complaining about not having prom or how uncomfortable a thin piece of paper felt on their face for 20 minutes a day. I rubbed ointment of the reddened bridge of my nose, scarred by a respirator I wore for 13 hours a day, and I rubbed my bruised ego even harder.

It took months, and I mean months, for me to let go of the hurt and offense I felt at others negating my pain. I had to lay it all down and be grateful that they didn’t have to know the things I knew, see the things I had seen, or remember the trauma that could still pop up unexpected as I sat on my porch drinking coffee.

I have forgiven the offense, but I cannot forget the trauma I experienced. I know I’m not alone in this. I think of the wonderful, brave men and women, doctors, nurses, respiratory therapists, and other healthcare workers who served alongside me during the worst of it. We all had that hollow-eyed look, at the time, and I think even now are like a feral cat hesitantly approaching a bowl of food left in the garage. We want the good news. We want the numbers to go down, and a return to normalcy. Yet we can’t forget. The death, the hopelessness. We were supposed to save lives, yet there was a time where nothing we did worked. If you entered the COVID ICU, your chances of leaving it alive were slim to none. It’s not supposed to work like that.

I’m back on social media, and it’s about the same. It hasn’t changed, but I have. I realize I cannot change anyone’s mind. I cannot be a voice of reason or experience to anyone who doesn’t want to hear me. I let it go, as my daughter’s favorite princess would say. Opinions are still strong, and people like to voice them. People have their opinions on masks and vaccinations, and I won’t try to change that.

I would only say this. Don’t belittle what someone else decides to do, or God-forbid, question their belief system or faith. In 2020 there was this saying, “we’re all in this together.” While I could appreciate the sentiment, it just wasn’t true. We all experienced the COVID-19 pandemic, but exactly how it impacted us was very different. We were not together in the differing traumas we experienced. I didn’t suffer through financial hardship. I kept my job the entire time. Those who didn’t have money to pay their bills experienced a trauma I cannot relate to, but it’s also a reciprocal relationship. I saw things at the critical care bedside that the average person cannot fathom. That is why I try now to not be offended anymore. Others cannot understand my trauma, and I cannot understand theirs. I didn’t have family die. I suffered depression and anxiety, but not as much as I’m sure others did. I try to remind myself of that.

If someone continues to wear a mask when the mandate has been lifted, that’s their prerogative. If someone wants to wear their mask outdoors or in their car, with no other people in sight, that is their decision. You cannot know what they personally experienced the past year. Keep that in mind. If you’re totally against the COVID vaccine, I respect your personal decision, but I would encourage you to do the same. Every ICU nurse I worked with got the vaccination. Our work didn’t force us to do this. The trauma we experienced did. So, if I could offer any friendly advice as mandates and restrictions ease, it would be this. Don’t lessen someone else’s trauma simply because you didn’t experience it in the same way. Instead be grateful that you can have the perspective you do. Some of us, like myself, wish we could forget.

2020 Tried to Crush the Spirit of Nursing

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“He what?!” I replied in shock.

“He died last night,” my nightshift coworker answered.

I didn’t tell him goodbye.

I didn’t say that last part out loud. I simply thought it to myself. I guess I couldn’t speak it out loud. It was as if I feared giving my feelings a verbal voice would cause the cool, professional demeanor we all strived to maintain to instead crumble in grief. I suppose that part is wrong, though. We didn’t strive to be aloof; we just had to remain disconnected in a sense to keep doing the job. Especially this year.

If any year could go down in history for trying to crush the spirit of nursing, it would be 2020, the year of COVID-19. As a critical care nurse I have watched too many people die this year. I mean, outcomes are often poor in the ICU, but this novel virus has taken things to a whole new level. There was a period of time this year where I watched at least one patient die per my shift, and many times more. One patient doesn’t seem like a lot, until you add them together, day after day, month after month, shuffling in for another crazy shift, praying that a success story would emerge.

A story. You see, it wasn’t just a room number or patient vacating a bed. It was a story, a beautiful life story, a real person, with family, friends, and a purpose in this world. As a bedside nurse you learned these people’s stories. You spoke to crying wives on the phone, you watched hysterical daughters try not to fall apart as they waved through the glass window to their mom who didn’t know they were there.

You said things like, “he seemed like he was doing better yesterday…”

Or you lamented, “I feel so bad for her three, young children at home.”

Sometimes we shared the stories. They were just too heartbreaking to keep inside. We didn’t mention things like names, but rather the way the father of four had made us appreciate life. I had told my husband about this most recent life story.

“Can you imagine,” I asked my husband, “being stuck in a glass box for over three weeks, not seeing your family, just strangers in masks who come in every once and a while? Can you imagine not being able to breathe good enough to even take a bite of food? I feel so bad for him!”

I had not taken care of him the day/night he died. They had given me another assignment. All day I had considered going into his room to say hello. I kept meaning to go in and try and brighten his day, but the hours had passed without me doing it. Whether it was the busyness of my own assignment, or the fact of all the personal protective equipment I had to put on to enter his room, I had missed the opportunity to say hello, or even goodbye. I knew he was doing bad, but I was hopeful he’d make it. I was always hopeful.

“I wish I could hug your neck.”

That’s what he had said, in between labored breaths and the roar of the sealed mask pushing air into his stubborn lungs. I had sang to him. He frigging loved it. He said I made his day. I had come in frequently, even though the gowning up was a chore, and we weren’t supposed to overly expose ourselves. Lord, I had even gotten down in his face, through his sputtering coughing, trying to hear what he spoke in his weak, short of breath conversations. I remember simply praying for God to keep the seal of my own mask tight. That man needed someone to know they cared, to give him a quick sip of water before he frantically asked to put the oxygen mask back on. And it made me feel good when I scratched his back and he said, “you’re the best!”

That’s what I thought of when I found out he didn’t win his battle with COVID-19. His story. And his personal story stacked on top of all the other stories from this year. The woman my age, who also had three daughters. Or the guy who couldn’t speak English and looked scared to death as we tried to explain emergent intubation without an interpreter present. I thought of all the weeping families, and I also thought of the gratitude they had bestowed our way even in the midst of their own grief.

I think about those sad stories, too many lost for a single year, and I try not to think about the coming months, the tragedy they could bring. I cling to things like memories of where I helped ease pain, prayed with a spouse over the phone, or the hope that this virus is getting weaker. I think of Queen Esther in the Old Testament, and how her uncle surmised amidst danger and possible death, “perhaps you were made for such a time as this.”

Maybe that is why we do what we do. Perhaps we were made for such a time as this. I’m pretty tired of unprecedented happenings this year, but I would encourage all my nursing peers with this thought. If not us, then who? Who would care for the hurting and dying? Who would scratch backs, offer a cool drink, or sing a joyful song in the middle of a trying situation?

2020 has tried to crush the spirit of nursing, but we’re pretty good at fighting back. Just know, I grieve with you. I recall life stories cut short with you. I link gloved hands, across the world, and I lift you all up in my prayers. We will beat this.

PTSD in Nursing

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Last night my family and I drove to pickup dinner. I had asked my husband if he still felt uncomfortable taking our young daughters into a public restaurant, and he had been quick to say, “yeah, I don’t want to do that.”

The numbers had gone down, but that did little to change the routine we had carried since April. I’m very honest with my spouse about my work, and as such, he suffered from the same problem I did. We knew too much. There was no way in hell we could be blissfully ignorant, and I don’t mean that offensively. I truly wish I could forget this year.

As we pulled up to the restaurant to get our curbside pickup I noticed the large group of people sitting outdoors. The tables weren’t spaced like they had been just a month prior, and people milled about inches from other groups, laughing, smiling, not a mask in sight.

“That doesn’t look like continued social distancing to me,” I said to my spouse, pointing towards the outdoor dining.

The thing was, I didn’t want to be the social distancing police! I didn’t want to see pictures of church gatherings on Facebook and wonder why no one wore a mask. I didn’t want to cringe at friends starting to gather again, throw parties, and enjoy life. I didn’t want to be wary of strangers. I didn’t want to worry about my daughters drifting over to play with some new kids at the pool. I wanted everything the way it used to be, but I couldn’t for the life of me forget the past four months. I just couldn’t.

For nurses and other healthcare professionals who have been in hotspot areas of the COVID-19 pandemic, I think we’ve received injuries that are invisible. We’re nursing wounds no one can see, and the scars we carry are still raised and angry. So while a large part of society has basically forgotten a pandemic was here, nurses are still trying to catch their breath.

I think of a skittish cat, jumping with shackles raised at every tiny sound. I think of someone who has been abused, how they’re always suspicious for when the next hand will be raised to harm them. It wasn’t fear that griped me, but rather an awareness of what the virus could do. For so many people COVID-19 was like a really bad cold, or maybe the flu, but for the hundreds of patients I had seen in an inpatient, critical care setting, it was a death sentence. All that people with no hands-on experience could say about the virus was that its mortality rate wasn’t that high, but you know who I never heard say that? Those of us at the bedside the past four months, sweating profusely in our respirators, while we pumped aggressively on someone’s chest to help their heart restart. The reason you didn’t hear that from us? Because 90% (or more) of those patients did not live. Last I knew, our hospital had tried to save over 200 people, without success. We did everything humanly possible. The virus is that bad. For the families of those two hundred and something lost, statistics for survival rate meant very little. For those of us who had cared for them, it meant even less.

So, here we are with case numbers declining, but I still don’t feel comfortable allowing my children to go to a restaurant or play with other kids in the neighborhood. To me, it’s life and death, and until someone can tell me what makes one person just get a scratchy throat, and the next guy (with similar age and health) be unable to survive, I must remain the way I am. I cannot help it. My poor husband, who has seen my defeat amidst so much death, he cannot help it either. We’re still over here self-isolating, wearing masks in public, and social distancing when we do get out.

Today my husband said, “I hope they’re wrong. I mean, it doesn’t have to get bad again, right?!”

You see, the healthcare field, based on their knowledge and models, has their own predictions for the next few months. Those of us knee-deep in the muck of this novel virus are like the skittish cat I mentioned. We’re waiting for flu season 2020. It will be like the two tropical storms converging, but when COVID couples with flu, it will be a level 5 we fear. I don’t want to listen to projections, but I try to be realistic.

Y’all, I don’t know if it will ever be the same. I don’t know if I will ever be the same. I’m so aware of germ transmission at this point, I’m surprised the skin on my hands isn’t falling off from hand sanitizer and washing them. Today I let my daughters play with two little girls at the public pool. Then I spent the next twenty minutes praying silently for God’s hedge of protection around them, worried I had made the wrong decision. I don’t want to be that mom, but I’m that nurse. I just can’t seem to be any other way.

I’m not alone, y’all. I cannot unsee the frightened look in a patient’s eyes before we stuck a breathing tube down his throat. I cannot forget the fact that although I wanted him to live, he didn’t. I can’t erase the images of the handful of critical care patients who did leave my floor alive, but did so forty pounds lighter, unable to do the things they had done prior to being a COVID survivor, some with holes in their neck to keep breathing. I think back to when I was active duty military after 9/11. At some point, as we continued to receive soldiers from The War on Terror, I grew so very tired of seeing young men (boys, really) with only one limb remaining, or their face mangled. I just wanted the war to end. I think your civilian healthcare workers of 2020 are feeling much the same. We’re tired, we’re anxious, and we’re depressed. We’re overly protective of our families, but we’re also happy to be alive. We’re in need of a break, and even though the case numbers are on the downtrend for now, we don’t really believe the end is even close. We can’t catch a break, and our patients can’t catch their breath. It’s an ugly scene for bedside nursing, and so many of us will never be the same.

When you say your prayers tonight, try and remember your frontline workers. We feel like we’ve been forgotten. And although we’d keep doing what we do even without accolades or good vibes, I personally covet your prayers for my team. This year has been traumatic, and I don’t think it’s something we can ever forget.

A Window Into COVID Critical Care

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My eyes ached. You know that gritty, raw feeling, like you’ve been crying razor blades or something? That’s what it felt like. I made an extra effort to focus on the freeway lines that zoomed by as I drove towards my safe place. Home. That’s where I could forget my day, where I could escape, leaving the sadness and stress sitting in the seat of my car, ready to be picked up again in the morning.

I had told my coworker that afternoon that it felt like 10 pm. My eyes had been hurting then, at what surprisingly was only four o’clock. I had assumed it was because of the tears. Now that I think about it, though, it was probably just the weariness of what I had seen. Not just that day, but every day for months. It was like being witness to a horrible car crash, and being unable to extract the victims. Except the wreck never ended. You relived it every day. I realized my eyes hurt from watching that repeated carnage. I wasn’t sure I’d be able to unsee it.

There is a weight sitting heavy on the heart of healthcare right now. From a critical care point of view, it feels like the dreaded elephant on your chest. It’s this heaviness brought on by unspent grief, coupled with a frantic frustration over the things we cannot change. You see, COVID-19 has brought us something we’re not used to or comfortable with. Defeat. It’s beating us, pretty much every time.

The world, and certainly the United States, has experienced the unparalleled effects of this novel virus. We’ve all experienced the shutdown, the isolation, and the economic loss. What a large percentage of people, outside of the healthcare system, are not seeing is the wicked behavior of this disease. They don’t see the cruel nature by which it attacks, making certain that stories of survival are few and far between for those poor people who happen to fall into respiratory distress under its grip. Y’all, it just won’t let the people go.

Here it is in a nutshell. Because we’ve shut the hospital doors and won’t allow you in. Here is a window into COVID Critical Care.

Death. Over and over. It does not matter what we do, or what we don’t do. It doesn’t matter if we follow every recommendation, give every medicine, and check every single box. Nine times out of ten, if you end up on a ventilator with COVID-19, you are not coming off until your heart stops. That is why my eyes hurt.

You can see your patient turn the corner, start looking better, wean down the oxygen from 100%, finally. You can say to the spouse something you try not to say lately, like, “I’m hopeful. Things are looking better. I’m very optimistic about this.”

You can say those things one week, a few weeks into the particular ordeal, and you can want to believe it in your heart so desperately, but then you can have your hand on that same spouse the following week, praying for comfort while they cry, holding them while they weep in grief because your hope just didn’t pan out. That is why our eyes ache. You cannot unsee some things. Some pain etches itself into your retinas.

Listen, we knew what we were getting into with nursing and medicine. We knew that death and dying occur. We’ve dealt with this our entire careers, some of us for twenty or thirty years. What we were not prepared for was constant death. See, in nursing you win some and you lose some. But you win some! Do you see where I’m going? We’re used to having some good news to throw into the mix, but this pandemic hasn’t been playing by the usual rules. It has its own book, and sadly that manual is still being written. As it stands now, and since this began, the odds are not in our favor. The real Hunger Games are worse than you ever saw on TV.

We are fighting, y’all. We are doing all the things we do so well. There are many times over the years that I’ve been part in successfully reviving and continuing the life of someone who probably should have been allowed to pass on to the hereafter. In those moments I have said, “we are too good at what we do.” Well, this year has upended that statement. This year, we can’t seem to be good enough. We can fight, and we can do all the great things we normally do, but nothing can seem to alter the poor outcomes of critically ill COVID-19 patients. It. Is. Killing. Us. All of us. It is breaking our hearts, but it hasn’t stopped, so we just keep fighting.

You can watch a patient you’ve personally fought for, die every shift, every day, and it’s draining. Sometimes it’s more, sometimes it’s less. I don’t know the numbers, but I know how it feels. It sucks. Where’s some good news?!

I can count the success stories, on one hand, and I’m so very grateful for them. But they’re not enough. The bad is still outweighing the good in intensive care. Even when you do have someone get wheeled out the door, they’re not the same. The effects of this continue, and we don’t even know to what extent yet. I’m not a negative or fearful person, but gosh, that’s scary. The significant and lasting damage to lung tissue is real, and it’s crazy. We won’t even talk about the other physical and emotional tolls.

Our eyes hurt from the things we cannot unsee, from the tears we sometimes cannot stop. Our hearts hurt for the grieving families, for the pain of our patients and their loved ones. Our brains ache from trying to understand the vast variations of presentation and progression of this virus, and our minds are blown by the damage it can do. This virus is cruel, it’s uncertain, and it’s unlike anything we have seen. We have worked beyond what we believed we were capable of doing. We have carried ourselves to physical points we have never experienced before, but also emotional roller coaster rides we never anticipated. So, while the Nation at large is angry to watch football and not be made to wear masks, we’re just over here trying to survive. We’re just over here trying to make our patients survive, even as we know that statistically they will not.

Check On Your Nurse Friends. We Are Not Ok.

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I took a survey from my employer today, and as I went through the questions I was surprised by how easily I could answer one way or another. It was a survey for how the pandemic, COVID-19 was affecting us, and as I clicked each bubble I understood even more just how much things had changed. One question that stood out to me asked if I thought about work more when at home. The fact was I had always been proud of my ability to leave work at work. I am an extremely compassionate person, but after twenty years in healthcare I had learned that to keep my sanity intact, patient care needed to stay at the bedside. It would be there waiting when I returned. But today, as I pondered the question on the survey, I realized that had changed. Everything had changed.

It had really started to hit me, the weight of it all, a few nights ago. I sat in bed the night before work and I prayed. I felt so down, and the fact was I had for weeks. There was nothing wrong going on in my life. I wasn’t financially stressed. My marriage was amazing, my children healthy and adorable. I had absolutely nothing to be upset about, yet I was. The only out of place factor I could pinpoint? COVID-19.

Years ago I had come to a place in my nursing career where I absolutely loved my job. I considered patient care to be a privilege, and even on tough days I considered it a wonderful vocation. It was a calling, and I carried the task with a smile. This past week I noticed an unwelcome feeling coming over me. It was a feeling I hadn’t experienced in many years. It was dread. I was dreading the return to the critical care bedside. How could I dread something I loved so much? I cried out to God to bring back my joy for the field.

When I sat in bed praying to feel better I realized that all this was hitting me harder than I thought. I realized that even though I thought I was doing ok, I really wasn’t. Even though I thought I could handle stress well, I don’t guess I had ever experienced stress like this.

Typically, nursing is about healing. A patient comes in sick, and we make them better. That’s not COVID-19.

And yes, I had experienced lots of death and dying. It was part of the job. So it wasn’t the people dying that got me. It was the fact that most of them seemed to be dying. The ones that were in Critical Care, anyway. The prognosis of these people was horrible, and when you have to break that to a daughter who can’t talk to her mom, or even see her, it’s depressing.

I was used to elderly and debilitated patients dying, but this was different. I was seeing people my age, younger, or just a few years older, and they were not doing well at all.

Nursing had always been a career where I had to be careful with infectious disease. I frequently encountered illnesses I could pick up and take home if I didn’t use proper protection or hygiene, but this was different. It was so new, and I watched the information available change day by day. One minute it’s airborne, the next droplet. One day the CDC says one thing, the next day, something else. The suggested PPE (personal protective equipment) changed faster than I could keep up, and it became this constantly evolving situation. I sadly knew that each time I came to work things would be different than when I left.

Do I need to shower and change clothes at work? Is it in my hair? The questions I had to ask myself. Is a Level 1 mask good enough, or is a Level 3 safer? Wait, now you’re saying it’s aerosolized and I should definitely wear googles? Why didn’t anyone tell me that yesterday?

Am I bringing bad stuff home to my children? They’re so little still. The fact that our government and healthcare system was treating the response to this unlike anything I had ever encountered only added to my thoughts. I mean, your president says everyone needs to stay home. Except you. You need to run into it head on! Unless your patient’s heart stops. Then, don’t run; put on your PPE first. It was going against everything we had ever done as lifesavers!

Everyone was watching us. People whose sole job was to make sure we were protecting ourselves properly. And while I appreciated the effort, it also made you feel pretty odd. I mean, what kind of crazy crap makes hoards of upper management and administration watch your every move? What exactly were we dealing with? The answer to that seemed to change every day!

I never felt so helpless. Everything we tried seemed to be in vain. They typically weren’t getting better. One week this was the go-to drug of choice, the next week something else, and the next week the surprising news that none of it would improve outcomes. In fact, it might make it worse.

It didn’t matter that the mask or respirator hurt my face, left bruises and sores, or that it left me feeling drowsy and cloudy headed after so many hours on straight. It didn’t change the fact that I was paranoid about the seal, worried that the tiny virus could somehow get through.

The stress made me become the type of person I didn’t want to be, short tempered and easily frustrated. The high acuity of the severely critical patients forced me to become the kind of nurse I didn’t want to be, hurried, harried, just struggling to keep them alive, keep my head above the water. My shift would end and I’d be sure I had missed something, which drove me crazy, but at least they had lived through my shift. They would likely die after I left. The prognosis was always poor.

Seeing the fear in their eyes, or hearing the words, “am I going to die,” remembering those words after they were gone. Holding their hand, offering comforting, muffled words, but knowing you were no adequate substitute for their loved ones.

Speaking of loved ones. We had those too, and just this week my nine year old said sadly, “Mom, I don’t want you to go to work. I’m worried you’ll get sick.”

But then I also had loved ones who had no idea. As I was leaving work today it occurred to me that not many of my family members had called to check on me. It wasn’t their fault; they didn’t know. I had not told them the toll this pandemic was having on me, and that’s when I knew I needed to. I see Facebook posts of people who don’t even think the pandemic is real, or that it’s like the flu. They have the privilege of not knowing how hard this is hitting me and my coworkers. I don’t normally try to play a pity party or seek attention, but I realized that a lot of people just didn’t know. They didn’t know that we’re not ok.

I have spoken with my coworkers and peers, and all the ones I have questioned are feeling the same pressing weight as me. They’re tired, worn thin, worried, beyond the typical stress of saving lives on a daily basis. It’s beyond skipping lunch and bathroom breaks to keep someone from dying. That’s just a regular Thursday. This, this is different. This is harder.

I don’t know the answers, and I don’t know if things will ever be the same. I don’t know if there’s anything you can do to make it better for your nursing friends. You can pray. You can send us a message, drop off some toilet paper, or even just a long-distance hug. We need so many hugs right now, and social distancing is messing that all up. The typical outlets aren’t available to decompress, or the ways we deal with stress are not allowed. Nurses have the added weight of homeschooling, when that’s not something they are used to, or a spouse out of work. We’re dealing with all the same stress and aggravation as the rest of the population, but also the additional stress of facing this monster up close and personal.

We can’t pretend it’s not happening or busy ourselves with conspiracy theories. We’re too preoccupied with telling ourselves, “it’s not your fault. You did everything you could do.”

This is all I can write right now. There’s more, so much more, but I am exhausted after a day of the above. I need to lay down so I can wake up and do it again. See, that’s the great thing about nurses. We are not ok, but you’ll still find us when you need us. We’ll be in the clinics, ER’s, and units ready to do all we can do for those who need us. We’ll worry about us later.

How I Fell in Love With Nursing. Again.

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First love is easy, isn’t it? With stars in your eyes and a naive nature, you swing headfirst and heart-strong into the relationship. You have dreams for the future, the butterflies for excitement to spur you forward, and even a bit of healthy hesitancy to keep you honest. But somewhere between that first date (or shift in the case of nursing) and eventual broken expectations, you end up feeling betrayed. It’s nothing like you hoped it could be. You end up disappointed, likely broken-hearted, and sadly, if your experience was especially harsh, guarded and skeptical for any silver lining that might exist up ahead. Sound familiar?

A profession you can truly love isn’t that different from a romantic relationship. It’s something that gives your life a new purpose, a reason to hope, excitement, and the ability to get better at it as you go along. It’s the chance to think of someone other than yourself, but like any relationship, the one with your career can become strained. I’ve been in the medical field for 20 years now, and I think I’ve experienced every stage of the process. I mean, if Nursing was Dante’s Inferno, I probably transversed through every circle. Y’all, I fell out of love with it, and it took purposeful determination to make my way back into my partner’s good graces. At one point, I think I hated it. Just being brutally honest here.

That first year was something, am I right? Fear, panic, but somehow an exciting adrenaline rush, a pride that I’ve discovered you can’t let slip away. I was proud to be a nurse. I was proud of my vocation, and I was proud of the hard work it took to get me there. I was proud of that R, and of that N, and for a while no one could take that from me. But then came the bad apples. Damn, if they don’t ruin the barrel.

Somewhere between holding an elderly woman’s hand and double charting for the billionth time, my heart started to harden. Do you know the difference between a good nurse and a great nurse? I was always a good nurse. I took care of my patients, and I got the job done. I was honest (for the most part), and I did no harm (that I’m aware of). I smiled at my patients’ faces, and I even meant about 80% of what I said. This will sound so harsh to the layman, but my fellow nurses will understand. It’s not easy giving all of yourself with little to nothing in return. I mean, yeah, you get the paycheck, but that even seems paltry in the face of preventing death or giving up Christmas with your family. So, it becomes a job. A thing you do, day in and day out. I can even recall telling my husband I felt stuck. Lord, help me, I did. I could think of no other “job” where I could work 24 hours, yet get paid for forty hours, while maintaining the best benefits offered in our little city.

I ask again, do you know the difference between a good nurse and a great nurse? A good nurse gets the job done, but a great nurse loves the job they get to do. I guess I had to move from one to get to the other.

All I know is, I entered the field like a young, star-crossed lover, but about a decade into it, I wanted to breakup. I had become disillusioned, and it wasn’t what I thought it could be. Maybe I entered the career thinking I could make so many differences, but I wasn’t open to what could change in me. I became a woman focused on the obstacles before me, and blinded to any blessings scattered throughout. I wasn’t heartless, mind you; I still felt contentment when a patient told me how much my care had meant to them. But those Hallmark moments couldn’t outweigh the injustices I felt. I focused on every single hardship in my field, and I took personally each offense. I allowed the Negative Nancy’s to feed the fire of bitterness inside me, and I assumed every demanding patient canceled out the kind ones. There’s certainly that need for self-care, but I think I came to a place where it was almost always about me.

“Why is this so hard,” I asked, never contemplating for very long how it must be on the other side of the bed.

“What do they expect of me,” I would question angrily, without asking myself what I might give.

I saw my field only as a difficult endeavor, and seldom as a privilege. I carried the weight of a thousand martyrs, except I had forgotten the cause for which I gave myself. I was a good nurse, who did my job, but not a great nurse who loved the opportunity to do it. And I suppose that’s many of us. It’s not that we don’t enjoy what we do; it’s just that sometimes we hate it just as much. That sounds so terrible, when I type it out like that, but if you’ve never held a position where you don’t cry while cleaning the dead body of someone you just hugged that morning, then you may not understand. If you haven’t been punched, kicked, or called the worst of all swear words by someone you’re trying to help, then you won’t get it. If you haven’t cringed over calling someone in a position above you, knowing they will scream at you merely for doing your job, then this may seem like harsh words. If you haven’t felt the anxiety of trying to do the work of two people, while not making a mistake that could cost someone else’s life and your career, then you just won’t have a clue. It’s not easy to carry the weight of so much on tired shoulders, and for many who do, they end up angry and perhaps even resentful for a profession they once loved so much.

Back to the relationship bit, it’s as if the marriage is falling apart, and you don’t want a divorce, but you can’t look at his socks balled up on the floor another day or you might snap. I guess sometimes, when you realize you don’t love them like you used to, you have to take it back to the beginning. You have to remember the first time you saw them, that first date, or first, tender kiss. The spark is still there. You just gotta know how to stoke it.

I recall sitting in a computer class taking a critical care course, and I was digging it. Us Critical Care folks, we love all that medical stuff! Sitting there, I knew I loved the knowledge. I loved the dynamics. I loved the process. I loved the people. I loved making a difference in people’s lives. I loved nursing. I did. It was time to act like it.

Back when my husband and I were just dating, I remember we had been off again, on again, at one point. I had found out some stuff, and each of us had been idiots. We loved each other, we knew that, but we were kinda just coasting along, existing as a couple. Like, maybe involved, but not committed entirely to the future of it. Well, anyway, I remember standing in the card aisle on Valentine’s and I had found the perfect, mushy card for him, when suddenly God smacked me upside the head.

It was like, God said, “Brie, if you’re going to give that to him, you need to mean it.”

And I was like, dang, you’re right. I love him. I really do. We can work through this.

And we did. Every day since our relationship got better, and even now, each day is better than the last. I guess, I had to come to a place in my nursing career that was similar. I loved it, but I had to start acting like it. I had to do more than just show up. I had to get invested. I couldn’t focus on my husband’s faults, any more than I could deny my own. And I couldn’t selfishly fixate on what nursing took out of me. I had to start giving of myself more. I had to see through clear eyes. If you focus on a stain, that’s all you see. What you should look at is the fact that the fabric is still good. It can be washed. Nursing was still good. I think my vision of it had just become tainted.

My career truly began to change when I focused on the opportunity to provide care, the privilege of meeting people at their darkest hour, and leading them back into the light. I threw off sympathy and instead embraced empathy. I put myself in my patient’s shoes. Heck, even the administrators’ shoes. I saw my occupation as the ministry it was, my chance to care for the hurting, and to help those in need. I didn’t face the relationship with what I could gain, but what I could give. I didn’t focus on what wrong was being done to me, but rather what good I could sow into it. Y’all, I fell in love all over again, and it wasn’t because the object of my affection was perfect, but because it gave me purpose, passion, and a sense of fulfillment. Was it still hard, at times? Yes! But beyond that it was good. In fact, it was great. And then I realized, I was great too.

How to Find Peace in Patient Care

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Not long ago I encountered a new nurse with multiple questions, and while I adored the fact she sought answers to the things she did not know, I also sensed a self doubt within her. I totally got it. I saw myself in her wide, startled eyes, and even fifteen years later I could easily recall the hesitancy prevalent in being a new nurse. I remembered well the fear, worry, and realistic concern that I might do something wrong. I mean, it’s true. Hastily made mistakes could kill people. But I also could remember the irrational fear I had held, the anxiety that I would mess up even the things I knew how to do. For years that irrational worry had made nursing far more difficult than it needed to be for me. And though a whopping, healthy dose of attention to detail and awareness could save your license, as well as a person’s life, one step over the line into performance anxiety and bedside-care doubt could tire you quickly. No one could survive the burnout of that particular feeling. I saw that fear in this new nurse’s eyes.

As a newer nurse you have a choice to learn from your mistakes and press on, or you can crumble under defeat. You have the choice to build on your knowledge and gain much-needed confidence. I’ve seen the other side of the spectrum, mind you, as I’m sure most of us have. It’s that overly confident, cocky new grad who thinks they know everything. They don’t ask questions, and it’s usually the patient who suffers. They teach their incorrect knowledge to the new hires that follow, and safe technique goes out the window. So, I’m all for the pursuit of knowledge, asking questions, and taking an extra pair of eyes along. Heck, after twenty years in healthcare I still ask questions and seek new answers daily. That’s not what I’m talking about. I’m talking about doubting the knowledge you do have or anxiety over skills you hold under your belt.

This problem of bedside anxiety won’t go for everyone, and if it doesn’t pertain to you then I say, that’s awesome. Truly. Because it sucks. I think it’s the introverted, overthinkers who encounter this problem the most, and it will surefire make you resent your career. I used to be that nervous nurse, but no longer. I found my peace in patient care.

So, here’s what I said to this new nurse when she spoke anxiously about the continued stress of making a mistake in nursing.

You have no control over out of control things.

And that’s the truth of it, my friends. I used to be one of those people who desired control over all the things! I think most critical care nurses have that desire within them. I wanted everything just so-so, my ducks in a row, and my plans laid out. Basically, I desired a Mary Poppins kinda day, everything practically perfect, and anyone who’s nursed for like five minutes knows that ain’t happening. But it wasn’t just that. I also put too much pressure on the control I had over a patient’s outcome. And, yeah, while my performance could positively or negatively affect my patient, my ability to do well couldn’t stop someone from checking out to the great beyond. Somewhere around my tenth code, where the patient didn’t make it, I realized this.

I don’t care if you knock out your compressions like an ACLS guru, if a patient’s heart is tired of pumping, they will probably die.

I don’t care if you give every medicine correctly, checking allergy lists and the five rights, if a patient is too far gone to respond to the treatment ordered, it won’t matter.

It doesn’t matter if you give the best Diabetic education and insulin administration teaching on the planet. If a patient wants to chug Mountain Dew like it’s the air they breathe, they’ll be back next month in DKA.

It doesn’t matter if you provide the most encouraging and uplifting advice to the addict, you may find out they’re dead next week. I’ve had this happen.

It doesn’t matter if you provide the best care in the whole hospital, certain families will still complain.

I don’t care if you do everything right, catch every mistake before it happens, and think three steps ahead for your patient’s best outcome. If it’s their time, then it’s their time.

It’s not you. It’s not me. You can’t control an uncontrollable situation.

For me, I had to realize that I can only do what I can only do. I can’t get everything done. I won’t check all the boxes administration wants me to check. I can’t place myself in two rooms at once, no matter how much my charge nurse may wish it was so. I can’t control what a patient’s family does when I leave the room, and I can’t change what a person does when they wheel off my unit. I can’t save everyone. Sometimes because they don’t want saving, but most of the time it’s because healthcare is bigger than me. Life and death is bigger than me. Destiny, God’s will, or whatever you personally call it, is bigger than us all. We can only do what we can only do.

We come in and do the best we can. We work with what we’re given, which often times is less than we need. We do the absolute best we can, and to quote my favorite work-husband of all time (love you, Terry), we try and “leave em better than we found em.” But then we just gotta let go; let go of this idea that we hold life and death in our hands. I mean, yeah, how I titrate those three vasopressor drips can mean the difference between life and death for my patient! And giving the correct med or wrong one will have good versus bad outcomes. It’s my keen eye that catches a potential problem before it becomes a real problem, and that makes me feel very good. Yet I can’t keep bad from happening if it’s gonna happen. I can do my best, but that’s all I can do.

In nursing we hold much responsibility. As we’ve seen in the news, our mistakes can be costly, to more than just ourselves. That’s why we keep learning, keep asking questions, and keep trying hard. What we don’t do is fear. Fear, worry, and anxiety have no place at the bedside. Fear and anxiety will tell you that something bad might happen. Realistic thought will tell you that something bad will happen. Maybe not today or tomorrow, but one day it will. You can do everything flawlessly and it still will. You have to let go and just do what you know to do, realize that you’ll make mistakes, but you’ll learn from them. Sixteen years ago I failed a clinical exam because I didn’t give my patient up in the chair his call light before I left the room. Do you think I’ve ever forgotten to give a patient their call light since? I haven’t.

You’ll mess up, miss something, and forget plenty. Personally, each day before I work I pray in the shower. I ask God to “help me hear His voice and do no harm.” It has worked well for me thus far, but I also know I had trouble hearing that small, steady voice in my heart until I let go of the fear that I wouldn’t. I had to become confident in where God had placed me as a career, and each day I go to whatever floor and whatever assignment with that same peace. I’m going where I need to be, with the patients I need to have.

I can’t control everything that happens at the bedside, but I can control my own thoughts. After all, it’s my thoughts that drive me.

What’s a Bad Day in Nursing Like?

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I walked quickly along the crosswalk, the little, illuminated, man-figure on the street sign guiding my way. My hands in my pocket, head slightly down against the smattering of cold rain, and body and mind weary from a long day at work, I made the short walk to the parking lot where I could make the much anticipated journey home. It had been a bad day.

When suddenly, out of nowhere, a car jaunted through the dark, directly at my person. Startled and shocked I froze, much like a deer in headlights, stuck to the pavement I stood awaiting my impending death. I stared in terror at the driver who had turned quickly into my path across the street, and I saw them staring back just as surprised.

I kept walking.

My heart hammered. They almost killed me! I thought.

A moment later, that is the perfect representation of my day.

It almost killed me.

As I got into my truck and drove home I felt certain I would cry. I mean, all day I had wanted to. Many moments throughout the horrendous day I had desired to duck into a supply closet and release a torrent of tears. For surely that would let loose the stress that mounted within me.

On a bad day in Nursing you may want to cry, but you don’t. I think it’s because you’re afraid you won’t be able to stop.

Yes, I had felt certain I would cry on my way home, but once alone and away from my bad day I realized I could not. There was nothing left. I felt so spent, so dry, so expended, that not even a single tear could fall. I wanted to cry. I felt like I needed to cry. Surely it would make me feel better!

But there was nothing left. I had used it all.

A bad day in Nursing can be like that.

You give all you have, you hit a wall. You think to yourself, I can do no more, I can go no further!

But then you do. Why? Because you haven’t a choice. Your patients need you.

As I drove home I thought about my day. I wondered how I could have done things better. I wondered if I had given my patients the best of me that they deserved. My guilt over human limitation weighed on me, and I knew I had to push it off.

“Lord,” I prayed, “help me to let it go, to leave work at work.”

A bad day in Nursing can follow you home. Your family can suffer, your marriage take the brunt. My children already had to deal with a tired mother after twelve hours bedside, a mother who wished to cuddle and hold her children, but often was so exhausted from a day of caring for others, had little left but to sit on the sofa like a stump. I couldn’t take home thoughts of work stress too. They didn’t deserve that.

So I tried to leave the bad day behind me. I imagined it floating from my body and being left in the air behind my vehicle as I sped away, turning up the radio and smiling at the Tracy Chapman song, my bad day like dust that I shook off, exhaust from my tailpipe.

I still thought of it a little. It was as if I had to slowly let go and let it drip away, rather than the dramatic leave behind scenario I imagined.

A bad day in Nursing can’t really be quantified. You can try and say, “well, this wasn’t the worst day I’ve ever had.”

The worst day was when that baby died.

Or, it wasn’t as bad as the day I had chest pain. That day I fought for twelve hours straight to keep that man alive. Something about the stress of knowing your actions mean the difference between life and death for someone you don’t even know personally.

A bad day in Nursing isn’t something that can be walked away from. You can’t just go take a break. Sometimes a coworker can help, but usually they are just as busy as you. So you hold your urine. You count on invisible fingers that it’s been 19 hours since you last had something to eat. You try and figure out how you can make the anxious patient calm, the angry family member happy, or the condescending physician a decent human being. You hold one portable phone to your ear while the unit secretary announces another call for you on hold.

Just a minute.

Be right there.

I’ll take care of it.

A bad day in Nursing isn’t something you can check out of mentally. When you’re fed up, finished with the day (emotionally, that is), and certain your nerves can take no more, you still keep going. You can’t decide to do it halfway or to give less of yourself. You can’t go somewhere else in your head or give a mediocre, halfhearted performance of your duties. When life is on the line you always have to be vigilant and present, 100%, no matter if you feel you have nothing left to give.

That. Is. Nursing.

It is giving your all, even when you think you can’t. It’s hitting a wall, and then walking around it. It’s reaching the end of your rope, then miraculously finding there’s more. It’s being empty, yet still pouring out your tank. It’s running, even though you feel as if your legs have been cut off. It’s reaching the end of yourself, and then starting again. Sometimes it’s a time clock perseverance, where you ache for the end of your shift, because only then will it be over. The bad day, that is.

After a bad day I always question myself for a moment.

Did I do the best I could do?

How could I have done better?

And of course…

Can I keep doing this?

This morning I saw a friend on Facebook. It was someone the field of Nursing had brought me. It was someone who had happened upon my hospital bed (if you believe things just happen), and it was someone whose life had changed. They had told me it changed because of the things I had said. This person had come to my ICU bed as an overdose, another one in a string of so many before. Broken in so many ways. Some people saw a pointless case, repeat offender, hopeless addict. I saw a hurting heart in need of love. For some reason my kind words, encouragement, and love showed this person that they were capable of change and worthy of a better life. Just an ordinary day at work, nothing spectacular, yet a life had been saved and changed. This friend was still clean six years later. An event that almost ended in death had instead turned into a new life. And I had something to do with that.

That thought (the one that what I did mattered) brought me peace and joy. I was reminded that while there will be bad days, there are also good days, and what I do has an impact. I am where I need to be, with purpose, and I can meet each day with the expectation of doing something wonderful. Sure, some days will be hard ones, ones where I feel like I barely got by, or that I did horribly, but then they won’t be.

Bad days in Nursing are like nothing else you know, but the good days can have a positive impact you never imagined possible.