Brie Gowen

Savor the Essence of Life

If These Walls Could Talk

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I heard weeping. It was soft at first, as if trying to be kept at bay, but it suddenly grew in volume and intensity. It wasn’t the tears of a simple disappointment, like ruining your favorite pair of jeans with a bleach incident. No. It was guttural. It was the sound of pent-up grief spilling over.

It wasn’t an uncommon sound. Not in the ICU. Not for an ICU nurse of twenty years. Yet, despite the familiarity for myself, I still felt my eyes sting. Her cries. Oh my goodness, the pain underneath each whimper; it made my own heart break.

I knew what was transpiring. Even though I currently sat at my patient’s bedside, as I had for days, the poor woman too sick to be left without watchful eyes for more than a few minutes, I had been next door. One room over, but hundreds of miles apart in terms of prognosis. My lady was improving, slowly, but as I always say, slow and steady wins the race. Not so next door.

Fifteen minutes prior I had heard someone call out, “you got some atropine in there?”

I walked one ICU room over, perusing the bedside monitor as I entered. It was serious. Nothing on the screen was compatible with life. I began increasing the IV medications dripping into the patient’s veins, hoping to stave off the impending doom. All in vain, the EKG line went flat. The nurse at the bedside began compressing his sternum to keep the blood flowing, and I ripped open the crash cart to draw open the medications to try and bring him back to us.

In a flash the room filled with warriors, wearing scrubs and flying into action. One round, two rounds, three rounds.

“No pulse. Asystole. Resume compressions.”

With an entire room full of helpers, I had excused myself from the bedside. They had enough hands. Some nurses thrive on the adrenaline of a code blue, but I had seen so many through the years, far too many to count, that I was fine to sit this one out and allow the other professionals to drive.

They got him back, and I’d like to say it stayed that way, but it did not. His heart stopped again. The family stood in a huddle outside the room, holding each other. One young woman was in the floor, her grief too heavy for her legs to hold, and that was the source of the painful wails. A chaplain brought a chair. Someone else grabbed some tissues and water. These were the things we could do. We couldn’t save the loved one in the bed, anymore than we could take away the pain that released itself in heart-wrenching tears.

When I first heard the crying in the hall, after nearly weeping empathetically myself, it occurred to me how often these halls held the tears of grieving family. They cradled the disappointed spouse after hearing bad news. They steadied the angry son who couldn’t believe there was nothing more that could be done. Many times, thank God, these halls even expanded with the joyful laughter of miraculous recovery. If only these walls could talk!

They’d be shouting emergent orders from a physician, “get the RSI kit now!”

Or the muttering of an exhausted nurse, on the fourth day of a string of twelve hour shifts, “just an hour to go.”

There would definitely be a lot of questions.

“How did this happen?”

What do we do now?

What would momma have wanted?

And plenty of expressions of surprise, coupled with confusion and disbelief.

“But he was doing better. He just asked about the dog.”

“She’s only 28 years old! Parents aren’t supposed to outlive their children!”

“I never knew he was so depressed!”

There would be expressions of hope.

“Dad is a fighter. He’s gonna make it.”

And expressions of love through surrender.

“Mom wouldn’t want to live like this.”

There is so much these halls could say, if only they could utter words, but they’ve kept the secrets whispered within their walls under tight lip. I sometimes wonder, on days like today, if the walls stay silent simply because they don’t have words. Some of the deepest pain of loss is spoken through silent tears, agonizing cries, and even resigned sighs from the warriors who lost the last battle. Maybe the walls don’t talk because even mere words would be too difficult to express the emotions that course through its halls. Perhaps silence, a listening ear, and a space to lean on is the best these walls can do.

The Scars That Don’t Fade

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Three years ago. Wow. Looking at the black and white photo of my face, I feel… empty. Sometimes emotions are like that. It’s not a void of emotions, but rather an onslaught. Too many to comb through and pick just one.

This week the hospital I’m at put out a policy stating we didn’t have to wear masks anymore. After three years of wearing them constantly! After a shift without one, I felt so strange. Every time I rose from my computer I felt naked. I felt as if I was doing something wrong. I felt afraid, even. Like, shouldn’t I wear it anyway?! I saw other nurses with their masks still on the full, twelve hours. My comrades who remembered.

I cannot explain the emotions to you if you weren’t there, but I’ll try. It’s trauma in its purest form. I told my therapist that it reminded me of the pain I had seeing armless, legless, faceless Marines come into my care as a Navy Corpsman. It wasn’t war three years ago, like it had been in Iraq, but in a way it was. It felt that way. So many of my friends, family, and acquaintances couldn’t wait for masks to be a memory, but for the beside, ICU nurses, they were more than paper. They were more than a mandate. They were life. And that sounds silly saying it out loud, yet we clung to what we hoped would protect us.

In the beginning of the pandemic, we saw far too many people die. At the beginning, it seemed like they all died. My ICU at the time kept track of the deaths, and in nine months I saw 263 slip away. It did not matter what we did to try and make them stay.

263 doesn’t seem like a lot of people if you’re looking at national averages or through a political lens, but to those who wore respirators, goggles, gowns, and gloves, it’s too many. Each patient had a name, they were loved, and they were missed. They weren’t allowed to stay on an earth where people would become angry at a medical community trying to help. If they were, would they have stood up for men and women like me who only wanted the lucky folks outside of the trenches to believe us when we said it was bad?! I think so.

I think the immigrant, with frightened eyes, rapid breathing, and no understanding of the English language would have managed, to translate, “they saved me!” But he can’t, because we didn’t. He was my first, personal death to Covid-19.

So many would follow. The guy who through struggling gasps would tell his wife via phone, “I’ll talk to you soon,” had been the end of me. I had made eye contact with a fellow nurse, through perspiration and plastic shielding, eye contact that agreed sadly on a mental level, “no, sir, you won’t.” And he didn’t. I couldn’t take it as personal anymore after that. I just went on auto. We all did. Doing all the things, that meant nothing to combat that virus, and meant even less to communities who said we were stretching and fabricating the numbers.

It hurts too much to say much more. By the time other strains were rapidly killing middle-aged people like myself, I had completed insulated myself from a world that rolled its eyes at me. Yet, I still tried to help. I can remember trying to convince the man, three years my junior, why he needed to prone to get his oxygen levels up, while he groaned in broken, struggling exhalations that Covid wasn’t real.

I’m glad things are better now (in terms of virology), and we can finally have the option to drop the masks that protected us. But in someways, some things are worse. The pandemic didn’t just kill fathers, sons, mothers, daughters, and friends; it killed the community of togetherness that had helped so much in my previous, frontline battles after 9/11. Where did those people go? The ones who said, together we are better, and we can stand against this. It was replaced by factions. Factions made up of those who three years later are hesitant to drop a mask because of the things they saw, and those who never would wear them anyway, because they didn’t see the things I can’t forget.

The scars on my nose and cheeks faded, but the other wounds, they’re incredibly harder to dull away.

Nurses, Why Are You Surprised?!

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Nurses, why are you surprised?!

When a community treats its nurses like it treats its fast food workers, this is what happens. I mean, they don’t wanna flip the burgers, but they’ll be first to complain and ridicule the people who won’t. They desire someone else to take the orders with a smile, work the holidays and weekends, yet stay silent about the wage that isn’t appropriate to the task. You won’t catch a senator running the burger joint drive-thru anymore than you’ll spot them cleaning someone’s granny’s butt, yet they will make the decisions about how it should be done, or how it should be compensated. So, why are you surprised?

Healthcare has become a business of customer service, with profits based on satisfaction scores, but the difference in us and say, a department store, is we also are distracted by the tiny hindrance of keeping people alive while we smile, in between the deliveries of turkey sandwiches and warm blankets. No other career will you be expected to cater to the public’s fancy in such a palate-pleasing manner while also being held legally liable for a simple, human mistake that could end in catastrophic harm. In other words, make sure the customer is always right, but also make sure that you are. In healthcare you can lose your job for customer dissatisfaction, but you can also lose your home and livelihood if your math calculations aren’t up to par. Maybe that’s why we’re surprised. Hmmm.

Twenty years I spent at the critical care bedside, giving my everything to my patients. And while I experienced seasons of burnout, I never stopped loving it. I love it still. But I couldn’t do it anymore. In November I took a 50% pay cut (as in my hourly pay was cut in half), for the same amount of fulltime hours, but in an environment that was less stressful than direct patient care. So, what led me there after 20 years?!

I tried to be nice and say it was things like an aging back, and while it’s true that 20 years of turning obese men to clean their bottom has destroyed my spine, that wasn’t the main reason I had to step away. It’s not the main reason we see a shortage in healthcare across the board. Heck, we never minding wiping pee and poop off people who didn’t appreciate us for it. It was the fact that you, the politicians, the administrators, the voting public at large, don’t appreciate what we sacrifice for our communities. Y’all, that hurts.

The past two years were like a knife in my back from a longtime friend. I saw the public as a whole, who had no problem before messaging me late at night for advice about their sick kid, suddenly decide I had no idea what I was talking about. They trusted me to take care of their father after open heart surgery, but they rolled their eyes at my opinions on a pandemic.

We said, “we’re drowning!”

They replied, “the numbers are a lie!”

We begged them to wear a mask, stay home, or even, God forbid, consider a scientifically proven vaccine.

They laughed. They shared memes making fun of the science they had trusted us to treat them with for decades, and they even used our own faith against us. That probably hurt the most. As a woman of faith, personally, who loves Jesus and people, I couldn’t understand how my service to others in love suddenly meant so little. Ok, I’ll admit it; I was surprised.

Those like myself, working in the ICU, under horrible conditions, to work tirelessly and fruitlessly, combating a virus we couldn’t defeat, were forgotten.

I remember reaching out to family and friends afar, expressing the pain of what I was witnessing, and it was met with monotone, false sympathies.

“Oh, I didn’t realize it was that bad. I’m so sorry.”

“Meanwhile, let’s remember what’s really important here. This is all a hoax to take away our freedoms and religion.”

So, while we hurt, they swept our lamentations under a rug, shining the spotlight instead on political platforms.

In the midst of our distress, many frontline workers fell away, and to boost the bodies required to fight a pandemic, they increased our compensation. Finally! I always hated it took half a million people dying to prove we’re worthwhile.

But now the dust somewhat settles. Remote workers return to the office, mask mandates are removed, school is somewhat normal operating procedure, and Johnny Q. Public (or politician or administrator) remembers what they’re paying the exhausted frontline, while conveniently forgetting what brought us to this point. Why are we surprised?!

Why are we surprised that the people who complain about the wait at the drive-thru, while thoroughly refusing to work at the drive-thru for minimum wage, are the same people complaining about the wait at their local ER?! They’re not gonna wait tables for pennies anymore than they’ll hold life and death in their hands for what you make as a loan officer or insurance underwriter (who make about the same as a nurse with 15-20 years experience)! In other words, they want to ridicule the fast food workers and waitresses who refuse to serve them for a wage you can’t even pay your increasing rent and grocery bill with, calling them lazy and entitled. In the same vein, they want to call us money-hungry, accuse us of taking advantage of a national staffing shortage, when all we want is to finally be recognized for the pain we’ve endured.

While most everyone stayed home in pj’s, we went to work. When people feared an unknown virus, we faced it head on. When you wanted our advice, you took it, but when it contradicted your politics, you shamed us. When there are not enough servers at your favorite restaurant, you end up having to wait a long time. Inconvenience. When there are not enough servants at the hospital bedside, your lifesaving healthcare is delayed. Death. Death that we will be held liable for. And you are surprised we don’t want a cap on our salary?!

Don’t take something we love and guilt us into killing ourselves physically and mentally for a salary that won’t even begin to dig us out of the legal bills we are crushed under after staffing shortages hasten us to make a mistake. Just don’t.

I couldn’t do it anymore. I had to leave the hospital bedside, the critical care nursing I still love. Even a wage that blessed my family so much, wasn’t enough to compensate me in such an exhausting environment. The thing is, there are a lot of nurses like me, mentally and physically done after these past few years, no matter the compensation.

How do you think it will go if they cutback the pay for those who remain?!

Will any of us be surprised when there are no bedside nurses left?

Chew on that.

A Nurse’s Take on the Covid Vaccine

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I wasn’t going to do this, but then someone messaged me how much they respected my opinion. I realized that I have to speak my heart. Even if it makes people angry. So, here goes.

You go to the doctor for a well-visit. When your doctor suggests you need a medicine for your blood pressure, even though you feel fine, you take the prescription. Your doctor tells you high blood pressure puts you at risk for a heart attack. So, you follow her/his advice, and you fill the prescription.

Do you search the ingredients of the pill? Do you tell your doctor “no way, I don’t know what’s in that pill!

No. You trust your physician. The professional. You take the blood pressure medicine per your doctor’s advice and knowledge, backed by research, that hypertension can lead to heart attack or stroke.

When you have chest pain, you go to the emergency room. You let them do whatever they need to do to save your life. You trust the doctors, nurses, and yes, the creators of medications to save you.

Let’s say you’re a Christian. Do you not go to the ER when you have chest pain? Or do you not take the advice of your doctor to start a BP med? Do you say, “God will protect me from heart attack and stroke. I’m not falling for this false narrative.”

No. You trust your doctor. You trust the hospital. You trust medicine. No one questions your faith in Jesus when you get an emergency appendectomy instead of asking for a healing at the altar.

What changed in 2020?

Social media. False information. The perfect storm created by a huge, scary pandemic. When people are afraid, feel out of control of protecting themselves and their families, and are under pressure emotionally and financially, they become open to whatever will help them regain balance or control. If we can blame someone else, make something less frightening, and divert attention from the thing that actually frightens us, to something else, we jump on it. For example, Covid isn’t bad; The Left is bad. Ok, Covid is real, but it’s really a problem with immigration. Masks aren’t preventing the spread (even though operating room staff have used them for many years to prevent the spread of germs), it’s just a way for rights to be taken away.

Instead of focusing on the sanctity of ALL human life, we focus on statistics that fit our opinion.

Let’s say, Covid 19 is only fatal .1% of the time (a number I just made up, because youtubers do it all the time). Now let’s look at a real statistic… you have a 0.0002% chance of getting struck by lightning. Are you going to swim in a thunderstorm? Or go stand on the golf course with your club raised high during lightning? Why not?! The chances are really slim you’ll get struck!

It’s because you’re not an idiot. You do what you need to do to avoid getting struck by lightning.

You go to your annual well visit with your primary care doctor, and even get your prostate checked.

You get your child vaccinated against polio.

You wear seatbelts even though you’re a really great driver.

If you’re a Christian you have faith in God to save you, but you also understand you don’t walk out in front of oncoming traffic. That would be dumb to put Him to the test like that. You might just find yourself waking up to Jesus smiling and saying, “wow, Bill, I really can’t believe you did that. Didn’t you appreciate the vessel I gave you for my purposes on earth?”

And I can’t help but wonder if right now Jesus is asking some of us, “don’t you appreciate the vessel of your neighbor?”

That’s all I got for now, guys. I’m exhausted. I’m tired of working my buns off in the critical care unit to save people who my experience thus far with Covid shows me, won’t get better! 😭 It’s devastating. I’m tired of seeing more and more prayer requests come across my newsfeed for healing from Covid. It’s not that I’m against healing or praying. It’s that I hate this is still a thing! I truly believe better vaccination rates would have made this not the issue Delta is right now. There, I said it.

We trust science thus far, until this, and I just can’t wrap my head around it! I love Jesus more than anything, but I believe His Father created humans with the knowledge to create medicine and save lives. When we live longer, we can reach more people with His love and truth. Believing in medicine isn’t saying you lack faith; it’s actually a belief in the wisdom and knowledge that God has given mankind. Thank you, Lord. That’s why I’m a nurse. Life and death is in His hands, but sometimes He uses me to keep life going. What a gift!

So, I pray you will take my advice. I am consistently praying in the Spirit, and listening for His truth. There is not one, single day that goes by that I don’t seek His will and listen for His heart. I took the vaccine without a moment’s hesitation. In fact, I cried happy tears when I got it. Thank you, Lord, for giving scientist the knowledge to help us fight this virus!

Do with this information what you will. Not sure I’ll say much else about it. I’m just too tired. Lies are so much easier to believe than truth.

Sincerely,

The Exhausted ICU RN

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.

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.

The Side Effects Nurses Are Having From COVID-19

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I fell asleep the other night feeling so beaten down and defeated. I had tried to scroll mindlessly through my Facebook newsfeed before bed as I used to do to decompress after a long, thirteen hour shift at the critical care bedside, but it had only succeeded in making me more upset. I wasn’t even mad about the ridiculous post I had seen shared by a friend claiming coronavirus was a “Democratic hoax.” It would have made me mad back in April, when I knew this thing I fought was really real, but at this point, as numbers climbed even faster than I had imagined they would, I was just tired. I had erased the very true comments I had written on the aforementioned post, and I had fallen asleep knowing that was just one more thing I had no control over.

I had zero control over the public’s perception of this virus, and even though I had intimate details of what Covid was really like, it didn’t matter. I could change opinions about this about as much as I could about mushrooms being gross. The fact was a lot of people really liked mushrooms, and I had zero chance of making any of those folks agree with me that they were slippery and weird. Touché. I guess what ground my gears was having an appetite for fungi was a matter of preference, but in my book COVID-19 was as sure as the button nose on my masked face. For me, standing in the muck of this mess, it was not debatable.

And so I drifted asleep feeling bummed that public perception was just one more thing I couldn’t control. This concern toppled over the crown of a hundred other uncontrollable factors I held as a nurse during a pandemic. My healthcare peers and I faced a novel virus, new to us all, and we swam through the treacherous waters together. Initially, much fanfare and support had followed the medical community as we stood bravely against this foe. But now? Not so much. Nurses were no longer the darlings of the working world. We were lumped in with all the other exaggerators, seemingly wringing our hands for a bug that experts on social media described as “basically the flu.” I mean, you can’t applaud someone who combats a fake virus.

The thing was/is, I didn’t need applause. But I did desire someone to take our words for it. Instead it seemed a large part of public opinion favored the advice of YouTubers or folks with one-lettered names like ‘Q.’ I couldn’t tell if people were so scared they convinced themselves it was fake, so distracted by the conspiracy theories that they truly believed it was all a political ploy, or so dense that they didn’t care. After all, I had even seen some people in nonclinical healthcare suggest we all go out and catch it.

Just the day prior I had heard such an idea of herd immunity, and while I understood the general premise and points, I could only reply, “I still can’t figure out what makes you the type of person who this affects like a mild case of the flu versus the people whose lungs are attacked and die. Until they figure that out, I don’t want to roll the dice with my family.”

See, that’s the burden bedside nursing carries. The physicians, respiratory therapists, and nurse aids in the trenches too. We all see what it can and does do to a person. Young, old, healthy, sick. Doesn’t matter. It will kill anybody it so desires. We wish we could end this crap already too, but we’re too personally involved with corona to play roulette.

I see people protesting being required to wear a mask in public places. Meanwhile, I’m triple checking the seal on my respirator to make sure I don’t take this virus home to my family. I see people griping about wearing it for a thirty minute shopping trip. Meanwhile I fall asleep with my nose still feeling numb from the pressure of a mask for thirteen hours straight.

The next morning when I arrived at work, all prayed up, and mostly rested up, almost immediately someone asked me what was wrong. You see, I’m the singing nurse, the smiling nurse, the uplifting one who always lightens dark moods. So when I’m not exuding those things, it’s noticeable. After a second person asked, I realized I was suffering from the side effects of a pandemic. No, I wasn’t sick with a virus, but I was sick with the emotional, physical, and mental toil of the virus. You can only exist in so much uncertainty, sickness, and sadness before you succumb.

I thought of the patient who breathlessly called family to say quickly, “well, they’re putting me to sleep for a while. Talk to you soon.”

The memory left my heart hurting, and I recalled how at the time my eyes had met those of a coworker, both of us hoping that was true, but knowing that statistically and according to gut feeling, the patient likely would not wake up again. And that’s the biggest battle we face. That was what kept us awake at night. That’s what might create future PTSD for many, and it’s what made my spirit feel so heavy since this had begun. The rising case numbers, incidents, and COVID admissions only worsened an already aching heart. It was the thing we wanted to control the most, but the one thing that sadly we could not. No matter how hard we tried. People were dying, a lot of them, and for those accustomed to healing, this bitter pill was especially hard to swallow.

The side effects to COVID-19 on healthcare workers are multifaceted. They’re not just placing their physical bodies at risk, or even that of their families. They are also investing their hearts. The emotional and mental toil cannot be imagined unless you have faced it head on personally. I am a veteran, and I don’t use this term loosely, but I do consider this a battlefield of sorts. Nursing is fighting a war, one they feel they are losing, both at the bedside and in the court of public opinion. We’ve got battle scars already. I can’t imagine how it will feel down the road.

So, if you see a nurse, please cut them some slack. If they’re sharing about the benefits of social distancing, hand hygiene, or wearing a mask, realize it’s because they care. They’re not pushing any hidden agenda, playing politics, or even in on the “government hoax.” The fact is, we’ve seen far too much death already, we anticipate to see much more, and we want to prevent that if at all possible. There’s so much with this pandemic we cannot control, but maybe we can help save a life.

And for goodness sake, stop trying to convince us it’s not a big deal or as bad as the media says! I don’t even watch the news. But I do believe what my eyes tell me. And right now, sometimes through tears, they tell me we have to work together to stop this thing. Please.