Brie Gowen

Savor the Essence of Life

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.

3 Facts From the Nurse

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I was so excited when things started to get back to normal status post quarantine, and I know you agree. While the family time was great and it was awesome to slow down and reflect on life, in all reality I was tired of an isolation world. I missed going to restaurants and letting my children go out into the neighborhood to play with their friends. I wanted the public pool reopened, and I wanted to go into a store without worrying I might contract something. I wanted store shelves to be fully stocked, and more than anything I wanted people to see my smile that the face mask hid. I was ready for a return to normal.

As a critical care nurse, I talked with my peers about a resurgence of COVID-19 before restrictions even lifted. I mean, we intelligently hypothesized it would, but I guess there was that part of me, the starry-eyed dreamer, perhaps, who hoped that Coronavirus could just disappear. Yet despite my desires, I knew it had not, and that knowledge was nailed home this week. So, consider this a Public Service Announcement, friendly reminder, or simply some advice from your friend on the frontlines of healthcare.

1. COVID-19 did not disappear. I repeat, it did not magically go away. The numbers of active cases began to fall because, logically, the population had been self isolating at home for a month or more. The powers that be wanted to prevent a spike of infection that would overwhelm the healthcare system. Remember the term “flatten the curve?” Well, they did just that. We (pat yourself on the back) did just that. We kept contamination and disease spread at a minimum while stuck at home, and in that process saw infection rate numbers drop from their April highs to a nice May low. Good job.

As numbers dropped the noise became less. The news networks found new stories to report, and COVID took the backseat. But hear me now. Just because it’s not on every single news channel, that doesn’t mean we cured it. It’s still here.

2. COVID-19 pandemic was not a hoax! Listen, I love a conspiracy theory as much as the next guy, but trust me on this one. It is sadly and tragically very real. While working on the frontlines of COVID, in a critical care COVID isolation unit, in a large, multi-ethnic, highly populated area, I saw far too much of this pandemic. My area wasn’t as bad as NYC, but in the face of this disease, it doesn’t have to be. Outcomes were not great, and I had to be intentional in self care not to crumble under the stress and depression of far too much death from this disease. I wish to God it wasn’t real, but none of us can unsee the fear on our patients’ faces or soon forget the tearful prayers over the phone with family.

I know that when things improve it’s easier to say the problem was overstated. When you desire for life to return to normal it’s easier to convince yourself it was never that bad. I mean, you can go into public without fear if you tell yourself the government and media faked statistics to exert control. When you don’t know someone personally who has suffered with Coronavirus or who has worked around it, it’s easy to ignore. You can just pretend it was never a thing to begin with, and you can get back to life per usual. Gosh, I wish I had the privilege of thinking this way.

3. COVID-19 numbers are on the rise. I’m sorry, I’m sorry, I’m sorry. I don’t want to be the bearer of bad news. I don’t want to be a joy-kill. I want to go to the mall and take my kids to amusement parks. I want everything like it was before, but that time is not right now. I don’t honestly know if things will ever be the same, and in some ways, maybe they shouldn’t be. Remember the great stuff we learned through this all? Like, washing your hands? Yes, we should still be doing that.

Three weeks ago I saw the best COVID-19 positive numbers I’ve seen since this started. It was awesome!! The unit was almost empty, and it seemed a welcoming sight compared to the previous couple of months.

Two weeks ago I barely noticed that the numbers had doubled I think a part of my brain acknowledged the fact, but that hopeful gal inside tried to push it away.

This week the numbers doubled again. This week staffing is tight to care for these people, and the rooms are filling back up. When I saw the number of positive cases I knew this was it. This was the predicted spike/return/resurgence of cases after restrictions were lifted. Y’all, I’m not gonna lie; it kinda scared me.

Here’s the thing. We can beat this. We can be smart. We can do the things we know we need to do. Do you remember how soap, Lysol, Clorox, and hand sanitizer flew off the shelves in April? Well, that makes me wonder, were folks not being sanitary prior to this pandemic?

It’s ok. I’m not even mad. You can continue your newly found habits to keep this thing manageable. Wash your hands. Don’t stick your hands in your mouth or touch your face if you haven’t. Wear a face mask when you’re in large groups. If not to protect yourself, then to protect someone else. Clean surfaces, and maybe chill on the big group gatherings until we get a better handle on this. It’s ok to still social distance. You don’t need to be up in everybody’s grill anyway. That’s also how other (less deadly) viruses spread.

In the return of COVID I’ve seen people advised as an outpatient to self-quarantine, ignore those doctor orders and infect their whole family. And while a young person may feel just fine, an aging parent or grandparent won’t fair as well.

I’ve seen people come to the hospital to get tested (and test positive) after leaving their shift at a restaurant. SMH. If you are symptomatic, stay home! I know we all need a paycheck, but this is life and death. I’m not exaggerating. I only wish I was.

Bottom line. Although COVID-19 left the news networks, it hasn’t left the hospital bedside. It hasn’t left your neighborhood. I’m not trying to scare you, but I am trying to educate you. Be smart and practice the previous guidelines. Just because life seems like it’s returning to “normal,” that doesn’t mean we have to. We can be better than before.

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.

COVID-19: An Inside Look

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Perhaps it’s because I’m a registered nurse working the bedside of this virus, but I feel like I’ve seen plenty of information about what it’s like for healthcare workers fighting this COVID-19 fight. I’ve seen stories about violence towards people in scrubs out there, but personally I’ve received nothing but support and encouragement. Most of my friends know about our struggles with personal protective equipment (PPE), be it the fears it will run out or the frustration with the ever-changing guidelines of safety by the CDC. People have seen the struggles nurses and others have wearing the same masks for twelves hours or more straight, and aside from them seeing the bruises and pressure sores on my face, I’ve told my family how the continuous wear causes me to feel fuzzy-headed and drowsy (not a good feeling for a critical care nurse).

We (as a healthcare team) mostly keep quiet about the inconveniences of no bathroom or water breaks. I mean, it’s just how it is. Another straw to add to the back of an already sagging camel. Yet, despite any struggles we face physically, or even the fears we attempt to overcome mentally, it’s been so helpful to have the praise and support of family and friends. I know they see me, and they try to sympathize with the war we’re waging against this tricky contagion. I guess, what I’m trying to say is, I feel like a lot of thoughts and prayers have been directed my way, but recently my heart has been breaking for the patients I serve.

If you could see inside my little world, behind smudged googles and hot breath, you would see how COVID is attacking more than our ability to go to the mall, or even beyond our inability to pay bills. You see, this pandemic is more than being forced to stay home, schooling your children, or even (sadly) being unable to gather with your church or extended family. I saw it went beyond missing my baby brother’s wedding, or not being able to find our favored toilet paper. Because beyond sinking stocks and failing businesses were people dying. Scared, alone, and confused.

If you could stand here beside me you would see the real effects of COVID-19. You’d see the frightened eyes of a patient when a crowd of strangers rush into the room, moving quickly, with a sense of urgency. You’d glimpse the fear the patient exuded over all the people surrounding them in hoods, masks, and billowing gowns. The worst part about a mask? They can’t see you smile.

If you stood in my shoes you would hold a patient’s hand with your own gloved one, attempting to offer comfort, wiping away a stray tear, patting their arm compassionately.

“You’re doing so good. It’s ok. Don’t be afraid.”

While foreign tubes are being inserted, with language barriers in place, you’d try to explain why rolling onto your belly in the hospital bed is needed to perhaps help getting a breath be less excruciating.

If you sat at my desk you’d try and calm a family member, over the phone only, since visitors aren’t allowed.

If you stood outside the glass fishbowl, like me, watching lifesaving procedures being performed in unprecedented ways, to keep staff contamination at bay, you’d feel your heart break while staff worked feverishly to sedate the anxious patient, just prior to passing down a endotracheal breathing tube. If you could read the patients frantic thoughts at that moment just prior to sweet sleep, you would be certain he wondered worriedly, “what if I never wake up?”

Because people aren’t waking up.

Y’all, I can’t understand all this. It’s not like anything we’ve ever known, and I’m sure you’re getting that Sci-Fi movie vibe too. As if we’re walking through a dream we can’t wake from, we all feel that surreal mood. It’s hard for everyone, and we all feel the sting, but we have to remember to feel more than just how this is affecting us personally. We gotta try to imagine how it’s impacting the world at large, how we’re all hurting in one way or another. Because, you see, it’s our ability to empathize with another than binds us, and if we can stand together (even as we’re physically apart), we will stand stronger when the dust settles. Eventually it will.

Who Do You Say I Am? A Guide to Victory in Pandemic.

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Easter is quickly approaching, and it seems we’ll still be under social distancing at that time. I know for many Christians they may have never spent an Easter Sunday not in church, and I was reminded this morning of an Easter Sunday I spent at the hospital bedside years ago. I recall being disappointed that I wasn’t in the house of God that holiday, and it was then that the Lord spoke something very strongly to my heart.

He said, my resurrection lives in you.

With all the happenings globally as of late, I am reminded of His Spirit at work in us. And with all the common reactions to this pandemic, I am reminded of some lyrics I heard in a song recently.

It said, God isn’t hard to find.

I suppose that seems way off base to many people, especially lately. After all, so many times God seems silent. When tragedy strikes, like now, He can especially seem distant. But when I heard those lyrics the other morning I was hit by the truth of it. You see, God isn’t hard to find. It’s just hard for us to do the locating. We’re too distracted by the world to realize that He is here with us all along.

It’s not hard to see the fear out there. It’s not hard to feel it yourself. I realized after a four day stretch at the hospital bedside that I was overwhelmed with the very realness of all this. I was inundated with COVID-19 statistics, the ever-changing instructions for how to deal with it all. Uncertain and evolving information from the CDC and those in power above me made my head spin. I discovered pretty quickly that I had to be intentional in my time with Jesus, because everything else vying for my focus was pretty intense. Not only were the worries of having enough food to eat there, or how the economy would suffer, but also the real threat of taking home a dangerous illness to my family.

This morning, and last night, I was drawn to the book of Matthew. I read it before bed, but also again this morning,

Matthew 16:15-16 (NIV)

15 “But what about you?” he asked. “Who do you say I am?”

16 Simon Peter answered, “You are the Messiah, the Son of the living God.”

As Easter approaches I’m reminded of the days leading up to the Crucifixion. Jesus enters Jerusalem with much fanfare and praise, the crowds singing and proclaiming Him a king. Yet five days later the same words of “King of the Jews,” were used to find Him guilty and sentenced to death. Public opinion was a shifty one, indeed, and it’s in Matthew 16 we see Jesus gently leading Peter to the realization that it’s not what the crowd says that matters.

Who do you say I am?

This is becoming a question that Jesus asks us all. Who is the Lord to us during such a time as this? Is He an angry God, distant, pouring a plague on His people, only to forget them as they suffer? Or is He the Messiah, the Savior of the world?

In the midst of COVID-19 and the fallout of this pandemic, it’s hard not to be afraid. We see the news, the growing numbers of infected, and of course, the personal stories and accounts coming from those working in the thick of this illness. Some of us see dwindling bank balances and empty cupboards. Others see plummeting stocks, or death up close and personal. I’m reminded again of our dear disciple Peter. He knew, before it all went down, that Jesus was the Son of God. He spoke it out loud in faith, yet we all remember what happened before the cock crowed three times. He denied Jesus. It’s a disappointing turn of events in scripture, yet Jesus still fulfilled what He spoke in Matthew 16. He still built the church on the rock that was Peter. That’s good news for us!

When Jesus spoke about building the church, with a mere man who He knew would deny Him down the road, He spoke this.

The gates of Hell will not overcome it!

Today, we face the straining of Hell coming against us. A spirit of death and sickness come in a virus form, and a spirit of fear tries to make us deny (or forget) the power of our God, but Jesus promises that evil does not win. It can not overcome us!

Another verse comes to me as I write this post.

Psalm 121:1-2 (NIV)

I lift up my eyes to the hills– where does my help come from? My help comes from the Lord, the maker of heaven and earth.

As believers, we can find God. It’s not hard, after all. He is here in us. He has not forgotten us, and actually has promised our victory. He doesn’t want us in fear, denying the power He gives us to overcome problems, but He does still provide us victory, knowing we will have our doubts. Today, I would remind you to ask of yourself the same question that Jesus asked Peter.

Who do you say I am?

Is He the rising infection rates or empty store shelves? Is He the dwindling economy or uncertain future? Is He the depressing news reports or scary Facebook posts? No! None of this is a surprise or uncertain to our God. He is the Messiah, the Savior of the world, the Great I Am, and He will! Be encouraged.

Three Things God Says About COVID-19

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Nothing brings character out quite like crisis. You will see some of the most courageous people charge into a burning building, but sadly, you will also see the ones who knock down the weak, trampling them to escape calamity. You will see people who instill fear, take advantage of a bad situation, yet also the helpers, the ones who pick up the fallen, serve the weak, despite their own trepidation, and give more than they take. I would like to think that all followers of Jesus fall into only one of the above mentioned categories, but sadly we all can fall to fear, panic, and survival of the fittest. Yet, in a time of chaos and uncertainty, I believe God calls His children to a deeper level of trust in Him. So, consider this a friendly reminder, to all of us who profess the faith, to follow the commands God has put forth for us in His word.

Without further ado, here are three things God is telling us amidst COVID-19.

1. Stay home! I want to put this as best as I can. I completely understand the fear of losing financial resources. I totally do. Most of us don’t have a huge savings built up, but I’m trying to encourage a kingdom mindset amongst all of this. I want my brothers and sisters out there to try and see this situation as an opportunity to grow deeper in dependence and relationship with Jesus, to not fear the waves that come, but trust the one who controls the storms. It’s not the boat that will save you; it’s the One who controls the ocean. He will provide.

Also, let’s think about what’s important. Is it staying current on bills or human life? Trust me as a healthcare provider on the frontline of this. It’s serious. People are dying. Maybe not you, the healthy twenty-something, but you can be without symptoms at the beginning of the virus and pass it along to people you do care about. Your grandparents, your friend’s immune compromised child. Life will always trump bank balance.

Then there’s this little nugget.

Romans 13:1-2 (NIV)

Submission to Governing Authorities

13 Let everyone be subject to the governing authorities, for there is no authority except that which God has established. The authorities that exist have been established by God. 2 Consequently, whoever rebels against the authority is rebelling against what God has instituted, and those who do so will bring judgment on themselves.

Please trust the experts in disease transmission on this. Let’s not listen to that mom in your private Facebook group.

I won’t say I believe every word from a politician’s mouth or especially the news, but I do obey the authorities God has placed over me. Our government has given very clear and strong recommendations, and a large number of people are still ignoring the highly educated, well established plans to slow the spread of this virus. You are hurting others, you are hurting yourself, and you are disobeying more than the president you don’t like. You’re disobeying scripture. Let’s humble ourselves under the authority God has placed over us, trust that His plans will prevail, and stay home! I’m a nurse and a Christian. I trust medical science, but above all my Savior. God has given us healthcare and healthcare providers with the knowledge to save us. Let’s trust that God-given wisdom that says staying home will keep this from getting bigger than our hospitals and medical supplies can handle. Please.

2. Stop hoarding food! I have had friends inquire of my family, if we have enough. Since we started living in an RV we have limited space for storage period. Our fridge is small, our pantry also. We can store about enough for a week for our family of five, and that means frequent grocery trips. This past week I went shopping after a twelve hour shift at the hospital bedside, and as most of you know, the shelves were bare. Yet as I made my way through the aisles I always found one to two of every item I needed, even if it wasn’t my typical brand. By the way, I only took one, leaving the other for the next person.

Matthew 6:25-27 (NIV)

Do Not Worry

25 “Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes? 26 Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? 27 Can any one of you by worrying add a single hour to your life?

I’m reminded of the Israelites in the desert. God provided enough manna for each day. Some tried to take more and keep it for the next day, but He caused it to spoil. He wanted them to understand that He was their provider, and they could trust Him to give exactly what they needed. I’ll bet there’s a lot of people today who may end up throwing out some food they bought in over abundance, never realizing that God wanted to show them what He could give them.

Jesus came showing us how to be servants, showing us that the first would be last, and the last first. He saw people in need and He fed them. Never once did He hold onto what God had given Him and not share with the rest. He didn’t take all the fish and bread from the little boy and split it with His disciples. He thanked God for the little He had, then God multiplied that gratitude to feed five thousand. Imagine the blessings we are missing out on because instead of thanking God for what we’ve been given that we need, we’re taking more than enough right out of the hands of the hungry. It’s going to rot.

2 Timothy 1:7 ESV

For God gave us a spirit not of fear but of power and love and self-control.

Don’t let fear drive your actions. I love my family, and I feel the need to take care of them. I understand that you want to get your family what they need, but stop and consider the fact that fear is driving you to load up a shopping cart with sixteen cases of water and twelves packs of toilet paper.

Which leads us to the third yet biggest commandment He’s speaking during this time.

3. Do not fear!

I say it again. Do. Not. Fear. There’s a reason this is the most repeated phrase in scripture. You see, fear is from the devil, and fear is a liar. Is all this kinda scary? You betcha butt! I am walking into a lockdown, negative air pressure, isolation, COVID-19 unit at work. Tons of healthcare providers around the country are doing this. If we let fear rule our actions, we would shut them all in a room and let nature take its course, but no, we go in and provide the very best, life-saving care we can. Are we afraid of catching the virus, or perhaps spreading it to our family? Of course! But we don’t let fear dominate and rule our actions. The reason the Bible says so frequently not to fear is because God knows we will. Sin has created some really crazy, frightening things out there, but faith in Jesus gives us a mode to combat fear and not let it rule our hearts and lives. He has overcome all evil, and COVID is no different. Even death has lost its sting, y’all. I serve a creator who gives eternal life, and the gift He offers is bigger than the most fatal of diseases.

Do you think this surprises God? Do you think He is as shocked as we all are by the death toll in Italy? No!

Psalm 139:16 ESV

Your eyes saw my unformed substance; in your book were written, every one of them, the days that were formed for me, when as yet there was none of them.

God knows beginning to end. He knew this was coming, and He knows how it will end. He knows the solution. He knows the good that will come from this. What the enemy means for evil, God will turn to our good. We have a tendency to forget that.

God is whispering amongst the chaos,

come to me, all who are weary and heavy laden, and I will give you rest. I will give you peace. I do not give as the world gives. Take comfort, for I have overcome the world. There it is. Do you not perceive it? I am making a way in the wasteland and streams in the desert. Hope like a river, it flows to those who trust in me. Do not be afraid. I will uphold you with my righteous right hand. Your foot will not strike the stone. I will rescue you.

If I were to offer any advice during this time of social distancing it would be this. Use this time to read the Bible. Y’all! There’s a wealth of truth and wisdom from the Lord inside those pages. Let them be a healing balm to your worried soul. Let them guide your decisions so that fear doesn’t lead you, but His peace sustains you. Listen to the real expert on what’s happening. Don’t just take my word for it.

Thank a Nurse, Today

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We all stood in a rough circle, listening to another briefing about safety policies and fluid plans going forward. I looked around at the nodding faces of my coworkers, asking important questions as needed, or giving suggestions to improve overall outcome. No one griped, guffawed, or rolled their eyes. We listened to conversations of personal protective equipment running low, and straightforward statements that a nursing shortage was on the horizon. Stoic, we stood tall, and not one person said, “that’s it. I’m outta here!”

That’s not what nurses did. When the going got tough, we got tougher. I was reminded of my time in the military. Serving during 9/11, I was active duty when the war in Iraq first began. I watched my spouse and 90% of my coworkers leave the hospital to deploy overseas. In their absence I worked 12 hours shifts, seven days a week, for thirty days straight until reservists arrived to help. And although I held honor, courage, and commitment at my core, let’s be honest; I didn’t have a choice. I belonged to the U.S. Government, and I worked in hard conditions because, “that’s what you told me to do, Lieutenant Dan.” But seriously, I did my duty without question. Civilian Nurses, they’re a little different.

I want you to understand something very important. All the things you’re feeling, you are not alone. Feeling scared? Overwhelmed? Worried for your family? Despite the frequent assumption otherwise, nurses are indeed human, with emotions and needs. We don’t want to become sick with COVID-19 anymore than the next person, and we don’t get jazzed about possibly taking it home to our young children, elderly parents, or immune comprised spouse. We get tired when we work extra, and we need to go grocery shopping too. Today, after my twelve hour shift, I stopped and picked through the scraps left at my local grocery store.

Your bedside nurse isn’t immune to deadly viruses, but they go to work each and every shift, fearless. We utilize our training and knowledge to stand on the frontline despite the fact that we have all the concerns you may be feeling right this very moment. Any nurse could call out sick, walk away, or refuse that request to work overtime, but we don’t. We face the music, no matter how screechy the melody, and we dance a graceful waltz through uncharted waters.

I guess it sounds like I’m tooting our own horn, or uninvitedly skywriting “Nurses Rock,” but doggone it, I can’t help it. I’m proud to be a nurse, and I’m proud to stand firm alongside some amazing men and women. They come in each shift, already, with sick children at home, a chronically ill, aging parent in their thoughts, or a relationship on the rocks thanks to long hours and less weekends off. Never mind showing up with a smile when a pandemic is on the rise.

Today was a crazy day at the hospital bedside. I saw more movement than we wanted, and I saw a team pick up the reigns. I heard a stray, “I’m tired,” or as 7pm neared a weary, “I’m ready to go home,” but I never heard a real complaint. I never saw a bad attitude today, and there was more than a few things that could make a person flip. I saw what I see most, every day. I saw nurses caring for their patients with compassion and skill. I saw my peers intervening to save lives, and advocating for the people in their care. In this regard, it wasn’t much different than any other day, other than all the masks, gowns, and protective eye wear. We still washed our hands, like we always do, and we used required precautions to prevent the spread of contagious disease. Again, like we always do.

I stood on the frontline today with a team that superbly carried out their duty, and despite the odds stacked against us, carried it out well. So, while a lot of things are uncertain and ever-changing in our world right now, one thing is the same. One thing is steady despite the storm, firmly rooted despite the slipping sand. It’s your bedside nurse. They are doing what they have always done. Excellent patient care with a smile. Your local Walmart may be out of toilet paper, and your child’s school may be closed, but your hospitals are still open, with all the amazing healthcare staff present and doing what they do best. In uncertain times, you can still count on that.

So, thank a nurse today! Thank the doctors, techs, therapists, and many other frontline staff. Show your gratitude to your police officers, and all the other people who go about their work just like any other day, with just a bit more stress in the mix. Wink, wink. I’m proud to stand in the ranks with so many who help keep this world going, even when life wants to shut it down.

What to Say When You See a Nurse Sitting Down

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I think part of the problem is you’re not used to seeing it. A nurse sitting down, I mean. There’s a reason I put a step counter app on my phone. It helps me feel justified when I’m scarfing down a couple of donuts at 4pm because I’m starving from a skipped lunch. Point being, the miles I walk on any given day at the patient bedside would trump just about any exercise routine I might try to begin. Between back and forth trips to a room or quick dashes to the pharmacy, I definitely burn my fair share of calories. What I don’t do a lot of, in comparison, is sit. And even if I am sitting, I’m usually charting. Yet that’s not the moment a passerby will catch me.

If you’ve been a nurse any length of time then you know that nursing has its own cruel version of Murphy’s Law. This happenstance will mean that uttering the word “quiet” makes crazy things happen, or that saying you’re all caught up will make the stool hit the fan. It’s that peculiar nuisance that makes your face itch like crazy when you’re fully donned in PPE, or your patient’s blood pressure plummet right after you lose your one working IV. You know what else it is? It’s the fact that the moment you sit down to take a break two things will happen. Either a call light will go off, or someone who isn’t working the bedside will walk by.

Ahhhh. You see the nurse, phone in hand, leg propped up. My, they almost look like they’re on vacation. I totally get it. First thoughts might be, “wow, guess nobody works here,” or perhaps “they need something to do!” It does look that way. But I wonder what might happen if we all put ourselves in the shoes of another before making snap judgments in haste?

I think you’d find out some things you might not know about your nurse. The propped leg? Maybe that’s to rest and alleviate pain in their bad knee that aches something awful after 13 hours on their feet. I find as a middle-aged woman that my body no longer agrees with how young I desire to be, but instead reacts like someone much older, especially after lifting the weight of others for three days straight.

Did you consider the phone use is a quick text home, checking on a sick child or a parent who’s fallen? It’s easy to forget in a population that spends the majority of its time caring for others, but nurses have families with needs of their own. As your nurse is giving 100% to the sick people under their care, their hearts still cry internally for whatever is going on at home. But you know what? Even if that nurse was checking their social media, it’s the first time they’ve relaxed all day, what, with keeping that post-op patient who’s been circling the drain from buying a one way ticket to heaven.

I think we forget the emotional stress and physical strain nurses go through on any given shift. It’s easy to forget the weighty stress of keeping someone alive. We miss the fact that the bedside nurse can spend hours at one person’s side, forgoing their own needs, to alleviate whatever ails the one under their care. But those are the unseen things. Those are the hidden gems a nurse performs each shift. They just see it as part of the job, and they certainly won’t brag. You’ll never know how they made that suicidal woman feel special for the first time in her life, or how they intervened for the safety of their patient, preventing what could have been a deadly event. You won’t see those secret steps a nurse makes each day, but you will see them sitting at the desk, apparently with nothing to do.

Maybe next time we see that nurse in that brief moment of respite and much needed rest we can think something like, “good for them. They need that moment of stillness to recharge for the difficulties ahead.” Because, you see, nurses are like a vessel, pouring out so much of themselves, but as everyone knows, any container eventually runs dry. So perhaps the next time you see a nurse sitting you should just know that they’re there for a refill before the next round of serving begins.