To health care workers in the COVID era, holidays mean death, and we knew Omicron was coming before it had a name. The wave caused by this variant has barely begun, rapidly gathering steam, and we are exhausted, attempting to pull from reserves badly drained by earlier surges.
Back in August, the beds of my hospital in Tennessee filled with COVID patients in varying stages of respiratory distress. Some wore a plastic mask that covered their mouth and nose, hooked up to a machine that delivered forceful breaths into the patient’s open mouth. Others were sedated, paralyzed, with a plastic tube down their throat, every breath driven by the ventilator that kept them alive. The anger of the nurses, myself included, surged along with the patient population. Rage seeped along the halls of the intensive care unit, burned in the quick conversations in the medication supply room, and settled around all of us as we tried to keep our heads above water for yet another push of the pandemic that had turned so many of us into open wounds. I was angry at everything: angry at the systemic failures of the government to act, angry at the individuals who treated COVID as a joke and angry at the disinformation that ushered in more death.
Every wave of COVID has been a special type of hell, but that August surge was much worse than those before it, as the summer of 2021 spiked to a boiling peak after a spring full of hope. This time we had the vaccine that should have put an end to all of it. The vaccine that I and so many health care workers had clung to like a lifeline for the first waves and the brutal winter was here, safe and effective—and largely ignored by patients that were first a trickle and then a torrent rushing into the emergency rooms, the medical surgical units, the intensive care unit, all gasping and dying and begging for a miracle, younger, sicker, crashing faster. Every death as devastating as it was preventable. Chart after chart told the same story: “COVID positive. Unvaccinated. Intubated, sedated, paralyzed. Prognosis is guarded in this critically ill patient.”
Eventually, that summer surge receded. By that, I mean that we occasionally had three or four open beds. My patients were all still sick, so sick. Many of them no longer had an active COVID infection, but their bodies had been so ravaged by the virus that they remained on breathing tubes as one organ system after another failed.
Whatever relief we felt at the slight lessening of pandemic pressure was short-lived: we already turned our eyes to the coming winter, to the holidays and the death at our heels. History repeats. My unit is full again. My co-workers and I are exhausted, angry and full of grief. The holidays brought with them another crush of death that will not reach a peak for weeks.
The medication room is a confessional for exhausted nurses and techs as we grapple with the awful deaths we witness and the understanding that the fatalities won’t stop, that the campaign of disinformation won and that many people won’t see COVID for the monster it is even when it stands shrieking in front of them. We seek solace in each other’s fury, in the knowledge that we don’t bear this anger and grief alone. Knowing that someone else sees and understands how bad things are brings a shred of peace. “Why are we even doing this?” my co-worker asked me in August, furious tears glistening in the corners of her eyes. We were both drenched in sweat and demoralized after another COVID admission that we knew would die in the hospital. “It’s been a year. I don’t want to do this anymore.” Just days after Christmas, the same co-worker grabbed my arm in silent support when I got choked up while giving her a report on a patient I moved mountains to try to save, both of us knowing that death was imminent.
I lost count of how many times I heard my colleagues say the words “I don’t want to do this anymore.”
I watched my co-workers develop post-traumatic stress disorder in real time, the shadows under their eyes deepening and the brilliant lights of their souls dimming under the onslaught of death. But the thing that damaged me more than anything else was knowing that we had a way out and didn’t take it. This sentiment has been echoed by many people that I work with, conservative and liberal alike, all of whom have seen the devastation that disinformation leaves in its wake. COVID is a hoax until someone you love is lying motionless in a hospital bed, half dead, being kept alive by an angry nurse, a tired respiratory therapist and a depressed physician.
For two years, medical workers around the globe have tried to spare others from paying the price of politicizing science and public health. Some people may have listened to us, and I hope that our warnings saved lives. Now, as the pandemic stretches into a second year and the desire to return to a normal life outweighs the recognition of what this disease is and what it does, the health care workers who take to social media and public forums to remind people that the pandemic rages on are treated with derision and hostility.
I have been in various forms of media discussing the pandemic, and while negative comments were always there, my last 15 minutes of fame in August was by far the most contentious. I wrote a thread on Twitter chronicling my first year as a nurse during the pandemic, and it went viral. As the comments (that I tried not to read) rolled in, I learned that I’m a fake, crisis actor. I’m getting paid to make COVID look worse than it is. I’m getting paid when my patients die. Just give them ivermectin. It’s that ventilator that kills them. Nurses and doctors are murderers. I wish I could say that these comments had no effect on me, but many of them, especially the ones accusing me and my colleagues of killing our patients, hit like a punch in the gut.
I’ve received multiple death threats and refuse to publicly identify my hospital to protect both myself and my co-workers. I see how easy it would be for someone who believes these conspiracy theories to act on their misguided rage. I saw a video on TikTok showing a man on security camera, apparently trying to get into the intensive care unit, threatening the nurses and doctors who he says killed his friend. “Why are you killing people with your treatment?” he demands. He states that he has been studying the routines of the nurses and that he has a gun at home. My in-person experiences with individuals who would threaten nurses physically or sue a hospital to force them to administer ivermectin or hydroxychloroquine, have been small but not zero. Each has left me angry and unsettled, at a total loss to understand how anyone could think that we wouldn’t end this misery in a heartbeat if we could.
Most patients and their families are kind, lovely people who are enduring something horrible, gracious in their sadness and understanding of how hard we fight to save the person they love. They vastly outnumber the small but vocal group who believe that we are choosing not to save their loved ones. “I know you’re moving heaven and earth for her,” a husband told me once, tears in his eyes. “I know you’re trying.”
I became a nurse because I want to help people. I don’t want to watch them die these horrible, preventable deaths, shift after shift and year after year. No health care worker does. Every time I speak publicly about COVID, it’s to beg people to listen to us so that they don’t have to learn the hard way, but the longer the pandemic drags on, the more I feel that I’m shouting into an abyss.
Medical workers are tired, we’ve been tired, but we keep showing up for the same simple reason most of us sought out this field in the first place: we want to help people. We have borne witness to immense pain and want to ease it, to bring life back into places of darkness and suffering. We’re not heroes or angels or any of the other things that well-meaning people call us. We are just human beings who are not immune to the pressure, grief and relentless crush of misery this pandemic causes.
Everyone has a breaking point. Many health care workers have been driven close to ours, not just because of COVID itself but because of all the ugly things that humanity—particularly in the United States—has revealed about itself in our response to COVID. An exodus of nurses began before the pandemic, created by impossible workloads and uncaring employers, and it will continue so long as selfishness and profit are valued above human life. Now the Centers for Disease Control and Prevention has released new guidelines that decrease the amount of time health care workers should isolate with COVID, which increases our risk of exposure. I expect these standards will fuel the next wave of exits. For two years we have sacrificed, broken our hearts and our bodies for a country that views us as an acceptable loss, yet more and more is asked of us by organizations that lack the spine for the mask and vaccine mandates that could bring us out of this hell. We are canaries in a coal mine.
Despite all this, all the complicated emotions and experiences that come with being a health care worker, people will always be drawn to the fields of nursing and medicine. Despite all of it, I’m glad I became a nurse.
There is always light, even in this unrelenting dark. The human condition has always been dogged by misery, genocide, colonialism, pandemics and petty wars; yet there is always beauty in small things. I remind myself of this when I feel overwhelmed by all the terrible things in the world, by the amount of death that I’ve seen since I became a nurse in July of 2020. I feel that dark tugging at me like a riptide, a constant crush of all the love that has nowhere to go and the grief that could swallow the world, and I feel the bravery and goodness of the people staring back into the abyss with me. After two years the death and darkness threaten to swallow us whole, and yet I look to my co-workers standing battered but steadfast against each wave of death, and I find courage to face it myself. This is what it is to be a nurse: facing that darkness and telling it that you are not afraid.