I am leaving bedside nursing.
I’ve been a nurse for ten years. During that time I have held hands, wiped tears, cleaned faces, combed hair, dressed wounds, and started IVs. I’ve drawn blood, started catheters, cleaned up vomit, and monitored vital signs. I have worked codes and done chest compressions and saved patient lives and lost others. I have been praised and thanked, and I have been punched in the face. I have been with patients at their very first breath and their very last one. I’ve been with people at their most human, vulnerable and difficult moments of their lives. I do this because I understand pain, I understand vulnerability. I am a trauma and abuse survivor. This is why, like many, I am a nurse.
For five years, I was a home health nurse caring for terminally ill uranium miners in their homes. On a typical day I would administer breathing treatments, assess breath sounds and hide my liberal leanings while my patients smoked cigarettes and watched “Gunsmoke.”
I like this patient population. But the job is not very challenging. I miss the fast pace of critical care, the opportunities to learn, the grit and challenge of working in a busy unit. So I accept a second job, working on-call at a local hospital.
Then Covid hits.
I am not working at a large research hospital or trauma center. My job is in a small rural hospital on the high plains desert of Western Colorado. The town I work in is known for mountain biking, conservative politics and a now-cancelled Headless Chicken Festival. There are wildfires nearby that cover my car with ash. Locals complain about housing developments and all the newer folks moving in from Denver. From the hospital, a view of sandstone cliffs hover over a valley of sagebrush and juniper trees. In the distance, solitary blue mountains rise to the sky. It is a beautiful place.
When the pandemic hits, my hours at the agency are reduced, so I quit my home health job and go to work full time for the hospital. I feel relief, as I didn’t want to expose the people who are most vulnerable.
The lack of PPE makes coming into work a daily game of Russian roulette. I am given an ill-fitting N95 in a paper bag. I worry about the virus contaminating my clothing. I ask management if we can wear hospital scrubs that are laundered onsite. They say that they considered this, but didn’t find it necessary.
At the end of each shift, my mind begins to spin. Did I catch it this time? Was I careful? Please God, don’t let me pass this onto my kids. I decontaminate at the end of each day, changing out of my scrubs in the garage and disinfecting my keys, car, shoes and phone.
My neighbors socially distance, circumventing any and all sneezes, coughs, and human contact. I envy them. I envy the sourdough starters they post on social media, their gardens and time with their families. I envy their choice to stay safe. Against public health and safety recommendations, hospitals and clinics pressure us to come into work sick. A culture of toxic presenteeism endures. Two thousand miles away, Congress votes against hazard and sick pay for healthcare workers.
One week I am exposed and must quarantine. There is no paid sick time. I am trapped between my conscience and the mouths of three children I must feed. I have no sick pay, although the state of Colorado guarantees it for healthcare workers. Two weeks of emails and phone calls go unanswered. The human resources administrator tells me to file for unemployment.
After quarantine, I am back at work. At the nurse’s station, I am staring at a wall of patient assignments — all Covid positive, and no respiratory therapist. No nursing assistant or aide. There are more patients than I can safely care for. I speak to management. Sorry, nothing we can do. My N95 is over a month old. One of the nurses is sobbing in the bathroom, scared she’ll bring Covid home to her newborn baby.
Some days I feel proud and accomplished. I work extra shifts. I feel a camaraderie with my co-workers. They are family. We help each other reposition patients, give meds and pass meal trays. We give our isolated patients limited human interaction that they are desperately needing. Each and every patient who recovers fills me with hope.
But most days I am simultaneously overwhelmed and numb. I am giving everything while spiritually I am checked out. Six hours into my shift, we run out of gowns. My mask reeks of my own sneezes and bacteria. The mediation scanners and computers in the patient rooms don’t work. I am constantly running on a hamster wheel of high patient loads, medications, charting, assessments, call lights, and huge stacks of demands from leadership requiring more than I am physically and emotionally capable of.
In a Covid room, there are no politics or rallies with angry maskless people demanding haircuts and trips to Applebee’s. There is a nursing home worker coughing non-stop while waiting on hold for two hours with unemployment. There is an immigrant from Vietnam who hoards fruit and apple juice from his food trays. He asks for help completing his food stamp application, but I don’t have time. There are simply too many patients to care for.
There is an oil field worker with a pulmonary embolism who insists Covid is a hoax. A grandmother who caught Covid at Thanksgiving. There are three members from the same church. Several guests from a birthday party gone bad. A terrified physician’s wife with hand tremors who pushes the call light ceaselessly. A man we discharge to quarantine at home. He is seen at the local grocery store the following day without a mask.
There are kind patients and there are rude ones. There are cold meals on styrofoam trays. There is oxygen tubing and medications and IV poles. There are baskets full of dirty isolation gowns and garbage that needs to be emptied and plastic cups of stale water. There are heart monitors and not enough oxygen probes. There is coughing and gasping for air. There are blood clots and chest x-rays revealing lungs full of fluid. There are patients who pee in the bed because I couldn’t get to their room in time. There are patients who are too weak to eat and need to be fed. There are confused patients who pull out their IVs. There is fear and there is profound loneliness. There are patients dying alone.
There are my apologies and my growing sense of guilt and failure. There is sweat on my back and dehydration and dizziness because I forgot to drink enough water under my PPE. There is my 30-minute nap that feels like five when I collapse into the front seat of my car on my lunch break. There are tears I burst into in the med room because I hadn’t slept for 3 days. There are 2 a.m. calls to physicians begging them to come in. There are hands of the dying I couldn’t hold. There is the cold, waxy yellow hue of skin and the silence of those who died alone.
I come home to debates and arguments on social media. I receive compliments calling me a hero and messages in my inbox calling me a fraud. An elderly woman at the grocery store sees me in my scrubs and accuses me of spreading disease. Several in the store aren’t wearing masks.
I don’t know whether I love or hate my job. Eight months ago, I felt motivated to help. Now I question my own sanity for putting myself in harm’s way. I wonder if my heroics are egoic. I certainly don’t feel like a hero. We begin demanding hazard pay. For three weeks we are given a bonus but only if we are severely understaffed. Then the bonuses stop. I have another exposure, this time in the emergency room. I avoid hugging my daughter for one week. Her father is a Covid nurse at another hospital twenty miles away. I wonder if he has been exposed. Every maternal instinct inside of me is screaming yet I can’t hold my own child or kiss her goodnight. This isn’t worth it, I tell myself. I consider quitting but I was not raised to be a quitter. Not quitting is what got me through nursing school. A horrendous divorce. Climbing a 14,000-foot mountain. I am resilient. Everyday on the drive to work I tell myself Just get through this shift, it’s only 12 hours.
I am a divorced, single mother and can’t find childcare, so I rely on my 18-year-old daughter. At her age, I was shuffling boyfriends, backseats, and hopping buses to Seattle. My daughter never had a graduation party. Her last day of high school ended abruptly. No prom. Her gap year program in Costa Rica was canceled. College on hold. She stays in her room socializing online with her friends in Boulder. I used to abhor her phone, now it’s a godsend.
Lines of missing assignments stare at me from my seven-year-old daughter’s Chromebook. Lily doesn’t want to do distance learning. She fidgets at her desk incessantly and most of her assignments are glorified video games.
One day the string on my N95 breaks. I go to the infection control nurse’s office for a new one but she is nowhere to be seen. I haven’t seen her in months. There are no N95 masks. I am given a PAPR but I cannot use a PAPR. They are noisy and I am mildly deaf. A severe strep infection and fever blew out my hearing in my 30’s. I cannot communicate with my patients. I cannot gauge their pain or their needs. There is nothing we can do. Try buying an N95 at Home Depot. I get home, sit in front of my computer and file an OSHA complaint.
Nurses have been fired for filing complaints. I have been following an incident in Minnesota where an emergency room nurse was fired for wearing hospital scrubs instead of his own, even though these scrubs were made available for physicians. He was trying to avoid bringing Covid home to his family. His nursing license was at risk of being revoked. I complete the form, take a deep breath and press “Send.”
A word comes to me: choice. If hopelessness is indeed a choice, then I must choose to leave the hospital. The hospital wasn’t stealing my happiness, I was giving it away. I was giving it away by punishing my body with lack of sleep and putting my health at risk. I was giving away my happiness with chronic stress. I was giving away my happiness by staying in an impossible situation. I was no longer a hero, I was a victim.
Two weeks later, I am called into a meeting with human resources. I’m told I am being fired for failing to properly waste an antibiotic and scan a medication. I am given a check for $121.00 and the contents of my locker. I keep my resignation letter in my purse, smile politely, and leave.
Later that day, I receive a call from a nurse recruiter offering me a travel nurse position on a Covid unit in Los Angeles. My phone gets bombarded with these calls and texts every day. I laugh and tell the recruiter I had just been fired, but it doesn’t matter. He offers me the job. I tell him no thank you, and hang up.
Nurses are predominantly women. A society that doesn’t value women will not value nurses. No Blue Angels flyover will fix a broken healthcare system and the toxic culture of nursing. No yoga class will remedy impossible patient loads and workloads. Being fired from the hospital felt like rock bottom to me, but I’ve learned that rock bottoms are new beginnings in disguise. Covid is traumatic, but hospital leadership and administrators further traumatizes healthcare workers. As long as nurses are treated like they are disposable, as long as old systems of power and managing by intimidation continue, we will continue to fail. If we want to save our healthcare system, we have to save ourselves first. We were sick long before we got sick.