I have always said that my choice to become a nurse was a calling and not a career. The powerful words of my mom and my grandma have stuck with me: “You would make the perfect nurse.” It’s almost as if nursing chose me.
This calling has shaped me over time. It has taught me about the vulnerability of people and the metaphorical masks they hide behind. My patients are in crisis. They have reached their physical, emotional, and psychological limits and are often vulnerable in ways they have never been before. As a caregiver, I take these moments seriously and feel the dance between privacy and exposure .
COVID-19 has shrunk the gap between the medical world and the public. For the first time, it seems like people actually have an idea of what I do. ICUs and hospitals have been front and center in the media for months now and the public is calling us heroes, front line workers, and saints. It makes me cringe. I chose to do this, love what I do, and go to work just like before.
The difference in going to work during this time is that I could get it. “It” being the very thing for which my patients are being treated. COVID-19 can be lurking anywhere, but I walk right into it. At first, that was so hard. I dealt with it by talking to my therapist, praying, writing a plan for my funeral, and talking to my husband about my wishes in the event that I need to be hospitalized, or even if I died. Those are conversations I didn’t think I needed to have yet, but knew it was time. I have two young girls, ages five and eight. One day my five-year-old asked me “Who will be my mom and dad if you die of COVID?”
In a matter of fact way, I told her she wouldn’t get another mom and dad, but that her aunt and uncle would take good care of her. She responded with an underwhelmed “Okay.” After talking it through, I felt better and my girls seemed to be too. Since then, some of the weight has lifted off my shoulders and I feel more free to give myself to work without a black cloud of “what if” following me around.
Who are COVID-19 patients? They’re young, they’re old; some were in good health before COVID-19, others were unwell. They are men, women, a variety of ethnicities and sizes — they can be anyone. Most of my patients have had underlying health problems and are in later adulthood; they’ve had different routes of exposure, but somehow they all ended up with COVID-19. Early on, I saw patients that had been exposed while traveling. Now I see essential workers — delivery drivers and grocery stores employees, or even just people who chose to play golf, finding themselves sick. Many others come from congregate living situations like group homes or nursing homes.
They almost all have harsh coughs that exhaust them. They sleep a lot and say they feel horrible. They complain that they can’t breathe, they don’t want to eat; some burn up with fever, some have diarrhea or feel nauseous. Some have lost their sense of taste and smell, most feel achy all over. Some are too sick to be able to talk to us at all, sedated on a host of medications and hooked up to multiple machines. The symptoms, just like you have read about, are as diverse as the patients themselves.
What does it look like to care for them? Sometimes it means propping up an iPhone for their family to see them and say hello. Sometimes it means sitting and listening because they are so lonely. Other times it means having long phone conversations with family to give updates and reassurance since they cannot be face to face. It means leaving the patients alone to sleep, giving them a warm blanket, or a back rub. Often it means turning them on their stomachs to help their lungs expand more fully. Prior to discharge, it means keeping them company and hearing their life stories just to break up the hours. And then there are the times it means holding a hand while they die because their family has reached their two hour visiting limit and has to leave. My heart breaks for the families that have to keep their distance.
I had one patient on the ventilator who was awake enough to communicate through writing. He wrote to me about his past career and his love for his family. I gave him a warm blanket and he danced in the bed. I had so much hope that he would be one to walk out of the ICU. Four days later, his family sat on the other end of an iPad screen and watched as he passed away, having to ask the awful question of “Is he still breathing?” while watching from afar. Through a choked voice and mask that makes it seem like we’re yelling, we had to tell them no. These moments become emotional imprints on all of our hearts.
At my facility, we allow one family member to come visit for compassionate reasons only, and for a max of two hours. They have to wear proper PPE, which includes a big hood with a vacuum pack attached to the belt. From what I read about other hospitals, this is generous. How do you choose who that one person is going to be? How do you leave when you know you’ll never see your mom/sister/loved one ever again? And yet, while others are out protesting and yelling to the online abyss, I have witnessed these family members quietly leave in tears. They are the ones hurting in the midst of this, and yet they are also the most understanding and compliant.
I have practiced over the years the art of compartmentalizing. I often download to my husband, who is also a nurse. He actually gets it. Then I look ahead. This time it’s harder. It follows me onto my Instagram feed, to my news outlets, to my everyday conversations with friends, neighbors, coworkers, and even my kids. It follows me home on my dirty scrubs and into my thoughts and dreams. I have nightmares weekly of forgetting to wear my mask onto the unit, having to code a COVID patient, or forgetting to go to work.
Minnesota is starting to open things back up. I get it, but at the same time I’m scared for what that means. It hasn’t hit my circle of people yet and I don’t want to be the one responsible for bringing it there. The guidelines make sense, but do they make sense for me? The fear is real up close in the eyes of my patients, in my whirling brain, and it’s real in the lives of the public.
The question then has been what do I do with my fear? At times, it means I face it with bravery. Other times, it means taking a break from any media source and hiding in the pages of a book. Sometimes it means talking about it with those close to me. Mostly, it comes back to choosing kindness in all situations and trying to see that everyone reacts differently to fear and loss of control. I want to look back and know that I treated the other like a neighbor, that I cared enough for vulnerable individuals to make personal decisions with them in mind. I want to hold space for people in their moments of fear like others have done for me.
And let’s not forget, the only enemy is the virus itself.
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