We’ve been at the frontlines of this fight for nearly a year now, especially those of us in critical care roles. I know the new “norm” for my typical day in the Covid ICU involves caring for critically ill patients who are ventilated, sedated, and often paralyzed/proned for improved ventilator compliance. I often find myself managing multiple lines and drains like chest tubes, orogastric/nasogastric tubes, tube feedings, and multiple IV lines…frequently more than 5 at any given time. These patients also tend to require emergent dialysis or continuous renal replacement therapy (CRRT). Many of the Covid ICUs are now open units, meaning we have to wear personal protective equipment (PPE) at all times leaving little or sometimes no time for breaks, meals, or hydrating. The patient load tends to depend on the availability of adequate nursing staff at any particular time. Some days, I have one of these typical patients and other days more than that.
To say that Covid has impacted the nursing profession, arguably the most extensively, would be quite an understatement. I wanted to bring some light to a few of the mental, emotional, physical, and spiritual dilemmas I’ve encountered over this past year working as a Covid ICU nurse.
One of the easiest aspects for the average person to imagine and relate to would be the mental effects this pandemic has had on nurses. Speaking from first hand experience, I can attest to the fact that I have encountered a new level of anxiety, depression, and self doubt. Despite using talk therapy to work though these times, I still have panic/anxiety attacks from time to time and have “as needed” meds on hand just in case. On my days off, I try to do low stress relaxing things to counterbalance the stressors from work. Social isolation is another concern, because this is typically both intentionally and unintentionally done. Others may stay away out of fear, or we may find ourselves becoming the more seclusive ones.
Emotionally, the impact is just as great when compare to the mental effects of the pandemic on nursing professionals. Aside from anxiety, depression, isolation, and self doubt, I’ve also experienced emotional lability, numbness, guilt, and feelings of helplessness and hopelessness. It is completely frustrating to do everything in your power to help a patient improve, knowing full well that it won’t make a bit of difference. Then you feel guilty for thinking that. Deaths start to take a toll on our gentle, loving souls…so much so, it eventually becomes this numbness that consumes you. Finally, I’ve noticed that lately I tend to feel increasingly helpless and hopeless about the career choice I made, the powerlessness I have against this virus, and the interventions that feel like they no longer serve a purpose.
I would also venture to say that being a Covid nurse also has an effect on our overall physical health. I’ve had days where I gain weight and have an endless appetite, while other days, I have no appetite and have lost five pounds in a day. While working with Covid patients, I find that I am dehydrated a majority of the time which causes dried and cracked mucous membranes, headaches, body aches and an overall aged feeling and appearance. Further, personally, I have suffered from a few stress ulcers over the past 12 months which cause extreme pain and require treatment with anti ulcer agents, antacids, and at times, courses of antibiotics. Not everyone internalizes stress in this manner that I do.
And finally, there are also spiritual dilemmas that have surfaced from working with patients of and living through this pandemic. Much of the time, I find myself searching for the meaning to life and meaning within my career field as an ICU/CVICU nurse. As a person who has never been devout with a specific religion, I find myself grappling with whether or not a higher being truly does exist. If one does, how do they allow so much suffering for each Covid patient I care for? How do they allow a virus to so extensively impact our world? Why do I keep putting forth so much effort when nothing seems to make a difference? Conversely, I also feel as though something is missing from my life that cannot be fulfilled by other people or material objects. Part of me believes this can’t be it, and there has to be more to life than this brief amount of time we’re on this earth. Plus, meditation can only spiritually fulfill a person so much…
Overall, there are a plethora of issues that have arisen from the coronavirus pandemic. What’s more unfortunate is that the bulk of these resounding and long lasting issues affect those frontline workers whom we rely on most to get us through these times. I’d even venture to say that one could compare these experiences and their effects to post traumatic stress disorder.
On a brighter note, there are a few good things that have come from this struggle as well. First and foremost in my mind is the enhanced communication and collaboration among colleagues and various disciplines. This has forced us to become excellent at delivering patient centered care. Additionally, nurses like myself, have had to take on unique skills and specialties in the wake of depleted resources. Often times, I function in the capacity similar to a respiratory therapist, phlebotomist, dietician, etc. Our patients cannot afford for us to be lacking in the skills and/or knowledge required to sustain their life or save it. Lastly, I have noted remarkable increased personal strength, resiliency, and adaptability. Take time to reflect on what this pandemic has done to change you and use it to your advantage. I challenge you, as well, to find something beautiful in all of this murky chaos. Keep fighting and keep pushing forward, because trust me…we need you and we are exhausted.