All Hands on Deck- The Pandemic Through The Eyes of America’s Frontliners
I sat down with two nurses for my final interview- Leslie, a nurse who received last-minute ICU re-training in the face of the pandemic, and Dave, the Head of Nursing at a hospital in Pennsylvania, which was hit particularly hard during the pandemic.
Batenburg: So, obviously, you two have been in this since the very beginning— what was it like when you got that first COVID patient?
Leslie: At the beginning, when you were told you were getting a COVID patient- it was really terrifying. You would get PPE tested- and if you passed, all you’d have to do was mask up with an N-95. In my thirty years of nursing, not once have I ever passed that test. This meant I had to wear the whole garb- it sort of felt like being an astronaut! There was a fan in the headgear, and it was incredibly claustrophobic. The air circulates around your hips, and then it is pulled in through a vacuum and out the top of your head- to keep it away from your face and keep the infected air away. It was incredibly difficult. When you get a COVID patient, you aren’t with them for just 30 minutes or so, you’re with them for four, five, six hours at a time, so you're in that space-suit for hours on end.
Leslie laughed a bit, describing how uncomfortably warm it could get in those suits- even with the fan. I went on to ask what it was like once the pandemic really broke out in the United States. I, like so many other Americans, were curious what it was like once patients began to swarm the hospitals, especially out on the East coast.
Dave: When we get news of a new pandemic, one that is meant to be world-ending, we sort of have to take a step back as nurses. Most times, it just tithers off. We thought it would be like Swine Flu or Ebola- we thought we’d have one or two patients, and then we would see the end in the US. Even when we got our first COVID patient in the ICU, we thought they’d be our first and only patient. We compared it to SARS, MERS, really any respiratory virus that has made a name for itself in the past few years. We got our first COVID patient on February 20th, and by late March, when we still had all of these new patients coming in 2, 3, and sometimes 4 per hour- we realized things were far worse than anticipated. My hospital was in the hardest-hit county in Pennsylvania. We didn’t have the nursing staff, and the patients took so long to take care of- we just had no way to handle it. We’d have patients being intubated within two hours of admittance.
Dave told me then about the issue with intubation- the process, when put into Layman’s terms, effectively results in a spillover of infected fluids from the throat, which puts every staff member in the room at risk. Not at all ideal for the nurses, nor for the theatre of the mind when attempting to picture the ordeal. After shaking that image, though, my mind went to where everyone’s does when they hear about intubation- the death that so often follows. I asked what that was like in the hospitals. How did nurses deal with the inevitable mass of bodies?
“The problem was not the mass of people, at the end of the day,” he told me. “It was the fact that we had no handle on treating them. It seemed like we were getting new guidance every day, and our patients died so quickly, and we had no idea how to slow this down. You hear a lot about the lack of beds in the hospital, all the new patients. That wasn’t the real issue for us- we had to bring in a refrigerated truck every day, just to deal with all the bodies and get them out of there.”
For those of you with a strong stomach or insatiable curiosity, Dave mentioned that there are a multitude of images of these trucks out there on the net.
I then went on to ask what the experience post-vaccine was like, particularly in light of the anti-vax movement.
“After the vaccine came out, we found ourselves getting what is known as ‘compassion fatigue,’ caring for patients day-in and day-out, our shifts doubled, just because we didn’t have the staff to supply all of these patients. In addition, all of our nurses were getting jobs elsewhere- places like Florida, California, etc., where you get paid so much more, which made working at the hospital back home so much worse. It was literally like being on the frontlines. I remember doing natural disaster nursing after a set of three tornadoes for the Red Cross- and this was a thousand times worse than that. We had to re-use gowns; we never had enough supplies- you had to throw out everything you were taught. You had to do crisis management every single day,” Dave told me.
“This all contributed to that compassion fatigue- after a year of watching all of these people die, and getting new ones in that are refusing the vaccine, refusing help- it gets hard to feel anything but the exhaustion.”
I turned my attention to Leslie, asking if her hospital experienced anything similar.
“For my unit, we had a disaster plan. Worst case scenario, we had to have more ICUs. Of course, I was an ICU nurse for 15 years, but I also hadn’t been an ICU nurse for 15 years,” Leslie added. “This meant I had to go through all the ICU training again, very last minute. It was awful. Being in the ICU at that time- all breathing machines and watching all of these people die- everyone was very uncomfortable.”
The two went on about various emergency action plans in the ICU, how it was carried out. Soon after the mention of the mention of the mask shortage among the general public in early 2020, conversation turned to the current mask debate happening across America.
“People not masking is something that angers me to no end. These masks help prevent the disease- and both political parties politicized it! It got to the point where I had seen so many people die that I essentially said to myself, ‘I’m okay if people don’t want to wear a mask, but if you don’t- don’t come to the hospital.’ I lost friends over this, but I’d seen far too many people who didn’t get the vaccine and didn’t mask- they always asked for the vaccine before they’re intubated,” Dave recalled. “I don’t think these people are stupid- you believe what your inner circle saying- your friends, politicians, your family. It’s very hard to see out of that. They aren’t stupid; in fact, I know many very smart people who believed those things, but it took them facing death head-on to be open to anything outside of their viewpoint. This isn’t red versus blue; it’s life versus death. I felt bad for them, really. There’s been a change in their patients- we went from parades, people banging pots and pans, police blaring sirens as they pass- to patients just being mean. They’re angry and frustrated, and I get it! They want to be better. We had a patient’s daughter curse out a nurse after her father was admitted for not giving him a medication that we didn’t have access to! It was insanity.”
I pressed them for more- what did this look like towards the end? Did that lack of compassion take any toll? Was there anything that helped them get through it? It was here that I heard a break in both of their voices- clearly, this was the hardest part of the pandemic. The aftermath.
“I think all of the nurses show some serious signs of PTSD from what we’ve experienced in the last two years. One of our students near where I work- she’s 17 and a very talented artist- painted a picture of what she felt we went through.” It was here that Dave began to choke up; his voice wrought with emotion. “It’s basically three healthcare workers embracing one another, and they form a heart. Every time I see it, I feel the emotion of the past two years. We lost a lot of staff- so many people couldn’t take it, and I understand that. I see so much hardness in folks- that compassion fatigue- and they can’t get that back. You can only see so much death. We’ve lost so much of our heart in the past few years in healthcare. Nurses and doctors are famous for their gallows humor- you have to have it when you see the stuff we do. You’re either laughing or crying- but that doesn’t happen anymore. Nothing is funny anymore; we’re all burnt out.”
The painting that Dave describes is the header image for this article and is titled “Everything Will Be Alright.” It was created by 17-year old Tiffany Nguyen. Leslie then told me that she had a similar experience with her hospital’s “bridge of stars.”
“I will say that during the height of the pandemic, we had a bridge of sorts. It led from the hospital to the parking garage- and it’s filled with windows. So we started to put stars on the windows- small ones for people who survived covid and went home, and large stars for people that were intubated and went home. To walk across that bridge to see all of these stars gave me goosebumps,” Leslie said. “That was at the start- by now, it is over the bridge, spilling into the hospital. It gives me hope, seeing all of our stars.”
As the interview wound down, and our time was coming to a close, I asked what they thought the best “next” steps were in this pandemic.
“Going forward, I think we need to get back to the new normal. I think we need to, well, normalize COVID. We understand now how to treat this, we have the medication, and we have trained staff. I go back to the Tuberculosis pandemic- the masking, quarantines- all of it. It so closely mirrors what we are experiencing now. They had dedicated TB wards, which slowly shut down as the pandemic died out. Nowadays, you get tuberculosis and get quarantined and medicated, and then you’re sent home when you’re better. I think that is our new normal- that is where we need to get to with COVID. The same thing with the Spanish Flu- those who were going to die died, and people either got the vaccine or contracted the disease, and then in two to three years, it was under control. Before COVID, nobody remembered the 1919 pandemic aside from historians and a handful of nurses,” Dave and Leslie laughed. “After 1919 came the roaring 20s- and I think that is on the horizon for us.”
