A nurse on the pandemic year: What we didn’t expect was the emotional toll | Essay

A "prone team," prepares to turn a COVID-19 patient onto his stomach in an intensive care unit on April 24, 2020. Photo by John Moore/Getty Images.

When I decided a year ago to volunteer at M Health Fairview Bethesda Hospital, caring for COVID-19 patients in our dedicated Intensive Care Unit, I had mixed emotions.

I would be lying if I said that fear wasn’t the biggest one.  

I’ll never forget stepping into Bethesda the night that it opened — I was so grateful that a couple of coworkers from Saint Joseph’s Hospital had volunteered to step up and fight this viral enemy with me.  

Hard-working staff, managers, administrators and other workers had gotten Bethesda up and running in a week’s time, to serve as a dedicated facility for patients with the most severe cases of a previously-unknown virus. I remember our manager, Angie, telling us, “Welcome to MASH 2020!” At the time, I wasn’t sure exactly what that meant. Soon enough, I would. 

During our first night at Bethesda, which we called “the COV,” I stared through the window of one of our first patients, and I said a quick prayer for him — over time, I found myself praying a lot while caring for patients. Sometimes, I prayed for myself, too. The patient was just a young, healthy man with no underlying health conditions that we knew about.  

The more days I worked, the more patients flooded in, and the Bethesda team became a well-oiled machine. What we didn’t expect at the time was the emotional toll. 

In my seven years as a nurse, I’d never seen so much death — I had six patients pass away over the course of one shift. This virus could infect anyone. At our busiest time, we had three ICU floors open. 

The days blurred together. A lot of staff members picked up extra hours, compelled to be there for our patients.  

Due to COVID-19 visitor restrictions, we also took on the role of family members for our patients. To keep our patients and ourselves safe, relatives were not allowed to visit their loved ones, unless death was imminent.

When I did have time off, my head was filled with thoughts about how patients were doing. I wondered if they would still be there when I returned. These racing thoughts made it almost impossible for me to get adequate rest and focus on my own young family. Even when I was at home, my mind was at Bethesda.  

We saw our community at its absolute worst, patient after patient coming on to the unit. For patients facing possible intubation, the sheer terror and anxiety they experienced was heartbreaking. 

Patients asked constantly, “Am I going to be ok?” What could I say? I’m still not sure if I ever came up with the right answer. All I could do was assure them that I’d do everything in my power to keep them safe. I made sure they knew the plan of care for that shift and, most importantly, let them know that they were never alone, even offering to pray with them, if they wanted.  

For patients on ventilators, the most common question we got was, “Can they hear me?” This usually came from family members, on a video call with their loved one via a tablet computer. They could see their loved one — but the patient had a tube coming out of their mouth, several IV pumps and the background noise of frequent alarms.

I believed that they could hear us, I told them. I always talked to my patients and told them what I was doing, even though hearing could be hard due to the negative air flow systems. It could feel like you were talking in a wind tunnel.  

I encouraged any form of communication to the patient through the tablet — some families played songs, read prayers or quotes from the Bible. I can think of one patient who always got together to watch hockey with his friends. He contracted COVID-19 and ended up needing a ventilator, but his friends would all join him over video call and watch the games together while he was sedated. 

Not only did we become physical family for our patients, in a lot of instances, we met their spiritual needs, as well. I can think of one prayer service that I was involved in for a Spanish-speaking patient. The patient was not doing well, and the family asked if we would participate in the prayers. They not only prayed for that patient, they also offered prayers to all the staff at Bethesda. They prayed with tears streaming down their faces, asking God to protect us and give us the knowledge to beat COVID-19 and find an answer. There was nothing more that any of us wanted than to give these people hope, answers, some good news.  

If I’ve learned anything about COVID, it’s that it’s extremely unpredictable. One day, you were thrilled to give a patient or family the smallest bit of good news — their loved one was moving in a positive direction. The next day, things would get worse. Some days, it felt like you took five steps forward and 10 steps back. You could see the disappointment on the faces of the patients and hear it in the voices of family members over the phone.  

In October, M Health Fairview transitioned COVID-19 care from Bethesda Hospital to Saint Joseph’s Hospital until the virus’ course of destruction is done.  

Fast forward to the past few months — vaccines are available, the number of COVID-19 cases are finally trending down and M Health Fairview has decided to end its dedicated COVID-19 ICU at Saint Joseph’s Hospital. It’s a process I’m familiar with, as the health system did the same at Bethesda Hospital after the second large wave came though Minnesota. 

This should feel like a hopeful, positive milestone, right? And yet, here I sit thinking about all that I have gone through. Up until this point everything seemed like it was on fast forward — a constant flow of chaos. If I wasn’t putting out fires as charge nurse, I was caring for some of the sickest patients I’d ever seen.  

Now that things have begun to calm down, and the end of COVID-19-specific care is near, I find myself having a lot of flashbacks about everything that I saw. Usually, they’re memories of patients that passed away, patients we tried our hardest to save but just couldn’t, family members that called every night. 

I think back to good memories, too: Patients we saved — we had one of the highest survival rates in the country — and watching a husband and wife see each other for the first time in 30 days. The unbelievable bond that was created between nurses all over the country that answered a call for help and didn’t think twice. The lifelong friends that I have made. 

Unfortunately, the hard memories outweigh the easier ones.  

I started to really digest everything that had happened, and felt alone even though I knew I wasn’t. I remembered “Make you Feel my Love,” an Adele song a wife would play for her sick husband every night. 

I took my daughter to her dance lessons one night and heard that song blaring from one of the studio rooms. Instantly I was transported back into that patient’s room, listening to his wife playing that song and telling him how strong he was and all the things he still had to live for. I was standing in the middle of a room with strangers, tears rolling down my face.

I knew I needed to talk to someone and sought medical help for the anxiety.  

With the help of some amazing people at Minnesota Mental Health Advocates, I was able to find a therapist to help me unpack everything that was constantly running through my mind. I am still working on my journey toward healing. 

My therapist diagnosed me with post-traumatic stress disorder. PTSD was never something I thought I would have to deal with in my career. I always thought of it as something that people who went to war experienced, not nurses. Then again, I never thought I would find myself in the middle of a pandemic, either.  

What I want people to know more than anything is that even though the rates of COVID-19 are decreasing, cleaning up the debris from the virus is just starting. I know several coworkers like me. You don’t always need to ask, you can tell by looking at their faces. The exhaustion from what we have gone through is apparent. But I also guarantee that if you asked any of us, we would do it again. That’s how passionate we are about our jobs and our community.  

It’s the things like this that the public never saw or experienced that haunt me. I didn’t go into nursing to be a hero, I went into nursing because I love people and I wanted to help them. I hope that this article reaches someone like me, someone who felt alone. I want you to know that you’re not. 

COVID-19 has changed so many lives, but I won’t let it beat me. Maybe there are a few new cracks in my exterior, but I hope to repair them and grow from this experience. I want to send a heartfelt thank you to everyone who has supported me the past year and almost three months. I wouldn’t have gotten through it, if it weren’t for all of you. 

Now, onto my next journey. 

Editor’s note: in the early days of the pandemic, Emily Allen wrote about why she volunteered to become a COVID-19 nurse. You can read it here.