There are very few things that shake me. As a nurse, I am used to the impossible, inevitable, irritating, heartbreaking, jaw dropping, sometimes hilarious realities that constitute human behavior. However, this pandemic has been shocking from start to finish, and I say that as a nurse who has caught her patient nonchalantly drinking his own urine as if it were a latte.
I honestly have put off writing because I don’t know where to begin. But I don’t think anyone really does, so I will start and see if the words come.
We recently expanded our relatively small ICU into our stepdown unit. We are all being stretched. Soon it will extend to our medical floor, and then the hallways and grand marble lobbies. But the most horrifying fact to me is now that, instead of the East River, our patients rooms now overlook the white tented morgue set up for this pandemic. And although it’s such a small thing, it’s a jarring and constant reminder that death is close. Perhaps it will come for you, perhaps it will come for someone you love, if it has not already, and the anticipatory grief is mind numbing.
Death is so rarely peaceful, especially not in intensive care. Modern medicine is an amazing and beautiful thing, and our efforts are often met with miraculous success. However, for many, instead of dying gracefully, peacefully, surrounded by families and loved ones, our patients die slowly, life draining from cruelly, in a second by second agony of tubes, drains, and medications titrated at mcgs per hour. Death is often prolonged because of the interventions we use to keep our patients alive. But some survive. So here we live, at the breath between life and death-seconds away from loss, seconds away from life.
Moral distress in nursing is heightened with the outbreak of this pandemic as we try desperately, sweating, bleeding, tearful, in full protective gear which we have rigged together in our own desperate attempts to stay alive, overworked with doubled or tripled nursing ratios, to achieve the godlike and impossible aspiration of turning back time, and again and again, only to lose to death again. I am not new to intensive care, and yet I watch this pandemic unfold and cannot fathom the ramifications. As nurses and healthcare providers we grieve the great losses of our world, our city, our communities, our families. We are all carrying the weight of Atlas, but nurses and physicians shoulder not only the weight but the physical and emotional cost of care, and we are not ok. We may not be ok for a long time. This pandemic will have enormous and lasting ripples on our lives and backbones and hearts. You will grieve, but we will remember the dying breaths, the screams, and the agony, and sometimes in the quiet, wonder if we did enough, if we are enough, and if there was anything else we could do, into the dark hours of the night.
All this, of course, if we live through this. I am told by a friend that 30% of nurses are sick at a hospital which will remain nameless. Another texted me, afraid, trying to find what happened to a friend and team member. We feel the fear, as we put on our scrubs, as we wear our masks throughout twelve hour shifts. As we run down hallways, as we attempt resuscitation, as we breathe with our patients, we are not superhuman or vulcan. We are very, very human.
I am trying to process, to breathe, to grieve, and to still laugh at the numerous idiosyncrasies of life. I had one patient get better. There will be more. There are so many sweet things in life-baby pictures, puppy snuggles, letters from friends, flowers, encouraging messages and notes, cups of coffee…amazing meals… I am beyond overwhelmed with the amount of love and support Collin and I have received and yet I am still grieving. Thank you for the love, we feel it minute by minute and it warms our hearts on the hardest of days. Yet over the past few weeks I have often felt lost and I often wonder how anyone can retain their own sense of self in this endless tidal wave of grief and loss and anger that threatens to destroy us.
I cried today for the first time since the beginning of the pandemic, I am certain I will again. I lost a patient, I’m sure it will not be my last. We did everything we could, but it was not enough. I listened to her husband sing to her and ask her not to go, but she did. Tears are healing, they remind us that there is space for our hearts and for our selves in this. Because families cannot be there personally, I try to wait in the room with patients as they pass, in their place, to hold their hand. I hope presence is enough. When I can find words, I will say them. But often I just stand waiting with them.
There is hope, even in death. There is light, even in darkness. There is comfort in the midst of horror. NYC, I do not know what will happen tonight. I do not know what will happen tomorrow when I go back to work, or the many days after, but I will stand with you for love and light until we can find it together.