I’m in a Covid hotspot and about to crack

[Zippy83]

I’ve been a hospice nurse for about a decade now, and had good coping skills related to death and dying, but there was definitely context involved. Now that we are having this insane surge in my area, for the past month the majority of the patients assigned to me are Covid positive or had Covid in the last few weeks. Many of them were not terminally ill with anything else prior to Covid, it is Covid that is killing them. Some patients did have cancer or other illnesses and were recovering prior to the Covid infection. And these patients are much more acutely ill and difficult to get comfortable, and time on hospice tends to be short since they are either discharged from hospital when it is determined that treatment isn’t working, or in SNF and never sent to hospital due to no availability of beds. Ages vary from 40s and up, with many of them under 70. I now jump for joy when I get assigned to an elderly person with end stage CHF or Kidney disease etc. 

In addition to the patients dropping like flies in a way I’ve never seen before, I’m encountering SNF nurses who cry at the nurse’s station because they keep losing patients left and right, healthcare workers who have lost family members to Covid and still come to work because they feel bad for the overworked staff, mortuaries telling us they can’t take the bodies because they are full. 
 

Up until December I really only felt like we were Covid-adjacent at my agencies, with occasional cases among patient and families. But the last 6-8 weeks or so have felt like a war zone. 
Any other hospice nurses experiencing this in your area? 

[TheMoonisMyLantern, ADN, LPN, RN]

I don't work hospice, I'm in LTC but I can certainly empathize with you. I enjoy providing end of life and palliative care, always have, and have always been comfortably with death and the dying process. That said, all these covid deaths have really gotten to me. I've been on the covid unit for weeks now, and even our residents that were relatively healthy and dropping like flies despite any intervention we try. It's really disheartening, as soon as someone has to get started on a non-rebreather or high flow nasal cannula it's like the warning sign that they're going to die soon. Many of them don't want to go to the hospital, and the hospitals are so overwhelmed they just send them right back to us if we do send them out. The whole situation is just so sad, families are so upset due to having such little contact with their loved ones through the pandemic, I hate making the phone call to tell them they've passed.

Have you spoken to either the chaplain or bereavement people through your agency? Maybe they could help you process your grief. Another option would be to utilize EAP if your company offers it. In order to keep you in the field I definitely think you need to talk to someone. 

Be well, and I hope things turn around soon.