My Dream Job as a New ICU Nurse
I have always known that I was meant to be an ICU nurse. Call it intuition, divine planning, or blind ambition. Since I was a child, my dream was to heal the sick, to protect those too weak to protect themselves, and to nurture those in their most vulnerable states.
From the moment I enrolled in nursing school, I knew that the ICU was the place I would call my home. No other fields ever interested me; I wanted to care for the "sickest of the sick." Every decision I made in school and during my first year as a nurse, came from an unshakeable need to land a position in the ICU. After pushing myself to the brink of insanity to keep the highest GPA in my graduating class, accepting a new-graduate position on a medical stepdown-ICU, and putting in countless hours of overtime and continuing critical care education, every sacrifice I had made up to that point paid off. I landed my dream job: a position as a Medical-ICU nurse. I had never in my life felt the sense of purpose, belonging, or fulfillment that I felt as I navigated my way through the first few weeks and fell into a rhythm on my new floor.
Unprepared and Unprotected
It's surreal to me, that this was only a few months ago, in November of 2019, when I felt so elated. In a month that has felt like a decade, my life as an ICU nurse has come to include only 2 realities: walking unprepared and unprotected into a warzone of death and isolation, and hiding in my home, for fear of infecting those I love the most with the very disease I'm fighting so hard against (COVID-19). Where I once felt excitement and purpose, I now feel hopelessness and defeat. I spend my waking hours trying to decide if it's better to be the coward who deserts her comrades on the battlefield, or the hard-headed, idealistic fool who goes down with a sinking ship in the name of duty. As the US assumes the title of "new COVID-19 Epicenter," I can't see a third, "preferable" choice for myself.
By now, the internet is flooded with nurses' testimonials, showing photos and videos of the unbelievable lack of resources and protection we have as we care for an escalating number of COVID patients. In one week, my hospital went from having 2 COVID quarantine units, to 6, with even more projected to be converted. My floor itself is not a designated unit, but each of us is sent to the critical COVID unit, at least once a week. This upcoming week will be my third week in a row using the same N95 mask; I was lucky enough to get a new face shield last week, as mine was so beat-up that it finally broke. Last week, my mask didn't even fit to my face, because the elastic straps are so thinly stretched. I have been praying that it lasts me through another shift, because we're just about out. Someone stole almost all the boxes of masks.
Skepticism and Mistrust
In the blink of an eye, my naivety has been replaced by skepticism and outright mistrust; I cannot believe for a second that the measures we as nurses are being forced to take while we care for infected patients, are remotely safe. We aren't protected; we know we aren't protected; we're offended and resentful over being told that we are protected. ICU nurses are quick thinkers. We know that what we're being told about our protective equipment is a desperate quality control measure, designed to prevent a panic.
Unexpected and Unprotected Exposure
I had to get tested last week, as well. Our whole floor got exposed, unknowingly, for a solid 6-8 hours. ICU is all about priorities, right? A patient comes in for a cardiac arrest, we're working on keeping him/her alive, and dealing with extraneous issues later. When a patient is crashing, we're also all in the room, helping each other out, working as a single well-oiled machine. Unfortunately for us, after an admission was sent up from the ED without being tested, we learned that this particular patient was from a "hot spot" county, and had been presenting with all the cardinal COVID symptoms for the past week.
I can't explain how it felt to hear my child sob when I told him that I couldn't pick him up for a few more days, because I might have the virus that was making everyone so sick, and I couldn't get close to him until I found out for sure. I felt unspeakable shame, like the most selfish human on the planet, for being so devoted to my "dream job." I sat all alone at my house for 4 days, crying and hating myself for becoming a nurse, until the test came back negative.
Fear and Guilt
Even after my negative test, I still feel the same nauseating fear and guilt, every waking moment. I can't sleep, and the few hours of sleep I have gotten, have been plagued by pandemic nightmares. The fear follows me everywhere I go, sometimes nagging in the back of my mind, sometimes churning in my gut. It's the same questions, every time: "How long before I'm infected? How do I tell my kid that I won't be coming home for a while, and he can't see me, because I'm so sick that it isn't safe? What if I pass it to my dad, who has been the only person I've allowed to keep my kid since this whole thing started? What if he, the man who devoted his whole life to raising, supporting, and protecting me, spends the last days of his life on a ventilator, alone, with no one to hold his hand and pray with him...because of me?" At these times, it seems impossible to set foot back in my hospital.
Then, I think about my patients. These patients are living my worst fears. They're unable to be at home with their loved ones, for weeks. If they're sick enough, they can't even talk to their families, because they won't last without a mask...or a tube. They're fighting for their lives, while we have to update their grief-stricken families over the phone, and tell them that they can't visit and be with them at their most critical hour. For these patients, we nurses are the only human contact they get. For the ones who inevitably will not survive, our voices are the last that they hear. Our hands are the last that touch them. Our prayers may be the last said for them, and our tears may be the last shed for them before they leave this world. When I think about the horror these patients and their families are facing, I can't imagine not showing up for my next shift.
No Answers - No Happy Ending
As much as I'd like to believe the hopeful messages that this pandemic will soon pass and our society will again be safe and free, I don't see it. With everything in me, I don't see it. Never in a lifetime would I have guessed when I became a nurse, that it would mean putting my own life and the lives of those who I love the most at risk, to save the lives of others. I have asked seasoned nurses for an answer, and the answer I've come to is that there's no answer. There's no happy ending. Those of us who have chosen to walk away, have done their best; those of us who have stayed, are doing our best. Unfortunately, right now, the best we can do is nowhere close to enough to protect ourselves and those around us.
For the time being, I will keep fighting the outward battle at the hospital against the pandemic for my patients. All the while, I'll keep silently fighting my own internal battle, until I figure out if it's better for me to be a coward and leave, or to be a fool and stay.