Reluctant Heroes: Thoughts On COVID-19

[Penandpaper, BSN]

It’s hard to believe that it’s been seven months since the coronavirus disease was declared a pandemic by the World Health Organization (World Health Organization [WHO], 2020). Working in New York, when I first heard rumblings about COVID-19, I couldn’t foresee the impact that it would have on our nation and healthcare systems. During the early stages of the pandemic, steps were put into place to slow the spread of the disease such as travel health notices and quarantine measures (Schuchat, 2020). Despite these efforts, the disease accelerated with approximately 5000 deaths by March 12 (Jones, 2020, p. 1684). According to Schuchat (2020), mass gatherings, air travel, and crowded settings such as skilled nursing homes, hospitals, and other institutions were responsible for the virus's acceleration (p. 553). COVID-19 and the resulting pandemic required much versatility from everyone as we were forced to adapt to our current reality. This led to various governing local, state, and federal bodies creating policies to try to curb the spread of the virus (Schuchat, 2020). Many schools were dismissed and switched to online learning. For those who weren’t furloughed or laid off, their work became remote.

Thoughts

For those of us nurses and allied health professionals still working, it was a perilous time fraught with constant changing policies; scarcity of supply; and patient overload. Hospitals were overcapacity; workers were falling ill, and everyone had to do the best they could with the resources and information they had at the time. Patients and even some staff members that were well-enough one day were discharged, only to come back in worse condition. Staffing shortages that existed were compounded and structural and social inequality in our healthcare system was exposed. “Across the country, deaths due to COVID-19 are disproportionately high among African Americans compared with the population overall” (Dorn et al., 2020 p.1243). Minority populations tend to be disproportionately affected by other health complications that can make the COVID-19 virus particularly lethal (Li et al., 2020). It is not surprising then that “although Black people make up 13% of the U.S. population, they [accounted] for 21% of deaths from Covid-19” (Warren et al., 2020, p. 121(1). Residents of long-term-care facilities experienced a higher number of deaths from the coronavirus, “[accounting] for 8% of all coronavirus cases but more than 40% of all COVID-19 deaths” (Chidambaram et al., 2020, p. 1).  It was a trial but the generous donations from the community kept us going. We were hailed as heroes and cheered, although at night it was hard to sleep as I thought about the circumstances. It was a difficult time but Summer came along and cases seemed to wane. It seemed promising that maybe this was behind us. That was a hope - not a guarantee. Businesses, schools, and stores began to reopen, occasionally shutting down due to pandemic scares. Nothing was for certain and policies flickered on and off.

However, it’s December and things seem bleak, and I, like many people, feel weary of our newfound reality which consists of COVID tests, Zoom events, and the endless news coverage. Cases have risen again and that brings with it its anxieties. Promises of a vaccine loom in the distance and I can’t help but hope for the world to return to normal, or something close to it. 

In Closing

The coronavirus disease will forever remain in the minds of those who lost loved ones and family and those who have recovered, yet face possible long-term complications (Jiang & McCoy, 2020). COVID-19 is not the first pandemic to be realized. Of notable consideration are three pandemics of the 20th century, those being Spanish, Asian, and Hong Kong flu (Kilbourne, 2006, p. 9).  However, unlike these past pandemics, technology and scientific advancements can lead to the development of efficacious vaccines in record time. Although the death toll continues to climb and the future remains uncertain, it is cause for optimism. In this optimism though, lest it not be forgotten those whose lives were put on the frontlines to combat this pandemic as well as those who paid its price. 

References

Chidambaram, P., Neuman, T., & Garfield, R. (2020, October 27). Racial and ethnic disparities in COVID-19 cases and deaths in nursing homes. Kaiser Family Foundation.

Dorn, A. V., Cooney, R. E., & Sabin, M. L. (2020). COVID-19 exacerbating inequalities in the US. The Lancet, 395(10232), 1243–1244.

Jiang, D. H., & McCoy, R. G. (2020). Planning for the Post-COVID syndrome: How payers can mitigate long-term complications of the pandemic. Journal of General Internal Medicine, 35(10), 3036–3039.

Jones, D. (2020). History in a crisis - Lessons for Covid-19. The New England Journal of Medicine, 382(18), 1681–1683.

Kilbourne, E. D. (2006). Influenza pandemics of the 20th Century. Emerging Infectious Diseases, 12(1), 9-14.

Li, Y., Cen, X., Cai, X., & Temkin-Greener, H. (2020). Racial and ethnic disparities in COVID-19 infections and deaths across U.S. nursing homes. Journal of the American Geriatrics Society, 00(00), (1-8).

Schuchat, A. (2020). Public health response to the initiation and spread of pandemic COVID-19 in the United States. Morbidity and Mortality Weekly Report, 69(18), 551–556. 

Warren, F. (2020). Trustworthiness before trust - Covid-19 vaccine trials and the black community. The New England Journal of Medicine, 383(22), p. 121(1)-121(3).

World Health Organization. (2020). Naming the coronavirus disease (COVID-19) and the virus that causes it. Retrieved December 3, 2020.

[The Seasoned Nurse, BSN, RN]

Yes this experience has been extremely taxing. We have to stick together because we have no option except to go through it. If you are at a low point, you are not alone. If you are having a positive day, pull someone up with you. 

This will be over one day. But we will never be the same. Thank you so much for sharing your insights.

[toomuchbaloney]

We are going to need to be ambassadors for the vaccine.  We need most people to get immunized so that we don't have to chase this virus every year. 

[BSN-to-MSN, ADN, BSN, RN]

I would quit this acute care job already with short-staffing, sicker than ever patients and administration's expectation to do it all with a smile on my face.

But, I need the income.

And, I have an extra motivation to pursue further education.

Get out of bedside in 2 years.

[Nursemedic74, BSN, RN, EMT-P]

I feel like I didn’t sign up for this but in reality I did and more.  I took the oath and that choosing to do so meant whatever happens including a pandemic.  What wasn’t including was lack of protective equipment, unsafe staffing ratios and cutting corners on patient safety.   Those are things we stand up and fight for.  I wasn’t ready to change my schedule to be a teacher for 4 days and then work for 3 in a virus filled environment that we knew nothing about and have no cure for.
I am pushed to my limits every shift, always out late, little to no break, under a painters mask fitted with filters I’m not sure that work and wearing high school Chemistry googles all while donning a trash bag with arms .... and it was a fight just to get that.  My mental health is stuffing and I try and pick my times to break down ... if I can.  All this and in the back of my mind is I hope I don’t bring this home to my children or  get sick and leave my kids with out a father.     There can be some pretty abrasive people on here with less that uplifting comments that are very articulate.  Please, If this is you ... save your witty comebacks and quips.  I’m just sharing my own opinion and venting in a forum that is united in more than just one way. 
thank you. 

[spotangel, DNP, RN, NP]

4 hours ago, Nursemedic74 said:

I feel like I didn’t sign up for this but in reality I did and more.  I took the oath and that choosing to do so meant whatever happens including a pandemic.  What wasn’t including was lack of protective equipment, unsafe staffing ratios and cutting corners on patient safety.   Those are things we stand up and fight for.  I wasn’t ready to change my schedule to be a teacher for 4 days and then work for 3 in a virus filled environment that we knew nothing about and have no cure for.
I am pushed to my limits every shift, always out late, little to no break, under a painters mask fitted with filters I’m not sure that work and wearing high school Chemistry googles all while donning a trash bag with arms .... and it was a fight just to get that.  My mental health is stuffing and I try and pick my times to break down ... if I can.  All this and in the back of my mind is I hope I don’t bring this home to my children or  get sick and leave my kids with out a father.     There can be some pretty abrasive people on here with less that uplifting comments that are very articulate.  Please, If this is you ... save your witty comebacks and quips.  I’m just sharing my own opinion and venting in a forum that is united in more than just one way. 
thank you. 

You got me with the Chemistry goggles and trash bag with arms!! LOL!  I remember  being in plastic overalls as we had no more gowns, sweating like a pig , going into Covid rooms hoping that my patients loss of smell was working in my case!! Every time I bend the cheap clear plastic face shield fell!

Seriously though, my heart ached for my dying patients though I bounced around rooms with peppy talk bolstering their spirits, teasing them gently with a smile in my voice! I would be up at 3 am, feeling panicky and checking out the calluses popping up on my flat feet after 13 hrs. I walked in to work and limped out! I felt bad for the new nurses that were not used to quicksilver rules , lack of supplies and of course crappy staffing ! I am grateful we survived and hope we are alive to tell the tale by the end of this pandemic!

[CalicoKitty, BSN, MSN, RN]

I've seen some posts about the "Person of the Year" on Time magazine, saying "Fixed it" putting a healthcare worker on the front. I know it is probably not true, but I can't think of the 2016 POTY could have done a lot more, so perhaps we would not be the "Fixed it" photo. But, yeah, I have gotten occasional "claps" and "thank-you" from random strangers. I don't want it. (Though the free food in April was kinda nice).

[Penandpaper, BSN]

On 12/15/2020 at 9:31 PM, The Seasoned Nurse said:

. If you are at a low point, you are not alone. If you are having a positive day, pull someone up with you. 

This will be over one day. But we will never be the same. Thank you so much for sharing your insights.

True. Thank you for yours as well!

[brandy1017, ASN, RN]

On 12/16/2020 at 8:02 AM, RN-to- BSN said:

I would quit this acute care job already with short-staffing, sicker than ever patients and administration's expectation to do it all with a smile on my face.

But, I need the income.

And, I have an extra motivation to pursue further education.

Get out of bedside in 2 years.

I decided to walk away and take early retirement rather than continue to deal with the short staffing, lack of essential supplies and risk to my health.  I have a small pension that will pay my mortgage and start spending down my 403b and Roth IRA and use the affordable care act for insurance.  It is crappy HMO insurance, but COBRA is unaffordable.

It was not my plan, but this past year I'm done being abused by management and tired of the stress causing nightmares, PTSD and uncontrolled hypertension on 4 BP meds.  My BP has already improved due to the lack of stress!

I don't know if I'll ever work again in nursing.  I check out the want ads but just feel stressed looking at the majority of them.  This will be the first time I've had both Christmas Eve and Christmas Day off with the family in almost three decades!

 

[turtlesRcool]

My thoughts?

I am now deeply suspicious of any group being hailed as heroes. This year has taught me that calling people "heroes" is another way of saying "sacrificial lambs."  That it's easier and cheaper to tell a small group of people they are expected to risk their health, their families, and sometimes their lives to be "heroes" than it is to make the tough decisions necessary to enable them to do their jobs more safely.  

I do my job. I do my job well. I never refuse an assignment. I never call out from work. But I'm not a hero. I'm an overwhelmed nurse who keeps going because my patients need care. But I'm also a nurse who knows those patients deserve better care than an overworked staff can give them.  I'm a nurse who knows it didn't have to be like this.

[ClaraRedheart, BSN, RN]

I've had so many truly horrible days at work recently that my whole day before a shift is filled with dread. I prioritize the best I can, but there's only so much you can do. I had a patient get dangerously low in his hgb because he refused morning labs. I'm one of the "hard stick" nurses, and could have tried to talk him into letting me get them, but my other patients were so sick I couldn't get to him until later. I forgot and when I saw a 30 minute window were no meds were due, I went to lunch, and downstairs, I remembered that I didn't get it and thought "wow... I really should have just waited until I got that lab". I had no idea how bad it was until he started getting symptomatic near the end of shift. I think everything worked out where he lived, but it was really scary and when his IV blew and I was it because picc team was gone, that was frightening when the blood was there and I couldn't start it because there was no access and his blood pressure was in the toilet. I feel like usually, people are not this sick. Our hospital has too many nurses out sick to decrease our ratios. Usually, if someone has a rough group, we can step in and help. We're all drowning now though. I have to go to work the day after tomorrow. I wonder if we could survive on a Walmart income. It's not worth this stress. I've thought of quitting my floor and going to a more predictable patient group... like a surgical hospital, but I ultimately couldn't leave them in more of a lurch than they're already in now. I'd feel worse, but this is killing me and I'm not coping well. 

 

[Penandpaper, BSN]

3 hours ago, ClaraRedheart said:

I've had so many truly horrible days at work recently that my whole day before a shift is filled with dread. I prioritize the best I can, but there's only so much you can do. I had a patient get dangerously low in his hgb because he refused morning labs. I'm one of the "hard stick" nurses, and could have tried to talk him into letting me get them, but my other patients were so sick I couldn't get to him until later. I forgot and when I saw a 30 minute window were no meds were due, I went to lunch, and downstairs, I remembered that I didn't get it and thought "wow... I really should have just waited until I got that lab". I had no idea how bad it was until he started getting symptomatic near the end of shift. I think everything worked out where he lived, but it was really scary and when his IV blew and I was it because picc team was gone, that was frightening when the blood was there and I couldn't start it because there was no access and his blood pressure was in the toilet. I feel like usually, people are not this sick. Our hospital has too many nurses out sick to decrease our ratios. Usually, if someone has a rough group, we can step in and help. We're all drowning now though. I have to go to work the day after tomorrow. I wonder if we could survive on a Walmart income. It's not worth this stress. I've thought of quitting my floor and going to a more predictable patient group... like a surgical hospital, but I ultimately couldn't leave them in more of a lurch than they're already in now. I'd feel worse, but this is killing me and I'm not coping well. 

 

Ugh. That seems like more than a tough day. That's a lot on anyone's shoulders. Glad you could get it off your chest. We are all drowning here with you.

On 12/20/2020 at 6:28 PM, turtlesRcool said:

My thoughts?

I am now deeply suspicious of any group being hailed as heroes. This year has taught me that calling people "heroes" is another way of saying "sacrificial lambs."  That it's easier and cheaper to tell a small group of people they are expected to risk their health, their families, and sometimes their lives to be "heroes" than it is to make the tough decisions necessary to enable them to do their jobs more safely.  

I do my job. I do my job well. I never refuse an assignment. I never call out from work. But I'm not a hero. I'm an overwhelmed nurse who keeps going because my patients need care. But I'm also a nurse who knows those patients deserve better care than an overworked staff can give them.  I'm a nurse who knows it didn't have to be like this.

My thoughts as well.