To be a coward, or to be a fool?

A first-hand account of the struggles facing this ICU nurse during the COVID-19 pandemic

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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.

Specializes in Critical Care (MICU).
17 hours ago, ML1376 said:

Please contact a health care provider!

Oh I did. And my employer. I have a drive through test scheduled tomorrow morning, and I’m quarantined for the foreseeable future.

Specializes in Critical Care (MICU).
5 hours ago, RN-to- BSN said:

I am sorry, but you went into that job full of hopes and dreams. And now all that is crashing. It will pass, though. You will awaken and see how the hopes of helping your patients by being there for them are rushed and criticized by the managers and bureaucracy of the hospital system. This is real nursing, unfortunately.

I enjoyed reading your post, very well expressed emotions. Thank you!

You are right-on. That VERY accurately describes how I’m feeling. I’m still a baby nurse; I’m only 2 years in. I still had a lot of that new-nurse idealism. I wouldn’t call seasoned nurses who don’t feel that way cynical, just more aware. I expected to lose some of my naive enthusiasm with time, but I wasn’t mentally prepared for the military style, “wake up, FNG, this is real-life now. You get what you get, right or wrong. The end. Buckle up.” And it has just overwhelmed me. I am sure there have been many before me and will be many after me who go into nursing very hopeful, and either suddenly or over time, get disheartened by the lack of support from the powers that be. I appreciate the input. Since we’re all just scratching our heads right now, just finding a venue to express what I’m dealing with and having others commiserate with me, has helped a ton.

Specializes in Psych, HIV/AIDS.

tiff-jenn-RN, here's hoping and praying for a negative result. Please keep us informed. (((((((((((((((((HUGS)))))))))))))))))

Specializes in Non judgmental advisor.
On 4/1/2020 at 4:36 PM, cazreye said:

I have no intention of putting my life on the line to save others. Especially when the risk to my life is due to poor planning and greed by those In hospital boardrooms. I didn’t sign up to go to a war torn country or work on an aircraft carrier. I got a job in my local hospital, who agreed to keep me safe by providing all ppe as required by osha.

This same hospital that expects so much sacrifice from me is the same one who puts ‘points’ on me for such infractions as being one minute late and forgetting my badge. Points lead to reprimands from managers and dismissals. They are the same ones who treat nurses like they are narc fiends and write us up if we don’t give a narc within one hour of pulling it. But these same petty bastards want me to risk my life and my children’s lives?

When anyone starts waving flags and playing on emotions, making nurses feel guilty, I always remind them this is a job. The same job that will reprimand and fire you for any number of inconsequential things. If you die they will just hire another nurse. The guy that runs your hospital doesn’t even know your name.

Beautiful

On 4/2/2020 at 11:42 AM, DTWriter said:

This may be controversial but I believe that nurses working during this pandemic should be getting their money worth. They should be getting paid more than they usually do (I.e. more so than a travel nurse's salary pre-pandemic). They should be receiving extra benefits (I.e. free food, free transportation, free lodging, life insurance, Scholarships for their family members, etc.).

If a nurse is not getting anything extra, then society is taking advantage of that nurse. As mentioned previously, if you die, they would just replace you with another nurse and give two ****s about those you left behind.

Yes, LIFE INSURANCE, and a Veteran's benefit style health and disability insurance for disease related complications.

On 4/1/2020 at 10:49 PM, Kooky Korky said:

This

Double Ditto and I'll raise:

When they give you "occurrences" for calling in sick, double "occurrences" if it is on the weekend or a holiday and your pink slip if you have 4 occurrences.

The following is just how it is as a nurse- there are shaming and punitive tactics faced when one calls off:

Quote

Craig R. Smith, the surgeon-in-chief at NewYork-Presbyterian Hospital, wrote in an email to staff on March 16...

“Sick is relative,” he wrote, adding that workers would not even be tested for the virus unless they were “unequivocally exposed and symptomatic to the point of needing admission to the hospital.”

“That means you come to work,” he wrote. “Period.”

https://www.nytimes.com/2020/03/30/nyregion/ny-coronavirus-doctors-sick.html

But Annals for Internal Medicine says:

Quote

We need to be more aggressive about respiratory hygiene and placing restrictions on patients, visitors, and health care workers with even mild symptoms of upper respiratory tract infection. Potential policies to consider include the following:

...

2) restricting health care workers from working if they have any upper respiratory tract symptoms, even in the absence of fever; https://annals.org/aim/fullarticle/2763036/coronavirus-disease-2019-covid-19-protecting-hospitals-from-invisible

Which of the above is evidenced based? But which is practiced?

Specializes in Respiratory-Sub-Acute.

As a Nurse you took an oath to Help people. sometimes it requires taking chances and putting your life on the line. If you are not willing to do that; you should not be a Nurse.

Specializes in Respiratory-Sub-Acute.

Nurse lexi, You took an Oath when you became a nurse. It obviously doesn't mean anything to you. Sometimes as a nurse you have to take chances and maybe put your life on the line to save others. Just like stopping at an auto accident or some other event. if you are not willing to do that, you shouldn't call yourself a Nurse. It is not the hospitals fault they do not have the PPE! it is the Federal Govt. that failed to prepare for this calamity. They Knew it was coming! In 2018. President trump disassembled the pandemic task force. He had many experts telling him that a pandemic was going to happen, just a matter of when. But he failed to listen to their alerts.

Specializes in Non judgmental advisor.
10 minutes ago, Jeffrey James Keely said:

Nurse lexi, You took an Oath when you became a nurse. It obviously doesn't mean anything to you. Sometimes as a nurse you have to take chances and maybe put your life on the line to save others. Just like stopping at an auto accident or some other event. if you are not willing to do that, you shouldn't call yourself a Nurse. It is not the hospitals fault they do not have the PPE! it is the Federal Govt. that failed to prepare for this calamity. They Knew it was coming! In 2018. President trump disassembled the pandemic task force. He had many experts telling him that a pandemic was going to happen, just a matter of when. But he failed to listen to their alerts.

Howdy, did you mean to address this to another member ?

Specializes in ICU.
1 hour ago, Jeffrey James Keely said:

As a Nurse you took an oath to Help people. sometimes it requires taking chances and putting your life on the line. If you are not willing to do that; you should not be a Nurse.

And you shouldn’t be posting with that bs. Whoever is to blame, RN’s should not have to put their lives on the line, every 12 hour shift, every week for an indeterminate amount time. Included in the oath you’re should speaking about, should RN’s risk the lives of their families snd loved ones? When graduating nursing school, I don’t remember swearing to be be willing to risk my life if my employer in, no matter who's to blame, is unable to provide adequate protection, or even mentioning anything about risking my life period. What nursing school did you go to where you swore to that? Either way, hope you’re kickin *** out there, Captain Covid. Focus more on healing corona patients and leave people alone who are having an incredibly tough time struggling to navigate this bungled pandemic.

All of this makes me sick inside.

I am staying in place so I do not have to refuse an unsafe assignment without proper PPE because ALL patients are possibly potential COVID-19 patients...just not tested yet and possibly asymptomatic.

I think most RNs cannot risk losing their jobs and they have no choice financially to not go to work...and this is heartbreaking.

I am lucky I can STAY HOME IN PLACE...and I hope I can find work after this. If not, I will say goodbye to bedside nursing.

Everyone has said it better than I could.

But, I served in the military and they 100% took better care of you and provided a much higher level of protection and ensured everyone had proper equipment and tools to do the job. They invested a lot of money in training you and valued you much more than any facility or hospital I've ever worked at. I resent the administrators, nurse managers, and a lot of my co-workers who have allowed and enabled this to happen. I have tried multiple times to bring nurses together to address issues and make positive changes on the floor, and each time, one-by-one, they would do a 180 and make me out to be the bad guy. I feel nothing but resentment and regret for choosing this "profession" and feel zero obligation to jeopardize my life, or my loved one's, for the system that allowed this to happen in the first place.

3 hours ago, Jeffrey James Keely said:

As a Nurse you took an oath to Help people. sometimes it requires taking chances and putting your life on the line. If you are not willing to do that; you should not be a Nurse.

When was the last pandemic?

I couldn't disagree with you more. It's like asking a police officer to work in a high crime area without their gun, radio, ballistics vest, ASP, OC spray, or backup.