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.

Anyone who would imply I was a coward for not risking my life or that of my family for work can go straight to hell and never speak to me again.

You're not a coward for being concerned about who would care for your son if you're not there. You're not a fool for doing your level best to save these very sick patients. If it was me choosing I would choose my son. Family always comes first with me. You will live to fight another day.

Specializes in Private Duty Pediatrics.

I respect those nurses who chose to come in every day, no matter what.

And I respect those nurses who choose to protect themselves and those they love by staying away.

It is an individual choice.

This a personal decision, I a personally am waiting for the pay to be worth my life.

We are being used as things that can be replace and discarded, the audacity of those institutions trying shut us up.

When we all die, everyone is going to day: well they know the sacrifice they were making"

In the the armed forces, people who signs up for battle aren't alone, when they die their family get taken care of, they get student loans forgiveness they get help, we do not.

I have been in school for the last 2 years getting my RN, if die I have no one to help my mother, I am not gonna put my life in the knowing she will be alone. Now if they start offering benefits that help the oneself behind then yes.

Specializes in Pediatrics.
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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.

This--totally. AND don't forget--these are the people who will call you off at the drop of a hat (drop in census) because YOU cost THEM too much (while managers never get docked), LOL.

Specializes in Critical Care.
On 4/5/2020 at 12:46 PM, 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.

Yes it is the hospital's fault that they don't have PPE! Give me a ***in break!

They don't have enough because healthcare has been destroyed by corporate Yahoo's ie snakes in suits that only care about bonuses, raises and promotions for themselves at the expense of safety for everyone else!

It starts with the constant under staffing, too high patient ratios, layoffs of support staff, to save money. So why the hell would they bother to keep adequate PPE available when they are running by the seat of their pants in a just in time we'll have as little available as possible to save money!

As others mentioned one minute they are threatening to write up and discipline you over petty infractions and the next they are begging and trying to guilt you into working without adequate PPE, at the same time bribing the CDC to lower the safety bar and then admonishing you to work OT on top of it. All the while the suits stay safe far away from the hot zone!

Wake the hell up!

Specializes in Peds.

I understand you completely. My background is ER but now I only do that per diem. I am full time school nurse during the week and work in the ER once or twice a month. Now school is out until who knows when. Next week was supposed to be my school's Spring break. I originally had a trip planned but like so many others I had to cancel it. To help out and keep myself busy, I signed up for a few shifts during "Spring break." I can't officially work during the week even though school is now virtual because the Board of Ed is still paying the nurses and the governor has hinted at activating school nurses to help out in an as yet unspecified way.

I worked last weekend - Saturday was OK but Sunday was awful. There were a bunch of call outs. I was put everywhere - triage, lunch breaks, and the dedicated area for COVID patients, an area which doesn't need to exist because just about every ER patient was a COVID patient. I came home exhausted and in tears. One patient who I triaged and seemed OK though slightly hypoxic, coded and died two hours later. When I gave another nurse a lunch break, one of her patients, a thin elderly woman with history of autoimmune diseases was complaining of being cold. I couldn't get a good pulse ox on her until I placed a non-rebreather and even then she cold barely get up to 94%. She was waiting for a bed for admission for almost 24 hours (not unheard of on a normal ER day) and I am not sure she will make it.

I felt so out of my depth the whole time and wondered if I should really be there, if I was really helping.

To compound matters, last year I was diagnosed with MS. The medicine I am on (Tecfidera) has helped with my symptoms. My neurologist told me that it won't affect my immune system and that I shouldn't worry about working. I called the compound pharmacy that makes it and spoke to a pharmacist who told me that I should NOT be taking care of any suspected COVID patients.

I don't know what to do. I feel like a coward if I cancel my shifts and resign when so many nurses are needed but I don't want to risk my life and those of my loved ones for a paycheck.

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.

My grandfather (a retired GM worker) told me and.my sisters a looooong time ago......he felt bad for us "young people" and thr way thing have changed inthe workforce for us...because these jobs dont give a damn about its workers anymore more, treating everone as if they are invaluable and indispensible.

7 hours ago, 819Nurse said:

My grandfather (a retired GM worker) told me and.my sisters a looooong time ago......he felt bad for us "young people" and thr way thing have changed in the workforce for us...because these jobs dont give a damn about its workers anymore more, treating everone as if they are invaluable and indispensible.

Did your grandfather mean that workers are not valued and are expendable?

To be invaluable and indispensable is good.

Specializes in Tele, OB, public health.
On 4/5/2020 at 12:46 PM, Keely PHN 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.

My God you are just everywhere spreading your shame aren’t you?
please take your nonsense elsewhere- we’re all full up on **** here

Specializes in Geriatrics, Dialysis.
On 4/5/2020 at 12:25 PM, Keely PHN 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.

I am surprised at this response from an experienced nurse. Nowhere, at no time did any nurse take an oath to risk their lives due to poor planning and poor implementation of disaster protocols.

However many are knowingly and willingly doing just that. Those that choose not to shouldn't be told they chose the wrong profession just because they are putting their lives and the lives of their loved one's above their job.

Would you say the same to a firefighter told to battle a blaze with a broken hose while working in their underwear? Do you think it's OK to send an officer to an active shooter scene with no vest, no gun, no back-up? Of course not. So why would you think it's OK to send a nurse into a situation that is clearly not safe and then berate that nurse for saying no?

Specializes in OR.
On 4/5/2020 at 12:25 PM, anonymous-phn-RN 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.

.....OK boomer. Can you just retire already with that attitude? Thanks!