The moral crippling of ICU nurses during COVID 19

By: Debbie Moore-Black, RN

Maybe we can take a deep breath. And breathe out slowly. Check our pulse. Go on that vacation far away or just visit a beach and watch the crashing waves. Listen to the seagulls, the breeze, the blue skies. And turn our cell phones off.

But as an ICU nurse who loved this speciality, Covid patients in the ICU was a war zone.
One ICU room would now carry 2 patients. Short staffed, our work load doubled, as we were also faced with lack of PPE’s.

The violins and trumpets and guitars blasting out at the employee entrance with big banners telling us we were heroes, when we knew it was just a smoke screen. The truth was lack of PPE’s. Put your N95 mask in a paper bag and wear it every day with every patient for one full week. Gown and glove, and face shields. Hurry and use the bathroom because you may not be able to visit the toilet for the next 12 hours.

As I interviewed several Frontline ICU nurses in the aftermath of Covid, I watched them talk to me, with their head hanging low. Monotone voice. And I heard the same replies.

Anxiety. Depression. Defeat. Death.
And it didn’t matter how many balloons or banners were at our front gate, we knew that we were working with the minimum. And we knew the outcome usually was death.

Camaraderie weakened and the need for critical care nurses grew exponentially throughout the USA. Some hospitals offering $5000-$6000 per week. And the ICU nurses knowing the chaos, the shortage of nurses, ran to other jobs for the money. And why not?
Leaving a huge gap with the ones left behind.
We isolated ourselves from our own family, fearful.

Fearful that we may be carrying the virus. Fearful of spreading it to our loved ones. There were no hugs and kisses and mommy/daddy…. We’re home from work. It was “don’t hug me, don’t touch me” as we took our decontamination shower and isolated ourselves.

We knew the drill. Bipap, then ventilator, central line, arterial line, IV pressors, steroids, plasma, dialysis. Prone position. Experimental drugs. Scrambling to see which one would work. Medically paralyzing the patient to get maximum oxygenation. Physicians and nurses and respiratory therapists working side by side.
A team of dwindling hope.

The patients not getting better. Nurses and physicians communicating via FaceTime with family members. Do everything. Crying, defeat.
The final goodbye as the nurse stood in for the family, holding the hand of a patient as they let out their last gasp. Watching a heart rate go from 140 to 40 in a split second.

And then the laypeople. The ones with no medical knowledge. The disrespect. The refusal to wear masks in public. The politics. The hoax theme. If they only knew. If they only were in our shoes in any ICU. If they only saw the battle of fighting for someone’s life and failing over and over again.

Depression, anxiety, helplessness, lack of sleep, fear, worry, empathy. And then came the physical signs of fatigue and defeat like headaches, nausea, exhaustion, breathlessness. Loss of appetite. And failure.

We didn’t need the music and the balloons and the banners clocking into the hospital. We didn’t need the “Hero status”. We didn’t need the pat on the backs.

What we needed were appropriate and plentiful PPE’s, safe nurse-patient ratio. Equipment that worked.

And day after day we knew after one patient we mechanically kept alive for 20 to 30 days and then pronounced their death and wrapped them up in a body bag, environmental services would hurry and clean and sanitize that bed for the next one. One after another. Only to know the outcome was death.

And now we can be thankful for those that stood in line and took the vaccine. We finally see the numbers go down. A sigh of relief.

A deep respect for this virus. A deep respect for science. For nurses and physicians and respiratory therapists. For the environmental services. For the educators that kept pounding away the message that this is real.

We bow our heads. And take that deep breath.
And I watch the waves crash into the sands.
And I empty my thoughts and can only hope and pray.

Never again.