One day I was assigned to a makeshift intensive care unit that had previously been an observation unit for highly stable patients waiting for test results. Many of the patients in this new Covid-19 unit were intubated, with ventilators breathing for them.
When I started the shift, a trained intensive care unit nurse was crying in the supply closet. She was overwhelmed and anxious, hadn’t worked on her familiar unit in weeks, and had been told that her next shift would be an overnight one — and she had no choice in the matter.
Many of us don’t have a choice. We are assigned to work in unfamiliar units, with patients who are outside our expertise, without any training. We’re lost.
Most shifts start with nurses crying.
Most shifts end that way too.“It’s out of our hands,” we hear from hospital administrators.
Nurses who typically work in outpatient clinics are being sent to inpatient floors and assigned to care for patients who are acutely ill. Many haven’t worked at the bedside in decades. The number of patients who have fallen in this unit has risen exponentially in the past two weeks due to lack of training of outpatient nurses.
I wonder if the patients know their nurses are overwhelmed, and that many of them are scared they’ll make a deadly mistake.
“Everyone is out of their comfort zone, just hang in there,” we’re told.
Doctors have been instructed not to enter patients’ rooms unless they must as a way to minimize their exposure to the virus that causes Covid-19 while nurses go from one room to the next, medicating, bathing, turning, and comforting their patients without changing their uncomfortable personal protective equipment, since supplies are limited. This work can take hours. It is not uncommon for nurses to go all day without drinking water or eating because that would mean removing our protective gear.
During one of my shifts, a doctor at my hospital posted several TikToks he made while sitting at the nurses’ station of a busy Covid-19 unit as nurses whispered words of encouragement to patients clinging to life supported by ventilators. Over our words and the hum of the ventilators, I wondered if our patients heard music coming from this doctor’s TikToks.
“We hear your concerns, but there’s nothing we can do,” doesn’t reassure or encourage us.
One day as I worked in the makeshift ICU, one of the hospital’s leaders went floor to floor making an important delivery. She approached our nursing station in her crisp professional attire and fresh disposition, and proudly delivered a supply of makeup-removing wipes. She told us to use the wipes to clean our faces before putting on our N95 masks so we could reuse the masks later, then moved on to the next nurses’ station without asking how our staff was doing or if we needed anything. I wonder if she had noticed the nurse crying in the supply closet.
“That’s above us, we don’t make those decisions,” is passing the buck at its worst.
Excuses from hospital administrators seem to have punctuated every shift for the past six weeks. The praise and applause from hospital leadership only go so far.
I can read in my co-workers’ faces and hear from the stories they tell that the biggest danger we face is not Covid-19. It’s the hospital’s administration.
Leadership is failing us, even as we stand firm in not failing our patients. We care for your loved ones, Covid-19 or not, monitor their vital signs, give them medications, rub lotion on their backs, help them to the bathroom, and brush their hair. We FaceTime their families from our personal phones so they can see their loved ones fighting to live. This is important care that nurses are proud to provide.
The narrative is simple. Nursing, and nurses, are not valued. It’s a shame, and maybe even a deadly shame, that hospital leaders don’t care about nurses like we care for our patients.
Jaclyn O’Halloran is a registered nurse who works in a hospital in Massachusetts.
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