I learned how to be a nurse behind a respirator and a yellow gown, amidst the constant beeping...

[demmiblue]

Link to tweet

I became an ICU nurse at the end of July in 2020, during one of the first peaks of covid when it was all still so new. I learned how to be a nurse behind a respirator and a yellow gown, amidst the constant beeping and hissing of ventilators that couldn't support failing lungs.

Because I was so new, I had no baseline for what normal nursing looked like; I just had a vague sense that it couldn't look like this. The unit was bleak and everything we did felt futile, and I realized at some point I felt more like a ferryman to death than anything else.

Some people lived, if they never got to the point they needed Bipap. Most didn't. By the time they came to us they were too sick, their lungs too shredded, kidneys already failing and blood already clotting and so often beyond the power we had to heal.

I would watch, feeling helpless, as they would go from a nasal cannula to a Vapotherm to a Bipap, and then when their chests started heaving and they started sweating I knew with heavy dread that soon they would be intubated.

There are places we can't call you back from.

I got used to the death. I walled it off, pushed it down, and did my job. I advocated for death with dignity, with as much kindness and comfort as we can muster, and accepted very early on that we can't save everyone.

And then numbers started going down.

We went from 3 covid ICUs to 2, then 1. I started to see what it was like to be a nurse in pre-covid time and realized how many people normally survive. The things I did mattered, my actions actually saved lives - no longer was death my constant, silent companion.

The more time I spent out of the covid unit, the more I realized exactly how bad it was; all the vents, the CRRT, the relentless march towards death that we could hold off for a time but never stop. Walking through the much smaller covid unit was like walking through a graveyard.

It is so much worse, this time. We all have so much less to give. We are still bearing the fresh and heavy grief of the last year and trying to find somewhere to put all this anger.

But the patients don't stop coming. And the anger doesn't stop coming.

Underneath that anger, I feel defeated. Nothing we do makes a difference. The world spins on, oblivious and belligerent, as we fight to save the tidal wave coming our way. With less staff, less resources, and a lot less of ourselves to give.

I don't know what to say that will make people listen. I wish I could snap so many people out of their selfish stupor but I can't, so I get to watch instead as people learn the hard way; with a tube down your throat. With a "code blue, code blue!" and the crack of a sternum.

With a three am phone call to your family, held by hands still trembling from the rounds of CPR, voice shaking, knowing that I am about to shatter someone's world.

You learn the hard way and I see it through. I carry the weight of your choices and the pain they cause.

It didn't have to be like this.

https://threadreaderapp.com/thread/1421815468436992003.html

[Hugin]

1. There's something we all can do to help this young RN.

GET VACCINATED!

[Initech]

9. [phone]

[lark]

2. It's so surreal, almost unbelieveable, that this is happening on purpose, repugs killing everyone.

How did we as a world get so stupid and murderous? Why are repugs killing themselves and us ON PURPOSE while being 100% in denial about all health facts? Why is there so many lies out there, all promoted by right wingers who are verging on nazism.

[lonely bird]

4. Undefined terms

What do I mean?

What is the definition of freedom? The Reich Wing has glommed onto a variety of words to use as agitprop. Freedom is key among them. Freedom has become defined as “you can’t tell me what to do”. They decry anyone they deem morally weak or inferior who takes help from the government even if they or their family get it themselves. And when their so-called freedom lands them in dire circumstances they stand with their hands out bellowing that they are “due” such help because it wasn’t their fault.

[wnylib]

12. Recently I heard President Biden

say what is missing in the shouts about freedom, when he was talking to reporters. This is not a verbatim quote, but he said that Americans are rightly proud of our freedoms, but with freedom comes responsibility for our actions.

This needs to become a mantra. There is no freedom without responsibility. As soon as you give up responsibility, you become dependent on others and lose your freedoms.

Of course we are all interdependent. There is no such thing as absolute freedom, only degrees of it. Actions always have consequences. Some consequences are within our control. Some are not. We have to be responsible about whatever is within our control.

[Texaswitchy]

3. Republicans destroy everything.

Can't think for themselves.

Follow Trump over the cliff.

Stupid people.

[HUAJIAO]

6. Republicans destroy everything.... Period..

[TNNurse]

7. This is so smart and so sad.

I am not sure I could have made it through that ICU orientation. Mine was not that brutal.

Brutal conditions are exactly what those people working in COVID units are enduring.

[Snackshack]

8. Nope...

It didn’t have to be like this. I will never forgive DT/GOP the right & some on the left and their selfishness that has prolonged this pandemic far beyond what it should have.

I see the images coming from Chicago and it is sickening because HC people like the lady that wrote this know what’s coming and it shouldn’t be.

[Bmoboy]

10. Advance Directives

Used to be that about half of all medical costs were racked up in the last six months of life.

I imagine that number has gone up with COVID.

Some of the (non-COVID related) medical interventions used to allow for extended life with some quality.

Not with COVID. Sounds like intubation has become a first sign of death in many cases.

As a retired nurse I cannot imagine how I would deal with all my patients dying.

I have completed Advanced Directives in which I decline intubation.

This pandemic is horrible.

[questionseverything]

17. I wish you would re think that

There are lots of times people fully recover after being tubed

I was “tubed” after seizures, woke a couple of days later in icu , foggy but far from my end

[Bmoboy]

18. My first nursing instructor

... I don't remember her name, but she was a long-sleeve all in white starched cap nurse.

After teaching CPR to my class of orderlies, she said "If you see me drop over in the hallway, don't touch me."

She said she had seen too many failed or crippling CPR attempts.

We all make choices.

As though I have anything to do with controlling this old body.

[Historic NY]

11. The nurses are getting over whelmed....

So the VA hospital when my niece works is getting swamped with Covid-19 patients the ones that refused vaccinations. They are out of ICU room down to putting people in positive pressure rooms. She's tried to get them organized so they don't mix up patients, quoting chapter & verse. There are some breakthrough patients, but they end up going home, the others will never get there. It almost become a 'combat medic' situation, treat what you can. As this RN describes its, pretty much what is happening. She called me last night, she's concentrating on her regular patients, with the new nurses. Its a super big place, she says they're now trying to convince all those unvaccinated Vets to get a shot to give them a break.

[Warpy]

13. I feel her pain. I'd just gotten my license when AIDS hit

There will be PTSD. There is for any nurse, but especially those who worked with people they were unequipped to help. Docs then were on the same treadmill: assess, intubate, pronounce. There was little any of us could do beyond offering the comfort of trying to help.

[BobTheSubgenius]

14. I'm sure she is one hell of a nurse.

She is definitely one hell of a writer.

[Grasswire2]

15. yes nt

[crickets]

19. Agreed. nt

[roamer65]

16. These adult antivaxxers should be triaged out.

Put them in a gymnasium somewhere with a cot.

We should not be exposing the front line personnel to the undue stress of this conundrum.

Children first, then 12-17 year olds and breakthroughs next.

[BSdetect]

20. k&r

[flotsam2]

21. As an EMT I had one cpr save

a 78 year old woman dying of cancer. She begged her family to take her home to die. Then when she went into arrest the family called and we resuscitated her. Old bones are brittle and I cracked almost every rib. She died in the hospital less than a week later. Some saves are not a good thing to do.

[Hekate]

22. It just didn't have to be like this...