Here’s Why a COVID Nurse Might Finally Quit
The jaw-dropping hell that’s been going on since the pandemic began
“With COVID you either clot or you bleed. If they’re not dying of COVID in their lungs, it’s wreaking havoc in their gastrointestinal system. It didn’t matter who they were or how old they were, there was just a lot of diarrhea going on. A lot. It was like, where is all this coming from? It’s just raging through them.”
I was talking to a nurse who quit a trauma hospital in Indiana after spending nearly 15 straight months caring for COVID patients. It was hard enough before the vaccine was created. But when patients kept filling the beds after the vaccines became available, the situation went from baffling to frustrating to anger-inducing to mentally shattering. After she left that hospital, she took off a couple of months and went to another Indiana hospital as a travel nurse, earning $70 an hour — which she says is very good pay for her in that state. As a travel nurse, she wasn’t caring for COVID patients. She wasn’t ready to go back to that.
The mental anguish and unrelenting, physically grueling work of the COVID unit left her so broken inside, she was ready to quit nursing altogether.
For privacy reasons, she doesn’t want to give her name. She is divorced, has two grown daughters and is a grandmother. She’s been a nurse for 15 years. She made a good salary before the pandemic, but even with hazard pay, she wasn’t amassing a lot of savings. So soon after leaving the COVID unit job, she began worrying about paying her bills. It was too soon for her to think about caring for more COVID patients. Or any patients. She signed up for gig work as a delivery driver. She harbored a fantasy about working in a local garden center, where she wouldn’t have to do anything but water the plants.
As of this this writing, 711,020 people in the U.S. have died of COVID-19. Currently, 61,750 Americans are hospitalized with the virus. About 56 percent of the total U.S. population is fully vaccinated, including 68 percent of all adults over 18 years old. However, in 15 states, less than 50 percent of the population is fully vaccinated. This includes Indiana, where the vaccination rate stands at just under 49 percent.
“You have to put certain stuff on, and at the very least it takes, like, a minute,” she said, explaining what COVID unit nurses have to wear to treat a patient. “So let’s say someone’s heart rate is 180. Maybe they’re having a heart attack and they can’t breathe. Or they’ve jumped out of the bed because there are neurological problems from COVID that make them confused and they don’t know where they are. It could be just the infection raging through them so they get fevers, which can make them delirious. We couldn’t help them until we put on all our safety gear first.”
I’ll refer to her as “this nurse,” but she could be any nurse who’s worked a COVID unit for any amount of time. The hours are endless. The noise from beeping machines is endless. The acrid smells are endless. And in these units, despite the easy availability of the vaccines, the patients have seemed endless. Even though she left the COVID unit in May, she often talks in the present tense, or as if she’s still there, when telling me what the whole experience was like — like a soldier recalling war stories.
“So, they’re delirious from COVID and they think they can get up and walk to the bathroom. But they can’t. So then they’re practically falling in their poo.”
I wasn’t sure I heard her correctly. Poo?
“Yes, men especially would rather fall and break their neck than poop in the bed. So they’re staggering to the bathroom with poo running down their legs. They think they’re at home. They’re confused. They want their family and family can’t be there. This is when family would often start asking about vaccinating the patient. But by then, forget it. The vaccine doesn’t work when you already have full-blown COVID.
This whole “poo” thing threw me. I didn’t know nurses were dealing with it on a daily, hourly basis. I guess I thought COVID patients couldn’t be eating much, so any stomach issues would have happened before they arrived at the hospital. Or not last long. I was very incorrect.
“It lasts for days. Some people get the gastrointestinal (GI) stuff really bad. They’re nauseous and they’re in pain. So when people say COVID doesn’t hurt? Yes, it does. And then out comes the oxy.”
“How is this happening to us in this day and age? How can people not wash their hands, wear a mask, social distance — and just get vaccinated?”
“So they’re depressed and crying. You’re crying because you’re like, ‘How is this happening to us in this day and age? How can people not wash their hands, wear a mask, social distance — and just get vaccinated? I mean, do you have to go to a party unvaccinated where you’re exposing yourself to this?’ But people do, because people haven’t seen what it’s like inside a COVID unit.”
Her patients also weren’t just “elderly.” She saw people in their 30s, 40s and 50s. One time she had a male COVID patient in his 50s whose brother had just died of COVID. The man’s wife was home with it; his mother-in-law was down the hall with it. He stands out because he was a “good” patient who was quiet and mostly just seemed sad.
“He was different. Most of the guys were really bad. They were just moaning and whimpering, depressed and in a fetal position. You’re not having any conversations with these people. They might have a wife and kids at home. But they’re alone in the hospital. It’s a nightmare.”
The Worst Human Behavior
I asked her more about this COVID-induced delirium.
“If you’re septic, meaning your body is, like, on fire with infections, it goes into your bloodstream. If you have a bloodstream infection or your lungs have COVID pneumonia, it brings on delirium. Three quarters of them were batshit crazy out of their minds. There was no ‘please’ or ‘thank you,’ that’s for sure. There was stuff thrown, there was screaming, there were tantrums. It was the worst human behavior… like being on a psyche unit.
“They pull their IV out or pull their oxygen off, and every single time they do that, you have to gear up and go in.”
She explained what putting on the gear entails.
“We have people to help us don and doff these outfits. Some go over your whole body. And there’s a mask that’s not even a mask — it’s like a respirator that looks kind of like Darth Vader. And then you have a shield over your face. And the gown and gloves. And it has to be in a certain order, otherwise you’re contaminating your cells.”
This nurse spent her months sometimes only with COVID patients, and other times with a combination of COVID and non-COVID patients. That meant she’d have to gear up, check and treat her COVID patients, then take all the gear off to treat the non-COVID cases. This doesn’t seem like an optimum situation.
This nurse did not work in the COVID ICU — where patients would have tubes down their throats to breathe, as well as other tubes attached to their bowels and bladders. The ICU patients are sedated. It takes a team of nursing staff to turn a patient on their stomach to breathe more easily, and then back again to avoid bedsores.
“But if a patient comes out of that and leaves the ICU, they come to us — and those tubes come out. And after lying there for, like, two weeks, they need bowel training, bladder training and physical therapy. And the nurses and everyone else have to get geared up to go in there to do the physical therapy with them.”
Those who make it out of the ICU and leave the hospital need to go to a nursing home or have home healthcare for rehab. This is when they learn their ADLs, or activities of daily living. Most people, though, didn’t make it out of the ICU.
“I think three-quarters of the people died. When the people under my care went to the ICU…. Well, there would always be one where we would think they were going to make it… and then they didn’t.”
The ICU sounds like a desperate place. This nurse describes a patient going on a ventilator.
“The tube going down their throat hooks them up to a ventilator. You can also have a tracheostomy or a hole put in your throat, and the ventilator will breathe through that. COVID patients often ended up with the trach because they needed an emergency airway.”
But ventilators and intubating patients did not happen on her unit. She was in what’s called a med-surg unit. Normally patients from, say, a surgery would go to med-surg to recover. But it became all COVID, all the time. Sometimes as the patient was being brought upstairs to the ICU, they would need emergency intubation on the elevator. Otherwise, the intubation happened in an ICU room.
“And that’s assuming a patient’s heart can handle that. Because if it can’t, you have to have CPR while they’re being intubated. And that’s a code. And now, guess what? Because the patient has COVID, everyone going in the room has to don all their protection. So this first minute of someone coding is staff putting on gear.”
These Are Not Happy People
Generally, a patient that “codes” isn’t breathing or is having a heart attack. Every second counts.
“There’s a certain bunch of protected medical people that roams the hospital with their gear on. These are not happy people, because all they do is intubate and code people in a way where they — the medical people — are protected. But it’s almost impossible to keep these COVID patients alive like that. We’re used to doing all sorts of things without all this gear and all these protocols. Like, we’re used to bagging them…”
I have to ask what “bagging them” means.
“Bagging is when you’re putting a triangular-shaped soft, squishy mask over their face and you’re squeezing an Ambu bag. It’s what you might see in an ER or in an ambulance. That way, you don’t do mouth-to-mouth. But that increases the risk of transmitting the virus so we had to avoid that. Even intubating increases the risk of exposure, so there are all kinds of special protocols around that. And this is going on all night long. The doctors are just doing this over and over, intubating this extremely obese young man or woman, or an older person.”
So… let’s say a patient does make it out. What then…?
“Even if you don’t die of it, you can still have a ton of ongoing problems that either never go away, or it’s going to take months or who-knows-how-long to recover from them. There are people who are younger than 50 that have permanent damage in their lungs because maybe they smoked for a few years then COVID got into their lungs. Or maybe you end up with mitral valve prolapse. COVID is causing all sorts of things. People just don’t think about it like doctors and nurses do. We’re like, “This is never going to goddamn end for us. Even if COVID is done, the sequelae of it — you know, the side effects — will go on.”
In the early days of the pandemic, hospital workers in cities like New York were shown appreciation during their shift changes with loud and grateful cheering, clapping, banging on pots and pans, and horn blowing.
But by spring 2021 in Indiana, hospital workers weren’t feeling very appreciated. Mostly, they were feeling burned out. After all, Indiana’s average 7-day COVID case rate has stubbornly remained as high or higher in 2021 as the year prior, including after Pfizer, Moderna and Johnson & Johnson introduced their vaccines. As of this writing, the state’s 7-day average is more than double the average from the same day a year ago (2,486 versus 1,136).
When this nurse left that hospital, she blamed herself. Sometimes she had three COVID patients and five non-COVID patients. Over and over again throughout her shift, she had to “don and doff” her protective gear. Many nurses, especially those in senior positions, quit to make more money as traveling nurses elsewhere. Or they just quit to stay home with their kids. This nurse felt an obligation to stay, to help her co-workers as much as the patients.
She Wasn’t Keeping Up. COVID Was Beating Her.
Then her worst night happened. This nurse says she only had three patients: one COVID and two non. The COVID patient was spiraling with COVID delirium. He’d had a stroke but didn’t realize it. His abilities were limited. She came into his room and he was on the floor crying. He had fallen. She had gone 10 years without having one patient fall. She got him back in bed and was filling out the report when one of her non-COVID patients fell. And then the other non-COVID patient tried to make it to the bathroom and fell.
This, she explained, is the type of thing that can never happen in a hospital. She knew it shouldn’t have happened. Despite her years of experience, best efforts and stubborn grit, she realized she wasn’t keeping up. COVID was beating her. She leaned against a wall and cried.
“This was almost an invitation to go to the emergency room myself. They asked if I wanted to go to the stress center. But, in between sobs, I said no. I couldn’t work anymore and I went home. It was horrible for me. And, I’m sure, for those poor patients. “
She gave her notice. Then she took time off. And recalled all she’d been through.
“We were working when there wasn’t a vaccine. We all just assumed we’d get COVID. Then we’re watching these people go downhill. We watched them die. We were using experimental things like zinc and hydroxychloroquine in the beginning. It wasn’t approved by the FDA; it was just what we had. I was like, ‘How about somebody else give this experimental shit? This is not what I signed up for.’ And people were like, ‘Well, you signed up for this job.’ No, I did not sign up to die in a pandemic or to kill people with experimental treatments. Meanwhile, people were infecting us. I can’t even believe I made it through that.”
Despite the reality of the 15 months working the COVID unit, she felt like a failure for not keeping up. For crying at work. For the patients who fell. She considered leaving nursing for good. But then, with time away from the COVID unit and its constant alarms, smells, Darth Vader masks and moaning, crying patients her head began to clear. That’s when she signed up to be a traveling nurse at a different hospital.
“Thank God. I did the right thing by quitting. I really feel like they were two seconds away from firing me because I couldn’t keep it together. Instead of being like, ‘Oh, we’re so sorry you’re so stressed. Let’s talk,’ they were like, ‘Okay you can go to the EAP (Employee Assistance Program).’ And there, they just really don’t know what to think if we tell them what’s going on in the COVID unit. They just sit there with their mouth hanging open when you say something like, ‘COVID poo smells different.’ They didn’t know what to do with that. So, it was time to go. I’m just glad I found a place that is different. I was a little fish in a big pond and I was getting eaten by sharks.”
People, Just Please — Get The Shot
After she joined her new hospital, she continued to feel better — both about herself and her career. One night, she talked to a patient who was feeling depressed due to chronic pain. The patient said she finally felt she was being heard and understood. This nurse is also more senior at this point.
“A new nurse was hanging out with me all night one night. And she was asking, ‘Okay, how do you stay awake? It’s my first night shift.’ So I told her about decreasing caffeine early in her shift, and using room-darkening shades so she can sleep when it’s daylight outside. I felt like I was mentoring someone.”
She’s been feeling appreciated. But she can’t go back to a COVID unit — not yet, anyway. She just wants this to end.
“People just, please — get the shot. If one person who reads this were to get vaccinated, that’d be great.”
Endnote: Although she enjoyed the travel nurse position, working in the other hospital’s COVID unit for so long left her with a type of post traumatic stress disorder. This nurse is no longer at that hospital. She’s seeking PTSD therapy and is currently considering finding a non-clinical nursing position.
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