ICU nurses weigh in on pandemic toll: 4 things to know

For many nurses across the country, the nearly yearlong battle against COVID-19 has brought on some of the toughest times of their career and unimaginable strain. Seven intensive care unit nurses from hard hit areas spoke to The Washington Post about the toll it takes to care for the most critical COVID-19 patients. 

Here are four things to know from their input: 

1. Leaving the hospital can be frustrating and hardly alleviates stress. For Kori Albi, RN, a COVID-19 unit intensive care nurse and unit supervisor at Boise, Idaho-based Saint Alphonsus Regional Medical Center, venturing out into the community is sometimes more daunting than being at work because there are so many unknowns. At the hospital, protocol is rigid and COVID-19 patients are clearly identifiable. 

"Going out into the community is scarier than coming to work every day," Ms. Albi said. "Because you don't know who has it." 

For Tammy Kocherhans, RN, a respiratory ICU nurse at Salt Lake City-based Intermountain Healthcare, seeing people in public who aren't following basic COVID-19 safety precautions is disheartening. 

"I find it completely disrespectful to the work we do to save people's lives, to have people think that this pandemic isn't real, to show utter disregard for people around them, not trying to do their part," she said. "And I really wish that I could take people on a day with me so that they can see what I see." 

2. Almost every day is an emotional rollercoaster. "I cry everyday when I walk in to work, and I cry every day when I walk to my car after work," said Allison Wynes, RN, medical ICU nurse at the University of Iowa Hospitals and Clinics in Iowa City. 

She also described a lingering fear that soon, all control could be lost due to the increasing pressures placed on hospital staff. 

For Nate Smithson, RN, a respiratory ICU nurse at Salt Lake City-based Intermountain Healthcare, the pandemic has introduced panic attacks outside of work. 

"Balancing work and life is something that used to seem possible," he said. "Now, it doesn't seem like there is any difference between the two. I fall asleep and I dream about my patients." 

3. Trying to comfort lonely, critical patients and families is an arduous process. For Cate Carrigan, an ICU nurse at the University of Mississippi Medical Center in Jackson, caring for younger patients is often the hardest. 

"They have families and they have kids just like I do, and it's hard coming into work and taking care of them," she said. "Knowing they're supposed to be going to college, they're supposed to be getting married … instead, they're laying in a hospital bed on a ventilator fighting for their life." 

All of the personal protective equipment gets in the way of trying to comfort grieving families, said Luisa Alog Penepacker, RN, an ICU nurse at Glenview, Ill.-based Glenbrook Hospital. 

"I used to be able to hug family members, but you can't with all that gear," she said. "When patients are scared, I will hold their hand even though I'm wearing gloves. I look them in the eyes as much as I can because really, that's all you can see. 

4. COVID-19 has flipped the expectations of new nurses. Kahlia Anderson, RN, an ICU nurse at Ohio State University Wexner Medical Center in Columbus, expected to ease into her nursing career by starting with less critical patients. She started in January, so there was no time for that when the pandemic started to hit the U.S. in February. 

"Everyone had COVID, everyone was sick, everyone was intubated or approaching intubation," Ms. Anderson said. 

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