Smells Like Trauma

COVID-19 was but a whisper in early 2020; a rumor being spread through the halls. This disease quickly gained traction and turned out to be more monstrous than anyone could have predicted. As PUIs (Person Under Investigation), were started to be admitted to my facility in New York City, and my work environment began to change. It felt like the beginning of the end. 

The first PUI COVID-19 patient I took care of was XXX. I recall entering the patient’s room to provide medications, and just knowing that this new mysterious disease could be hiding within these four walls was terrifying. Every cough, every sneeze filled this room with particles of an enemy we had yet to know how to fight. During that shift my patient’s COVID-19 results came back; POSTIVE. Now I enter this room only a handful more times before tonight’s battle with the enemy is over, but the war with the disease has only begun, and I could have never imagined what the next three months were going to look like.

The next few weeks saw COVID-19 positive numbers climbing rapidly and thus guaranteeing my encounters with the disease were inevitable and circadian. The disease quickly made it-self not only prevalent but also terminal, rapidly increasing the number of critical care beds needed. Normally, my facility functions on average 40 vented patients on a given day but at our peak we rose to an abnormally high average of 124 patients requiring mechanical ventilation. Every intensive care unit was full of COVID positive patients, multiple units were converted overnight to accommodate for the increase in demand. All hands on deck held new value; teamwork was truly tested and as a hospital it was amazing to see everyone come together. Being a Step-down Nurse I was required to elevate my practice overnight to help accommodate for the increase of critical care patients in the hospital. It’s something I always imagined I would do, but the circumstances were never what I would have envisioned. Amidst these new working conditions, there were limited supplies and the never-ending worry of contracting the disease itself. Personal protective equipment and critical care medications vanished overnight due to the unanticipated need for the high demand of the supplies. With that a new fear set in of not being able to protect ourselves while attempting to manage the care and safety for our patients lives.

Twelve-hour shifts were a thing of the past due to circumstance; 13 hours, no break, 4 ICU-level patients, no meals, constantly providing care. My body has never been sorer and more physically exhausted. Post-shift I forced myself to reflect and take notes as a self-initiative to learn how to provide the best care for my patients as there were new medication drips and critical care facets I had yet to encounter.  Mental exhaustion followed the physical burden was also present, and I was now thinking at a higher level of that I am used to on not one, but four patients. Coupled with the previously mentioned exhaustions was an over whelming emotional burden. A refrigerated truck containing the bodies of less fortunate patients greeted me at the start of every shift. Bodies whose last human interaction was shared through a cold glove instead of a familial hug. 

I’ve been told what complements the physical, mental and emotional exhaustion is a possible disorder: Post-traumatic stress disorder.  Living through such a merciless disease from the front row was difficult. COVID-19 orchestrated pulmonary cardiac arrests like it was a methodical symphony. These arrests or “codes” became something to expect for a work shift.  Overhead an ominous voice would announce the location and type of “code” for necessary personnel. Prior to the pandemic, at least once to twice a week, the voice would announce, but during COVID the voice would linger in the halls nearly six times a shift. From my experience on patients that coded from COVID-related medical complications resuscitation was successful but subsequently within five to ten minutes patients require life saving measures again. So, with the assumption of healthcare providers developing PTSD, this appears accurate but also will only be determined if there is a second wave here in New York City. 

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