By Lauren Powers, RN, CCRN 

I am an ICU nurse. I love what I do; It’s not just a career: It’s who I am. No other job could offer me the intimate opportunity to support and guide a total stranger through the worst (and occasionally best) days of their life. Nowhere else would I leave feeling humbled by what I do every day. Nothing compares to that. Simply put: You don’t find that sense of purpose and love for the work you do just anywhere.

Although 11 weeks have passed since the start of the COVID-19 pandemic, to me, it feels like it’s only been a day, the longest and most devastating day of my life. The lines of reality blur as I continue to write March while writing the date. My only concept of time became the days I was scheduled to work, and the days I wasn’t. The sun rising and setting became a matter of coincidence as I started my 12 hour night shifts. I don’t remember what my medical ICU looked like prior to COVID. I can’t relate to the feelings after tough shifts because they are now considered our good days. In comparison to this pandemic- There is no comparison to this pandemic and what it has done to me, my coworkers, and this profession.

Our typically open concept ICU now felt like help was over a mile away, only to be summoned by fists banging on glass doors and muffled cries through a masked mouth for supplies, life-saving treatments, meds. Or to reach a physician because your patient is decompensating. Or to call a code because they are dying. If you’re lucky, someone might be nearby to hear you. I still remember smashing my fists on that glass so forcefully that I was sure it would shatter, asking my coworkers if we were resuscitating COVID patients as a man lay in bed behind me hanging onto his life by a thread. Before, we had protocols on COVID-19 code blues, post-mortem care, family visitation. His flail chest became more pronounced with each sucking breath that the ventilator delivered. My scrubs sopping wet with sweat after three and a half hours of trying to save his life with my coworker beside me. I scream for a backboard as I ignore the risk, and I am reminded of my own morality, fully prepared to resuscitate this man alone as our only physician was intubating next door. No plan, no orders, no protocols. Just our training and instincts as ICU nurses and a dying man who deserved more than we were able to give him.

My coworkers outside of the room frantically wave us down as we lean the man forward and place the backboard behind him. I distantly hear them wail, “He’s a DNR!” as I intertwine my fingers and place my palms on his sternum. I can still feel the vial of morphine they handed me roll between my fingers as I stood over this man like the angel of death. Such a pathetic bandaid to make the pain “all better” knowing damn well in my heart that we should’ve been doing more. A petty little vial after 3 hours of pouring every ounce of what I had into this man. And all I get is a tube of morphine and a syringe; that’s all this man gets from us. I felt like we were giving up on him, and I didn’t want to; I wasn’t ready to. He was somebody’s someone. Doesn’t that mean anything during a pandemic?

I remember the disbelief that washed over me as the supervisor told us his wife couldn’t be with him during his final moments. I feel his hand in mine, his other in Diane’s, as we promise him he wouldn’t die alone. We wait for the room phone to ring with his wife on the other end. His blood pressure is dropping, heart rate slowing as those outside the room try to contact his wife. She isn’t answering. I pause before giving the morphine praying we would be able to hear the phone ring over the violent alarming of the monitor as his vital signs plummeted. I reluctantly push the morphine into his veins after not being able to stand the thought of his last moments in pain. His blood pressure reads 46/20. It stays there. We are jolted by the sound of the phone ringing, and we explain to his wife that he doesn’t have much time. We tell her the unbearable truth that he is actively dying. As the phone rests by his ear, a distant voice is heard from the other end for only a few seconds, and his arterial line goes flat. No pulse. He was waiting for her.

Tears and sweat drown my face as I try to rip off my PPE and exit the room. I didn’t want to leave him, but I couldn’t bear another second in that reality. A whirlwind of emotions crash over me, and my knees weaken. I thought, “If I can just get this gown and mask off, I’ll be able to breathe again.” Even after ripping the damp N95 from my face, I was still breathless, speechless, and broken in disbelief of what happened in that room. I was suffocating. I nearly collapsed as I stepped through the barrier of his room with my coworkers there to catch me. Never in my life had I felt that level of hysteria as COVID showed us that what we were fearing was actually much worse than we could’ve imagined. This became the new standard for the worst night I’ve ever had.

The best way I can describe the frontlines is trying to scream as loud as you can while underwater. We are all underwater, trapped in our fishbowl-like glass rooms behind closed doors, praying that someone will hear us. Imagine being the only thing standing between life and death for another human being, and everything you need to keep them alive is through a glass door that you can not open. While screaming underwater. We are drowning.

Lauren Powers is a critical care nurse.