By Soo Youn

After five years, Kami Cayce worked her last shift as a nurse in September.

For the 27-year-old Texan, the decision to leave seemed inevitable after a tumultuous year turned upside down by the coronavirus.

After initial stay-at-home orders, Cayce’s workplace, Baylor Scott & White Medical Center, resumed non-emergency and elective surgeries at rates even higher than before covid-19. Cayce says her workload increased dramatically while concerns about coronavirus were still top of mind.

“Nurses were forced to work above capacity while understaffed. Because of the increased volume of surgeries, patients would sometimes wait for a room for up to 10 hours after surgery,” said Cayce, a post-operation recovery nurse. She said the influx was required to make up for income lost when elective surgeries were being canceled.

Then a patient admitted overnight tested positive for covid-19 the next day.

Cayce says nurses who cared for the patient weren’t contacted immediately and found out only when they returned to work and heard from fellow nurses the evening. “They were not told to quarantine and were not offered testing to determine if they had contracted” the coronavirus, Cayce said. “They were expected to continue working normally with no extra precautions.”

“It was tough and is still tough to not be there helping. There’s a lot of feelings of guilt, but not enough to go back into an abusive system,” she added.

Throughout the United States, nurses have left — or are considering leaving — their jobs over coronavirus concerns and fears for their own safety.

Baylor Scott & White’s policy is that “caregivers are notified when a patient they have been in contact with tests positive for covid-19,” spokeswoman Julie Smith wrote in a statement, adding that they are offered “the proper protection,”

She said that “less than 1 percent of our patient-facing employees who have had an exposure to a covid-positive patient have themselves tested positive.”

National Nurses United, the largest union of registered nurses in the country, did not respond to a request for comment on the current working conditions nurses are facing. But many of its 150,000 members are involved in campaigns speaking out against the conditions.

This month alone, nurses at the University of California at Los Angeles and the University of California at Irvine held a news conference to protest their hospitals’ use of waivers in an effort to get around state laws guaranteeing nurse-to-patient staffing ratios. Nurses at Sutter Coast Hospital in Crescent City, Calif., voted to unionize. Nurses at Carondelet St. Mary’s and St. Joseph’s hospitals held a honk-a-thon in Tucson to draw attention to how overworked they are — including now having to care for three, instead of two, intensive care patients at a time.

The financial pressure on hospitals related to the downturn in elective and other non-covid procedures has also resulted in hundreds of nurses being laid off. In Minnesota alone, about 275 nurses have lost their jobs as hospitals downsized, said Rick Fuentes, spokesman for the Minnesota Nurses Association.

“At a time when we need every bed, every body to care for not just covid patients, but all the other patients, we’re taking them away. These were highly skilled and experienced nurses that were forced to go elsewhere because their specialties were taken away and they were no longer able to care for the patients and families in their community,” Fuentes said.

Other nurses say their concerns about a strained health-care system during the pandemic have only exacerbated existing problems. This, paired with the trauma of everything they have seen, has made continuing to work in the profession untenable for many.

Intensive care unit nurse Sandra Kirkby, 41, quit her job at the Chandler Regional Medical Center in Chandler, Ariz., in July. Arizona has been a consistent hot spot for the virus.

“It was not an easy decision to leave after 15 years of identifying as an ICU nurse,” she said. “I’ve advocated for patients to both physicians and hospital administration for 15 years. I’ve been active in process movements and trying to fix things. I realized that system is so beyond broken, and that after several mergers, working for a now-huge corporation, there was nothing I could do to fix it and offer my patients the best care.”

In April and May, as New York City dealt with a surge in cases, she worked at Maimonides Medical Center in Brooklyn.

“After the death I witnessed in NYC — much of it unnecessary if the hospital system wasn’t overwhelmed — I couldn’t put myself through that anymore. I couldn’t clock in and go through motions for a paycheck,” she said. “I realized my voice was too small to fix things.”

Since leaving, Kirkby started a blog called MsMindful to help educate people about covid-19. She’s also gone back to school to get a family nurse practitioner license.

In Central Texas, Cayce is still struggling with guilt over leaving as the pandemic wages on. She’s still not sure whether she will continue to work as a nurse in a non-hospital setting or start over in a new career.

After the year she has had, she still considers herself lucky.

“I am privileged to be able to take a year off to figure that out.”