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'What's it like on the front lines? It's hell.'

A Louisiana ICU Nurse shares the devastating story of what it's like working in the ICU for just one day during the coronavirus outbreak.
Credit: AP
Medical staff take care of patients infected with the COVID-19 virus in a train at the Gare d'Austerlitz train station Wednesday April 1, 2020 in Paris. France is evacuating 36 patients infected with the coronavirus from the Paris region onboard two medicalized high-speed TGV trains. The patients, all treated in intensive care units (ICU), are being transferred to several hospitals in Britany, as western France is less impacted by the epidemic. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. (Thomas Samson, Pool via AP)

BATON ROUGE, La. — I get it, some people don’t understand what is going on inside the hospital. To be honest, consider yourself blessed that you aren’t affected by this COVID-19.

I’ve been on the frontlines for three weeks, maybe longer, I stopped counting.

I have been working with some great doctors, respiratory therapist, nurse practitioners, physician assistants, nurses, housekeepers, etc. We have all become close because we rely on each other for help, laughter, and emotional support during a shift.

So, what’s it like on the front lines? It’s hell.

If you don’t want to know what it’s like, then stop reading this now.

They got a new patient overnight that had been coughing for a few days. They have a hard time breathing so the nursing home sent them to us. The patient had a conversation with the doctor and the patient decided they didn’t want to get on the breathing tube. You have to respect the patient’s wishes and make them comfortable.

We can’t continue to go in the room because that’s more exposure for us and using our protective equipment. So, we spent the entire shift watching this patient struggle to breathe. You see the breathing get worse and the grimace on their face. You give them a dose of morphine from their IV line that extends to outside the door.

Meanwhile, in another room, I’m having to call a family on Zoom so they can say “goodbye” to their eldest sibling.

This is just the beginning of my shift, it’s not even 8 a.m.

I gather up the phone numbers. We get everyone connected. We can’t get the Pastor connected. I get my gear on and go in the room with the tablet. I explain to the family, “we know it won’t be much longer and we wanted to give you the opportunity to speak with your sibling. The blood pressure keeps getting lower and lower despite the three different types of medicines we have to make that pressure go up.”

I let them know their family member was a fighter and they fought like hell for two weeks!

The family prays over the patient. They start singing a gospel song. My goggles are getting foggy and my mask is getting wet from my tears. How do you tell a family, “I’m sorry guys I can’t continue to leave the tablet in the room for you to be with your sibling alone. I’m sorry I have to end this call because we are allotted 5 minutes and I’ve given y’all 15 minutes. I’m sorry I have to end this very last phone call ever with your sibling.” 

They understood. The call is over.

I have to continue to take care of my other patient. I need to go help dialysis start on my other patient. I need to go help my other nurses that are tapping on windows from inside a room because they need more wipes or a sheet or a medicine. They can’t take off their PPE to go get it and then gown back up. Therefore, we help each other out and we run around and get supplies for each other. Sometimes we make silly faces with our eyes (the only part you can see) to make the other smile. Sometimes we write silly notes and hold it up to the window when we see you’re having a hard time getting those blood cultures because they’re a hard stick.

Three hours go by and we notice that a patient is on their way to God. We can’t be in the room with them so the doctor and nurse practitioner decide we will stand there and be with the patient outside the window.

They said to me “we didn’t want them to die alone so we wanted to stand here, which is the closest we can be.”

We stood their together as we watched her heart stop. The heartbeat end from 60 and then down to 22 and then you saw it go to zero. In my mind I said a prayer for that patient, but it doesn’t make it any easier.

Then I was needed because my other patient started having low blood pressure while on dialysis. This disease effects your kidneys often too.

Finally, I found time to eat the delicious food that already came up prepared and ready from one of the many restaurants feeding us. The doctor also bought us pizza knowing it hits the spot when you just need comfort food.
The day goes on. That other patient is still fighting and gasping for air, but not for much longer. We watch as the oxygen starts to decrease.

I can’t be with that patient. I need to go clean up my other patient and place them in a body bag. Thankfully (sarcastically saying this with deep pain), we just got restocked on body bags this morning because I requested them from our guy that stocks our supply room. I knew what kind of a day it would be, so I saw him and asked for them.

Then the patient’s family from the earlier tablet conversation calls asking for the belongings of their sibling. They said they would meet me outside. So, we follow our protocol on double bagging and zip tie the bag filled with belongings. I run downstairs to meet them. You see it on their faces. Happy to put a face to me, who they have been talking with for 5 days now, but sad to pick up their eldest sibling’s belongings. I don’t let them touch it and I place it in their trunk. You could see they wanted a big hug, but I couldn’t give it to them. Maybe they saw I needed a hug.

Time to go back upstairs. Three hours left to my shift, maybe less. That other patients heart rate was about 40 when I got back up. We sat there and watched that patient as I still had to chart my day. The doctor couldn’t be there this time, he had to go check on another patient in the other unit that needed a breathing tube. Then came back and this patient had passed.

It’s time for me to make assignments. As charge nurse I had to figure out which med surge nurses could take on which ICU patients. All except one patient was considered an ICU patient. There are now telemetry and med surge nurses having to step in to help us and take care of these patients with drips and ventilators.

While I’m on the phone with staffing our doctor is going around and checking on patients. He saw everyone was busy in rooms or charting. The nurse practitioner was making calls to family members giving them updates that usually aren’t what they want to hear.

The doctor grabs another nurse to go into my room. My patient’s oxygen starts tanking. The patient starts breathing all of a sudden with their whole body. That can’t be, this is the one of four patients in a month we were able to get off the breathing tube. I was in the room with respiratory when we saw she was ready and took the tube out her throat. This is three days later.

I’m still on the phone with staffing as I watch the other nurse gown up, get the mask on, get the goggles on and save my patient. I couldn’t handle another loss today. Satan cannot win.

The day is over and my little 11 bed unit had two deaths. These were just three of our patients. This disease is horrible.

I went home that night and I literally responded to texts with “I don’t want to talk tonight.” I knew I had to go back the next day for more. I don’t feel like a superhero.

This is not over. This isn’t even the start of the surge here in Baton Rouge. If people continue to go out and ignore all the requests, then this will go on for months! Just stay home already!

Yours truly,

- A tired ICU nurse on the frontline that just wants to see her family and hug her boyfriend sooner than two months from now

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