Inside a Covid I.C.U., Through a Nurse's Eyes | NYT Opinion

I was looking out the window of an I.C.U. of Covid. And that's when I realized I could watch someone die. I didn't even know who she was. But I was overcome with immense pain as she got closer to death every hour. What she didn't know yet was that when she left, just two days later, at least three patients would be dead. The vaccine offers hope, but the sad truth is that the virus continues its brutal slaughter in ICUs like this one in Phoenix, Arizona. The only people allowed entry are healthcare workers. They are overworked and underpaid in a flooded hospital.

I wanted to know what it is like for them now, after a year of witnessing so much death. Eager to show us their daily reality, two

nurse

s carried cameras so that we could see the ICU for the first time. through her

eyes

. “Unless you're there, you have no idea. Nobody can even imagine what happens in there.” This ICU contains 11 of the hospital's sickest Covid patients. Most of them are between 40 and 50 years old. And all of them are at death's door. It is an incredibly depressing place. I blurred the patients' faces to protect their privacy. But I was also worried that the blurry image would take away their humanity.

The family of this patient, who is rapidly deteriorating, allowed her face to be shown. And they easily told me about her. Her name is Ana María Aragón. She is a 65-year-old school administrator and grandmother. Sara Reynolds, the

nurse

in charge of this ICU, organized a video call with Ana's family to give them the opportunity to be with her in case she did not survive. “It breaks my heart when I hear families saying goodbye.” Doctors might be expected to run the show. But in reality it is nurses who provide the vast majority of care. "We do everything.

We bathe them every night.” “Rub lotion on your feet.” "Shaving the boys' faces." “Cleaning someone who had a bowel movement. “It doesn’t even register as gross.” “Look, I enter the room. I say, hey, it looks like you have Covid. And he might order a chest x-ray. He might order blood tests. I could order catheters. All of this is done by the nurse. It may have been 10 minutes. The nurse can spend seven or eight hours in the room, caring for them. Let's say there was a day when the nurses didn't come to the hospital. It's like, why are you opening? "Ibuprofen." Working shifts of more than 12 hours, isolated in this windowless room, these nurses survive by taking care of each other. "Aww thanks." And finding small doses of lightness. “(SINGING) Bad.

Breeze." “I'm getting older and there are all these new young nurses coming up. And I feel like a mom to all of them. Morgan, she has big aspirations. She loves to snowboard and she's very smart. And Deb, Deb is just…she's funny.” “I make fun of her all the time. I can tell her to do anything, and she'll just do it because I think she's afraid of me because I always say, make sure you don't have wrinkles in those. "Patients spend most of their time face down because it makes it easier for them to breathe. But the nurses have to turn them frequently to avoid pressure sores.

There was a woman in her 50s who was so critical that this simple procedure ran the risk. risk of killing her. “Even just turning them on their side will lower their blood pressure.” “In fact, their heart had stopped the day before. And so the concern was whether that would make their heart stop. again". "Then come. Push." ​​"We were all looking at the monitors." "I was relieved and thought we had made it." Arizona is a notoriously anti-mask state. And it faced a huge spike in Covid cases after the holidays. In January, the month I was there, Arizona had the highest Covid rate in the world.

As a result, ICUs like this have too many patients and not enough nurses. “Because they are so critical, they need continuous monitoring, sometimes only one nurse per patient. , whereas normally what we have is two patients per nurse. But there are definitely times when we are very pressured and we have to have a three-to-one task. “The nursing shortage has affected hospitals over the past year. help, travel nurses have had to fly to hotspots. Others have been forced out of retirement. Poorer hospitals like Valleywise, which serve a predominantly low-income Latino community, are especially strained. “Many of our patients do not have insurance.

Some of them have Medicaid, which pays them some, but unfortunately not enough.” This means they simply cannot compete with wealthier hospitals for nurses. “There is a bidding war. The average nurse here, more or less, makes about $35 an hour. Other hospitals, a mile or two away, might pay them $100.” “We lost a lot of staff because they accepted travel contracts. How can you blame them? “Sometimes it’s a once-in-a-lifetime opportunity to make a lot of money.” “Every day I'm free I get a call or a text. 'Hey, we desperately need help. We need nurses. Can you come in?'” This nursing shortage isn't just about numbers. “Physically it is exhausting.

We're just running. “We don’t have time to eat, drink or go to the bathroom.” “They have kids at home doing school online. And I think, my God, they haven't even been able to check on their kids to see how they're doing.” “My days off are spent sleeping half the day because you're exhausted. And eat because we don't eat often here.” Nurses have been proud to be ranked as the most trusted profession in America for nearly two decades. But during the pandemic, many worry that they will not be able to maintain the standards that earned them so much respect. "I can't provide the quality of care that I normally would." "It's absolutely dangerous." “That's demoralizing because we care.

We are nurses. It's our DNA." Ana had been in the hospital for more than a month. Her family told me that she was born in Mexico. She came to the United States 34 years ago, first working in the fields before landing her dream job in education. She is liked at her school. Her former students often stop her in town and shout excitedly: Miss Anita. She was very cautious about Covid. She demanded that her family always wear a mask and yelled at them to stay home. However, tragically, she somehow still contracted it. “It had been getting worse over the course of several days.

It's an image we've seen too often and we know this one is coming soon." As there is no cure for Covid, there is not much the staff can do. Once all ventilator settings and medications are at maximum, keeping a patient alive will only do more harm than good. Then Ana's family was forced to make a difficult decision. “And I talked to the family and let them know that we have offered, we have given, we have done everything we can, there is nothing more we can do. “The family made the decision to move into a hospice.” “If I'm there while someone walks by, I always hold their hand.

I don't want anyone to die alone. That is something that brings me peace.” "Thank you." "Thank you." “The dance floor is full. People hug each other, hold hands and almost no one wears a mask.” “I think, like many healthcare workers, I am very angry. And my faith in humanity has diminished.” “How can you think this isn't real? How can you think it's no big deal? “Free your face. “Free your face.” Arizona Gov. Doug Ducey has advocated for personal responsibility over mask mandates even though he was photographed maskless at a gathering and his son posted a video of a crowded dance party. “Even outside, they go, I don't care.

I don't wear a mask. I am not going to receive the vaccine. That's bullshit. The moment they get to the hospital, they want to be saved. They never say, 'I made the decision.' I am accepting this. Don't do anything, doctor.'” Half a million people in this country have died from Covid. Many have been in the ICU with nurses, not with family members holding hands with patients. “I always wonder: Will they still be there when I get to work? I keep it in mind when I get home. Will they be able to spend the night?

There’s one I can think of right now.” A patient in his 50s was so critical that he required constant monitoring. Every one of his breaths seemed painful. “There was one day when he looked a little better. And so he was able to shake his head and smile. And we organize a video call for you. And it was just the sweetest thing ever. He could hear his little grandson, he was probably about 4 years old. And I also saw it on the screen. And he was just jumping up and down, very excited. 'You're doing it, grandpa. You are doing it.

We love you. Look to you. You're getting better.' He just broke my heart. He broke my heart. "He's someone who I don't think is going to be there when he comes back on Sunday." But they had already told me something that Sara hadn't. The patient's family had decided to withdraw life support. “Did they do it yesterday? Oh. And I only think about his little grandson. And 'you're doing it, grandpa.' You are doing it'". He wasn't the only patient who didn't make it. When I returned to the hospital, I noticed that the patient's bed I had seen turned over was empty.

My heart sank. I knew this meant she had passed away. “The sad thing is that when I return those beds will be full. “They will have someone else there just as sick and they have a long period of a few weeks ahead of them before it is time for their family to make that decision.” I had never seen someone die before. And even though I didn't know these people, witnessing their deaths left me sleepless, exhausted, and depressed. It is incomprehensible to me that these nurses went through this every week, sometimes every day for an entire year.

I assumed the nurses were supposed to block all the deaths in order to continue, but they don't. They mourn each and every one of them. “I have always loved being a nurse. It's what I always wanted to do. And these last few months have definitely made me question my career choice.” And what makes their situation so tragic is that many of these nurses hide their trauma, making them feel isolated and alone. “We are the only ones who know what we are going through. I really don't want to tell my family everything because I don't want them to feel the same emotions as me.

I don't want them to know that I carry that burden when—it's a lot. I'm a mom. I'm strong. I can do anything. And I don't want them to see that.” Leadership in the pandemic does not come from elected officials or spiritual guides, but from a group that is underpaid, overworked and considered secondary, even in their own workplaces. Like so many others have dropped the ball, nurses have worked tirelessly out of the spotlight to save lives, often showing more concern for their patients than themselves. I worry that his trauma will linger long after we emerge from hibernation again.

Covid's legacy will include massive post-traumatic stress disorder on a scale not felt since World War II. This burden should not be ignored. "Thank you. Thank you. I'm sorry, yes. And you all are amazing."