It had been 24 years since I had worn navy-blue scrubs, but today, November 30, 2020, I'm wearing them as I enter the ICU where I used to work as an RN. For the past 20 years, I have been working in the Case Management/Clinical Outcomes Department providing patient education and working to improve patient outcomes at discharge. But with the COVID-19 crisis, the organization had asked all nonclinical RNs to return to clinical areas and assist with the increasing patient volume. What was supposed to be a 2- or 3-week assignment turned into 10 physically and mentally draining weeks. Although completely taxing, the experience was humbling and life-changing, particularly seeing firsthand the impact of frontline medical staff on the care of patients with COVID-19. The experience completely changed my outlook, and the lessons learned from the greatest health crisis seen in my lifetime awoke my senses in a new way.
As you read the following, allow your senses to experience the remarkable care and compassion of the ICU staff during some of the busiest months of the COVID-19 pandemic.
SOUND: The ICU doors swing open, and the day begins. The door will open and close hundreds of times throughout the day as staff members come in and out to care for patients with COVID-19. Each staff member brings a needed skill, supply, medication, support, and smile with each sound of the door opening. The cacophony of alarms sound constantly: ventilators, vital signs, and infusion pumps-all critical to keeping patients alive. Supply drawers open and close repeatedly, and the supply wrappers are being opened and used. The linen and garbage bags are tossed into the collection container. Isolation carts rattle as they deliver needed gowns, masks, and goggles. The voices of other nurses call for help to prone a patient or bring supplies to a patient's room so they won't have to doff their PPE. The voices of nurses on phone calls with families providing updates and trying to offer hope despite the undesirable outcomes that have befallen most patients with COVID-19 in the ICU. The staff's muffled cries of frustration, anger, and other emotions as they witness more devastation and death. And rarely-a joyful cheer for a positive outcome or laughter when the staff somehow finds some random humor amid a busy day.
SIGHT: For the morning huddles, the entire team gathers at the nurses' station to receive shift report and prepare to stand, run, react, and think critically for the next 12 to 13 hours. Someone gives an orientation to yet another travel nurse to make sure they are comfortable with all the equipment.
Throughout the day, PPE is repeatedly donned and doffed from head to toe. When on, only their tired eyes are visible. When taken off, sweat glistens on their faces and remnants of the N95 masks persist as lines on their skin. Their faces are filled with frustration, sadness, loneliness, exhaustion, hopelessness, and looks of yearning for a "normal day." Before these faces can recover, the process to care for the next patient begins.
Smiles, although few and far between, are obvious even with the mask as cheekbones raise and eyes crinkle. Videoconferencing is common as nurses and providers communicate with families of patients with COVID-19.
SMELL/TASTE: One probably never thought the smell of blue surgical masks and N95 masks would become part of the daily routine, but it is now. On a positive note, it does cover the smell of the staff's sweat under layers of PPE and the constant odor of the disinfecting chemicals. The delivery of flowers to the staff from the patients' families brings in a welcomed scent, as does the brewing of fresh coffee and the aroma from pastries and pizza sometimes brought in for the staff.
TOUCH: Even with gloves, the power of touch turned out to be very valuable to both patients and staff. Each team member's hands are instruments of healing and comfort. The strength of each team member as they guide patients to a prone position to prevent their oxygen levels from worsening. The hugs among coworkers when a patient dies or when they realize a family is torn apart. Each random touch from a colleague or patient offers reassurance, support, and admiration without even a word.
The 10 weeks in the ICU made this nonclinical nurse forever grateful to have been able to witness the staff's superior care. The ICU nurses were resilient, hardworking, and professional. With this total sensory experience, my hope is for others to fully appreciate the impact of the frontline staff in caring for patients who were critically ill amid an unprecedented pandemic.