Nobody’s Listening

By Robin Postell

Elizabeth, a Certified Nursing Assistant (CNA), is thirty-something, funny, clever, but not tonight. Her tone is pleasant, but she is grim, a little solemn.

Today she thought she would be off but got called in. This happens a lot these days as a new surge of COVID rushes through the hallways of the South Georgia hospital’s Critical Care Unit where she works. Once COVID patients leave her floor bound for the Intensive Care Unit (ICU), their chances of survival are narrow. 

“Pretty much when they go on the vent(ilator) it’s over,” Elizabeth sighs.

Elizabeth, who contracted COVID along with her youngest son, quarantined in a hotel with him to keep from exposing her other son and partner back home. She knows firsthand how draining it is, remembering her lips turning blue when breathlessly trying to carry a box to the car not long after being diagnosed. She still experiences weakness. But at least she wasn’t hospitalized.

“I can’t count how many people have died from it…I can’t count,” she says, noting that people are always asking her about the numbers. “I’ve been working here 12 years – and in the ICU and ER most of the time – but I’ve seen more people die of this than anything else.”

Recalling her first COVID patient in early 2020 is one of her most poignant memories. A sweet elderly woman, she would call down to the nurse’s station, asking for someone to come see her – that she was lonely, and afraid. Elizabeth remembers the patient telling the staff not to use the scarce supplies on her, to save them for others because she was old. Staff, including Elizabeth, were scared. Nobody was sure what COVID was capable of at that point.

Elizabeth has far too many stories like this one. Since then, hundreds of patients have come, and gone – for good.

The Critical Care Unit was at capacity at Elizabeth’s hospital in 2020 with all 17 beds full.

“Now it’s 24,” she says of the September 2021 uptick of COVID. “They’ve had to open the pediatrics wing this time.”

Is it the Delta variant? She doesn’t know.

“If anyone knows or has said, I haven’t had time to slow down long enough to hear,” she says. All she knows is they’re sick – really sick – and she’s tired, scared, and frustrated.

Elizabeth says she has always loved the job and helping people, “…until this happened.” The average pay for CNAs and RNs is not as high as one might expect, considering how they hold someone’s most precious gift in their hands – their lives, or those of loved ones. Elizabeth tried her hand at marketing for a brief stint before happily returning to her job at the hospital a few years ago. “Now they’re paying me so much more and I don’t even want to go in,” she says. “I feel like if my heart’s not in it, I shouldn’t be doing it.”

Like many hospitals dealing with COVID, hers is understaffed. “There’s no staff, because everybody’s burnt out,” Elizabeth says defeatedly. “People are reconsidering their line of work…including me.”

Dealing with patients who Elizabeth feels aren’t being realistic or conscientious enough about the risks of contracting the virus has taken a toll on her view of humanity.

“It’s exhausting and aggravating. It’s like nobody’s listening. No mask. Not washing hands. No vaccine. It’s like your kid climbing on the counter over and over and they keep doing it and then they fall,” she says. “It’s your body and your choice, but it’s exhausting. People who are already sick are just adamant that we’re all trying to kill them, and they won’t wear a mask…Of the 17 on our floor at one time, about six of them were convinced that it was just a scam.”

Some of those, she’s sure, died believing it. Others died regretting it. And there are always more to replace them with similar biases.

“One night on my way to work in July (2021), I had to pull over and I had a full-blown panic attack. I called in and said I just couldn’t come in. I couldn’t. I tried again the next day,” she said. “When I went back, I went to a desk job, watching heart monitors. It’s boring, but at least I can get a break.”

Various studies have shown that healthcare workers, specifically nurses, are candidates for long-term side effects like severe depression and PTSD from their COVID details.

“I hope not,” Elizabeth says to that.  “I really do.”

With school-age sons, one of whom, like his father, is opposed to the vaccine, and with patients and co-workers alike in constant inner- and outer-conflicts regarding the virus and its subsequent safety measures such as masks and vaccines, Elizabeth is overwhelmed.

“It’s infuriating,” she says with a clenched jaw.

Ultimately, she’s simply too busy and shell-shocked to argue, but this has a staggering impact on her overall well-being. At the throes of her tumult on July 30, 2020 – a day spent going “back and forth to the morgue” – she posted a hard-boiled lamentation to those she felt “weren’t listening” on her Facebook page:

Within the conversations of COVID, most people want to discuss their conspiracy theories, and all the misinformation and numbers…

With me being the can’t-shut-my-mouth kind of gal that I am…I decided to give you a list of REAL TRUE numbers and information that I personally have been struggling with lately…

4: The number of patient labels you need to take in the room during post-mortem care to help properly identify the Covid positive body.

3.5: The maximum hours I can actually sleep on a night I’ve worked. My mind is an absolute mess.

2: The number of tags you tie to the patients before placing them in the bag…if applicable the finger tag goes on the wedding ring.

12: The number of times I have come home and cried in the shower because despite my strong face act, I am so terrified and so heartbroken for these people and their families.

6: The number of times I have cried in a patient’s room, thank God these poor people can’t see my tears through my masks.

2: the number of times I have fallen to my knees praying to God to protect my family, my parents, my grandparents…

4: The number of times I woke up crying from the night before or sometimes looking for a crash cart.

5: The number of double-gloved fingers I’ve used to hold these peoples’ hands when they ask me to, because they are terrified, they can’t catch their breath, and they just know death is near.

1XXXXX: The number I use to sign out my mask every day – the mask that scars my face, hides my smile, keeps me safe, and takes my breath all at the same time.  This is also the number I use to sign out body bags.

2: Shoes that stay outside of my house because I’m so worried I will bring this into my home, or around my children.

0: The loneliest of numbers…the number of how many family members are in a room when a human being takes their last breath. It used to be a thing, that no one wants to die alone, but look at al these “fake” people…Husbands, brothers, mothers, sisters, just dying alone.

I don’t care about CNN or Fox news numbers.  I really don’t. I don’t give a **** about Trump, Obama, none of ‘em. Don’t give a **** about a Republican, Democrat, Libertarian, whatever you may be. Absolutely none of it.

I give a **** about compassion, I give a **** about empathy. I give a **** about love…I give a ****t about humanity and human decency. I give a **** about people dying alone.  I give a **** about the amazing, broken-spirited, tired, dedicated team I work with…

So please understand that while ignorance is bliss, some of us are forever scarred from this and its only getting worse. Feel free to suit up and join this fight, or shut your mouth while those who actually see it and feel the depth of it, the tragedy, heartbreak, and sadness of it, figure it out…Please stop spitting in our face. This disease has ruined so many lives forever. I can assure you no matter the numbers, conspiracy theories, or politics, for us this is all too real. 

We used to be heroes…

Now we are just tired…

Do better, America.

The post has been shared nearly 200 times since then, but a year later Elizabeth feels it wasn’t a message heeded.

“The thing that haunts me the most…” she writes to me, “is that I’ve seen a lot of death in my days, but COVID takes something away from even death. It takes away the solemness and the…spirituality, I guess is the word. You used to could watch someone die and know they were at peace. You could almost feel the angels in the room.  It even made you more comfortable with your own impending death, in a weird sort of way. But it’s dark with COVID.  It’s not peaceful.  You can’t feel a sense of heaven like you used to, only a dark cloud. The co-workers I’ve talked to about it know exactly what I mean. There is no peace in death anymore…It all just seems so wicked. But how do you say that? It’s just horrifying, lonesome, and quick.  God, it’s so quick, and just sad. There’s no dignity left in it.”

The words come out hard and blunt.

And why so quick? Because, she says, many patients get so confused near the end they will remove their BiPAPs (cumbersome face masks which blow oxygen into your lungs to make up for the oxygen for which your body is incapable of accessing).

“They become confused, which usually turns into them pulling on tubes and lines, especially the BiPAPs masks,” she explains. “When their masks come off for them to try and eat or talk, their oxygen drops fast. Down to the 60s, 50s, 40s, 30s, 20s…just too quick. Without the oxygen the heart can’t keep up…it doesn’t last long.  It slows down, tries to catch itself, but without that oxygen, it just can’t. Then it’s just over, just like that. So quick.”

Elizabeth watched one heart monitor go flat as she wrote out these thoughts.

“And it’s scary because with that mask on they are usually coherent,” she continues. “They know what happens if they pull it off. And I’ve seen a few times where they volunteered to take it off, said their goodbyes via FaceTime, and within minutes they are dead. Imagine deciding what time you want to die…”

Mulling these moments over, Elizabeth figures she can understand why they would make the choice. “Hidden behind a BiPAP, with all that air blowing on your face, having to use a bedpan, they get tired of it,” she expounds. “…when a few weeks before they were completely independent…then they can’t even get out of bed…In my opinion that’s really no good way to live either.”

This means the exhausted staff are chasing the oxygen levels the entire day. “You can’t do regular routine things because you run from room-to-room chasing these oxygen levels. When they die, it’s so easy to feel defeated. I mean, you’ve been trying to keep it up all day. Then, it’s just over.”

What does this mean for the rest of Elizabeth’s life? She says it makes everything harder, even going to the grocery store. Every aspect of her life now is consumed by overwhelming anxiety – all the time.

Elizabeth says the hospital tries to offer some relief for the staff via grief therapy. She saw a flier about it.  One day she saw that ice cream and pizza were being passed out.

“That doesn’t help,” she said, “doesn’t make it better.”

At this point, Elizabeth is holding on, watching the heart monitors; packed tight and full of experiences she’ll be parsing for years to come.

“I mean, do you not see the pandemics throughout history, like the Spanish Flu, come on, this isn’t something new. Are we really this pig-headed? The whole country?” she asks rhetorically. “I’m not a big fan of humans right now. I’m trying. Even some people I know, groups of friends, they want to talk to me and I’m like, ‘Ok, Joe Biden paid me to tell you all it’s a real thing,’” she vents. “Look, if you’re just that opposed to the vaccine, just be careful. Wash your hands, wear a mask. It doesn’t hurt you. Especially washing your hands.”