Covid Observations From the ICU

Let me paint a picture of what it’s like to be an ICU nurse in Austin TX right now.

Our 30 bed ICU is now all COVID. It’s not surprising, we knew it was coming and we’ve been preparing for it but our COVID population grew 50% almost overnight. We weren’t ready. ICU COVID patients are the most complex population I’ve ever worked with in my career as a nurse.

These patients go from conversing with you to needing emergent intubation and at the brink of death within minutes. Intubation is not lifesaving, that’s only the beginning of the things they’ll need to keep these patients alive. Once intubated, their oxygen saturation usually doesn’t improve. We need to be quick to sedate patients in order to paralyze them and place them on their bellies so their lungs have the best chance of oxygenating the rest of the body. This of course doesn’t come without complications, their pressures will probably drop. We need to make sure we are ready to tackle a drop in blood pressure because if you don’t, they will die. Oh, but for that you need some central access to give medications. Don’t have access? Well let’s hope you have enough staff to be able to place a line in quickly so you can give all of those life saving medications. Oh, they’ll probably need an art line too so you can accurately treat blood pressures. While you’re at it, you’ll need a DHT for enteral nutrition and medications. Also, a foley and rectal tube too. You’ll also need a few X-Rays to make sure all the lines are in the right place. Oh no, but temperature is 104 F! You don’t want the patient’s brain to fry so you cover them in ice and give them Tylenol (rectally of course because you still don’t have x-ray confirmation yet). Tired of reading? Wait, it’s not over yet. You still have your other patient who’s on multiple lifesaving drips and if they happen to run out they can die. You hear the pump beeping next door, you hope that you can reach your other patient before they start responding negatively to the abrupt cessation of the medication. But you can’t just walk out and go to the other room. Nope, not in a pandemic. You have to wait for someone to answer your plea over walkie to come and help you get to the other room...safely.

A few hours later, you are finally able to come out of the room. Covered in sweat because you’ve been wearing layers of PPE and your face covered in bruises from your respirator. You come out, not because your done but because you feel like you’re going to pass out.

There’s no cure, we see patients stay with us weeks on end as the virus completely destroys their organs. It is terrifying.

There has been multiple times this past week I’ve started laughing just to keep myself from crying. As ICU nurses, we see death all of the time but even that couldn’t prepare us for this. I’ve never seen so many of my coworkers struggle just to get through the day. We’re overwhelmed. We’re tired. We’re running on fumes. We’re human and this is not sustainable. Please do your part to keep this from spreading. It’s not a time for politics, it’s real and we’ve turned it into this mess. Do your part.