Notes From The Front Line

I can only imagine. It’s one of the most uttered phrases across the globe since the start of COVID-19, because for the majority of the population, the atrocities of this deadly virus can only be seen through the imagination. Since the initial shock of its arrival in Marion County and the official stay-at-home order on March 23, Indianapolis residents have joined the millions around the world watching from their windows as the virus continues to spread—except for healthcare workers, who have been fighting it on the front lines.

A nurse at Community Health Network, who requested anonymity, recalls the week COVID-19 cases flooded her hospital. The speed of change, uncertainty, and complete upheaval of her normal workflow caused a surge of panic.

“Procedures we’ve been taught about hygiene and health were thrown out the window,” she says. “Our course of action changed sometimes twice a shift. Nothing I was doing was working, the patients just kept getting worse, and that’s when it hit me: Holy shit, these people are really, really sick.”

As Community desperately tried to treat the growing number of patients admitted, despite lack of supplies, tests, and materials to keep even their own staff safe, she became angry, frustrated, and increasingly scared.

“We were doing all we could, but having to go against everything you’ve been taught and reuse masks until they’re visibly soiled with bodily fluid, the confusion about tests because there weren’t enough, and practicing in unsafe conditions—it was alarming,” she says. “You have to protect your patients, but at what cost to yourself?”

Beyond the fear of working in unprecedented conditions and dealing with a virus that has the ability to kill even healthy humans, she says the frustration of watching protests on TV, listening to talk of reopening businesses, and seeing people continuously breaking the stay-at-home mandate has been a slap to the face.

“This contributes to spread, and it’s us [healthcare workers] who are going to be in the line of fire,’ she says. “We’re all ready for this to be over, too, and I want to see my family and friends like everyone else, but this just isn’t the time.”

Despite the irritation of seeing people break the rules put in place to protect them, and despite the growing number of deaths and more than 3 million global cases, she says a sense of familiarity with the virus is setting in, and there’s a stronger sense of confidence, largely because she’s now seeing success with treatment.

“Yes, it’s daunting, but we’ve been dealing with positive cases, our feet are planted, and the overwhelming part is over. We’re understanding more.”

One memorable patient was a young father with no preexisting conditions. He walked into the hospital and within a few days was transferred to ICU, unable to breathe on his own. His lungs were so overworked, the ventilator couldn’t keep up and failed at one point, his blood pressure medication wasn’t helping, and the proning tactics showed no results.

“He came close to dying several times. We work hard on all our patients, but this one was exceptional because he was so young and there was no reason for him to die,” she says.

When he finally responded to treatment and eventually was released, the doctors, nurses, and staff lined up cheering, tears of joy streaming, just like in the movies. This was the turning point for her.

“Now, going into the hospital feels like just another day at the office,” she says. “Yes, it’s daunting, but we’ve been dealing with positive cases, our feet are planted, and the overwhelming part is over. We’re understanding more.”

Of course, some things don’t get easier. Although there’s been a collective acceptance of what COVID-19 is, what’s not been easy to accept is how people are dying: alone.

Family members can’t visit. They can’t be there when a positive diagnosis is read, sit with their loved ones when the worst sets in, be there when they improve or, sadly, when they don’t.

“Death is a part of nursing,” she says, “but what you don’t get used to is your patients being alone when it happens. It’s heartbreaking.”

The nurses at Community are using iPads to connect patients with loved ones. This has been especially helpful for older, more confused patients, she says, giving them a sense of comfort. But it’s not the same, which is why now more than ever she feels responsible for building trusting relationships with patients so that if they don’t improve, they know she won’t leave them.

It’s heavy, but it’s her work. “We’re here to help and serve,” she says. “I mean, who else is going to do it? It’s what we do, and the virus isn’t gone. It’s not going anywhere. Until the numbers decrease, this is our new normal.”