Feelings from the Frontline
At 7:30, whether it’s a.m. or p.m., I physically clock out from work. But, I wish it was that simple for my mind, that is still “clocked in” until 10 p.m., if not later. There are nights that I wake up at 3 a.m. before the next shift and find my heart pounding out of my chest, with a heart rate over 100, and a million thoughts swarming through my head. When I catch my breath and open my eyes, I realize I’m dreaming about work, my patients, messing something up, and putting a person’s life in jeopardy.
But the truth is, this isn’t just some bad dream. This has been a typical work night for me since the beginning of March. I currently am a Registered Nurse in Philadelphia, where my unit was converted to one of the hospital’s first COVID positive units. When I tell my co-workers about my sleepless night, they nod their heads, replying, “Yup, me too. Hasn’t stopped since this all started.”
This is what it’s like to be on the front lines of the coronavirus pandemic. It’s something that none of us ever expected or agreed to do, but here we are, doing it willingly and coming back each day time and time again. And while being a “healthcare hero” is an honor, we need to address that it’s taking a more significant toll on our mental health than we could have ever imagined. Or maybe more than we even currently imagine.
It’s hard to describe what it feels like to work to take care of patients suffering from COVID-19. And when I say, to work, I mean to try. There are moments where you feel like you’re fighting an uphill battle from the second you get a report on your patients at 7 a.m. You’re busting your ass all day, sweating, always on your feet, donning and doffing your PPE, and going nonstop for 12 hours. And when you wash your hands for the millionth time after your 12 hour shift, you leave work always wondering if you did your best.
It’s become one of those types of tiredness that simply can only be fixed by a massive hug from your Mom or a cold beer with your best friend. All you want to do is be with your family or friends or go somewhere you love. But, the reality is you can’t. And the icing on this pandemic cake is that everyone who you love and wants to see you, also really doesn’t want to see you. They miss you, but they don’t want to risk being around you. So you’re left out. There is a specific kind of FOMO seeing your friends seeing their other friends, their families, practicing social distancing, but in a more relaxed version of yours.
What they don’t tell you about being a “hero” is that you’re even more socially isolated than before. In these moments of an uphill battle or loneliness, I’ve found myself faced with moments of rare, raw humanity. These moments aren’t the feel-good ones that you see on John Krasinski’s “Some Good News.” These moments don’t make it to Tik-Tok, but they are just as important. Moments where you are holding up an iPad while a family looks at their parents, crying, knowing they are saying their last “I love yous”, trying to get as many as possible in before the call is over. The feeling that you get when an elderly man, with a sick son across the hall, both COVID positive, looks at you in the eyes and says, “I am going to die, aren’t I?” is gut-wrenching.
When you get home and leave your shoes outside your apartment and throw your scrubs in the wash, it’s still with you. There isn’t a metaphorical Gatorade or Michael Jordan’s “secret stuff” to help you replenish for the trauma of losing a patient. I catch myself crying at the simplest things. I know there’s no good Hallmark card for this, but it still hurts hearing those you love to say that “they don’t think they should be around you right now”. Are they right? A hundred percent. Does it hurt? A hundred percent. But I keep going, and since I keep showing up, I have had to find ways to cope with everything that is happening around me.
Since March, the word “PPE” has become a Google favorite. The commonly used medical term for personal protective equipment has now become the talk of the town. Our country is scrambling to find more physical PPE, like masks, gowns, respirators, and gloves. And they’re not wrong; we need it. But there’s a genuine part of me that wishes there was the same amount of urgency around “emotional PPE”.
How, as a community, can “emotional PPE” be provided to not only frontline workers but everyday people living through this? For me, I have found this type of “equipment” in my co-workers, my hospital’s resources, my family, and myself. My hospital has been able to provide free peer counseling during the pandemic. We are now able to debrief with a trained mental health professional for free after something really shakes you up at work.
I’ve said earlier that COVID had brought moments of raw, rare humanity, and I still see that with my co-workers. They can be described by every positive word known to humankind. They are the only in-person contact I see besides patients, and they are going through the same experiences as me. It feels good to share these experiences, knowing that I am not alone. In these “unprecedented times”, I also find myself turning to my very precedent family and friends. Whether it’s a funny Snapchat from my best friends, “The Chicklets,” or a group Facetime with the Grey Fam, I feel so lucky to have people in my life who listen and validate my feelings. People like that are more valuable than all the hand-sanitizer and toilet paper in the world.
And, sometimes, the most “heroic” thing you can do is be your own emotional PPE at times. I am on my own on my days off now, and I have tried every de-stress tactic you can find on a Buzzfeed article. I have found solace in doing yoga and focusing on my breathing. It’s incredible how many times I’ve heard someone say that, but it’s even more amazing what taking a couple deep, cleansing breaths can do for your mind. I run and walk outside as much as possible on my days off. I listen to Whitney, Stevie, Dave, the JoBros, and more and dance in my apartment. At night, I use a weighted blanket, turn on some white noise, and try to create a healthy sleep environment; the list goes on.
Without this “emotional PPE”, I don’t think we as nurses or other frontline workers would be able to continue to do our jobs and take care of ourselves. And when it seems like there is a shortage of “emotional PPE”, there are always people who want to help. It’s incredible the support we’ve seen from others outside the hospital, and I completely encourage it. It helps keep us going. But I hope you don’t forget about supporting yourself as well. Don’t forget your mask, of course, but try to remember your emotional personal protective equipment too. It feels nice to be considered “essential”, but really, we are all essential when it comes to taking care of ourselves.
We’re on the front lines. We are the first line. But the “front line” only works if there is the backup. If there’s a second line, a third line, to support and bolster the front line. And that’s not just for this pandemic. Dealing with anxiety and mental health, you are the “front line”. You can’t do it alone; you need the backup. For me, the second line is my family, friends, anyone who is reaching out a hand and saying, “I see you. I hear you. What can I do for you?” The third line is what I believe to be a sense of community. A sense of belonging to something that matters, whether that be a group of nurses, a team, a club, a family, a group of friends. I hope we take the time during this pandemic to realize that we are all essential and necessary. We cannot show up physically without showing up mentally. As businesses and restaurants start to open and life regains some normalcy, I hope that everyone will remember that the frontline workers will still be treating COVID-19 patients. And we will need your second and third line backup to get through the tough days. If we all show up for ourselves first and foremost, armed with our emotional PPE, we can show up for others.