The bravery and tragedy of nursing during COVID-19 pandemic

Every day I walk into our COVID-19 units, I am faced with the reality we are experiencing as nurses. I see the bravery of our staff, who leave their loved ones at home and put all their anxiety and fears aside to care for their patients. With heaviness in my heart, I also see the fear in the eyes of our patients and hear the uncertainty in their voices, as they try to comprehend their diagnoses and what lies ahead.

In contemplating these last few weeks, I reflect on the patients who have shown up at our hospital doors, extremely ill; many of whom were admitted to the ICU and placed on vents, almost immediately. Others who were stable upon arrival, but soon had to be intubated and downgraded to critical status.  And sadly, there are those who have succumbed to the COVID-19 virus.

One patient remains forever imprinted in my mind. When I approached her room, I could see how ill she was, her body looked sweaty as she lay there with her eyes closed. I watched her chest rise and fall and began to count her respirations….1…2…3… She struggled as she inhaled deeply, with long pauses in between breaths and moments of apnea. As a nurse who had seen this pattern of breathing before, I knew she was dying. Another nurse confirmed the patient was a do-not-resuscitate, now on comfort measures.

I stood there, saddened that this was happening to her; that she was all alone, no staff, no family and no friends in the room to comfort her. I believe that no one should die alone. No one.

I was informed that a family member was on the way but didn’t know how long it would take them to arrive, so I opened the isolation cart and began to pull out PPE for myself. Despite nurses informing me she was dying, I got donned my PPE and went in the room with her. I sat next to her, held her hand, and let her know who I was and that although she didn’t know me, I cared about her and she was not alone. I continued speaking with her and I felt she was listening to me, for at times her breathing and body became more relaxed, as if she was being reassured by my words. At least, that was my hope.

Over the next couple of hours, I returned to the unit to watch her through the window and called the charge nurse to check-in. Prior to returning to the unit for the last time, I called the charge nurse to let her know I was on my way but was told that the patient had passed away.  Thankfully, the family member had arrived.  However, when I went to speak with the family member, I saw her standing outside of the room. She had not gone inside.  This may have been due to the anxiety and fears surrounding COVID-19.  I went back to my office, closed the door and cried.

As a nursing director, I know I need to put on a strong and reassuring face every time I enter the building. Especially now, in the midst of all this fear and uncertainty, I have to be without cracks or weak spots, so my staff and peers can see strength in me – so that we can feel stronger together. I have had to remain focused on meeting the demands of this coronavirus pandemic.

But this is very difficult to do at times.

Throughout this pandemic, I have cried many tears and said many prayers. I have cried because of the illness and loss, because I felt I couldn’t give the staff what they wanted or needed. And, I have cried for myself, because I have to get through this.  Because I have no choice.  I am a nurse.

As a woman of faith, I believe I am in this place for a reason. God knew I would be caring for people in the midst of this COVID-19 pandemic, and I pray I am making Him proud. I am thankful to be a nurse and to be a part of the Kaiser Permanente family.

Cecilia Fleming-Tumer, MPH, RN, BSN, NE-BC is Director of Nursing Services, Medical-Surgical/Telemetry & Hemodialysis at Kaiser Permanente-Downey Medical Center.