Thirty-year-old Brittaney Crawford always knew she wanted to work in the health care industry. Growing up, she volunteered in nursing homes. She remembers being fascinated by ER shows on TV as a little girl.
"I loved reading like medical textbooks that we'd find at second-hand stores," she said. "I was really, like, kind of into a scientific brain. So my mom encouraged that. "
When she found her way to nursing school years later, the intensive care unit is where she felt most at home. She’s been a nurse for about 10 years now and currently works for a local health care system she asked us not to mention. She says the ICU is where she can make the most impact. Under normal circumstances, it’s challenging work — let alone during a pandemic that’s going on two years.
"ICU nurse burnout pre-pandemic was very high," she said. "We are taking care of the sickest of the sick. "We are going to have more bad outcomes — outcomes that we don’t want to see — than other floors might necessarily see. So the burnout for ICU nurses is very high."
Since the beginning of the pandemic, Crawford has been taking care of COVID-19 patients. She remembers back to 2020, when there was so much fear around the unknown of COVID. how was the virus spreading? What was the most effective treatment? When would there be a vaccine?
"Taking care of patients who are struggling to breathe, some ultimately end up passing away," she said. "It's so hard. It's so hurtful on every level. Going into work and having to take care of patients who you feel like are just suffering tremendously and sometimes you feel helpless."
The hospital’s spiritual care team created ways for the staff to mourn, remember and process those deaths. One common ritual is for a nurse who loses a patient to write everything down about that person — their memories of them and any pieces of their personality that stuck out. The nurse then “lights” a little battery-powered candle and shares with their colleagues who that person was.
"We've all kind of like shared our things with those specific patients and all kind of like held each other and cried and been able to let that emotion out and that feeling out and try to remember them," she said. "But there's just some that will be ingrained in my head forever."
Earlier this year, things started to look up. The vaccine was rolling out. Infection numbers were down. In the spring, Crawford says, it felt like health care workers were getting a chance to catch their collective breath. But that hasn’t lasted long.
"Things didn't go back to normal, per se," she said.. "But there were times when we would have more COVID negative patients than COVID positive patients. And that was really encouraging that things were kind of taking a turn. And it was good that we kind of had that time to kind of reset, to get ready, because it's kind of been intense in the way that it was last fall already so quickly."
In some ways, it’s been easy to slip back into COVID nurse mode. They understand the virus better, and there is a vaccine to keep health care works safe. They know what to expect this time.
"We have that pandemic nurse hat is what we kind of been calling it," she said. "So we know how to be a pandemic nurse now. So being able to put that hat back on and get back into it was a lot easier than it was last year because we didn't know what to expect and now we do."
It's like health care workers just finished a marathon and they thought they could take a break. But now there's a whole new marathon to run.
"We were able to breathe and have a Gatorade and have a sandwich. And now it's like, 'Hey, just kidding. You got to run another one,'" she said. "A lot of people feel like they're already at their limit and they're like, 'How much further can we run?' And sometimes you just kind of keep running so you can't run anymore. And that's what we're all doing right now."
Part of the challenge, she says, is getting people to feel comfortable with the vaccine. She says a big part of her job as a nurse is to help educate patients, not to judge them.
"There’s been people who don't believe (COVID-19) real who are actively sick with it," Crawford said. "And that's been another thing that's been extremely hard is trying to help someone who won't believe that they're sick despite being in the hospital, being on high levels of oxygen. When I'm presented with those situations, I try to give them as much information in a small amount of time that I have with them. As much as people like me and you think that everybody has to know about COVID, there’s been some people that don't even know that there's the vaccine."
Not everyone has access to the internet or computers. In those cases, Crawford prints out articles from the Centers for Disease Control and Prevention to provide more information. This happens more than you might think, she says.
And then there have been the COVID-19 positive patients, sick in the hospital, asking for the vaccine.
"I've had patients ask if they already have COVID if they can get the vaccine now. That has happened," she said. "Sometimes after you get to the hospital, it’s a little too late to be able to go that route. It takes a few weeks to develop some of that immunity that you get from vaccines and when you’re already sick you’re in a more difficult spot."
The COVID grind is like this unwelcome house guest that keeps showing up, no matter how many times she asks it to leave. She keeps putting one foot in front of the other. She leans on her colleagues, who are the only ones who truly understand what it’s been like to care for the sick during the pandemic.
"I think resiliency has kind of taken on a new meaning," she said. "It's a lot of self-sacrifice while also trying to care for yourself. It's pulling each other up when we're at our weakest moments and to keep going to keep fighting the good fight, to keep working through this and helping each other."
Sometimes, nurses are the last ones who hear the final words of a patient about to be intubated. Sometimes those turn into a patient’s last words because they never get off the ventilator. And then nurses become the messenger.
"Trying to get families together to tell each other they love each other, but there's been moments when that can't happen or that doesn't happen. And somebody has said something to you to say to their family or to you directly. And sometimes they're just thanking you for being in there with them," she said, before pausing.
"You just kind of have to be appreciative that you have the opportunity to be there for them."
To recenter herself after a hard day, Crawford goes out in nature. She lays in the grass sometimes and surrenders to the earth. Meditating helps. She remembers to breathe — in and out, in and out.
When she reflects on those moments of defeat, she tries to remember she has a skill set that’s not easy to come by, and that she’s needed. Right now, she says, she’s needed more than she’s ever been needed before. So she breathes — in and out, in and out.
And she gets back up.
