‘It didn’t have to be like this’: ICU nurse describes toll of treating COVID-19 patients

Doctors and nurses wore full-protective masks and face shields as they treated COVID-19 positive patients at a Tennessee hospital in May 2020.Joe Rondone/Associated Press

A woman who says she began her career as an intensive care unit nurse months after the COVID-19 pandemic began is speaking out about the toll of learning the job while being inundated with severely sick patients as hospital beds now fill up again.

Kathryn Ivey, who reportedly works in a Nashville, Tenn., hospital, posted a powerful Twitter thread this week describing how her feelings of helplessness in earlier stages of the pandemic have transitioned to anger.

Ivey wrote Sunday that her efforts felt “futile.” Now, as the pandemic has worn on, she said she feels “defeated” and said she wished she could “snap so many people out of their selfish stupor.”

I became an ICU nurse at the end of July in 2020, during one of the first peaks of covid when it was all still so new. I learned how to be a nurse behind a respirator and a yellow gown, amidst the constant beeping and hissing of ventilators that couldn't support failing lungs.

— Kathryn Ivey (@kathryniveyy) August 1, 2021

More than a year into the pandemic and as cases, hospitalizations, and deaths are once again rising in the US due to the highly transmissible Delta variant, Ivey’s reflections offer a glimpse into the grief being shouldered by health care workers on the front lines.

In some parts of the country, hospitals are becoming overwhelmed. The South, where vaccination rates are the lowest in the country, are seeing higher rates of COVID-19 transmission than places with higher vaccination rates.

In Florida, hospitals are expanding COVID-19 units; a health official in Austin, Texas, said ICU capacity is reaching a “critical point,” creating increased risk for people seeking treatment for non-COVID patients. The seven-day average of hospitalizations is up about 41 percent since the previous week, the director of the Centers for Disease Control and Prevention said Monday, and experts have said an overwhelming majority of those hospitalized now are unvaccinated.

Ivey became an ICU nurse in July 2020, she said, and learned to be a nurse while donning personal protective equipment in a unit filled with patients on ventilators.

“Because I was so new, I had no baseline for what normal nursing looked like; I just had a vague sense that it couldn’t look like this,” Ivey wrote. “The unit was bleak and everything we did felt futile, and I realized at some point I felt more like a ferryman to death than anything else.”

Some people who entered the ICU recovered from the virus if they didn’t require a machine to help them breathe, Ivey said. But most patients arrived “too sick” and “so often beyond the power we had to heal,” Ivey wrote.

Ivey described feeling “helpless” as patients worsened and progressively required more intensive equipment to breathe, until it became clear they would need to be intubated.

“There are places we can’t call you back from,” she wrote.

Ivey wrote that she began to get used to the death, saying she “pushed it down,” continued working, and “accepted very early on that we can’t save everyone.”

As case rates, deaths, and hospitalizations started to improve, the hospital where Ivey worked no longer needed three ICUs for COVID-19 patients, and Ivey was given a glimpse into what being a nurse looked like before the pandemic struck. She noticed how many people normally survive, she said.

“The things I did mattered, my actions actually saved lives - no longer was death my constant, silent companion,” Ivey wrote.

Working outside of the COVID-19 unit gave Ivey perspective into just how dire the COVID-19 unit was as she was surrounded by patients hooked up to machinery that was keeping them alive but not healing them: “the relentless march towards death that we could hold off for a time but never stop.”

“Walking through the much smaller covid unit was like walking through a graveyard,” Ivey wrote.

But now, “it is so much worse, this time,” Ivey continued. “We all have so much less to give. We are still bearing the fresh and heavy grief of the last year and trying to find somewhere to put all this anger. But the patients don’t stop coming. And the anger doesn’t stop coming.”

Ivey described feeling defeated at the same time, like “Nothing we do makes a difference.”

“The world spins on, oblivious and belligerent, as we fight to save the tidal wave coming our way,” Ivey wrote. “With less staff, less resources, and a lot less of ourselves to give.”

“I don’t know what to say that will make people listen,” Ivey continued. “I wish I could snap so many people out of their selfish stupor but I can’t, so I get to watch instead as people learn the hard way; with a tube down your throat. With a ‘code blue, code blue!’ and the crack of a sternum.”

Ivey described calling families in the middle of the night “knowing that I am about to shatter someone’s world.”

“You learn the hard way and I see it through,” Ivey wrote. “I carry the weight of your choices and the pain they cause.”

She concluded: “It didn’t have to be like this.”