As an ICU nurse who can't work during the pandemic, I'm experiencing survivor's guilt
My phone vibrates; my father-in-law has sent me a video. I open it and hear the sounds of enthusiastic applause. The caption on the video reads, “N.Y.C., 7 p.m.” I close the video immediately when I realize what it is, feeling ashamed. “This is for you!” he writes. But he’s wrong. They’re not clapping for me. I am not a hero.
As an ICU nurse in Nassau County, New York, I take care of one or two critically ill patients every day, usually after open-heart surgery or a serious accident. I operate ventilators and other equipment, honing skills for the past five years which are now needed during the coronavirus (COVID-19) pandemic, but there is only one problem: I can’t go to work.
Because of a severe injury to my hip, I have been on and off of crutches for seven months. Despite having two surgeries in 2018 and late 2019, intense physical therapy, and anti-inflammatory injection therapy, I’ve made little improvement. After my second surgery, my surgeon refused to clear me to return to work, citing the highly physical nature of my job. Since I will be starting graduate school in the fall, I reluctantly decided early this year that it would be best for my recovery if I didn’t return to bedside nursing. This was before I knew anything about the coronavirus.
I would have fought harder to go back to work had I known I’d be needed now more than ever. When I first heard about coronavirus, I was skeptical; to me, it was an overhyped news story that couldn’t possibly grow to the scale that it eventually did. But even with my years as a nurse, how could I predict what was coming?
I realized very quickly that I was wrong; coronavirus went from an abstract idea to a cold reality as New York got its first confirmed cases in March. Still, I didn’t worry too much about my coworkers or our hospital being overwhelmed. The unit I worked in is for surgeries and traumas, and not infectious diseases—but it wasn’t long before my ICU was converted to only treat coronavirus patients.
Again, I thought: What’s the big deal? Healthcare professionals are exposed every day to bodily fluids carrying highly infectious diseases without batting an eye. I reassured myself that my coworkers and friends had personal protective equipment (PPE) to keep them safe. But when I saw the Facebook posts from my colleagues saving their one measly surgical mask in a brown paper bag because they wouldn’t be given another for a while, I snapped out of my denial and my disbelief transformed into guilt. On some level, I didn’t want to believe that this situation could get so out of control when I couldn’t be there to face it with my teammates.
This is when the battle against the coronavirus became both personal and infuriating for me. I became hopelessly angry about the sacrifice my coworkers were making, begging for PPE donations while people who hoarded N-95 masks sold them for a huge profit online. I thought about how it would feel to enter rooms with COVID-19-positive patients with little to no protection and felt outraged that anyone had to be put in that situation. The possibility of my friends dying had become terrifyingly real. I could see my coworker’s funerals at night when I closed my eyes and felt a sickening injustice that I was at home while my colleagues fought this battle.
My friends were no longer just healthcare workers: They were soldiers being sent into a war zone without any armor.
On social media, I saw articles about healthcare workers dying followed by comments saying, “This is what they signed up for.” I was furious at how ugly and inaccurate that was. None of us signed up to die for our patients: We signed up to take care of sick and potentially contagious people but with protective equipment. I hate that my colleagues are being made to expose themselves and, even worse, that I’m not there exposing myself with them. I have never subscribed to the idea that nursing is a calling, but I have always firmly believed that it’s a team sport. There’s no worse feeling than that of letting down your team, and that’s exactly how I was feeling. In a time where hospitals needed every pair of hands, I felt like I should be there, despite my physical condition.
“Maybe I can go to work,” I thought. “Maybe I can push myself and somehow make it work.”
I asked my boss if there was any way I could help while still needing one crutch to walk. “I’ll tell my surgeon my leg is strong and that it doesn’t hurt to walk anymore,” I thought, knowing that was a lie. Desperate to find some way to contribute, I looked into working at coronavirus testing sites but found that it involved standing all day. My only choice was to stay home. Further damage to my hip would result in deferring graduate school, the inability to walk, or even having a hip replacement before the age of thirty. Worse than any of that, it could mean never being able to work in a clinical setting again, which would destroy every goal I’ve ever set for myself and eliminate my ability to help any future patients.
In that moment, I envied the 16-year-olds during World War II who were able to fake their age to enlist in the army. Unlike a fudged birth certificate in the 1940’s, it’s pretty hard to fake muscle strength and joint range of motion—especially when my job required standing for twelve hours and lifting/turning heavily sedated patients. I never thought I’d have to understand what it feels like to sit on the sidelines, at home with my family, while my friends fight to save lives in a modern war zone. My feelings are a mixture of fear, shame, and powerlessness. Me being spared from this hellscape has resulted in what I can only identify as survivor’s guilt.
People have often marveled at the courage it takes for a firefighter to run into a burning building when anyone in their right mind would be running out. Now I know their secret, and it’s not courage.
When helping people is what you do for a living, it goes against every instinct you have not to do it.
As the situation remains dire in downstate New York, my guilt continues to deepen. Worse than anything being reported in the news are the first-hand accounts I see constantly of what is happening inside local hospitals, and I don’t have the heart to tell my friends how it makes me feel. What right do I have to tell them when all of their shifts have become my and their worst nightmares? As this crisis progresses, the tone of social media has changed. Now, my coworkers’ posts about reusing PPE have been replaced with obituaries of classmates and colleagues. People in their twenties are writing wills. Colleagues are taking care of sick colleagues.
Finding self-forgiveness in my situation is a work in progress. I am accustomed to dealing with high-stress, high-adrenaline situations and processing traumatic events. When I was working, if a patient had a poor outcome, it would not be because I didn’t do everything in my power to prevent it from happening. I would be able to look a grief-stricken family member in the eye and truthfully tell them that I did everything I could. But this time, I am powerless to even try.
So far, all I can think to justify why I’m not there is that at least I’m not exposing my family to the virus. Then I’m reminded of all my colleagues’ families who are being exposed, and I feel ashamed. This experience has reminded me of the stages of grief, a theory by Elisabeth Kübler-Ross we learn in Nursing 101. I’ve already become acquainted with the first four stages: denial, anger, bargaining, and depression. I don’t know, though, if I’ll ever get to the final stage of acceptance and find peace in the fact that my role in this pandemic is not what I want it to be. My inability to help my coworkers highlights the limitations this injury has caused for me since well before anyone knew what COVID-19 was.
I take comfort in knowing that my coworkers will get through this. I have seen them do the impossible; they bring people back from the brink of death with calm, collected minds and steady hands when every second counts. I have held a grief-stricken coworker and cleaned their patient’s blood from their arms after that patient passed away, only to see them pull themselves back together and walk into the next patient’s room, smiling. I know they must’ve cried the whole way home. I certainly did.
Now they’re the ones who hold dying patients’ hands when patients cannot be surrounded by friends and family. All of this is done with grace, for thirteen hours at a time, sometimes with no food, no water, and no time to sit or go to the bathroom. Then they go home, sleep a little, and come back to do it all over again. No one ever used to clap at the change of shift before this, but now the whole world does.
I want people to know that applauding healthcare workers at 7 p.m. doesn’t erase the widespread recklessness that so much of the public is demonstrating right now. So if you want to clap for healthcare workers, do it. But, most importantly, stay home for them so that all of the sacrifices they’ve been forced to make will not have been made in vain. Do not make this already impossible job more challenging by unnecessarily adding to their burden. We owe it to these people—who have been deemed respectable yet expendable—to do our part and to do it well. I wish I could work alongside my colleagues to contribute to the cause and share their grief. But for right now I will have to find peace in doing my part to stay at home, wishing they had never been put in this situation in the first place.