Tracy Gordon Fox has recurring nightmares that she’s in a coughing COVID-19 patient’s room and she doesn’t have her mask on.
“I’m tired of hearing that it’s only the flu,” Fox said. “I’ve been a nurse for eight years and I never saw anyone die that way from the flu.”
Deaths don’t happen often on her floor, Fox said. There are maybe a few unfortunate ones a year. No one’s supposed to die — that’s not the point of the floor. Patients go there, stable and coronavirus-free, after trauma surgery to recover, to live.
Then, when the first wave of COVID-19 hit at the start of the year and overwhelmed St. Francis Hospital, the trauma surgery floor got turned into one for coronavirus patients. Suddenly, people were dying. Daily. Sometimes three, sometimes more. And Fox went from helping patients recover to feeling helpless to do anything to save them. It was like they were sent to her floor to die, she said.
Before the pandemic, there wasn’t much that intimidated Fox. For 25 years, she was a reporter who chased down crime stories and stood up to cops. She was even bitten by a police dog. But the coronavirus is a new kind of invisible beast, and though her floor has returned to being trauma surgery for months and she only occasionally gets floated to work with COVID patients, Fox is still haunted by the deaths.
“They died alone. We were so packed with patients who were sick and dying that we couldn’t be there for all of them as they took their last breaths. I think that bothers me most,” she said.
Horrifyingly, Fox’s experience isn’t unique. Across Connecticut, across the country and the world, medical professionals are feeling unparalleled stress and fatigue. On the front lines for long shifts, they’ve seen the worst of the virus that has already killed more than 5,300 people in the state, and they’re afraid they’ll see it again as hospitals fill up with the second wave.
Nursing has never been easy. It’s undoubtedly tough, and now the pandemic has exacerbated symptoms of post-traumatic stress disorder, depression, anxiety and burnout among health care workers, driven by the onslaught of death coupled with people’s dismissal of the virus.
“It’s horrific. People have no idea how sick the critically ill patients are,” said Elizabeth Arnold-Angelopoulos, an intensive care unit nurse who works in southeastern Connecticut.
Arnold-Angelopoulos rotates between the regular ICU and the COVID-19 ICU at her hospital. As cases rise again, she suspects both floors will soon fill with coronavirus patients. Though she wears a “coat of armor,” her work brings with it heightened anxiety, and her biggest fear is carrying the virus home. She won’t be with her family this Christmas in order to keep them safe, but she said the temporary pain is worth it.
“The thing that hurts me, a lot of my angst, is when I take care of critically ill people and families can’t come see them and they’re dying. Until you can see what happens, they just can’t even, in their wildest dreams, imagine what’s going on,” Arnold-Angelopoulos said.
Months after the initial outbreak, nurses are still learning to cope with the lingering aftermath. Fox has taken up meditating and journaling. Arnold-Angelopoulos reached out to her neighbor in the throes of her anxiety and the two have gone on many miles-long hikes with their dogs. As the weather chills, she’s worried about going back into isolation.
Hospitals, too, have understood that they have a role in helping their workers with their mental health. Many have hotlines, support groups and counseling. St. Francis, for example, has a strong emphasis on spiritual healing and even offers yoga classes in addition to its 24/7 counseling hotline.
“We as human beings are just as susceptible as those we take care of,” said Luis Perez, president and CEO of Mental Health Connecticut. “Don’t feel like you need to be the hero or heroine who doesn’t seek help. We’re not invincible.”
Nurses themselves have also recognized the need to care for one another. Hartford Hospital has adopted the HERO — Healing, Education, Resiliency and Opportunity — program, which trains nurses in self-care and how to identify and help struggling colleagues. There’s much more openness about emotions: nurses are human, after all.
“If you hold that in, that’s where you get really bad burnout,” Melissa Young, a nurse at Hartford Hospital’s emergency department, said. “These nurses that walk around jaded and like nothing affects them, they scare me because I’m afraid they’re going to get burned out.”
Young remembers crying and grieving after hearing one COVID-19 patient speak to her son on the phone about her final wishes. It was incredibly traumatic, she said, and as someone with a background in mental health and substance abuse treatment, she knows her colleagues need help knowing how to deal with the aftermath of this devastating virus.
“We have to be the support for each other,” Young said, adding that she copes by helping others; she volunteers on her time off and will assist with tasks that were mundane before the pandemic, like buying groceries.
Macllerly Rios, an assistant manager in the emergency department, said she will do anything to help the staff get through the pandemic, whether it’s a change in schedule or just sitting down to talk. With a little boy at home, she switched to the night shift when schools shut down and she couldn’t find day care. She also finds herself increasingly stepping away from paperwork and coming out of her office to help on the floor as the hospital again fills up.
“It’s so easy to feel beaten down by the length of the impact of the pandemic,” said Dr. Steven Marans, a child and adult psychoanalyst at the Yale School of Medicine. Like at other hospitals, mental health help is systemized at Yale to reduce stigma. “Our nurses and our hospital staff are taking action to do the best we can to combat an experience that none of us have ever had before.”
Every time Young drives by hearts on buildings, she feels seen, like someone empathizes with her and understands the sacrifices she and others have made. For Arnold-Angelopoulos, signs of gratitude and love bring her to tears and remind her that the community cares.
And on the flip side, people who don’t wear masks and insist that the virus is a partisan hoax cause great anger in those like Fox, who wishes everyone would just “do the right thing” and follow state guidelines.
“That will make these next few months a lot easier to get through. I know it’s hard, but it’s not as hard as losing someone. It’s just one year of holidays as opposed to losing many, many years of holidays with your loved one if they’re not here anymore. Help us help you,” Fox said.
EDITOR’S NOTE / CORRECTION: The original version of this story said Fox had taken “medication” to cope with stress, but has now been corrected to read “Fox has taken up meditating and journaling.”