COVID-19: An Unwelcome Visitor in My ICU

The novel coronavirus has presented numerous challenges and opportunities to learn.

• I learned the letters “C” “L” “A” “M” and “P” are the easiest to write on a glass door with a dry erase marker, while wearing layers of personal protective equipment and attempting to see through fogged, prescription glasses, while the letter “S” is the most difficult to write in reverse.
• I learned that I can use a small white board to communicate to my colleagues the supplies that I need. However, my patient, who was on the edge of intubation, struggled to be heard over the nonrebreather mask and the flow of oxygen over his face as he talked to his son on the telephone, perhaps for the last time.
• I learned that COVID-19 is a shocking disease process, stealing the breath of the patients it infects at an alarming rate.
• I learned COVID-19 is a thief of life and vitality.

Globally, nurses are inventing, communicating and creating – all motivated by improving patient care and patient outcomes. It is rare for a healthcare provider to assume a singular role – we are clinicians, educators and leaders, delicately balancing these professional and personal obligations before, during and after the pandemic. As a practicing CCRN in an ICU with patients who have COVID-19 and also a member of an academic faculty – I am responsible for educating undergraduate nursing students and the next wave of healthcare practitioners in the post COVID-19 world. This juxtaposition of new graduate nurses, the front lines of intensive care nursing, and research and education, is a true spherical view of nursing.

The intensive care unit is accelerated, dynamic and fluid. Generally, the patient population we treat outside the pandemic situation has its own set of predictable unpredictability, but not on this scale. Currently, the patient census is high; yet there are moments when it is eerily and noticeably quiet. Although we, like many other institutions, have moved to a strict visitor restriction policy, there is an unwelcome visitor in the critical care unit, and we are powerless to stop this visitor from entering. We are unable to ask them to leave, but we are finding ways to rise above this visitor and to protect our patients and each other.

The constant influx of new guidelines, recommendations and evidence-based research leads us in our rise, and I am extremely fortunate to be part of a strong and supportive academic community as well as communities within AACN. Sharing resources, stories, and communicating best practices translates to advancing the science and discovering new knowledge. Throughout these shifts, these days and nights, we are constantly reminded of our vulnerability as human beings and have been immersed in an ice bath of information about epidemics, epidemiology, pulmonology and morality.

If the fog of fear and uncertainty is thick, the gratitude, love and respect from everyone is certainly the light that burns the fog away. We all need reminders that it’s OK to be sad, or mad, or angry or scared – certainly myself included, but it's also OK to step away, to open a window and to allow the light, the music and the humor to come inside. There was a world before COVID-19 and there will be a world after COVID-19. A different world, yes – but a world in which there will still be all of the joyful parts of our vivacious lives that COVID-19 could not catch. Be excited for the world after COVID-19 even if it might be different – it will be great.