A young man was admitted to a Philadelphia hospital in the early spring of 2020, one of the many patients infected with a new airborne virus that the hospital’s staff had been swarmed with for the past few months. It was highly contagious, they were told. It was deadly.

The World Health Organization (WHO) identified this strain of severe acute respiratory syndrome (SARS) as coronavirus, or COVID-19, and eventually declared its widespread effects a global pandemic on Mar. 11, 2020.

The new patient entered his hospital room on the COVID floor, where a bed was placed on one side of the room, a bathroom on the other and ample space in between for his family that would never get to visit, for the hospital staff that would rarely enter his room unless it was absolutely necessary.

Registered Nurse Patrick Hurley took note of the fact that this patient “looked fine, looked very healthy,” a trend that often indicated an easy recovery. With minimal help, the patient climbed out of bed, his feet touching the cold hospital floor. 

Yet two steps later, he nearly collapsed to the ground in desperate need of oxygen.

“He was struggling for air and it scared the hell out of me. That’s the first time I knew that this [virus] was something very, very serious because I had never seen something like that before. He only took two steps towards the bathroom and was gasping for air. I’ll definitely remember that,” Hurley said.

Nurses across the world have been forced to realize the severity of this pandemic first hand, given a nearly impossible task of saving lives with minimal knowledge about an unprecedented virus. Yet it is not only the coronavirus in which they are battling. Between staff and equipment shortages, countless patient lives lost, and extreme mental health strain, nurses have been stretched thin for over a year as the pandemic forges on. 

Over 2,900 healthcare workers died from coronavirus in the United States by the end of 2020, according to Kaiser Health News. The struggle for those surviving nurses is not only to hold on to the power of living through what others could not, but being motivated by it to help future patients.

According to the American Lung Association, the coronavirus attacks the lungs first, invading the epithelial cells lining the airways and respiratory tract. It prevents the cells from clearing out irritants, “flooding our airways with debris and fluid.”

While some patients may experience symptoms like fever and cough, others go asymptomatic and run the risk of further spreading the virus unknowingly. Individuals over 85 years old or with chronic illnesses are the highest risk populations, however nobody is immune from the virus’s ability to kill.

“Some people get affected differently. You can be 30 years old and die from it. You can be a 19 year old and die from it,” said Andreas Kaluli, a registered nurse at another Philadelphia hospital.

While nurses are working hard to keep their patients alive each day, they also must worry about protecting themselves. Personal protective equipment (PPE) such as masks and gowns were scarce in hospitals at times, making it more difficult to care for patients safely.

“I think that [my hospital] definitely made decisions based off of supply and not off of scientific research. For instance, the masks. The N95 masks were initially meant to be worn once and thrown away. Then the hospital was saying, ‘We’re going to sterilize them so drop them in a bin after you wear them for seven shifts,’” Hurley said.

The limited supply and high demand for PPE forced hospital staff to get the most use out of the least possible amount of equipment during the peak of the pandemic last spring. However, hospitals have now adapted to prepare for surges of patients at this capacity, and have even learned to become more creative in handling shortages when they arise.

Kaluli believes that although hospitals are better equipped with both supplies and information for the second time around, it is the refusal of people to follow Center for Disease Control (CDC) guidelines that is keeping patients in hospital beds.

“We didn’t know a lot about the virus, that’s why it was so scary. So now the second time around, we do know more about it, but I think people got immune to just thinking the virus is around and no one cares anymore,” Kaluli said. “That’s the problem. If everyone just wore a mask and just obeyed by the CDC guidelines, we wouldn’t be in this place right now.”

The CDC recommends wearing a mask in public settings, staying at least six feet away from others, avoiding crowds of people and washing your hands often. However, with the phased reopening of schools, restaurants, shops, gyms and other businesses, practicing everyday preventive actions and taking the necessary precautions are often set aside during this second wave.

According to The COVID Tracking Project, the peak in April 2020 reached a seven-day average of 2,116 deaths per day. As of Jan. 13, 2021, the newest peak soared to a seven-day average of 3,323 new deaths daily. 

The increase in both cases and deaths due to coronavirus has not only affected the loved ones of the deceased patients, but the mental health of doctors and nurses across the country.

Dr. Carole Lieberman, board certified psychiatrist and bestselling author, described healthcare workers as feeling “terrified” and “helpless” in the face of losing countless patients.

“The most devastating impact… is the overwhelming number of deaths they’ve felt helpless to prevent. They identify with the victims – imagine them as their mother or father or grandparents – or even as themselves. So, each loss takes a personal toll,” Dr. Lieberman said. “At the same time, they are terrified of getting COVID themselves, and upset about the lack of equipment… As some of them are now having to decide who lives and who dies, it puts even greater stress on them.”

This stress and exhaustion is called “compassion fatigue,” a concept heavily studied by Dr. Chelsia Harris, executive director of Lipscomb University’s School of Nursing. Dr. Harris described it as “…when a healthcare provider or anyone for that matter gives and gives and gives of themself selflessly, they hypothetically give until they give out.”

According to Dr. Harris, being “unable to handle the emotionality” of the present circumstances amidst the pandemic has greatly affected healthcare workers’ ability to take care of patients.

“We have to all think about as healthcare providers, most of us got into this profession because we have a deep desire to help another person, to help a human being, to have true empathy and a desire to alleviate whatever it is that they’re going through,” Dr. Harris said. “You add a global pandemic that is taking the lives of so many people and the very reason, the very fabric of why we got into this role in the first place is kind of being ripped from us. It’s one failure after another of being able to help our patients.”

Harris described how nurses’ new expectations of failure, loss, and bad outcomes have created a wall between their jobs and their emotions.

“This whole idea of compassion fatigue and the numbness to caring is when a person literally says, ‘I can’t handle this emotional response I’m having anymore and so I’m going to put this guard up to protect myself,’” Dr. Harris said. “They are drained of what emotional and spiritual energy that they had left to give to people, because it’s almost now like they know what they’re walking into and they know what they’re going to face.”

Kaluli agreed that there is a numbness he faces in the hospital now during each shift, learning not to let the trauma of the cases he sees at work follow him around off the clock.

“The worst part is that I’m so desensitized right now. Kind of like, nothing bothers me,” Kaluli said. “Nobody was prepared to handle a pandemic on this scale.”

Truly no healthcare worker was prepared for the immense loss and sacrifice brought on by the unprecedented coronavirus pandemic. Dr. Donald Landry, physician-in-chief of NewYork-Presbyterian/Columbia University Irving Medical Center, told the Wall Street Journal that the first peak “was ultimately baptism by fire.”

Hurley was only ten months out of nursing school when he was sent to work on the COVID floor for the first time. Nurses across the country, both young and old, could not have had enough experience to prepare them for this. 

Cepani Harjo, a registered nurse at a hospital in Nassau County on Long Island, kept a journal of his work in the Intensive Care Unit, with the following entry dated Mar. 20, 2020, his first day caring for COVID positive patients.

“I feel as though I’m swimming with my clothes on just trying to do my ordinary nursing tasks. The plastic gown has a suffocating feel to it and I start sweating beneath it within a few minutes. My glasses fog as the N95 diverts my humidified breaths upward. As the day progresses, humidity accumulates in the mask making it harder to draw breaths. A test that took a few minutes takes fifteen now,” Harjo wrote.

Like Harjo, the entire nursing community has felt the effects of their normal job being flipped upside down due to the pandemic. Still, they continue to show up and care for patients, which Dr. Harris claims to be one of the best things to come out of the pandemic

“I’ve just watched people step up to the plate. I look at my precious students right now and these young men and women in spite of a global pandemic are saying, ‘Sign me up. I want to go serve, I want to do this,’” Dr. Harris said. “I think a lot of people have actually been attracted more to nursing over the last year because they see that we have the ability and capacity to make a great difference in the lives of the people we serve.”

Not only have nurses risen to the challenge, but vaccine manufacturers like Pfizer and Moderna have taken on the responsibility of creating a safe and effective coronavirus vaccine in the quickest amount of time possible.

Kaluli and Hurley both received the vaccine, with Hurley crediting the quick vaccine availability to the preexisting research from the 2003 SARS outbreak as well as the government’s push for a speedy distribution.

“The government has really stepped up to cut out all the bureaucracy and the red tape that normally delays these vaccines and said, ‘Just approve it. Just approve it,’” Hurley said.

As the vaccine has been a light at the end of the tunnel signifying a nearing end to the pandemic, Kaluli reflected on the good that has come out of it.

“The best part is that it makes you appreciate life. Don’t take anything for granted,” Kaluli said. “As a nurse, the best part for me is that it makes you prepare. I’m stronger now.”

Riley Forrester is the outgoing social media editor for The Inkblot and a member of the Class of 2021. She will be attending Coastal Carolina University.