ICU Nurse: ‘I Want To Scream’

Editor’s note: We’ve been reaching out to hospital workers throughout the city to find out what they are seeing as they treat patients during the pandemic. Elena Lerma, an ICU nurse at a Dallas hospital, wrote this about her work with COVID-19 patients and has allowed us permission to share it.

By Elena Lerma

I walk into my patient’s room and find him crying. He has been on his high-flow nasal cannula for three weeks now at nearly full support. His belly is red and worn down from following our directions to lay in the prone position. He beat cancer only two years ago. He wants to get better.

I ask him to tell me about himself to get his mind off things. He tells me he is a stone cutter, has been for 12 years. He is excellent at what he does. He is very proud because he has made enough money to help his oldest son go to school to become something more. He cries harder because he fears that it may have all been for nothing. His oxygen drops into the 80s, and he struggles to recover. I increase his support to the highest setting.

I think about his kids at home. How do they feel scrolling through Facebook and Instagram while people still put the word pandemic in quotation marks as their father wastes away in isolation? Probably the same as I do.

A Code Blue alarms, and I make my way to the room.

On my way back to my computer I walk past the third brother. A machine sits outside his room that is nearly as tall as I am. Two thick tubes full of blood snake their way between the machine and his neck. This machine is filtering his blood because his kidneys have failed. I look up to his monitor. His oxygen level is in the 70s where it’s been all night. I don’t bother checking the ventilator because at this point, I know we have maxed out our settings. It’s only a matter of time.

I think about his kids at home. How do they feel scrolling through Facebook and Instagram while people still put the word pandemic in quotation marks as their father wastes away in isolation? Probably the same as I do.

I think about how this entire family may pass within a matter of days, and how blessed I am to have escaped a hospital visit after testing positive. Inhale a little deeper, exhale a little longer. I stop myself from going too far in my thoughts because I realize that flu season is around the corner.

It’s the 11th hour and the monitor alarms for a heart rate of 160 and oxygen of 60. I go to the room to help, and see a man’s body lifeless in his bed. I stand by his side to hold his hand and recognize him as the patient I took care of last week. He struggled to find a mask each time I entered the room to prevent me, in all my gear, from being in his place. He had something funny to say each time I entered, always saying thank you as I left. He has chronic back pain and would prefer a warm pack on his back over pain medicine. His point of contact is a niece, whom he loves very much. His belly is also red because, he too, wants to get better.

And here he lies with tears in his eyes, and a new tube in his throat. I want to scream. His nurse is doing everything she can, but there are better ways, faster ways, more efficient ways – but she does not know them. It’s not her fault. She is new and has found herself in the midst of a virus that has stolen hospital beds from every other ailment and new nurses from the shade of a “new grad” umbrella. I help her make the patient comfortable and teach her things that I had two years to learn.

I leave the room and find myself in a storage room with tears running into my mask because nothing we are doing is working. I think of all the family members I have had to call and give unimpressive updates to, the ones I’ve had to break the news to, and the ones that have understandably yelled back at me in frustration. I think of the eyelids I’ve had to close and the body bags I’ve had to zip. I think of all the tears shed by myself and my coworkers for the lives that we so briefly knew, but seem to be fighting for the hardest. I shed some more because this is only my first shift of the week, and I have three more to go.