I write this, wiping away tears, confronting fears, at the nightmare that gets worse every day. One week feels like a year. I cringe every time the phone rings: another nurse sobbing uncontrollably about conditions in the ICUs — so many make-shift ones now — where all bets are off; about a colleague who is positive and sick; about one who is intubated; about another one who’s succumbed to this dreaded plague…
HOW MANY TIMES did we warn our hospitals, government, bosses, the media: “We’re not prepared for a disaster.” We pleaded for staff, supplies, space, beds, training, nursing schools. “Don’t close hospitals. Don’t cut health care. Stop the for-profit frenzy. Support our public health infrastructure. Provide free nursing education.” We were accused of being alarmists, unrealistic, unreasonable — even greedy.
Nurses were functioning at bare bones before COVID-19 hit, pushing ourselves to the limit. We’ve now learned a new definition for “limit” in COVIDspeak — there is none. The rules for infection control change with the wind — and the whims — of corporate forces and the political “leaders” who depend on their campaign contributions, who value liability concerns and optics over human lives. How dare they!
HOW IS IT POSSIBLE that the wealthiest country in the world is incapable of producing protective gear? Wuhan was a warning: so many lives lost in one province. Did we learn nothing from that? From the measures taken to contain, control and combat the virus? Is our nation so arrogant that it cares little for people in other nations? That we think we can’t learn from their experiences?
Over three months have passed since the virus was named. But over the past 50 years we’ve seen manufacturing relocate into countries with cheap labor, few safety rules and repressive anti-union policies. This was promoted in spite of the damage it did to the paychecks of US workers and the lives of those in outsourced nations. And so, much of our PPE is produced elsewhere.
While American workers had no say in outsourcing, we and our patients are the victims of the practice. Hospitals refused to listen to us, and so, again, we are the victims. Many of our elected leaders chose to side, not with us, but with the hospital industry and insurance companies, allowing draconian cuts and closings…and so we are the victims. And now, we not only have to fight the virus, we have to fight our employers and our government to safely care for patients…and to survive ourselves.
The CDC, the government, our hospitals, the health care system itself — all have failed us. They missed the boat but left us to drown in the water. So many people are dying that we‘re mastering new techniques in double-shrouding more often than in calculating new drips. What we thought was unimaginable a week ago, is the new reality: our docs deciding who gets actively coded in an arrest and who doesn’t — based on prognosis — and age — and the need not to “waste” precious PPE. How can we live with ourselves in the aftermath of such things?
We are afraid to go home. We can’t take care of our own parents for fear of infecting them. We don’t see our kids. We tremble at the simplest mistake in removing soiled—but totally insufficient—gowns and masks. We have strategies to strip off our clothes on porches, stoops and yards. We worry about family, neighbors and friends. We assume we’re COVID-19 positive but testing is backlogged and not always accurate. And we wonder, as we have overlong waits for test results: is a positive result a death sentence or a reprieve, because we are alive.
The president has the power to implement the Defense Production Act (DPA) to mandate industries to retool and manufacture nothing but PPE and hospital supplies like vents. But he says, instead, “the market should rule.” The market has led us down this rabbit hole.
The crazy beauty of this horror is that we have seen coworkers and neighbors, community groups and unions, families and strangers, assemble (virtually) to support us and one another. Our faith in good people is reinforced. Volunteers sew masks, procure N95s and gowns, raise funds to get materials, cook meals, offer their homes. We are blessed in that way. And we have each other, our heroes alongside us, who pronate patients with us, deliver precious oxygen, medication and nourishment, share newly obtained PPE, food, liquids, allow us to cry, even if not on shoulders.
But even as we fear for our lives, our patients’ lives, our family’s lives — we’re angry. We’re disgusted. And we’re fighting back. We invent our own PPE when the hospital can’t — or won’t — provide it. We have the media’s ear… and we’re talking. We’re organizing, to make do, and to make noise.
We’re not only the canaries in the mine of this catastrophe, we’re the witnesses to the neglect, incompetence and criminality of the insufficient, inexcusable response to the greatest challenge facing us in our lifetime.
Silence is not an option.