Nurses in the trenches of this pandemic are suffering burnout and PTSD like never before: A survey of 10,000 frontline nurses around the country in June found that one-third have experienced severe mental health issues due to the ongoing crisis.
Now they’re among the vulnerable groups being targeted by a fresh round of grants from First Lady Tammy Murphy’s charity, the Pandemic Relief Fund, to help address the mental health costs of COVID-19. Of the $2.5 million, more than $440,000 will go to Nurse2Nurse, a peer hotline for nurses and their families.
It’s not just a sympathetic ear. The nurse on the other line will be trained in COVID-related issues, ready to connect them to therapy or support groups, and follow up if necessary.
To get a sense of the need, editorial writer Julie O’Connor checked in with Christiam Fajardo, who at the height of this pandemic was overseeing a team of nurses caring for COVID patients at Saint Joseph’s in hard-hit Paterson — while caring for his own patients, too. Below is an edited transcript.
Q. Why is this so different than the stress you normally face on the job?
A. I guess it’s the fact that we didn’t really know at the beginning how to treat this; there was so much unknown. Fear and anxiety were rampant throughout all of the nursing profession. I’m also a professor at William Paterson, and even my students were experiencing stress and anxiety. All we knew was, whoever gets this, pretty much, doesn’t survive, and we didn’t really have the tools in medicine to accommodate all the needs of these patients.
One of the major issues I encountered as a leader was having my staff coming into my office, and meeting my staff in the breakroom or in the actual unit, and they’re broken down. Because they’re like, ‘I’m here to make sure I can do my best for my patients. But how do I now go home with the potential of exposing my family and my loved ones to this?’ That really was what gave me the most stress and fear. What do I say to the nurse who is choosing between being a mom to a child at home who is immunocompromised, and being at the bedside?
Q. About a third of the nurses surveyed said they were having symptoms of depression. Have you seen this?
A. I have seen it firsthand. As leaders, we feel accountable for our staff. They’re the real frontline, and we’re here to support them. So we took on a lot of the emotional part, their fear and anxiety. We were like, ok, go take a break. But ourselves, we didn’t take breaks. We created a small room in our unit that has aromatherapy, where the lights are dimmed, and you have a chance to go in and collect yourself. To make sure the nurses were able to do that, I was covering their patients. And patients were dropping, left and right. They were dying.
What made the biggest impact is, they were dying alone. We tried to be at the bedside the most we could, so that no one could die alone. That was a lot of the emotion of it. And every time we lost somebody we cried, but we cried together. We instituted a ‘Pause for dignity,’ where we stood in the room, we bowed our heads and we just recognized this person for who they were. We thanked them for allowing us to care for them. We’d say, everyone did an amazing job. We all did everything we could. And when we were done, we went to the other side of the unit and came back, and the room was already turned over and the new patient was moving in. You didn’t have much time for grief.
Q. Some have said it’s like being in a war zone.
A. From the beginning, we started using war terms when it came to COVID. I think it was because it happened so suddenly and there were so many unknowns. There were times when you couldn’t even get your mask on, and the patient was going into respiratory failure in front of you. Do you protect yourself, or do you run into the room? The two minutes it takes me to put on this mask and my PPE are two minutes that this patient is going without oxygen. And they’re going down. It was happening so quickly that you couldn’t even react fast enough, in a safe manner for yourself, for you to be able to care for your patient.
Q. Did any of your staff end up getting COVID?
A. I was very lucky. Those who did had very mild symptoms. But we also had a nurse who passed from COVID in another ICU. He wasn’t in my unit, but all of the nurses, everyone became more fearful. I had de-briefings about it. It was very tough on that unit because they took care of their own nurse, and their own nurse ended up passing in that unit. It broke everyone’s heart, but it brought them closer together. When you talk about resiliency, it was definitely exemplified in that unit.
Q. You say the grief often hits later.
A. I think, because we were going a mile a minute, a lot of their anxiety and fears didn’t come through until after we had a reset, a little lull in the influx of patients with COVID. People had a moment to think, to really take in what we went through. That’s when I think the PTSD set in. And when we were talking about a second wave, people were even more scared. We lost a lot of good nurses. Nurses with experience who were close to retiring but weren’t there.
Q. How is their retirement affecting the fight against COVID?
A. Those who are leaving are being replaced, and we’re building new people into our team. But the experience is what is gone. These are really sick patients, they can go from being very awake and doing well, to their oxygenation dropping to very dangerous levels for no rhyme or reason. They just go down. So they need to be closely monitored. And the people who used to be there to mentor and support the newer nurses, they’re moving on.
Q. Are your nurses vaccinated yet? Has that changed anything?
A. Yes, absolutely. The vaccine has brought a level of hope. Some are hesitant, but a good 80 to 90 percent of them are vaccinated and it gives them a sense of, ‘ok, we can move forward from here.’
Q. If we don’t find ways to help nurse cope, what do you think will be the effect on the profession?
A. Definitely it would increase the nursing shortage. I don’t think anyone is going to want to come into this profession, as willing as they do now. Caring for people is one thing, and wanting to help others, but when it puts you against your own body, your own family, I think it’s definitely going to be very hard for us. And if there’s nobody coming into the profession, who is going to take care of the patients? The quality of their care may decrease.
I think that nurses are definitely a special kind of people. The selflessness that I saw from the nurses taking care of these patients — even through their fear and their anxiety, they showed up, they came to work. It’s a calling. It has to be deep-seated, in order to go through this and still wake up the next day and come to work. The word ‘hero’ gets thrown around a lot, but honestly, a lot of them didn’t see it as that. It was just, ‘We’re humans and we’re going to take care of each other. This is what we do.’
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