Viral Video Highlights the Trauma of a Nurse's 'Worst Shift' During COVID-19

Every morning, we health care workers pack our bags full of our fears and our worries. We lace our shoes and remind ourselves why we do our job. We think of the reasons to be thankful. Our health, our family, our friends, our pets. We zip up our bags, put on a smile and go to work.

But we need you to know that we are still human. We are stressed. We are tired. We are on edge. We are full of fear. 

Many people have seen the heart-wrenchingly raw video posted by D’neil Schmall, an ER/ICU nurse in New York working the front lines and taking care of COVID-19 patients. In her unedited video, recorded after what she describes as her “worst shift” at the hospital, she tearfully explains what life is like in a hospital during this global pandemic. You can see the video here.

“Today was a really rough day… I cried the whole way home in the Uber today,” she said between sobs. “The driver was like, ‘Ma’am are you OK?’ And I was like, ‘I don’t think people understand how stressful this job is. I wouldn’t trade it for anything in the world, but it’s so stressful. I wish people could just understand…’”

In the video, Schmall reveals the daily trauma of working with people who have been infected by the virus. She explains that nurses in her unit are working five to six days a week for 13 to 15 hour shifts. From my experience, in a typical ICU unit, nurses are assigned two patients at a time. That is how we are trained. That is what work used to look like. Today, however, Schmall and her colleagues are caring for 10 to 16 critically ill patients who have no family or friends by their sides. Imagine being expected to indefinitely increase your work hours and multiply your workload — all while operating in an increasingly dangerous environment, in an increasingly stressful and uncertain world, without assurances that you have all of the equipment you need. 

“I just feel like there’s only so much any one person can take,” she said. “I’m tired of walking into rooms and your patient’s dead. You just walk into a room and there’s a dead body there.” 

According to a study of health care workers in China working with COVID-19 patients, 50.4% reported symptoms of depression, 44.6% reported symptoms of anxiety, 34% reported insomnia and 71.5% reported distress. Health care workers are being asked to face circumstances that are challenging their own mental health. They need support. They need help. The stress experienced by us on the front lines cannot and should not be ignored. It’s unimaginable. Schmall offers us a chance to imagine.

In addition to the trauma of experiencing death in the COVID-19 units, Schmall explained how difficult it is to lose fellow health care workers.

“I feel so much sadness for my fellow nurses, sisters and brothers, that have lost their life taking care of people,” she tearfully expressed. 

As a nurse myself, I can relate. The sadness is real, as is the fear. Watching our fellow nurses and health care workers die from COVID-19 makes us wonder if we are next. In the video, Schmall suggests that hospitals provide resources like counselors for health care workers who are overwhelmed by working with COVID-19 patients day after day.

“Everyone is really concerned about the patients, and I understand, I completely understand,” Schmall said. “But if your staff is not doing well, then who is going to take care of your patients?”

A 2019 review of articles on workplace-based interventions to improve the mental health of health care workers showed that employee engagement was a common theme of effective interventions. Hospitals must include frontline workers in conversations regarding mental health and make the health care workers feel supported. We are staying up late, unable to sleep. We are waking up early reporting to work to repeat this cycle. My unit has a big piece of paper up in our break room where we anonymously write comments and concerns. That’s a start. But where do we go from here?

Nurses are not asking for your pity, and we are not asking you to remind us that we signed up for this. We know our jobs. We know what we signed up for. But we do not acclimate to death, and the stress still hurts. Shmall reminds us that we are human and we need to have more compassion for each other. We are all stressed and we are all hurting, but we as nurses are not supposed to show it at our job. We must hold back our feelings to focus on our patients.

In this time of crisis, we must rely on each other. We must talk to each other. We can cry together. We can worry together.

Find your person. The TV show “Grey’s Anatomy” introduced the use of the expression “your person.” It was used to describe two best friends in the show. Your person can be your spouse, your mother, your sister, your friend or anyone else you feel comfortable with. Tell them you want to talk and just need them to listen. If they work in health care, that’s a plus.

My person is my friend who was one of my mentors when I started working in the Intensive Care Unit. I talk to her about my feelings, my concerns. I cry to her and she cries with me. She understands, since she works in the same ICU as I do. She has years of experience on me, so she usually can tell me an inspirational story or help me put my issues in perspective. However, sometimes I need to vent so I tell her that, and she lets me vent without interjecting. The best advice I can give you is to find your person.

Like Schmall, I’m proud to be an ICU nurse and wouldn’t trade it for the world. But, I’d like to ask you to make space for us in your hearts and prayers. We are, after all, still showing up, still doing our best despite the pandemic, and — most importantly — we are still your sons and daughters, spouses and partners, mothers and fathers, friends and neighbors. Donated meals, community claps out windows, thank you cards, likes on social media are all great. But for us, the stress and trauma will endure after we flatten the curve and stop social distancing. Let’s make sure that we continue to support and listen to each other long after the pandemic becomes a chapter in our history books.

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