Last May, we asked four local nursing professionals to share their distinctive perspectives on what then already felt traumatic: a worldwide pandemic caused by the outbreak of COVID-19. We now consider COVID an all-too-familiar disease, one that will join the likes of smallpox and polio in the history books of medical villainy.
Now, 12 months later, we have asked the same front-line heroes to update and expand on their perspectives on the continuing fight. Vaccinations are here, entering thousands of arms each day in Memphis. Variants of the virus have arrived, too, adding new layers of complication and anxiety even as reasons for optimism increase. With sympathy for the too-many lives lost and for all those grieving, and with inspiration from COVID-19 survivors and those who have cared for them, we share these views with hope for a healthier tomorrow.
PHOTOGRAPH BY Greg Campbell
Amanda “Mandy” Holder with her new son, Axel.
Amanda (Mandy) Holder, BSN
Intensive Care Unit Nurse, Medical Response Team Nurse, and Patient Coordinator — Methodist Le Bonheur Healthcare and Methodist Hospital - North
From Halls, Tennessee, Amanda Holder attended UT-Knoxville and earned her nursing degree from the University of Memphis. She interned at Methodist Hospital – North and joined their nursing staff in 2016. A year ago, she told us, “It’s an amazing feeling when you make connections with patients and their families, and you see them through. We play a short part in their lives, but our impact can be profound. I’m proud to be a nurse.”
How are you? This past year has been difficult for most everyone, but front-line workers like you have witnessed the effects of COVID-19 on a daily basis. How do you take care of your-self while also taking care of others?
I think most healthcare workers would agree when I say that we are tired. This past year has been one of the most difficult many of us have experienced in our careers. Across the country, nurses are working twice as hard with limited staffing resources. Nursing, however, remains our calling. We will still care for our patients and we’ll continue to serve our community — because that’s the call we answered.
“Only those of us who have braved the frontline will completely understand the day-to-day challenges we faced.”
To be honest, we probably haven’t taken care of ourselves to the extent that we should. Our focus has been to take care of others and we’ve put ourselves last. Mentally recharging is one of the best things we can do for ourselves. Personally, I spend time outside especially on pretty days, just enjoying nature. Having the vaccine broadly available now gives us added hope that we’ll soon be able to enjoy a vacation and spend time with loved ones again.
The outpouring of community support has also really been encouraging. We’ve received goodies and snacks to help refuel our bodies and our minds. The appreciation shown to healthcare workers has been something that has refreshed us all — no matter how big or small the token of gratitude.
Worst-case scenarios predicted a death toll in this country of 250,000 from COVID-19. Instead, the coronavirus has claimed more than half a million lives. What were your thoughts as the number of cases steadily rose?
My initial thought was, will this ever end? At the beginning, it was hard to see the light. Healthcare systems were treating so many sick patients and not all were covid-related. Seeing the daily increase of COVID-positive patients, though, was especially tough. I remember each patient I treated, some who lost their lives to covid. As the pandemic intensified, we saw success in new treatment options and our PPE supply remained steady. Those small wins kept us going.
Many people are still skeptical of COVID-19, preferring to think that another disease has caused the loss of a loved one. Have you encountered patients with this attitude, and if so, what do you tell them?
I’m familiar with this perspective and offer this as an example: If a patient with known heart failure was hospitalized and was diagnosed with pneumonia then later passed away — would you say they died from pneumonia or heart failure? The answer is both. Because the heart was impaired, it was not able to compensate for the infection in the lungs, which also put additional stress on the heart. I think it’s fair to say that it’s similar for covid-19. Underlying health issues, coupled with covid, only complicate issues for patients and can have a devastating impact.
With the vaccine rollout, we are hopeful that we are seeing light at the end of the tunnel. When do you think we can return to normal life again?
There is certainly more light visible now and it’s encouraging to see a decrease in the number of COVID cases. I’m hopeful that masking and social-distancing guidelines will ease by the end of the year. I also think it’ll continue to be important to follow standard precautions like proper hand washing and respiratory etiquette. But as more people become vaccinated and we gain a better scientific understanding of what has happened within this last year, we will be able to adapt and return to a new normal. I have to believe that.
What impact do you think the pandemic has had on the nursing profession? Will it discourage people from becoming nurses, or inspire them because they see the leading role that nurses have played?
Nurses are more valuable now than ever. A hospital cannot function without its nursing staff and the nursing shortage became very evident during the pandemic. Unfortunately, I do anticipate the nursing shortage will continue and maybe worsen. Last year, I mentioned that nursing is a calling, and it is. However, the pandemic has taken a huge toll on nurses physically and mentally. But I also know that during this pandemic, someone’s life was touched by a nurse. And because of this — that someone will want to be a nurse, too.
How has the pandemic changed the average “day in the life” of a nurse?
During the height of the pandemic, we suited up much like a soldier prepares for the battlefield. We faced many unknowns and had many questions — how many patients would we see today, what will their conditions be, will any lives be lost, would co-workers fall ill, would we have enough PPE, blood products, and other supplies. It was intense and I’m not sure that any amount of training or education could fully prepare us for what we encountered every day.
Only those of us who have braved the frontline will completely understand the day-to-day challenges we faced. We focused on providing a safe environment, which meant limiting visitation and navigation throughout the hospitals. Limited visitors meant more phones ringing as anxious family members and friends called for updates on their loved ones. Nurses not only provided care to patients, they were also providing comfort to family members.
Before the pandemic, most of us could leave our work at work. But this was different. The weight of the pandemic went home with all of us. From the patients we lost to the patients still hanging on that we wanted so badly to save. Pre-pandemic — even in the ICU — we saw good days. We saw so many patients recover and we saw the difference we were making. This pandemic had us wondering what difference we were making. Sometimes it was hard to tell.
But in the midst of all of that, we innovated. We collaborated with other colleagues and other disciplines like never before. The nursing teams paired up with respiratory therapists to find ways to increase oxygenation. Nurses partnered with physical therapists and mental health technicians, and nurses began working even more closely with physicians to strengthen communication between the medical teams.
Routines changed and the way we provide care has changed; but, the heart of a nurse and a nurse’s role remains the same — we always put the patient first.
