Behind the Mental Health Crisis in Nursing: Testimony of a California Traveling Nurse

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Registered nurse Bryan Hofilena places a “COVID Patient” sticker on a body bag of a patient who died of coronavirus at Providence Holy Cross Medical Center in Los Angeles, Tuesday, Dec. 14, 2021. (AP Photo/Jae C .hong)

The tragic suicide of a nurse last week at a Kaiser hospital in Santa Clara, Calif., underscored the heavy emotional toll that the COVID-19 pandemic has weighed on healthcare workers for more than two years. The growing mental health crisis among overworked and traumatized healthcare workers is reflected in the mass exodus of nurses from the profession.

Olivia, an intensive care unit (ICU) travel nurse from California whose name has been changed to protect her identity, has spent the last two years of the pandemic in some of the most stressed places in the state.

“I saw pictures of me a long time ago. I am happy,” she said. “That person is no more.

“We have been under a lot of stress. I can not think straight. I have post-traumatic stress disorder (PTSD). I have anxiety. I can barely leave my house. I have an 8 year old child that I have to take care of.

Olivia described how personal protective equipment (PPE) was rationed at the start of the pandemic, “They [hospitals] locked N95 masks. They would only give you one.

“At first the nurses were the only ones who entered the COVID wards with an iPad so the doctor could talk to them… They tried to tell us not to wear N95s at first. They told us to wear bandanas. Some nurses had to wear the same N95 for a month to work with COVID patients. They didn’t even let us bring our own gear. I said, ‘Now people are dropping dead around me and you can’t give me an N95. If you don’t want to give me a mask, I’m going home. Our entire career, we’ve been told to only wear an N95 once. You had a TB patient, you put it on once.

“I felt like they were trying to kill us. We’re disposable. We don’t matter, we’re garbage. Oakland nurses had to use trash bags for isolation gowns They had to work on their own staff who died from COVID. I never had COVID and I’m so grateful. People around me caught it and got sick.

“It’s not my job to die. You send firefighters with oxygen and their equipment. You don’t send us anything. It’s like you gave me a stone and a stick and sent me off to war expecting me to shut up.

Olivia explained the effects of COVID-19 on patients. “I have a daughter who was 22. Arrived by ambulance. Out of breath. Older daughter came in with a urinary tract infection, had no shortness of breath and seemed fine. She didn’t know she had COVID.

“The girl who was out of breath and has COVID positive, her lungs looked great. The eldest daughter, her lungs were completely covered in COVID. That’s how it moved all the time. People were fine and the next day they came back and in 24 hours they were dead, on 16 infusions and bleeding.

“During COVID, I didn’t save a single person in that first year and a half. Not a single person left the ICU. At one point, it was like a morgue where everything the world was intubated.

These conditions are extremely difficult, even for experienced nurses. Hospitals have asked nurses from other specialties to care for them with little preparation, she said. “They brought a group of telemetry nurses to intensive care. They said they would train them. Within days, they had full-fledged COVID patients. I told them they were heavy COVID patients and told them they had to say no. It’s your license. If something happens, trust that they are going to come after you and no one else.

Indeed, Olivia’s warnings were proven in the case of RaDonda Vaught, a Tennessee nurse who was criminally convicted for a medication error she reported through proper channels. “They throw them under the bus to save their own ass. They don’t support it and find out where the flaw is in the system. There are thousands of medical errors. They just aren’t reported. She might not have reported it at all, and no one would even know.

“Nurses are under a lot of stress and a lot of them can’t handle that stress. Obviously nurses bring a gun to work and kill themselves,” referring to the recent workplace suicide of a nurse at Kaiser in Santa Clara.

She noted that “so many nurses have died in the past two years. For my first 20 years, I did not know of any deceased nurses.

Olivia mentioned a nurse she knew who forgot to put on her N95 mask and rushed to perform CPR on a COVID patient. Tragically, the nurse caught COVID-19 and died seven days later. A 2021 study from the UK found that in 2020, nurses died of COVID-19 at around twice the rate of the general population.

In addition to the loss of healthcare workers to the pandemic, Olivia noted that many have died by their own hands. “A nurse from another facility came out and saw one of the CNAs [certified nursing assistants] jumped off the garage building because she couldn’t cope with COVID anymore. And then the nurse had to work on her. This pretty much screwed her up and she had to quit breastfeeding.

“A fellow nurse mentioned that another nurse had recently jumped off a building while on a shift at another site. And a few months ago, a nurse in the intensive care unit who left in the middle of her shift said, “I have to get something from my car” and killed herself. You don’t hear any of this on the news. I didn’t hear about it, which happened two hours away from me, on the news. Nobody cares.”

Even before the start of the pandemic, nurses in the United States were at more than twice the risk of suicide compared to the general female population, nurses also being at high risk.

These same pressures weigh on so many healthcare workers, including Olivia. “I was suicidal, especially in the midst of COVID and several months after. I have never felt so mentally unstable. I scared myself. I didn’t want to be here anymore. I am losing it. All this for what, for my job? What I did for 22 years? Why? For corporations and society to turn their backs on us and tell us to suck it? I’m trying to get advice. They say there is free advice, but where?

“How do you expect me to pay $500 a month as a single mom with two kids just to get mental health care? I can not do it. I loved my career. I don’t even want to work anymore. I have anxiety the day before work. Management doesn’t care about us. No one even came to me and said, ‘Are you okay, are you okay?’ We should have free health care for what we are going through.

“How many billions are you going to spend on Ukraine but you can’t give us a billion for PPE?” she asked. “In the middle of COVID when Black Lives Matter was having a peaceful protest, I watch the peaceful protest and the SWAT team was there and they had $80,000 worth of gear. Meanwhile, I come home from my nightmarish shift covered in COVID with an N95 on. I am at war and they are watching a peaceful protest. This makes no Sens. Where is our equipment?

“We need more support. We need more mental health care. We need a debriefing. We need advice. We need staff. We need DACs. We need more nurses. We need our breaks. Don’t interrupt us during our breaks. Don’t blame us for taking our breaks. Stop writing about nurses. We are not the problem. The system is the problem.

Olivia insisted that nurses’ unions had done nothing to improve the situation nurses face. “Unions are useless. I had a problem with Kaiser trying to accuse me of something I didn’t do. I went to see my union representative and he told me: “If they want to get rid of me, they will. So I left, I quit.

“I want to leave the nursing profession, but I only have 10 years left before I can retire. And now a nurse comes to work and kills herself. Now I’m afraid that a colleague will come to work and kill me. It’s no longer safe. This is simply not the case.

Olivia was excited about the Stanford Nurses’ Strike Committee’s call for a statewide nurses’ strike. “God, that would be awesome. It would be amazing… It doesn’t matter where you go, it’s the same. I don’t care if it’s Stanford. It is for the highest placed to earn money. Underneath it all is still the same BS… We need to unite and stand up.

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