Kathryn Ivey Profile picture
Aug 1, 2021 12 tweets 3 min read Read on X
I became an ICU nurse at the end of July in 2020, during one of the first peaks of covid when it was all still so new. I learned how to be a nurse behind a respirator and a yellow gown, amidst the constant beeping and hissing of ventilators that couldn't support failing lungs.
Because I was so new, I had no baseline for what normal nursing looked like; I just had a vague sense that it couldn't look like this. The unit was bleak and everything we did felt futile, and I realized at some point I felt more like a ferryman to death than anything else.
Some people lived, if they never got to the point they needed Bipap. Most didn't. By the time they came to us they were too sick, their lungs too shredded, kidneys already failing and blood already clotting and so often beyond the power we had to heal.
I would watch, feeling helpless, as they would go from a nasal cannula to a Vapotherm to a Bipap, and then when their chests started heaving and they started sweating I knew with heavy dread that soon they would be intubated.

There are places we can't call you back from.
I got used to the death. I walled it off, pushed it down, and did my job. I advocated for death with dignity, with as much kindness and comfort as we can muster, and accepted very early on that we can't save everyone.

And then numbers started going down.
We went from 3 covid ICUs to 2, then 1. I started to see what it was like to be a nurse in pre-covid time and realized how many people normally survive. The things I did mattered, my actions actually saved lives - no longer was death my constant, silent companion.
The more time I spent out of the covid unit, the more I realized exactly how bad it was; all the vents, the CRRT, the relentless march towards death that we could hold off for a time but never stop. Walking through the much smaller covid unit was like walking through a graveyard.
It is so much worse, this time. We all have so much less to give. We are still bearing the fresh and heavy grief of the last year and trying to find somewhere to put all this anger.

But the patients don't stop coming. And the anger doesn't stop coming.
Underneath that anger, I feel defeated. Nothing we do makes a difference. The world spins on, oblivious and belligerent, as we fight to save the tidal wave coming our way. With less staff, less resources, and a lot less of ourselves to give.
I don't know what to say that will make people listen. I wish I could snap so many people out of their selfish stupor but I can't, so I get to watch instead as people learn the hard way; with a tube down your throat. With a "code blue, code blue!" and the crack of a sternum.
With a three am phone call to your family, held by hands still trembling from the rounds of CPR, voice shaking, knowing that I am about to shatter someone's world.

You learn the hard way and I see it through. I carry the weight of your choices and the pain they cause.
It didn't have to be like this.

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More from @kathryniveyy

Dec 2, 2022
The people now ending up in the ICU with covid are those who've had it before. Some were hospitalized before, others had a "mild" illness that damaged their lungs. People come in with non-covid issues and end up on the vent with a peep of 18 and a paralytic because of the damage.
Others come in with something completely unrelated, end up vented for surgery, and everyone is scratching their heads as to why they aren't improving and then someone mentions "oh yeah he had covid four times and that's why he's on oxygen at home."
Sometimes I just think about how the reckoning for this will never come and yet I see it, every day. The cost of this is so fucking high and I'm still infuriated that so many people get to ignore it. Millions of people died. I saw a sliver of that and I am haunted.
Read 6 tweets
Sep 5, 2021
"This is not the update wanted to give you. Your husband died about fifteen minutes ago. I'm so sorry."

The rest of it is harder to say. He wasn't alone. The respiratory therapist and I stayed with him until the end, squeezing his hands, telling him it was okay to go.
We told him he fought well, had been so brave for so long, and he could rest. We wiped his brow and watched as he slipped away, out of his body and the devastation of the illness and into a bright light or a calming dark that wraps around you like a prayer.

Souls linger.
Some longer than others. Mostly just a few seconds, counted by the sudden tingle deep in my spine, a shifting awareness that there is more in the world than I can see. A few seconds where the veil opens and the naked truth of the world is almost revealed before it closes again.
Read 12 tweets
Nov 22, 2020
How it started How it's going ImageImage
I love being a nurse. Didn't exactly expect to be a new nurse in the middle of a highly politicized pandemic but life comes at you fast and even in a pandemic, there's nothing else I want to do. Caring for the sickest of the sick is an honor and I treasure my patients.
It is devastating to watch people die when those deaths were avoidable and it's even more devastating when you watch them die the same way, time after time after time. It's devastating that basic common sense and decency has been politicized.
Read 4 tweets

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