I've probably watched close to a hundred people die from COVID, working in ICU in the past year during this pandemic.

I know it's been close to 100; over half of patients, when they get bad enough to make it to ICU, don't make it. They just.. Die. No matter what we do. 1/ And it's TERRIBLE. It's AWFUL. It's indescribable.

Caring for someone, getting to know them, their family, yet knowing they'll die, regardless of everything you're trying..

It's soul wrenching. 2/

As an ICU nurse, I'm tired of watching people die of COVID.

So. Tired.

Please..

Get vaccinated so your grandma or friend or father or daughter or mother doesn't have to come to me and die.

All I've done the last year is watch most of my COVID patients die. I've never, in seven years of nursing, four years in critical care, experienced something like over HALF of my patients dying, no matter what I do.

And I'm TIRED of it.

The very bottom of my soul is thin and stretched and barely surviving.

I suppose why I feel so strongly about families rescinding DNR orders and aggressively resuscitating a love one who made their wishes know, is that it feels like it devalues that person's death, and in so doing, devalues their individual journey.

Death is sad. It is hard. 1/ But death is inevitable, and the suffering is only for those of us left behind, not for those moving on.

My grandfather was a chaplain for 35 years, and always said that death was never the hardest for those dying; it was always those left behind he had to comfort most. 2/

I'm tired. So tired.

I just want America to be healthy and take care of one another.

Please stop making things like this.

I am tired of these, too.

Instead, vote for better leadership, and a healthcare system that exists for YOU. Stop creating a world fueled from your apathy towards your neighbors' lives and well being that has led me and others like me to have to put ourselves in needless danger.

Stop saying that people around you aren't your problem.

I'm gonna tell you all a secret: I'm actually still in the camp that this is "just like the flu", if the flu chose to slam us in a pandemic form, a la 1918.

I have seen some nasty flu deaths. The flu has ALWAYS had the potential to do this, we just don't acknowledge that. Really, ANY viral respiratory illness has always had the potential to do this to us, we've just always felt safer and more secure with a known enemy than a new one, even if that known enemy has always had the potential to be ugly to us and just hasn't for a while.

I remember my grandfather telling stories of my great grandmother being notoriously callous and hard. Not abusive, just with a steel exterior, and hard to love.

I never considered why.

She survived WWI, WWII, the great depression, and the 1918 flu pandemic as a Navy nurse. I have been finding myself pulling away from people, being less touchy, less emotional, more distant, more turned into myself.

Self preservation, coping mechanism, survival skill, whatever I might call it, I do find myself being harder to love lately.

I have a perhaps lengthy message for all my med-surg and floor nurses, so don't mind me if I take a few seconds of anyone else's time. Feel free to read this, or skip it. I just needed to discuss a few thoughts. As an ICU nurse, I have been following the talk of needing ventilators with trepidation. These patients who get sick enough to need pulmonary life support also need a lot more: Proning, nitric, high PEEP, hemodynamic support with pressors, etc.

There is no talk of how gruesome, macabre, and unnatural it is to have someone be aggressively treated for ARDS: Proned, paralyzed, sedated, skin blistered or bruising from pressure points that come with proning. Bleeding and oozing from their mouth, nose, and eyes. Most of the people that we're talking about getting ventilators will die this way.

Proned, paralyzed, alone, never getting to say another word before they die, or as they're dying.

Their family will only get updates from afar, they won't get to be with them while they're sick.

I'mma take a second to rant here about the talks I keep hearing about ventilator numbers.

Estimates from the WHO have inpatient requirements currently at 1/5 of those who get sick. Only about 5% of those 20% will need critical care, and not all of the 5% will need ventilators. Meaning our greatest needs will be in solid med-surg nurses and medical beds, not ICU. The most patients in terms of numbers will be medical, not critical.

The most critically ill with ARDS already have pretty bad outcomes, with a 50-97% mortality once they're on a vent.

This pandemic so far has created some insane unknowns. Restrictions, rules, lockdowns, coupled with fear and borderline panic everywhere.

As a ICU nurse, I have gotten used to death, and dealing with how that looks and feels, for families and for patients. One thing I wasn't prepared for with this pandemic was how visitors would be so restricted, and how many rules would limit the normal process that families experience with critically ill or dying patients. Many places are completely not allowing COVID-19 patient visitors are all.