Trauma Lingers for Frontline Nurses

5 min read

2020 was a year unlike any other, and for nurses and other medical staff at the frontline of hospital care, it was one they will never forget. Sam worked in a nursing home in Atlanta. Emily interviewed her recently about those frenzied first months of COVID-19 as “everyone was dying all around us.” Many seniors who became infected were taken to the hospital and never returned. Others that did were on oxygen and, as Sam describes it, barely living. The emotional trauma of work that year was stark and unrelenting, leaving the nursing staff heartsick and exhausted. Not surprisingly, there was extraordinary burnout globally among nurses.

And, for many, those frenzied, chaotic, and stressful days are still with them: Three years later many carry measurable signals of long-term trauma. The situation is worst for those who also contracted COVID-19 themselves – typically in the line of duty — and to this day still suffer from some of its long-term physical effects. For some it’s disabling fatigue, memory inconsistency, and dizziness. For others, like Sam, it’s chronic muscular and back pain and trouble breathing. Many also have trouble sleeping and are dealing with mild to severe depression.

Trauma Lingers

Trauma is an invisible mediator of well-being, affecting both the emotional and physical self. The effects of Long Covid on hospital workers and other frontline workers from 2020 are rarely discussed in the media, even though millions of frontline workers were infected with COVID-19, many died, and others — unable to work — now are relying on their families for their care and to help make ends meet.

Sam was infected for the second time with COVID-19 in May of 2020, when many people were only becoming infected for the first time. Although the first bout was mild, her second infection put her in the hospital. “Take your oxygen levels,” her mother told her over the phone from Illinois. She did and had a hard time registering the numbers because they were so low. By the time she got to the hospital, she was barely conscious; she went into a coma for several days and was hospitalized for 36 days. Sam recalls fever dreams and an intense spiritual experience that moved through living and dying, staying and going, being and moving on. She remembered a voice asking, “Do you want to stay or do you want to go?”

Sam’s hospitalization through June 2020 coincided with the news of George Floyd’s death. The event is especially memorable to her, despite her state, perhaps because it was looping on the news in the background. She explained that it wasn’t just because she was Black that losing Floyd was so emotionally resonant, but also she identified with his death. She, in moments, felt somehow as though she had died with him. She remembers saying, “Stay here, we matter. We deserve to be here.”

When she left the hospital, Sam could not live on her own and moved to Illinois so her parents could take care of her. She lost her job, her home, and her community in Atlanta. Eventually, she moved her stuff out of her apartment when she realized she couldn’t go back to her old life. When Sam talks today about this time in her life, it is these vivid hospital memories that make her feel as if her life had gone through an extraordinary fracture.

As social scientists, we have the means to place Sam’s struggles to recover physically and emotionally from her intense, unresolved COVID-19 trauma in a broader societal framework. More Black Americans worked the types of essential worker positions that had an escalated COVID-19 risk. They represent 30% of licensed practical and vocational nurses and, as Sam’s story illustrates, had very up close and personal exposures to pandemic grief and suffering (including that of their co-workers) very early on. Black Americans not only were more exposed to COVID-19 infection, but recent studies are also showing they have experienced elevated levels of trauma, psychological distress, and mental illness associated with that grief.

The Long Road Back

Sam is much better now, but requires ongoing rehabilitation and care. At the beginning, Sam would fall consistently — her legs buckling beneath her. She says the enduring muscular pain is one of the most consistent Long Covid symptoms that she’s carried with her, apart from her emotional trauma. After she finished the physical therapy her insurance covered, she was worried because her recovery had only just begun and it was clear that she would need months of rehabilitation. Thankfully, Sam qualified for a program that cost only $100 for ten visits of physical therapy per month. This physical support — along with counseling and online therapy groups — has been crucial for her recovery.

She said, “I think that’s something insurance companies need to realize. Therapy is needed much longer than what they offer. If I didn’t have this therapy, I wouldn’t be up to this point. I might be bedridden. It’s not just one person, you need support: mental support and financial support. If not for my parents, I’d be homeless or dead by now. People who are sick need support. At first, I felt like a burden at times and I’d ask my mom. She’d say, Sam, I’m just glad you’re here, you’re not a burden.”

Today Sam is back working — the new job feels safe, pays okay, and enables her to engage with people. Sam’s family continues to support her. The last real struggle left to heal is the deep emotions related to surviving the pandemic while so many died or are in much worse condition than she is. She considers her COVID-19 experience a “near-death experience” and talking about COVID-19 is still triggering some days. But those days are less than they used to be and have been essential to her healing.

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