Healthcare has a dirty little secret and if you aren’t part of the club, chances are that you don’t know anything about it.  Aside from COVID 19, short staffing, and the lack of hospital beds to accommodate those who need them, there is yet another crisis that has been overshadowed and hidden from public view.  What is the secret? Healthcare is dangerous. In fact, so many doctors and nurses are choosing to leave the bedside because of this very reason. Patients have become more aggressive and violent than ever before.  We are in constant danger while trying to provide care to our patients. We aren’t given body armor or weapons.  We aren’t provided with appropriate security.  We are essentially defenseless.  What we ARE given are computer modules to aid us in de-escalation techniques, signage that boasts zero-tolerance, and debriefing after an attack to inform us of what we could have done to prevent the incident. 

I am an emergency room nurse at an inner-city trauma center. I can’t pretend to understand what other areas in the hospitals are facing when dealing with their patients, but I can assume that after they are admitted to hospital their behavior doesn’t magically improve. However, I can only give the perspective from an ER nurse’s point of view and this is what I know:

Violence in the ER has been a problem since before I began my career in the late 90s. In the first decade of my career I experienced being slapped, punched, and cursed at on a regular basis.  I was also involved in an active shooter and hostage situation in which patients and nurses were held against their will and physically and sexually assaulted.  It was horrible and traumatizing and changed my life and the lives of so many forever.  

These incidents weren’t only happening in my trauma center out in West Texas. They were happening all over the country. So much so that nurses were joining forces to help create legislation making assault on healthcare workers a felony in multiple states.  It wasn’t until 2013 that the law was passed in Texas. 

So many of us working in healthcare will be forever grateful to the diligence and dedication given to the criminalization of assaults committed against healthcare professionals. When the law passed in Texas, I felt hopeful and empowered for the first time in my career.  Looking back, I had been assaulted both verbally and physically many times in my 15 years as an ER nurse.  As many of us understand, violence against nurses has always been considered "part of the job". 

Fast-forward another 10 years in the ER and nurses at the bedside are still being verbally and physically abused.  From the lack of support from hospital administrators, to police departments who discourage filing reports, the laws in place can only provide us with a certain level of protection.  We need to do more and we need to develop an approach that is proactive instead of reactive.

Every week in the ER in which I am employed, nurses are threatened, intimidated, and physically abused by patients and visitors.  While we can report these incidents to hospital administrators, little can be done to prevent this behavior.  We can post signage that boasts a "zero tolerance" approach to staff abuse, but the reality is that because of EMTALA these violent and abusive patients still have the right to medical care through the emergency room.  

Recently a patient was angry because of long wait times.  He was yelling and aggressive.  He told the nurses that he was going to "rape (them) all and kill (their) children" and that he was going to call his cartel friends in Juarez to "rape and kill" the rest of the staff.  Because of EMTALA, this patient was allowed to remain on property and seek medical care which is well within his rights. Nurses are afraid and powerless. 

Another patient physically picked up a nurse, threw her over his shoulder, and ran through the exit doors in attempt to take her against her will.  She was screaming, kicking and hitting him but was unable to break free simply because he was so much larger and stronger. Thankfully he was tackled by several firefighters and a few other employees who were able to stop him from abducting her.  In lieu of an arrest, he was moved to another area of the emergency room to complete his care. It was explained to the nurse that because she wasn't physically injured and he was stopped before completely exiting the premises, no violation had occurred. 

Just a few weeks prior to that, another patient attacked a nurse in the lobby of a local ER.  This patient was restrained by visitors and other patients who quickly acted to defend the staff member. Again, this patient was allowed to stay on campus to see the doctor and receive medical care because it is within his rights as a patient. 

The stories that actually make it to the news are only the tip of the ice berg.  From an active gunman that was shot and killed inside of an emergency room in Irving, TX, in late June of this year,  to those that were killed when a patient opened fire at a hospital in Tulsa, OK, in early June of this year, these incidents continue to happen.  Even when we know from experience how these situations can escalate to tragedy and loss of life, we do nothing to change the laws to protect the people who have dedicated their lives to caring for the ill and the injured. 

Stories like these can be given in example over and over again.  I have my stories, my coworkers and friends have their stories, and I can say with full confidence that you have examples of your own to add to the long list of assaults.  When is enough going to be enough?  What will it take for the government to consider the rights of healthcare workers in regards to a safe work environment?

Earlier this summer during a meeting to review EMTALA laws, nurses were reminded that we are mandated to provide care for violent and abusive patients and that it takes a certain level of "nobility to provide care to someone who is abusing you."  In this new era of awakening, this is the type of gaslighting and victim-shaming that our society is attempting to rise above.  Unfortunately, administrators everywhere are being forced to regurgitate similar semantics because their hands are legally tied. 

This has got to stop.  This behavior not only places healthcare workers in danger, but also jeopardizes the safety of innocent bystanders.

While EMTALA was originally created to protect the patient from being turned away due to lack of funding, I cannot believe for one minute that we have to disregard the safety of healthcare workers to meet the expectations of this law. 

How can we amend EMTALA laws to aid in the guaranteed protection of our nation's healthcare workers?  What has to happen before someone hears our cries for help? Why do healthcare workers have to work in an environment filled with fear? I can no longer stand by idly and watch nurses leave our profession battered, bruised, and emotionally scarred. It is time to stand together.  It is time for us to demand a safe work environment. It is time to prevent the abuse before it happens and I for one am ready. 

It finally came.  The moment I have been dreading is finally here.  COVID has made it to my home.  For the past year and a half, I have been waiting for this moment.  Everyone who knows me understands where I stand in the battle against this deadly virus.  As a nurse in an over-inundated inner-city ER, I have seen my fair share of COVID.  I have attempted to be as transparent as possible about this journey with everyone I know.  I have been raw.  I have been real.  I have been realistic.  I have been passionate about science and vaccinations.  My husband and I even participated in the Pfizer trial to help expedite making the vaccine available to those around us.  As soon as possible, we even encouraged our teenager to get her vaccine.  She, too, made the choice to follow science.  I have read study after study regarding this pandemic.  I have done what most healthcare professionals have done.  Most of us believe that knowledge is power and therefore I continue to stay abreast with this ever-changing virus and the steps we are and should be taking to stop the spread.  BUT GUESS WHAT…It wasn’t enough.  

In an effort to continue with my transparency, I feel that I need to share the current situation with which we are dealing.  Two days ago, my daughter was feeling a little under the weather.  She acted responsibly and went for her COVID PCR which was positive.  She was immediately sent home from college to quarantine and that is exactly where I want her to be, aside from the fact that now I have COVID in my home where there is one unprotected human…my unvaccinated son who has had autoimmune issues and has zero business contracting the virus.  

Some of you will take this as an opportunity to question why we get vaccines if we can still contract the virus.  I understand that.  I also understand that all vaccines add an extra layer of protection and are not a cure.  I also know that the chances of my daughter having a serious case of this illness are slim because she has been vaccinated.  This vaccine has been an answered prayer for us.    

So many people are flooding into hospitals through the ER right now who are infected with COVID.  It breaks my heart.  They are so sick.  I know that by now most people have decided where they stand regarding the vaccine.  Most of you have made it abundantly clear to me whether you feel this virus to be serious or not. Many of you have discredited me and my fellow medical professionals by disregarding our first-hand knowledge when it comes to the pandemic.  I know that everyone isn’t in favor of getting the vaccine.  That is fine, too.  Just know that you are rolling the dice with your life.  I truly hope you win.  Many who are taking that chance are not as lucky.  How do I know this?  I know this not because I am reading Facebook articles or even scientific journals to gain my knowledge.  I know this because I am seeing it with my own eyes.  I am fighting it with my own blood, sweat, and tears.  I know this because I have seen patient after patient and friend after friend die from COVID. And I know this because out of all of the people that I have seen who have died or have had serious complications from this virus have only one thing in common: They were not vaccinated.  So, for those of you who have drawn a line in the sand against the vaccine, I would challenge each of you to reexamine your reasons for drawing that line in the sand.  It just might be that we have learned enough in the past 2 years to actually warrant revisiting the idea…and who knows?  The life you save might actually be your own.  

For Brian...

I am sitting in the waiting room adjacent to the covid ICU. I shouldn’t be here, I’m not allowed. But I am here. That’s what you do when your friend asks you to show up.

It’s been almost 9 months since this pandemic began to run our lives. Nine months of mask wearing and debating. Nine months of sifting through new guidelines just to resort back to the old ones a few weeks later. Nine months of watching people rip each other apart over whether or not to believe science.

Today I am sitting in a waiting room next to the COVID ICU. A room that is filled with couches that are pushed to the side, elevator doors that are blocked, bins with reusable gowns, extra ventilators, intubation equipment, and the recycled PPE of the staff... Earlier an excited nurse came in. She began digging through dozens of paper sacks on an industrial wire rack. She had been looking for about 5 minutes when she snatched a paper bag and said, “YES! Thank goodness!” She then remembered that she wasn’t alone and turned to look at me explaining that she had just remembered that she put her OTHER N95 in this room in September, that her current mask was beginning to get fuzzy and she had been inhaling fibers all day...
I am sitting in what used to be the waiting room of the covid ICU. I am sitting here because one of my dearest friends is finally being allowed to visit her father. He’s been alone in the hospital since the last week in October. He has COVID pneumonia. He’s in his mid 60s and has a history of some lung disease. People feel so relieved when they hear that...mid 60s...preexisting health conditions...those two things make the average person feel safe. It leads them to believe that because they don’t have any health problems and they are 20 years younger, they are in the clear. I hear so many people say so many ridiculous things. “Everyone’s going to get it eventually, we might as well just get it over with”.... “Masks don’t help”... “This disease is a government hoax”...”It’s only dangerous for the elderly and those with underlying health conditions”... or my personal favorite, “When it’s my time to die, it’s my time to die.” 
It’s funny how brave we are about death and dying until it’s something we are actually faced with. When we are under the impression that we have all of the time in the world, time doesn’t matter. However, the minute that we find it slipping away we begin to regret the time we didn’t spend wisely. 
I am thinking about this while my friend is sitting next to her father in his ICU bed. She is holding his hand, trying to say things to help him fight. He hears her, I believe that. He is intubated and on a ventilator. He has tubes protruding from his chest and his face. He is swollen from IV fluids and steroids. But he hears her. He can’t speak or squeeze her hand but he feels her holding his. He feels her and he is loving her back. I know this because I know him. THIS family knows that COVID is real. THIS family knows the pain of separation in a time when closeness is needed. I have painted a picture of my friend’s dad for you...A picture of a 66 year-old man with lung disease that is now fighting for his life in the ICU, but that isn’t who he is. This is a 66-year old man who still holds a full-time job in healthcare. This is a man that sees his family, swims with his grandkids, plays jokes on people around him, and makes the world a better place. He has devoted his life to the people around him. He is active. He is healthy enough that you probably wouldn’t even know that he has underlying health issues just by looking at him. This is a man that came to visit my son in the hospital more times than any other person in our lives did. He prayed with us. He laughed with us. He called and texted frequently. THIS is the picture you should have of him in your mind. He is not feeble. He is strong. He is my friend. If it wasn’t for COVID, he would still be doing all of these things. COVID has taken all of these things from him. I hope he can get those things back. I PRAY he can get those things back. Only time will tell...
I guess my current take-aways from all of this are that time is precious and COVID is real. Do what you can to find a balance between living your life to the fullest and taking the precautions needed to prevent the spread of COVID to your fellow man. Whether you like it or not there has to be a happy medium somewhere in between reckless and recluse. Please be safe out there. We have got to find a way to navigate through this together..our futures depend on it.

Exhausted.  Overwhelmed.  Belittled.  Mocked.  Contaminated.  Doubted.  Unimportant.      Sacrificial lambs… Nurses went from Hero to Zero in 3 months.  Before the “Political Agenda” went viral, nurses were seen as heroes willing to put themselves at risk to help save the lives of all patients, including those with COVID-19.  We were hailed as some of the most insightful, caring people on the planet.  We received calls from friends and families asking for our professional opinions. We had people stopping by for house calls and assessments.  We were respected.  Who would have thought that all of that would change the minute we asked you to wear a mask?  A mask.  A stupid mask.  Why is there so much doubt over the efficacy of masks? Five months ago, if your surgeon would have presented herself to you before your surgery and proclaimed that she and the rest of the OR staff weren’t going to wear masks during your operation, you would have cancelled your surgery.  You would have said that they were putting your health at risk by not wearing face coverings while they were cutting you open.  You would have reported them to hospital administration and the department of health.  But the minute a politician tells you to wear one in the interest of infection control, a mask is no longer something to keep you safe.  That politician asked you to wear a mask because the medical community urged him to do so. That little mask is the answer to reopening our economy. Unfortunately, a mask has now become an area of contention.  A mask is now a way to control you. A mask is now an infringement upon your constitutional rights.  

How many laws are already in place for the greater good? Driving while intoxicated…Seatbelts…Vaccines…Attending school as a child…Catalytic converters… The list could go on and on.  But wearing a mask during a pandemic seems to have pushed everyone over the edge.  All of these stupid, fake articles on social media have turned everything upside down.  

If I hear one more proclamation that the death rate isn’t high enough to warrant all of these precautions, I might scream.  There are fates much worse than death.  This virus is taking away people’s lives even if they aren’t dying.  I know a 20-something RN that contracted COVID while caring for patients.  Yes, they are alive, but they now need a lung transplant. Of course, they will never get one because many of you think that every single death is being counted as COVID-related and thus there will be no applicable donors from which to get the lungs. (People with infectious disease cannot donate their organs.) Do you see how ridiculous that sounds?

Every day I read posts about people refusing to wear masks. The interesting thing is that soon after, the same person is posting about a medication their doctor has placed them on for blood pressure or cholesterol.  Why is the medical community trusted on one hand but not the other?  It is truly maddening.

I wish that politicians were able to stay out of the business of healthcare, but they can’t.  We cannot rely on the decisions of our fellow citizens to keep us safe.  Apparently, it isn’t enough to know that YOU wearing a mask can prevent ME from getting sick. That just seems so selfish to me.  I would personally do anything that I could to keep you safe.  I love my fellow humans.  I used to love being a nurse. These days it seems harder than it should.  My face is tired of being covered at work.  I can’t speak.  No one can hear me or understand what I am saying.  I cannot truly make that human connection that I so crave through my practice.  It’s difficult to assess my patients because I cannot see their faces.  I now have to act as sole emotional supporter for my patients.  (They don’t have their family at the bedside, reassuring them, supporting them.) Nurses are the ones filling in those gaps.  We are being pulled at from every angle while at work.  We have to wear gowns that are essentially shower curtains with ties. We sweat all day.  We have doctors that won’t enter patient rooms because they don’t want to be exposed.  Nurses don’t have that option.  

After work, it is impossible to escape the backlash from our acquaintances, friends, families, and the media.  Everyone knows more than we do.  Everyone is now a nurse, a doctor, an epidemiologist, a fact-checker, a protestor, a lab technician…everyone knows a friend of a friend that got a positive test result but was never tested.  (Insert eyeroll)  On that note, please let me inform you that people are absolutely still dying of cancer, heart attacks caused by cardiovascular disease, trauma, and strokes.  No, the medical examiners aren’t padding the data by labeling all deaths as COVID. That is completely ludicrous.  If they were, can you imagine how high the death rate would actually be? There are roughly 8,000 deaths each day in the US alone. That would be approximately 1.2 million deaths since March caused by COVID in the United States.  I urge you all to try to find a balance between conspiracy theories and truth. 

People want definitive answers about this virus.  The sad thing is that we really don’t have any answers.  We don’t know how to treat it.  We don’t know what the final repercussions will be for those who have contracted it.  We don’t fully know how to prevent it from spreading.  The important thing to know is that we are working around the clock trying to figure it out. Please be kind to us during this grueling process.  It is personal to us and it is personal to us because we are living it.  While you are sitting at home wasting your days on social media reading conflicting articles, we are watching this all unfold first-hand.  While you are worrying about a face-covering, we are watching people suffer with each breath like a fish on the banks of a river.  It is not a hoax.  It is real.  Please be patient with us.  We will figure it out. Until then, my prayer for you all is that you keep yourselves safe. My prayer for you is that your only contact with COVID is through your social media platforms.  

Sorry to infringe upon your constitutional rights.  I just wish you would wear a mask…But hey, if you don’t and you end up as one of the critically ill, so be it.   Guess who will be there to hold your hand through it, pray for you every day, and do everything in their power to give you the treatment you need to survive…Your Nurses.  

“Nurses should chart in the patient rooms.  Nurses should leave the computers at the desk for the doctors. We need to limit their (Doctors’) exposure.”  -ER Doctor

“For the first time in my career, I’m not proud to say I am a nurse.  I feel belittled and mocked.” - RN

“Healthcare professionals are not alarmists- We don’t want you to get sick.” -RN

 “You’re afraid of a virus so you want me to wear a mask?” -Anonymous

 “It’s none of your business if I wear a mask or not.” -Anonymous

 “Wake up people.  Masks aren’t filtering the virus.  The particles are too small.”- Anonymous

 “I have never hated being a nurse until now.”-RN

For the past few months I have been reading and listening to everything I have been able to get my hands on in regards to COVID-19.  I have read medical studies,  looked for trends in lab results,  listened to doctors, and literally have learned everything I can learn from reliable sources.  Having said that, I am no expert on this crazy virus.  I still have so much to learn, we all do.  The one thing that I keep coming back to over and over again is the complete division it is creating in our world. People are angry.  People are scared.  People are confused.  People don’t know where to turn for the answers.  From speculations that numbers are skewed to the government wanting to microchip everyone,  the conspiracy theories are running rampant. 

I have watched so many videos that were uploaded to the internet…videos in which people pose as experts and make claims that play on people’s emotions.  A few days ago I watched a video where a “nurse practitioner” (she didn’t give her name) said that her friend, a “nurse” (she didn’t give her name, either) said that the hospital she worked at (she didn’t give the name of that hospital) was just letting patients lay there and die…she claimed that they were “murdering” patients.   She said that the hospital was refusing to give life-saving medications (surprise, she didn’t tell us which meds) and other treatments (again, no specifics given) and that patients were so critical and that the doctors weren’t even bothering to gain consent for emergent procedures. (Newsflash- in an emergency, doctors don’t have to gain consent, they do what is right for the patient)  I also watched the hour-long video where two doctors claim that this virus is no worse than the flu. (Pretty irresponsible for them to do this…especially because they can be immediately discredited by the facts that their urgent cares were failing due to the stay-at-home order and thus they had financial ruin in their immediate future, not to mention that one of the doctors isn’t even a Board Certified Physician)  However, so many people gave them 100% credit because they are doctors. Why? Because those doctors were saying what so many of us want to believe.   None of us want to be social distancing.  None of us want to wear masks.  None of us want to believe that a virus could take out hundreds of thousands of people across the globe. None of us want to be inconvenienced in any way whatsoever.  That’s why it is so easy for us to listen to the naysayers regarding COVID-19.   Yesterday I watched the video of some attention-seeking doctor that was essentially kicked out of the medical community for falsifying studies and tests. The sad thing is that people are actually believing what she says.    In my eyes, she is a waste of good, clean oxygen.  People who knowingly place others in harm’s way are literally doing the devil’s work for him.  She is no better than a drunk driver.  (I am also a little creeped out that she looks like Carole Baskin.)   

I have heard people saying that most patients aren’t “that sick” and that this virus is no worse than the flu.  This is partially true although it is much worse than the flu.  But wow.  Just wow.  When they are sick, they are SICK.  I have been a nurse for longer than I would like to admit.  I have always worked in inner-city ERs that see thousands upon thousands of patients each year.  I have only seen a handful of influenza patients that are as critical as the “sick” COVID-19 patients we are taking care of.  IT IS NO JOKE.  Pronating patients who are on the ventilator? What kind of madness is this?  It is bad, people.  I cannot tell you with enough passion…THIS VIRUS IS REAL.  I can also tell you that hundreds of thousands of people are walking around with CHF, COPD, and countless other diseases.  Those people are living full, productive lives.  If they contract COVID and die from it, THEY DID NOT DIE FROM CHF OR COPD.  THEY DIED FROM COVID.  If it weren’t for COVID, they would still be leading productive lives with their underlying health conditions.  I just don’t understand the disconnect with this subject.  I do know that when you make light of this virus, it feels like a slap in the face to those of us dealing with it in our lives.  Whether it be medical professionals or loved ones of those who have succumbed to the virus. 

I am also a little tired of hearing how Bill Gates is responsible for this virus and that it was released from a lab so that he could make millions from the vaccine…or microchip us…whichever version you want to believe.  (or maybe both?)  I don’t know if you guys realize this but Bill Gates is a capitalist.  He is a brilliant mind who has served himself well.  It is no surprise that he might seize the opportunity to invest in something that might bring him millions of dollars in revenue.  Why is that a bad thing?  The virus is real.  We need a vaccine.  We need someone to fund the research behind the vaccine.  I really don’t care how it gets here as long as the vaccine gets here.  Vaccines don’t cause autism.  Vaccines save FAR more lives than they cause harm.  You don’t want the vaccine?  Fine.  Don’t get the vaccine. I don't think the government should mandate this vaccine.  I am actually thrilled about how many people are now on board with "MY BODY, MY CHOICE".  (I have been arguing this point for decades.) Let me repeat myself...Get the vaccine or don't get the vaccine. But you can bet your bottom dollar I will get it, my husband will get it, my children will get it…hell, even my dog will get the vaccine if the DOCTORS and their PEER-REVIEWED RESEARCH says we will benefit from it.  And guess what? That beautiful vaccine will allow me to doff that PPE for one final time in regards to this god-forsaken virus… I.  CANNOT.  WAIT.  

Moving on to censorship…Yes.  YouTube and Facebook have removed several videos that “don’t meet community standards.”  This has people in an UPROAR.  Is this censorship? Maybe.  The disconnect comes into play when you consider that both of these are companies owned by people and not by the government.  The videos they are taking down are videos in which people are posing as “experts” and influencing those of us who aren’t sure where to turn.  They are preying on our fears and our lack of knowledge.  They are speaking to us in terms we can understand.  They are saying exactly what we want to hear and we are collectively giving them their 15 minutes of fame.   I pose this question to those of you bothered by the removal of their videos…  Which side of the argument were you on when a private business owner refused to bake a cake for a gay couple who was getting married? For me, that was a hard one.  While I support a business owner’s right to operate their company as they see fit, I do not support discrimination.  I also find it ludicrous that anyone would want to provide revenue for a company that doesn’t support their personal beliefs.  (Disclaimer:  I fly my rainbow flag high in the sky.)  Don’t like the fact that FB and YouTube remove videos?  Remove yourself from YouTube and Facebook.  Quit supporting a company that you don’t feel supports your right to free speech.  I mean in all honesty, both of those platforms are robbing us of true-life experiences anyway.  We scroll through social media and watch videos in lieu of spending time with those we love.  We are wasting precious time and there is no one to blame but ourselves.

I don’t know where we will all end up after COVID-19 is finished with us.  What I do know is that I applaud those of us who have given pause to all of this governmental control. There have definitely been negative impacts from the shutdown.  Companies are failing and families are suffering financially.  It is horrible.  I do, however,  think it has truly helped us to better prepare for the impact of this virus.  We have learned more.  We understand better how to care for the critically ill.  We have since learned that this virus isn’t airborne transmission and is instead droplet transmission.  (WHEW)  We are more aware of infection control in general which makes me happy.  I am also happy that we are reopening our state.  I hope that we can do so with caution and intelligence.  The truth is that COVID-19 is here to stay.  We cannot stay shut down forever.  But let’s take this opportunity to make a commitment to each other…Let’s take this opportunity to be better, to do better, to communicate better, to seek understanding better, and to look to actual experts for guidance.  Yes, you can get lost in all of the speculations but that is exactly what they are…speculations.  I for one hope I can look back on all of this and be forced to make a public statement regarding how wrong I was about the severity of this outbreak.  I don’t think that will be the case but I assure you….No piece of humble pie will have ever tasted so sweet.