I can’t sleep anymore. When I close my eyes in the dark I hear the alarms. The constant noise of the monitors soft beep warning me that the patients oxygen level has dropped below 85% despite intubation, sedation, paralytic, FiO2 of 100%, PEEP of 20, nitric at 40 ppm, and proning. The insistent beep that the blood pressure is low and I need to add another medication to force the tired body to perfuse organs that need oxygen to work. The R2-D2 noise of the CRRT warning me that I need to attend to the machine working as kidneys. The scream of the ECMO ( the machine bypassing the lungs and heart)has an altered flow. The beep that is the IV pumps warning me that the medications need to be replaced or that the IV is occluded or there is air in the line. The gasping of the patient in the next room on maximum bi-pap setting. The begging to not let them die. “I can’t breathe. Please save me.” “I am right here with you. We are going to do everything we can do help you. You are going to go sleep now and we are going to put the tube in.” The phone conversations with loved ones and the tears via the phone. “Your loved one is not doing well. We are doing everything we can to keep them with you.” The organized chaos and noise as we crack ribs, push medications, shout times and medications, the noise of the defib powering up. The FaceTime,”You told me you would fight please don’t give up. You promised you would come home to me.” The silence as we turn off all the machines. As we silently mourn a life passing. I can see all their faces. I carry them with me. All the hands I held. All the times I said, “You are safe. We are going to do our very best.” The images and sounds torment me now as we head down even further into this pandemic. I am not the nurse I was before March 2020. I am not the person I was. Death walks beside me now. We lose more than we win. We went from 1-3 deaths a month to 1-3 deaths a day. The ghosts haunt me. In the quiet dark I remember and I am haunted.
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