A young nurse who never envisioned herself working in disaster circumstances during a viral pandemic was forced to reconsider her career path once the strain of providing care became too much, just one example of the toll that COVID-19 has taken on healthcare workers.
Hannah McSwain, 26, started her career in nursing in 2017 at AdventHealth Tampa hospital, where she worked as a team leader in the progressive care unit, an intermediary step between the intensive care unit and a general medicine floor where patients still need a high level of skilled nursing care. In spring 2020, the PCU was converted into a COVID-19 unit, one of seven in the hospital, and McSwain was tasked with leading her team of nurses through the daily rigors of caring for patients who often would not leave the hospital with their loved ones.
Just as her husband and parents began to worry about her emotional well-being after two pandemic surges, McSwain noticed changes in her coworkers as well.
“Other people tend to notice a difference in your personality before you notice it yourself,” McSwain told the Washington Examiner. “My coworkers that I worked with every single day in the COVID unit … it started to get to where the look in their eyes, just nothing was behind, no passion for what we were doing. The weight of everything just was building and building.”
The transition to working in all-COVID-19 units was supposed to be temporary, she said. McSwain had not anticipated that she would have to work in a series of disaster scenarios that would force her to reconsider her career in nursing. Prior to becoming a registered nurse, she was a patient care technician in a nearby hospital where she never imagined such gruesome scenes as those that became so frequent and traumatic in 2020.
McSwain began her search for a new position in late spring just as the rates of new daily cases in Florida began climbing rapidly ahead of the summer surge. Florida’s Department of Health has never published data showing the number of patients currently hospitalized for COVID-19, but data collection by the COVID Tracking Project shows that new hospital admissions reached a record high with over 9,500 new patients in July before steadily declining through mid-October.
McSwain and her coworkers enjoyed relative but short-lived calm in the early fall before learning that their units would be converted for COVID-19 care again, news that hit her “like a wave of emotion.” She noticed a change in herself almost immediately upon returning to work as a COVID-19 nurse when a patient died of the disease that same day.
“I was really surprised by my emotional response to that, just because after the first wave, we had really seen a lot of death, and you get kind of acclimated to the process of dealing with that and speaking to families,” McSwain said.
She added that “after not having done it for a couple of months, and then, all of a sudden, you’re doing it again, it was almost shocking — the emotional response that myself and our staff had as well.”
The passion and drive she and her coworkers usually felt in their jobs disappeared, McSwain said. The constant conversations with families about their sick relatives who likely would not survive off the ventilator, the growing daily death toll, and the persistent “cloud of negativity” over the unit contributed to her increasingly depressed moods.
“We have very limited ICU beds, but it ended up being as though like the staff on the PCU floor would have to then help the family members deal with the probable, very soon loss of their loved one. We almost feel like we’re hospice nurses,” McSwain said.
She began to isolate herself on her days off and found it increasingly difficult to communicate with friends and family members about the emotional toll her job was taking on her.
“I would come home and not really have any motivation, even on my off days, to try to socialize with people. I wouldn’t really have the energy to reach out to people that I used to talk to and all the time, which was concerning for them,” she said.
Several of her fellow team leaders have also sought out new positions in the hospital following a traumatic year treating COVID-19 patients. One of McSwain’s coworkers similarly experienced a growing depression that left her spending most of her days off crying and unable to leave her bed. She left her position in the PCU earlier than McSwain did.
McSwain begins her new nursing position this week, where she will work in the post-cardiac surgery step-down unit where patients are cared for after undergoing serious heart surgeries. While she feels a sense of relief now that she will not be in direct contact with COVID-19 patients, McSwain said leaving her previous post brought up “mixed emotions” after months of bonding with her fellow team members.
“You’re kind of soaking in everyone’s anxiety and fears, not only the patients but the staff,” she said. “And if you don’t have a good outlet, somebody to talk to you about it, it just sits on you, and you hold it, which can be really unhealthy after a while.”
To date, more than 24 million coronavirus infections and nearly 399,000 deaths due to COVID-19 have been confirmed in the United States. Last week was the deadliest so far, with states reporting more than 25,200 fatalities, 25% more than in any other week since the pandemic began. Deaths are ticking up in the South, primarily along the Atlantic coast. Meanwhile, coronavirus-related deaths are on the decline in the Northeast and the Midwest, regions that were previously COVID-19 hot spots.