I have always wanted to write about the fascinating vignettes of Emergency Department life. This blog is my creative attempt to highlight the ups and downs of life in my busy ED. It is not just a room anymore, it's a department. It is the gateway to the scary world of hospitals. Despite the grim faces of nurses struggling with the increased volume of patients, we find time to celebrate humor and simple joys; this is how we survive.
Five years ago, on March 11, 2020, the World Health Organization officially declared COVID-19 a global pandemic. I remember the day as if it were only yesterday. The memories are vivid in my mind; the heartaches of losing friends and numerous patients leave an emotional scar in our hearts that will haunt us for the rest of our lives. The fear remains that another pandemic might come and change our world again.
I wrote this about my burnout:
At the beginning of April 2020, the Covid-19 pandemic burnt me out.
I remember waking up in bed, physically drained from a fitful sleep and emotionally shattered by the friends and patients we lost. I debated calling out sick that morning because I dreaded hearing the frequent overhead pages for the code team. For the first time in my long nursing career, I was at a crossroads I never thought I could ever be at; I thought of quitting. I wanted to run as far away as I could, away from dying patients, away from the heartaches. But I could not abandon my staff, so I stayed resolute in fighting alongside my courageous staff in that dreadful war.
Five years later, I feel privileged to be part of the army of healthcare staff worldwide who battled the war. Today, I browsed through the photojournals that chronicled our fight.
Yes, we survived. There was a light at the end of the tunnel. It was just taking one day at a time, putting one step ahead, until finally, the vaccine came, and later on, we finally took off our mask.
I am not the only one remembering that day. The burnout and the PTSD that followed were real.
Five years later, these are just distant memories for most. I know that for all the healthcare workers who struggled through the "war," it was an emotional and challenging process to move on to the new normal. May we all support each other as we learn from the past, and hopefully, we will not have to go through this again.I celebrate the resilience of these nurses and all those who continue to make a difference every day.
At the beginning of April 2020, the Covid-19 pandemic burnt me out. At one point, I was ready to quit nursing. I wanted to run as far away as I could, away from dying patients, away from the heartaches.
I remember waking up in bed, physically drained from a fitful sleep, emotionally shattered by the friends and the patients we lost. I debated calling out sick that morning just because I dreaded hearing the frequent overhead pages for the code team.
The Apex of this pandemic that we were preparing for came much too early. Doctors, nurses, and techs were running around responding to calls for intubations, desperately trying to race against time. We were all covered from head to toe with impervious gowns, face shields, double gloves, boots, and surgical caps; the N95 masks would later leave marks on our faces. The scars in our hearts were unseen, PTSD a real threat.
We were protected, we assured ourselves, but how could you be confident about how safe you are when the Covid fatalities keep on rising? The whole hospital (and the whole city) was in a pandemic chokehold.
It took a few minutes of deep breaths before I could summon the courage to rise from my bed. For the first time in my long nursing career, I was at a crossroads I never thought I could ever be at. I considered myself unshakeable. “Been there, done that; nothing can ever make me turn away from Nursing,” or so I thought.
That morning, I felt burnt out, but I went to work. To fortify myself, I looked up onto the heavens and whispered, “My Lord God, take charge of my life.”
ON THE FRONTLINE
The New York streets were empty. The City that Never Sleeps was in total lockdown since March, and only the essential workers were allowed to travel. Along the Cross Bronx Expressway on my way to work, what was once a traffic nightmare looked more like an apocalypse with nary a car nor a truck in sight for miles on end. Times Square was a ghost town. The silence was both eerie and deafening. I felt like I was going to war, but I was scared and helpless. I hated being vulnerable.
I was on the frontline but felt like a spectator. I was not actually at the bedside giving direct care as I wanted to be. The responsibility of being a Director of Nursing in an emergency department amid a healthcare crisis was overwhelming, but not more than what the ED nurses, techs, medical providers, and other ancillary personnel had to go through. I can only imagine the enormous impact of the unending crisis on their psychological well-being when their best efforts sometimes fail.
My nurses forbid me to go into the rooms, even to help prepare the bodies for the Morgue. They wanted me safe. I even joked that I was not that old, that I could fight alongside them. Just like in Imposter Syndrome, I felt inadequate and not quite pulling my own weight on the battlefield.
All I could do was make rounds, check on the staff, order supplies, request the Incident Command for more staffing help, coordinate travel nursing coverage, handle family complaints, and act as a cheerleader and emotional support for the staff. I followed up with my quarantined staff members for Covid exposure and illness. It was difficult to hear their anxiety and I feared that they could hear the quiver in my voice, so I preferred texting to phone calls.
I saw the patients come through the Triage Area, with no family members to sit by their bedside. The patients were whisked directly to the rooms with high-flow oxygen masks to aid in their breathing. I saw patients inside the isolation room as they lay with apprehensive eyes looking at their oxygen saturation numbers on the cardiac monitors.
I also remember the eyes of the ER staff beyond the masks and their face shields. Eyes that were sad and worried. Eyes haunted by the final goodbyes between the patients and their loved ones on the iPAD. Eyes filled with despair because of the unprecedented challenge wrought by the coronavirus onslaught. These were our darkest times.
I tried to be transparent with my information to the staff. But I grappled with what I could share. So, in my emails and our daily huddles, I talked about the nurse travelers coming in, the other non-clinical activities, and non-emergent procedures that were put on hold to deploy the staff to the ED and the other patient units. My news was upbeat and hopeful as I could possibly communicate to my already disheartened staff. I told them of the other surge capacity activities that the hospital leadership initiated to accommodate the influx of Covid-19 patients.
I did not share my concerns about the grim statistics and the dwindling supplies and equipment (since we compete with other hospitals for resources). I did not share that the Morgue was full and that there were Medical Examiner trailers on our campus. I did not confess that I wanted to quit nursing.
I did not want to stop and answer questions about my state of mind for fear that the tenuous hold on my fragile emotions would break. I did not want anyone to see me ugly-cry because of the sadness in my heart. So, I cried behind the doors.
My priority was that my staff would feel supported so they could take care of the patients who needed their expert help. I had to be the leader that they deserved. I learned how to look confident on the outside, although I was frazzled on the inside. I could not afford to be weak.
EPIPHANY: SELF-CARE
The staff needed mental PPE. We corroborated with the Mental Health Liaison psychologists, who offered counseling and other options for the team to de-stress, decompress, and start healing our broken hearts. My epiphany was that I had to do self-care. How could I help my staff when I was running on empty?
In my personal life, through all life’s ups and downs, I relied on my family and friends, my church, and my writing to endure. I knew I was strong enough to survive my personal travails, but I was unsure if I could remain a nurse amid the challenges that had brought down my other colleagues. I resolved to look for my joy triggers at work. I knew I had to heal myself first before I could lead others.
One day, one nurse asked to speak with me. That nurse broke down crying as soon as we got into my office. The words of pain and despair poured out, and the repressed emotions from the past months finally tumbled out. The nurse was not suicidal but was profoundly sad and depressed. We talked for a long time, but mostly, I just listened. I called one of the mental health counselors and arranged an emergency visit. Then, we hugged, and the nurse thanked me for listening, and for being there. I am glad to report that today, that nurse is now healthy and is thriving well.
FINDING MY JOY
Covid-19 would not be my downfall. Having witnessed the heroism and fortitude displayed by all healthcare personnel during these uncertain times made me realize how much I love the nursing profession. In my little way, I am privileged to have made a difference. That moment of indecision in my nursing career, that short period of burn-out, that temporary insanity is no longer. I have recovered my self-worth. I found my joy and my “why.”
What turned me around? What prevented me from leaving my profession? My healing came as I continued working as a nurse. I poured out my emotions into my daily journal, a catharsis to help me exorcise my negative feelings. My writing brought everything into perspective. Much as there were so many heartaches, I found comfort in our small triumphs. As a nurse, I was part of the army against this virus.
There were numerous things to celebrate. Let me count the reasons why we persevered:
The clapping and appreciation from the hospital neighborhood and other heroes like the firemen and the cops.
The outpouring of support from the community with unsolicited food deliveries (which both fed our bodies and our souls)
The staff working as a team and caring for each other
The staff comes in extra days so their peers will not work short-handed.
The deployed staff working in unfamiliar places and doing their very best to help
Dancing to the music “Call on Me” whenever a patient was discharged.
Getting a Thank You from a patient and his family
The staff rising to the challenge, despite the threat of Covid-19
The knowledge that every single hospital employee was doing their best under the direst of circumstances
The realization that we were doing God's work
I created a Facebook photo album of pictures from the staff to celebrate the resilient group that they are. It was a way to pay tribute and highlight this particular group on the frontlines of this war. I wanted to preserve in posterity the faces of the brave ones who came to fight the battle against Covid-19.
The FB photo album grew into a photo journal. It was to chronicle the moments of levity captured in-between moments of heartbreak; just before they rush back to the unit to save more lives. Frozen in time, the pictures showed the ED team taking a much-deserved break, a respite from the hard work. Just a little breather. There was a spirit of camaraderie, of having bonded as we worked together. As time went on, the staff started to SMIZE, they smiled with their eyes.
These healthcare workers, heroes of my time, were simply inspiring.
Last May 2020, the hospital managed to celebrate the Year Of The Nurse creatively despite the constraints of social distancing and face masks. We danced on the streets, gave out cookies and cupcakes, published our virtual nursing journal, enjoyed the gifts from numerous sponsors, and were treated to an aerial display from the US Air Force and the Navy. The festivities were a harbinger of hope that we would survive. The end of the pandemic would come. And then we prayed for the vaccine, our fighting chance.
In 2022, the American Nurses Association chose the theme, “You Make A Difference.” Nurses in all disciplines and sectors truly matter as we give our patients a chance for a better life. Every Day. Our strength is rooted in determination and dedication to serving those who need help and fortified by the challenges and disruptions of the past years.
Like every single nurse standing strong despite being bruised and shaken by our pandemic ordeal, I am still here. I am proud to be a nurse.
The past year affected all of us in immeasurable ways. What began as a promise of recovery from the horrors of 2020 with the Covid-19 vaccine fizzled out, like a New Year’s Eve sparkler dying out. In January 2021, I was hopeful that I would be able to travel soon to see my family in the Philippines. It was not to be. The US is on its 5th Covid wave with Omicron threatening to infect one and all.
As I prepared for our church’s Year-end Thanksgiving for 2021, I cleared my mind in grateful reflection. I can proudly say that I am blessed. Last Dec. 25-26, the Church of Christ (Iglesia ni Cristo) members celebrated our year-end Thanksgiving in person, instead of on Webex as we did last year.
INC Hymn #134
Oh my Father, I now deeply meditate
On the blessings, You give day by day
Truly You have never failed to care for me
And You provide my every need
It is my duty, Lord, to praise and worship You.
Ever worshipping your name faithfully;
It is my duty, Lord, to offer all to You
Oh, the very life You give to me.
Despite this year being still challenging in many other ways, there is still so much to be thankful for.
The Gift of Life
Family and friends
Work
My new book
For all these, I am thankful.
I am grateful to be an educator and a nurse leader.
When I left my previous job and started another journey, I was extremely gratified by the overwhelming support and love from my nursing staff, as well as all those who I have worked with. Their words are precious to me and have given me strength, inspiration, and determination. Their validation of my work meant to me more than I can ever express. I will forever hold them close to my heart.
I would like to share some of their thoughts:
“You have been an exemplary role model for me. Many times over the past year, I have felt overwhelmed and hapless. You were always available to listen to our complaints- even when you knew that there was nothing you could do. You displayed continuous optimism, even in the midst of what seemed like a never-ending nightmare during the COVID peak last year. You are the primary reason that I kept coming back to work and picking up extra shifts when I could. Thank you for that.
You will be the standard that I will compare others to in the future. I hope that wherever you go, you will continue to show others the light when it seems so dark.”
“Thank you for everything you have done for me and the department. You were with us every day fighting on the frontlines as we fought our first pandemic. Your encouragement and support helped me get out of bed in the morning to come to work. Although I was scared every day coming to work while pregnant, I always knew you were there to support me. For that, I will always be grateful.
You always encouraged us to be the best version of ourselves and to further our education. I always enjoyed your CEN questions in your weekly email, an email I looked forward to. I appreciated your transparency on department initiatives and staffing. I always knew you were fighting for us every day. You were an extraordinary leader and I hope one day I can strive to be a leader like you."
“I feel so lucky to have had you throughout the pandemic, We could not have done it without you.”
"Please know
how grateful I am that we had you as our leader, especially this past year. I
will never forget you."
New nurses: passing the torch
Today was the last day of class in 2021 for the new graduate nurses in the nursing residency program that I was consulting with. Knowing the challenges that they will be facing as they start their career as ER nurses, I shared with them how I survived the psychological land mines in a complicated but emotionally rewarding profession. In a way, I felt I was passing the torch and I felt compelled to encourage them as much as I could.
Gratitude journal. Finding my joy. Work-life balance. Self-care. Knowing that I made a difference. Sharing my love of nursing. Grateful meditation. All these fortified me and kept me standing through the years.
I asked the new nurses to reflect on what things they are grateful for. They recounted those special moments when patients thanked them for their compassionate care. Some even said that even if their patients forgot to thank them at times, they feel empowered to have made a difference in their patients' lives. It was an emotional exercise for all of us, and I tried to hold back my tears. I am proud of them.
They ALL expressed their gratitude for the opportunity to serve as a nurse, despite this Omicron threat and the short-staffing.Then they thanked all the other instructors and me for guiding them and preparing them for this career.
Hearing the words of praise from these new nurses was a gift I didn't know I needed to hear.
Here comes 2022. Happy New Year, everyone. Be safe. God bless.
Today is a moment of reflection for all of us. I wrote this in my journal, not knowing that Covid would still persist as a menace a year later. The loss of lives is still staggering and so emotional. Two more losses, one was an agency companion/sitter at work and another a church member in the prime of her life. When will this end? I did not expect to hear sad news so close to home when we're almost on the home stretch.
Today, we gathered in the Resus Room to pay respects and
remember our co-worker. Although she was not an MSM employee, we claimed her
as our own because she was assigned to the ED for 4 years. June was an agency
employee sent to watch patients who were emotionally disturbed, suicidal or
patients who are Fall and elopement risks. It was not an easy job; the patients
were challenging, but she persevered and tried to help as much as they could when she was sometimes sick herself.
The room was filled with nurses, techs, and other ancillary
workers. It started slow but soon the staff was sharing their memories of her.
The chaplain led us in prayer. It was difficult to hold back the tears because
I did not think that one year later, we would still be mourning the deaths of
people we know. I didn't know that I needed the hug. The staff had a good cry then we dried our tears as we went
back to work.
This second wave of Covid was not as intense as the first
wave, but what is unrelenting is the slow road to recovery. Maybe it is our
impatience to return back to normal. Maybe it's the frustration that people
still die, despite everything we have learned.
One year later, my son is still safe and we have been indulging in our food trips, mask, and all. My 90 y/o mom is socially distanced in our home, with all her needs catered to by my family. We did her birthday celebration via Zoom on February 14th. And I had my vaccine.
In reflection, I realized that coming out of this terrible
period is doable. There is light at the end of this tunnel. We have to take
care of ourselves, still seek those things that give joy to our lives, hold on
for those moments of triumph, celebrate the lives we have saved, give thanks
for the science of the vaccine, and rejoice for the grace and blessings of
having survived through it all. Simply put, just keep on hanging in there. I
look forward to the future of hope.
Alicia Keys’ “Good Job” By
One Voice Children’s Choir
Nurse Jess entered the Emergency Department with her
trademark walk, hopping with every other step, swinging her arms as she went
straight to the Charge Nurse Station. As the Director of Nursing, she could
have just looked at the dashboard on her Mango watch/minicomputer/phone to see
the unit metrics. But she likes being in the middle of the action. Besides, her
usually unflappable charge nurse Mae seemed a little bit frazzled as she
answered her Comdevice, and mumbled something about “Remember 2020”.
Jess entered the ED where she had been a nurse for 20 years,
the last two years as the much-respected nursing director.Finally, they are in the new ED wing, a
state-of-the-art facility. Thanks to the generosity of the family of a
prominent New York trillionaire. The 78-year-old man came in with a broken
femur after a nasty fall but was so impressed by the efficiency of the ED
staff before he was whisked to the OR. He lingered on just in time to say his
goodbyes to his family, but he made them promise to build a new ER. And the
family donated billions of dollars to create an ED well-suited to meet the demands
of a new Covid19-like crisis. No more hallway patients, every patient in their own private room with some amenities like a tv, electronic patient tracker, and a nurse-call device.
Jess outfitted in the hospital-mandated IRC (Infection
Repellent Clothing) for this new disease outbreak from
Texas. The Tyvek 3rd edition suit is very light with its own
breathing apparatus the size of her hand. Her face shield mask is clear and
does not fog nor suffocate. The plastic material covers her entire face and
connects to the Tyvek suit itself. Thankfully, this new disease is not anywhere
as virulent and as overwhelming as COVID-19. A shudder went through Jess’ body as she
remembered the year 2020, the Year of the Nurse which nobody ever anticipated
to turn out to be a nightmare year for every healthcare worker. In the year
2030, it looks like they’re in a repeat of 2020.
Last month, ten years ago was a distant memory, relegated to
the hospital archives. Right after the nth ZoomstatCom meeting with the Infection
Control Czar last week, the hospital leadership went into UltraPreparedness/Response Mode. The Incident Commander declared in his
authoritative voice, “We are now in ICS level 2 and we expect to be in Level 3 soon.”
After the meeting, she scrolled back on her personal online blog
to look for her Covid Diaries. In 2020, the ED was declared an endemic area.
Ground Zero or more accurately, the war zone, for the hospital as the patients came in gasping for breath and the ED staff rushed in to fight for the patients to survive. The
staff heroically stepped up to the plate, buried their emotions, and proceeded
to take care of the patients. It was a whole year unlike any other that no one in
his right mind would ever want to go back to. In one of the Covid-19 memes, The “Back
to the Future” Emmett Brown admonished Marty McFly not to ever go to 2020 with
his time travel machine.
Jess did not have to peruse the blog to relive the memories.
Her heart ached in remembrance. She thinks she had some form of PTSD from that
event, just like some of her colleagues. Thankfully, she was able to draw
strength from her family and friends, as well as from her ED work family. Going
through Covid hell proved how resilient healthcare workers are.
“Thank God, you’re here!”, Mae uttered in relief. She was
still in nursing school when Covid-19 exploded. She heard terror stories from
all the senior nurses, but now, her wild-eyed look resembled what Jess' 2020
nurses looked like. There were still several of those bad-ass nurses around; their eyes are calmer now, their experience during the Covid war gave them steel of nerves, and today, they serve as inspiration to their younger colleagues.
Jess swallowed her fear and made sure her smile reached her
eyes above her mask. As the nursing director, she had to be a tower of strength,a source of truth, a comforting presence, and a
purveyor of hope. Even if she felt a little apprehension as she saw the electronic
dashboard in the Nurses' station with the throughput metrics and unit statuses highlighted
in Red. It has not changed through the years, we still use the Red Surge as a common language that the ED is in crisis.
Dr. Johnson sauntered to the Nurses’ station. Like Jess,
Brad experienced Covid-19. He wore his veteran status with honor, which in a
way, comforted his fellow doctors. Jess and Brad are ten years older now, wiser and toughened by their experience. Jess consulted with Brad and they decided to
call a unit huddle.
Mae’s voice crackled over the staff’s Communication devices
that were clipped on their scrubs. Except for those currently involved in a
patient’s care, most of the unit staff gathered in the 5-bedded Resuscitation
room. Unable to maintain physical distancing, the nurses, doctors, techs,
pharmacists, registrars, environmental services members, transporters,
respiratory therapists, case managers, and even the paramedics attended the
huddle.
Brad addressed the whole staff, “Ladies and gentlemen, we
are at this point of declaring the ED as an endemic unit. Meaning, you will
have to be in full PPE when you enter the ED door. Don’t give me this crap that
you cannot breathe because our masks are a hundred times more comfortable than we
have in 2020. We cannot afford to have some of you out sick. Use your PPE”.
Jess addressed the staff. Knowing that everyone is compliant
with the Covid and flu vaccine, she proceeded to tell the staff that another similar
mRNA vaccine is being tested by the scientists. There will be some protection
from the Covid vaccine, but this new vaccine will be specifically targeting
this new disease called Joslin30.
Jess reviewed the surge and escalation protocol. Although
the NEDOCs score is high, all the patients are secured in their private rooms,
most of which are with negative pressure. The patients have their own
sophisticated TeleFam monitors to connect with their families remotely. Visiting
hours were suspended except for special circumstances. The newly-reorganized CDC
Fauci organization issued a much-vetted Joslin30 treatment algorithm which is
immediately started in the ED. The point-of-care Joslin30 screening test is
top-of-the-line accurate with a one-minute result time. Additional medical and
nursing staff reinforcement from the National Medical Guard will be in the ED
in two days. Supplies and equipment, and most importantly the ventilators are
well-stocked. Three additional hospital units are being prepared for additional
patients and will be available in a few hours.
As Jess relayed all the updates, she could see the staff
visibly breathing in relief. They needed to hear the updates; needed to hear that no patients have died so far, and that patients are responding to the aggressive drug cocktail. Jess herself believed that the world is much better prepared for this new challenge. They clapped at the end of Jess’ summary of the ED
status. She brought them hope and confidence that this crisis will soon pass.
“This is 2030, not a repeat of 2020. This time, we have an
intelligent and responsible President who does not quarrel with her own
Infection Control chief. This time, the science we trusted in 2020 is bringing us a new vaccine soon. This time, the government officials are on the same page. This time, our hospital is prepared for all eventualities. This time, we
will get through this in just a month or so. Thank God, this is not 2020.”
This is not just my story. This is also a snapshot of my department's journey through the horrors of a pandemic, with all the heartaches and the small victories. Nobody comes out of this war unscathed.
January 1, 2020
This will be a good year. This is the Year of the Nurse.
January 25-
China is far away; the danger of the coronavirus that devastated Wuhan is far away. (Or so, I thought). The hospital cautions us to prepare but there is a general sense that it’s just like the FLU. The CDC says that the Flu killed more people than the Wuhan virus. I thought we were safe here in America. Hey, even POTUS downplayed Wuhan. Life goes on.
February 17-
The Novel coronavirus is here. The DOH, CDC, and WHO issued their guidelines. At triage, get the travel history, check. Ask the patient if he has a cough, fever, or upper respiratory symptoms, check. If they’re elderly, double-check. Mask yourself and mask the patient. Isolate. The Infection Control staff is overseeing our response. The algorithm was distributed to the staff. We got this.
February 28-
We received about three patients with fevers, cough, and positive travel history and they were just mildly sick. It’s not bad, I assured myself, I assured my staff. Who was I kidding? I was scared.
March 8-
What’s going on? The hospital is full-on in Incident Command mode. There is a frenzy of activities; meetings after meetings. Don and doff training. Write the standard work for Triage. Plan for Surge capacity. Look for alternate places. I requested more RN travelers and techs to help us out during the apex of the COVID patients.
The projection was that we have about 3 weeks before the patients who need the ventilators. Three more weeks to get the extra staffing and supplies. We need more N95s. I was assured that we have enough on stock but we might have to consider conserving the masks because the public is hoarding those masks. Hello? Mr. Q. Public, you are depriving the healthcare workers of the much-needed masks.
Oh, don’t forget to buy toilet paper. The Chinese factories are not manufacturing toilet paper anymore. The grocery shelves are bare while eBay sells the now-precious toilet paper at ridiculously illegal exorbitant prices. Hmmm, maybe buy a bidet?
Photographer- unknown
March 11-
The World Health Organization has declared COVID-19 a pandemic. Now reaching global proportions affecting 114 countries. The news brought a frisson of fear down my spine. I texted my family in the Philippines and instructed them to stay at home, to shelter in place, to keep my 89 y/o mother safe. I called my son who lives two towns away from me. I made him promise that he will work from home, that he should never leave without a mask, and that he should always wash his hands, He laughed at me indulgently and reminded me that he used to work in a research lab and that he, of all people, knows how to thoroughly wash his hands. He knows he has to self-distance and wear his mask every time he goes out. When we Face-timed, he jokingly rolled his eyes at me. He knows I'm just being a mom.
March 12- Fear. It is scary. Like going to the battlefield. We wonder,
"Are we doing this right? Are we
using the right PPE? Are we handwashing long enough?"
And yet we go to work. Every day. Despite our fears.
March 13-
It is good to step away from the hectic COVID-19 prep and planning activities (even for just a few minutes) to celebrate our Clark 8 Acute Behavioral Unit staff with a “Caught for being Great” citation from the amazing Physical Therapy team. As per the PT leaders Alicia and Helen, the Mount Sinai Morningside Clark 8 staff took the initiative to reach out to PT to borrow the patient lift device and get themselves trained on a machine that they never used in their unit before. The staff was so engaged and so receptive to learning new techniques to improve their disabled patient's experience.
March 14-
My email to the nursing staff: I know that there is not much we can say as we go through this COVID-19 crisis together. What I know is that the ED staff continues to give their very best despite the anxiety of the unknown. The emergency department itself can be chaotic and stressful. This is the nature of our work, and right now, your minds are probably spinning with the barrage of inservice, instructions, and simply the demands of being on the frontlines in this war. I just want to thank you for your amazing hard work and resilience. Thank you, thank you. If you have any questions, please do not hesitate to e-mail or call us (Anthony, Cynthia, Lauren, and I- even if you just want to vent). FYI, all the COVID-19 testing for our admitted PUI patients came back NEGATIVE, including the last one who went to the ICU (WR, 35 y/o male).
We are trying our very best to mitigate our current circumstances and ease your workload during surges:
1. We are in the midst of finding alternate sites to move those who are Worried Well and those with mild symptoms that can be treated and released quickly. We may be using the Heal Center and Clark 9 with non-ED staff.
2. This weekend, we are piloting the use of the Ambulatory Care Clinic to refer the ESI 4-5 patients to decant the ED, thankfully with their own Ambulatory Care staff.
3. For admitted patients, more Isolation rooms were created in 7West and soon in 7E ICU for critical care surges.
What we ask of you is for you to be nice to each other. Watch each other’s back and use the buddy system when you’re donning and doffing. If you can come in for OT, please let us know, even if just to relieve for breaks. More than ever, we need you to come to work. And because we need to care for our own selves, try to Plan Your Joy. We’re in this together.
March 15-
It’s a Saturday spent at work. The ED is getting overcrowded with patients worried about their symptoms, we have the worried wells, but there are more patients coming with respiratory distress. We opened the ambulatory clinic on the second floor with the physician assistants and ambulatory clinic staff seeing those with mild-acuity symptoms. The ED leadership had a nice plan on how we will surge up. We meant to start allocating some rooms for COVID patients in the Main ED for Phase 1, then will advance to Phase 2 with additional rooms that can hold the COVID patients, then Phase 3 using Peds and Eval. It’s only Saturday and we’re already in Phase 2. Out of the 30 boarders in the ED, only two were not COVID. Now we see patients presenting with abdominal pains and testing positive for COVID.
It was a long tiring day. I ordered pizza for the staff, and they all came running to the conference room. I sat down to eat my ham with pineapple pizza pie but did not have the strength to finish the whole thing. I had the feeling that things are going to get worse, then worst before it becomes better. May God bless us all.
March 16-
Wow! A family with 4 kids from the community came to the Mount Sinai Morningside ED to thank the staff for our service during this COVID-19 pandemic. They brought several pies of pizza with handwritten Thank You cards from the kids. The ED staff works hard every single day but has been totally amazing these past weeks amidst the fear and uncertainty. Being on the front lines can be scary, but this gesture really warmed my heart. I am so glad that the staff is recognized for a job well done. I had my Joy late this afternoon after a full, exhausting day.
March 17-
I'm supposed to be off today but have been on the phone since 630am with back-to-back conference calls. Our hospital President just mentioned our ED with a special mention of my LinkedIn post about community appreciation.
March 18-
It’s my youngest sister’s birthday party but we cannot celebrate at our favorite restaurant. So, I just wrote on FB: “You are loved by everyone because you have a generous heart. Who would think that a grumpy little kid will grow up to be so lovable (a little less grumpy, hahaha)? We'll get take-out food, as everybody else shelters at home. I took the day off (although still working at home). At least, we have toilet paper, woohoo!!!”
March 19-
It was a heartbreaking day. We lost three patients in the ED today due to COVID. Their chest X-rays were horrible, "bilateral confluent diffuse airspace opacities". The doctors tried high-flow oxygen, then BiPAP. But the patients were tiring out. They needed the ventilators to give them time to marshall their immunological response to the virus. It was frightening to witness the patients gasp for breath. The nurses, the doctors, and technicians were the front-line staff who managed to conquer their fears. Equipped with their personal protective equipment (PPE) of gowns, face shields, goggles, and N95 masks, they ran towards the patients, reminiscent of how the firemen and EMS crews ran toward the World Trade Center buildings on 9/11.
The ED was full, NEDOCs score was in the 160s with 40 boarders and five waiting for ICU beds. There was a sense of urgency as we tried to arrange for transfers to the floors. I made several calls to Admitting office. Where are the beds? I was frustrated but there was not much we can do until the beds open up upstairs. The Incident Command Center was directing the storm of activities to support the hospital operations and ensure we have enough PPE. Although we are in scary times, I felt secure in the knowledge that the hospital leadership was truly responsive to our needs.
March 20-
I am the nursing director but I do not do direct bedside care like these brave men and women do. But I sure do my damn best to support them as best as I can do. I fight my own battles to secure more staff, equipment, and supplies. I spend 10-12 hours in the hospital five days a week, and then we’re expected to be on call for any emergencies. The nursing directors were just told that we have to do the Incident Management huddles at 830am even on Saturdays and Sundays. Even with all of these, it will certainly not compare with the higher risk that the bedside staff faces every single day.
I am both proud of and worried for all the direct care providers, nurses, doctors, techs, and respiratory therapists. Both the frontliners and the last recourse. They deserve all the glory and all the tributes for a job well done and for what they keep on doing. These are dark times, and the staff just keeps on rallying in the middle of the war against COVID-19. They are awesome and so inspiring.
Some of my staff were out sick on furlough; I was hoping that they were self-isolating with just fevers and a few aches and pains. I prayed, please no shortness of breath. I fought my tears as I called or texted the staff, just to check in, just to make sure that they are okay. I preferred texting because I didn't want my staff to hear the quiver of fear in my voice. I held my breath until they assured me that they were breathing fine.
I received this text from a nurse: “Today was a rough day with all the sick patients in the ED but having our EMS there was soooo helpful. They were so eager to step up and work. They were so interested in all the patients, treated them with so much respect, and helped me out tremendously. If they weren’t there, I think today easily could have been one of those days you go home and cry or bury your face in a pint of ice cream. I hope they come back every day and thank you for having them there.”
I felt feverish. My temperature was 97.8. Thank God.
March 22-
In the #YearoftheNurse2020, the COVID-19 pandemic is certainly challenging the resolve of nurses, and all the healthcare workers (doctors, PAs, techs, registrars, handlers, and ancillary staff), all over the world. The Emergency Department staff steps up to the plate as they have done time and time again. In the war against this coronavirus, the warriors choose to give their best amid the anxiety, fear, and stress. Strength, courage, and dedication are manifested in every single one of them, no matter what their job entails. These are the faces of the brave ones, those who uphold their duty above all else. Thank you, everyone, as well as the other warriors in the inpatient units and in the ICUs. I am so proud of all of the healthcare workers here and everywhere.
As you can see, the community acknowledges all our efforts. The food just keeps on coming, a gesture of appreciation from the people who depend on us for their healthcare needs. The Thank Yous certainly mean a lot; they remind us of the reason why we are doing this. We are working for the patients who need our care. This is one department's journey in pictures, chronicles of individual and the ED team strengths. I started my COVID-19 album on Facebook. I wanted to capture in posterity those moments of levity in between moments of heartbreaks. We will survive this madness.
March 24-
The nerves were getting to the staff. As the handlers were giving out the new goggles, there was a misunderstanding about the distribution. I got to the ED right when one nurse burst into tears, she was frustrated because she did not get her new goggles, and she was holding her flimsy old ones with the frayed strings. I mediated and got her the new goggles that she deserved. I know that the tears were of frustration, were of fear. I could only pat her back and stay by her side until her tears stopped. She did not want to leave her assignment. Then she took a deep breath and smiled, “I am okay.”
The RN travelers are not here yet, but at least some Procedural nurses and techs were redeployed back to the ED. They can do tasks, labs, and lines, Team Nursing we go. Then, we received some EMS techs and paramedics arrived. All hands on deck. We needed all the assistance we can get. The doctors and nurses have been rushing to the rooms to resuscitate the sick patients who come right after another. I saw one of the doctors sitting at the desk with anguish on his face. He just called the patient’s son that his father passed away. The apex came two weeks early.
March 25-
The nurse manager and educator were out on furlough, and half of my leadership team. My assistant nurse manager was busy trying to staff the unit. For the first time in all my years as an ED nurse, I felt I was drowning. The ED NEDOCs score was high in the 170s, we are seriously overcrowded with two intubations going at the same time. I kept an eye on the ventilator reports. We are low on the BiPAP but we're getting some delivered in the afternoon. The hospital converted some inpatient units to ICU beds but our patients were not going up quick enough to decant the ED. I must say that I am impressed on how the hospital converted some units into COVID-receiving units in a matter of days.
A 55-year-old COVID patient succumbed to cardiac arrest. Too young to die. It could be anyone of us. There was shock in the nurses’ eyes. After he was pronounced, the team members offered a moment of silence to pay their respects to the patient. There was no family to mourn him at the bedside. I tried to help out with the post-mortem but the nurses told me that they can handle it. One nurse said, “We cannot afford you to be sick. Who else will look out for us?” I almost bawled in front of the team. I felt a little bit useless and somewhat useful, even needed.
March 26-
My nurse’s husband was admitted to the hospital for shortness of breath related to COVID-19 and she could not stay with him. No visiting rule, even for her. It broke her heart to be so helpless. I cannot do anything. As she cried on the phone, all I could do was listen and cry along with her. I called the nurse manager in that inpatient unit to keep an eye on the husband. I visited the unit but the patient was asleep. His breathing was normal and his oxygen saturation was 96% on nasal cannula. He will be okay. At least, my nurse’s husband is not in the ICU.
March 27-
I heard two medical codes being called in the ICUs in just one hour. There were more calls for respiratory therapists throughout the day. The ED is like a warzone, we are a COVID unit after all. I saw a blur of yellow isolation gowns when a group of doctors and nurses responded to Room 22 in the ED; they have to intubate the new patient. Not even five minutes later, another call for help in Room 1 for a high-flow oxygen machine. And another patient in respiratory distress was rushed in by EMS. The charge nurse called out for another team to Room 2. I had 36 boarders in the ED, all complaints related to COVID, some confirmed, some PUIs, some PUMs. The nomenclatures and the changing guidelines from CDC are confusing. The intensity level is high in the ED.
March 28-
After an exhausting week of being the Administrator on Call in the middle of a brutal week of COVID-19 response in the hospital, I needed to do self-care in order to get re-energized for probably a more brutal week. And then reading the Thank You cards from the #mountsinaimorningside community, I see the reason "Why" we are doing this. This is our "Ikigai", our reason for being. The ED received an outpouring of love and support from the community. Food deliveries came unsolicited almost every day. And they were calling the healthcare workers their heroes.
Late at night, I received a call from my assistant nurse manager about the Visiting rules. A family member wanted to see her dying mother in the ED. The No Visitor rule was just enforced, but for end-of-life moments, visiting was allowed. The iPADs help with facilitating communication between families but nothing can take the place of an actual visit. The unit leaders all said yes. My chief nursing officer and chief medical officer approved. It was a humane decision to allow a daughter to say her final goodbye. No one should die alone.
March 29-
The news painted a terrible picture of the dire situation at my previous hospital. Suddenly, Queens is now the epicenter within the epicenter. The harrowing details of devastating deaths and inadequate staffing, PPE, and ventilators told the rest of the world that we are in deep trouble. My heart broke for what my former colleagues were going through.
I posted this on LinkedIn and FB: I just want to pay tribute to the staff at Elmhurst Hospital, my work home for 21 years. My love to the ED staff who continues to give their very best. I left a piece of my heart with you. Even as I do my own work here at Mount Sinai Morningside, I think of you on the frontlines at the 'Hurst. May you get the help you most deserve. You are all amazing. Be safe, be strong. This Thank You sign in front of the hospital should let you know how the community appreciates you all. The artist Scott LoBaido showed his gratitude to the Elmhurst warriors thru his art. As a nurse, I appreciate the sacrifice you all do. We're in this together.
March 30-
Artist unknown
This says it all. It takes courage to go where nobody else wants to go. It takes dedication to leave our families behind. It takes resilience to bounce back from a shift of heartaches and frustration to come back another day. It takes some kind of craziness to be a health care worker at this time of great stress. It takes someone special and amazing to be on the frontlines of this war. The nurse represents ALL the healthcare workers in the middle of this fight against COVID. Kudos to all the nurses, doctors, PAs, NPs, techs, registrars, resp. therapists, transports, EMS workers, Security, EVS workers, engineering, IT support, and all the administrative leadership staff who work behind the scenes to open more and more beds for us. AJA! Laban lang!
April 1-
I don’t remember who and when the 7pm clapping actually started. Suddenly, there were videos of clapping and cheering emanating from the apartment buildings around Manhattan. New Yorkers rallying to support those who cannot stay home. They were united in applauding the healthcare professionals working on the front lines of the COVID-19 pandemic. It felt good.
Then at 7pm, the sirens of the New York Fire Department provided a heart-warming surprise tribute. The New York Fire Department Engine 47 gave their respects to the staff of Mount Sinai Morningside right at the corner of Amsterdam and 113th Street. A wall of heroes applauding the new, albeit reluctant, heroes of our time. The ED staff loved returning the applause. The rousing celebration of the work we do somehow validates all the sacrifices that we make. There were air horns, somewhere distant the clanging of pots and pans. Soon the ED staff was joined by other hospital workers from the inpatient units. They hooted and cheered, for a few minutes forgetting the horrors behind the front door of the ED. In moments of crisis, we savor those moments which make sense of everything we do.
April 3 The eyes have it. As I go through the ED, I see all the staff bravely going through the day. Behind their masks and face shields, they put their thumbs up but I could feel the rising anxiety. I had to peer into their face shields to see who I was talking to. The eyes told me what they were feeling. Sad eyes from the deaths they have witnessed, more than they ever did in a single shift. Worried eyes because they needed assurance that they will not bring this virus home to their family. Haunted eyes for witnessing the final goodbyes between the patients and their loved ones on the iPAD.
But they are here, doing their job the best that they could. It's the worst of times but I see the staff stepping up. A physician assistant brought an iPAD to the room so the patient and the self-quarantined family can talk to each other. The doctors slumped in their seats as they held their phones to their ears, as they fielded questions from the worried families. The nurses and techs gowned up to prepare a patient for the morgue. At 3pm, the techs gathered around after huddle to say their prayers. They are the heroes of these uncertain times. And to survive, I see them supporting and being kind to each other, sharing the hand-made masks and surgical caps donated to them by worried friends.
In the staff lounge, on her break, a nurse removed her tight N95 mask as she settled down on a chair to rest, the string marks stayed on her face; red bruises under her eyes and on her nose. She closed her eyes, probably in meditation, probably just to get her bearing. Like everyone else in the healthcare world, she was exhausted. I closed the door so she can have her moment of peace.
April 6-
Here's our Mount Sinai Morningside crew. Taking a respite from the heart-breaking work to just enjoy ourselves and support each other through the hard times. Somehow, we found time to just have a little fun, and at the same time exhort the public to stay home. #stayhome #flattenthecurve #mountsinaimorningside.
April 7-
Positive news of survival should be celebrated. In our fight against COVID, we have to gather strength and hope in those things that affirm our impact on our patients' lives. We have to find the joys that will keep us moving forward. The digital board in the lobby announced that there were 137 patients who went back home to their loved ones yesterday. Today, my nurse's husband was number 138. Finding our Joy in small victories.
A staff nurse who was out on sick leave called me crying. She saw the staff video and expressed her guilt for not taking her place at the bedside with her peers. Other staff members expressed the same thing to me. I told her gently to take care of herself first, that the best thing she can do for us is to just keep us in her prayers.
A week ago, I suggested to the Incident Command Center to post the Good News of our discharges, as a kind of a morale-booster to the staff, to remind them that we are saving lives. I wondered if our city will give the healthcare workers our own ticker tape parade, maybe in the Canyon of Heroes.
April 9-
Check this out. The husband of our ANCC Diana Velazquez from the Emergency Department paid tribute to the healthcare workers of #MountSinaiMorningside. Matt Hong serenaded us with a sexy sax rendition of "When the Saints Go Marching In". Cool!
This never gets old. A much-needed boost from our friends at FDNY, heroes themselves. There are new chalk marks of appreciation on the sidewalks leading to the ED, all from the Morningside community, their own little way of appreciating the staff at Mount Sinai Morningside. This time, the firemen were joined by the NYPD officers on horses. I saw my nurses' eyes filled with tears of joy and gratitude.
April 10-
I am glad I was able to witness a patient's discharge; he is a COVID survivor. The patient broke into a wide grin as he was met with a chorus of well-wishes and boisterous applause at the #MountSinaiMorningside lobby. It is an honor and privilege to be among a group of people who cheered this patient. Much as he appreciated the warm send-off, I felt similarly blessed. It was a great feeling, a much-needed pick-me-up. There was encouraging news about the downward trending admission rates but I couldn't shake a lingering sadness earlier because of some losses of people I know. At that moment, I was energized, I felt joyful seeing the patient's grateful smile. I caught his eyes and I felt my own tears fall as he mouthed. "Thank You". I never took care of him, but he was everybody's patient at that time. Sir, Thank you.
April 11-
Pause and Applause have started at #MountSinaiMorningside.
We PAUSE to reflect on the lives lost due to COVID-19 and to strengthen our resolve to fight for the lives we can still save.
APPLAUSE is a more joyous occasion. We clap when a patient is discharged. We applaud to rejoice for the life that was saved; someone's loved one who was given a second chance.
April 12-
"Always call upon our Father
When afflictions, you may suffer;
He’ll never forsake you in your hardship.
His help He will give as long as you shall live"
This I believe. I had to believe that the pandemic will soon end. Our worship service is now on Webex. The video was grainy, and the choir hymns were canned, but the minister delivered a spiritual and uplifting sermon. My church (Church of Christ) has been doing the virtual worship service by Webex for several weeks now. I miss going to Church; I miss the brethren, the hymn-singing, just being in the House of God. This is just a bump in the road, a little test of faith. After the service, the minister beamed with relief when he saw the faces on the screen. We waved back at him. My soul needed it.
April 13-
One of the nurses relayed that she triaged one of the first COVID 19 patients she took care of last month. She recognized the eyes of the patient; those same eyes who looked at her with dread when he came in with double pneumonia and had to be intubated on his first visit. She thought he was the sickest of the sickest that horrendous day with a poor prognosis. But he was discharged two weeks later. This time he came because he was short of breath on exertion.
As he sat on the triage chair, he relaxed and even laughed when the nurse stated she recognized him. His eyes were not as frightened anymore, just concerned. He later smiled with relief when his oxygen saturation showed as 99% on room air. He acknowledged he just had to give time to feel stronger, for his lungs to go back to normal. Nurse Jovy told me that she sobbed in relief when the patient left to go home.
April 14-
After a heartbreaking loss of a church friend that had momentarily shook my world, this picture somehow eases the pain, even for just a little moment. One of our own ED staff, a registrar, was discharged after weeks of hospitalization for COVID-19. The word Social Distancing did not really enter my consciousness at that time, sorry. In defense, everyone was all masked. The lobby of the #MountSinaiMorningside was filled with thundering applause amid chants of his name. It was a celebration of a life saved, of winning one against a dreaded disease, of teamwork and unity, of survival (not just for the patient but for all those who continue to fight).
Joining this celebration was one of my nurses who survived COVID herself. She was one of the loudest cheerers. Seeing both survivors were inspiring. The moment was all-powerful, and a big morale-booster for those in the biggest battle in our professional lives. It was a joyful celebration of the men and women who fought for this patient. As I saw the numbers on the Discharge monitor continue to climb, I am hopeful that this nightmare will soon pass. It was a special Thank You that another one got away. Take that, COVID!!!
April 15-
I feel a deep, aching sadness in my heart. Yesterday, one of the most-beloved members of our church passed away. I cried for the family he left behind and for the generations of church brethren that he touched. I cried for every single one of my friends and acquaintances who died due to COVID. There is a pain of loss and the continuing fear of losing some more. Too many friends who lost family members to this pestilence. Too many precious lives gone.
April 16-
There are others in other states with a myopic understanding of how dangerous this coronavirus is and they demand to ease the lockdown. The healthcare workers continue to venture out every day to take care of the sick so that others can stay home. I feel anger that there are people who bemoan about being bored out of their minds due to staying at home. I feel disgusted at those who disregard the tragedy of lives lost just because they think that their freedom is curtailed.
The Stop-the-lockdown movement is fueled by ignorant, uneducated people who were not yet touched by this pandemic. They are just adult versions of that stupid teenager during the spring break in Miami who stated, “If I get corona, I get corona. At the end of the day, I’m not going to let it stop me from partying. What is wrong with these people?
ADDENDUM:
April 20- I must have looked dejected as I walked through the lobby. I had my surgical cap and my N95 mask on but I was still recognizable with my ubiquitous white lab coat. Somebody asked me “How are you”. I shrugged my shoulders, squeaked a weak “I’m okay”, and quickly turned around. My tears threatened to overwhelm me and I did not want to ugly-cry in the middle of the lobby. I did not want to break down, I did not want to curl into a fetal position. A part of me wanted to say "I'm having a tough time" but I was not ready to share. I just heard of a church friend and church deacon passing from COVID-19. This is heartbreaking. In my previous hospital, five hospital workers succumbed to the complications of Covid-19. The threat of contamination looms over our heads like Damocles' sword. When is this going to end?
April 23-
This morning looks like a miracle to me. I can breathe better. I had a good night's sleep after the surprisingly calming effects of my crossword puzzles and the soothing music of Anne Murray. Earlier that day, the Mental Health Liaison met with the staff to offer some options to de-stress, to decompress. We need to do our Mental PPE. I prayed not for myself but for my own family and my work family. Then, I turned to the one thing that always calms me down: I write. I wrote what my heart spoke.
There were only 8 patients in the ED, three of which are COVID patients waiting for the med-surg beds. No ICU patient at this time. More nurses than there were patients. For the very first time ever, our NEDOCS score is -2 (negative 2). The charge nurse later texted me in the afternoon that the volume had picked up. There were now 40 patients in the ED with some trauma codes and non-COVID patients in the mix.
FaceTime eased my loneliness when I spoke with my son. He had just been working at home and he is safe. My mom is also safe in Manila, enjoying her wine now that there was no more beer to procure. It is how she relaxes at home. Everybody at home and at work is safe. That's all I needed to know.
My temperature was 97.8F. Most of my staff members who were furloughed are back to work, ready to join the fight again. Governor Andrew Cuomo said that the COVID-19 war is not over but he cautions against prematurely stopping the lockdown.
July 30-
What a year it is. It's not over yet. The tsunami of
admissions had abated here in New York but there is still fear of a second
wave. There are more non-COVID patients
in the ED. The patient census had dramatically gone down. There are more nurses
than patients. Now I can breathe better. I am sleeping better. There is light
at the end of the tunnel.
Sept. 29-
To heal myself, I turn to the things that I am grateful for:
my family and friends, my church, my work family, music, books, food, puzzles,
and our dog. I look for my joy triggers. That is how I keep myself sane amidst
all the challenges of life in the new normal. And then, I write. I write what
my heart speaks.
October 4-
I hear the laughter now. I see my staff SMIZE; their eyes are smiling above their
masks. They know it is not completely over yet, but they find strength in each
other.
Nobody comes out of this pandemic unscathed. We have to
actively and deliberately plan our joys in and outside of work. One of the nurses shared her joy when a recovered patient
recognized her eyes when she cared for him in the ED.
As we all put together the pieces of our broken hearts, we
march onward, stronger together.
December 13-
The second wave is here. Covid 2.0. It is a scary time. But
the vaccine is here. There is HOPE and RELIEF. It is the beginning of the end. I am hoping that a few months from now, I can
finally travel and hug my mom again.
For us. For our families. For you. For our country.
December 17-
I got my Covid-19 vaccine today and so did some of my ED and
ICU colleagues. Finally, the Pfizer vaccine is here. I have been waiting for
this. Now that we’re on the Second Wave of this horrific pandemic, I am
confident that we have what it takes to fight back with a vengeance. I am
joyful that this is the beginning of the end of this disease that has gripped
us in a chokehold for so many months. T But now there is hope. I must
confess that I was teary-eyed because I can see the light at the end of the
long tunnel. The vaccine is a game-changer. This will afford all of mankind to
get back to the new normal. Thank you to the scientists and the volunteer research
subjects; they are heroes themselves. Maybe, a few months later, I will be able
to travel and hug my mom again.
#LetsBeatCOVID19 #Havefaithinthescience
December 31-
It was a heart-wrenching year. A year of profound sadness, despair, and helplessness, of fears and anxieties that continue to haunt us
to this day. This disease has gripped us in a chokehold for so many months.
Somehow, the collection of pictures turned into a journal of
our collective experience during the pandemic. I encouraged others to share
their personal reflections; I understand the need to share, to relieve the
heart of the burden of fear.
The ED staff fought together, united as we were never
before. We had to work together as a team; it was the only way to survive on
these darkest of days.
For me, Journaling is a coping mechanism, it puts things in
perspective; it slows things down to manageable parts. It is a therapeutic
activity to drain the brain of stressful recollections. It gives me time to
breathe, to process my emotions.
When written on paper, the pain loses its intensity. Like a
catharsis of negative emotions. Not that we can ever forget. We just need
to keep our hearts from breaking into a million pieces, just need to find
comfort in the small triumphs. Just so we can continue to fight and survive.
The war against Covid-19 is ongoing, but having the vaccine
is a huge relief. We have a fighting chance.
As 2020 closes… HOPE. Looking forward to 2021 being a better
and safer year for all of us.
