“Why don’t you just quit?” These words have probably gone through nurses’ minds at least once in their careers in response to being overwhelmed with all the responsibilities and stresses of being a nurse. But then, we stop, assess the situation, and remember why we entered this profession. As a staff nurse and relief charge nurse in an urban medical center in the middle of the pandemic, it has been rough, to say the least. I have actually been asked this question several times these past few months, and my immediate response is, “I’m a nurse. That’s not what I do.”
I work in an area of the hospital that routinely deals with difficult decisions and situations: the oncology unit. Every day, we deal with a multitude of thoughts and emotions. Some days I find myself happy as I discharge someone who has achieved remission of their cancer, and later heartbroken as I hold a patient’s hand who just learned that their cancer has returned and metastasized. Some days my team and I high-five after swift actions that saved a person who was deteriorating, and later on next door, my co-workers and I can hardly keep ourselves together after losing a long-term patient due to cancer complications.
Our unit is mixed, which means we do get medical-surgical overflow, and I do, on occasion, float to other medical-surgical units. Floating usually means working with a different mix of patients and staff members, but I have grown to love floating. It means that I get to challenge myself and work with a new team and build relationships with different people. It gives my day variety. I would have never thought I would dread floating, but I did ... because it was to the COVID unit.
Of all the emotions I have felt going into work, I never would have thought I would be terrified. But these last few months, that is what I’ve felt every morning as I get ready. And frustrated that my team and I don’t feel protected, confused that there is yet another policy change, a new piece of equipment, a possible workaround. I drive to work sick to my stomach—will today be the day I’m infected, or worse, am I already infected and passing it on to others, my vulnerable patients, my family? Never would I have thought that I would walk up those steps feeling empty, after the loss of a fellow co-worker and friend to this relentless virus. And seeing family members bring their loved ones to the hospital and hugging them for what might be the last time is enough to make me lose it.
But the nurse in me keeps pushing forward—for my patients, for my students. What do I do with this fear, frustration, confusion, and sadness, though? I decided to do what the nursing process tells me to do: assess the situation and make a plan. I educate myself, and I tread lightly. When I am not working or resting, I look up research on new developments. I ask questions, and I face these emotions. I take action and participate in movements to give my fellow frontline workers and I a voice, to advocate for our own protection, and in turn, our patients’ and families’ protection. I continue to think of ways we can engage our patients who no longer have their loved ones at the bedside. I contact my support system, because although we are told to social distance, there is no way we can go about this journey alone. I constantly do something, because I know if I stop, I haven’t done my part. In this world of uncertainty, I do the thing I know how to do, and that is to be a nurse.
So yes, I am nervous and scared, but to those who ask me, no, I am not going to quit. I am going to keep fighting and advocating for my patients, my loved ones, my fellow healthcare team, and for our future. In the words of Florence Nightingale, “I attribute my success to this—I never gave or took any excuse.”
No matter what, the fact that nursing is my calling remains with me, and that is why I show up. And will continue to show up.
Marissa H. Rafael, MSN, RN, CMSRN, is a staff nurse in the oncology/medical surgical unit at a medical center in Oakland, California, USA. She is also a nursing clinical instructor at CSU East Bay and a member of Sigma’s Nu Xi at-large chapter.