Cassandra Alexander - Year of the Nurse: A Covid-19 Pandemic Memoir

On April 25th, 2021 at 10:55 in the morning I messaged my chat group of girlfriends from where I work as a nurse on an ICU floor: Nothing like feeling strongly suicidal at a job where youre supposed to be keeping people alive, and then tweeted that my mental health wasnt great and deleted the Twitter app off of my phone because I didnt want to overshare.

That I felt like dying.

That I wouldve rather died than still be at work.

In 2020 there were roughly four million nurses in America. Only 2.7 million U. S. soldiers fought in the Vietnam War.

Those soldiers who came back from Vietnam, having witnessed atrocitiesand in some cases, participated in themwere changed forever.

You cant send four million people into a wartime-equivalent situation without there being psychological consequences.

And yet thats what America has done.

Nurses spent a year battling a largely unknown assailant. Running low on gear. Fearing we might bring something deadly home. Getting coughed on by people who pretended that our fights were imaginary, that our struggleswatching people die, day after day, no matter what we didwere literally fake.

Nurses are fucked up.

We are going to continue to be fucked up for quite some time.

And unless theres an acknowledgement and a reckoning, healthcare as we know it in Americas going to be hamstrung for the next decade.

I do not know a single nurse who doesnt want another job right now.

Even before covid, burnout levels in nurses were epic. In 2017, 31.5% of those four million nurses changed jobs due to burn out.

A brain drain is happening right now, as I type, as nurses across the nation figure out what safety and well-being looks like for them. Some people will wind up being stay-at-home-parents, some will go into R&D, and others will just retire a few years earlier than they had planned to, because theres nothing like watching people die for a year to make you think maybe you should go and live.

Unless youre me, and yeah, well get to that.

And?

A large number of us hate a large number of you. (Although likely not the you reading this book.)

If you spent your pandemic fighting masks, voting for Trump, or going on vacation, though? Those of us with the blood you caused on our hands actively wish you ill.

Im just being honest.

Were going to remember, as we all go into this, our first safe summer.

Because, unlike you, some of us will never get to forget.

This really is a therapy book, and I really was suicidal. But unlike many in my nursing cohort who got through 2020, I am also a professional writer. I dont know what Im thinking half the time unless I write it downso I do.

And I kept track of what was happening with me last year. Ive gone back and sorted through my personal journals, emails, and tweets to share with you what it was like being a nurse in 2020. This book is going to be a kind of scrapbook, in that I have ancillary material that Ill quote and share here, in addition to my original thoughts upon it.

A lot of it is going to be immediate, and a lot of it is going to be raw.

Im not here to make apologies about how angry this book will be. I cant, not when thats the reason Im writing it. Because I need to do something, anything, to quench this ember of hate I have in my heart. Jesus cant touch it, and neither can love.

I need someoneyou, if youre reading thisto try and go there with me. I want to take you along and show you what it was like. I want to make you feel my fear and desperation.

You might learn some shit along the waybut mostly I just want to not be so alone.

I know a lot of people want to shut the door on the past and move on the future, but to that I say, How can I? When this thread of betrayal that this country has woven through me is sewn so deep?

I think this is the only thing I can do that will help to set me free.

And so, now that youre warned, lets begin.

T HE FIRST BIG NOTICE:

All individual patient information has been changed so as to be unidentifiable, and no part of this book constitutes actual medical advice.

THE SECOND BIG NOTICE:

After putting in a lot of thought, Ive decided to err on the side of readability versus 100% authenticity when it comes to correcting some of my spelling, spacing, and abbreviations from newsletters and Twitter.

While the immediacy that such accurate reporting provided felt right, I ultimately decided that I didnt want there to be any artificial barriers, such as grammar mistakes, between my text and the reader.

These changes will be superficial though, and under no circumstances will I be changing the factual content or the feelings behind any of my tweets.

THE THIRD BIG NOTICE

Ive added the occasional authors note from the present day in the original text with my initials in brackets: [CA].

THE FOURTH BIG NOTICE

During covid I worked in an ICU in the Bay Area. I know I was incredibly lucky that we were never a hotspot in the way that NYC, Los Angeles, or other countries were. Thats probably why I had the chance to process some along the way.

My experiences are not meant to be universal to all nurses. Hell, I know some nurses whomind-bogglinglyvoted for Trump. If this is you, please stop reading and go ask for a refund.

What I want this book to be is an acknowledgement of what it felt like to be at the bedside in 2020, accessible to both nurses and laypeople alike.

Nursesthis means that Im occasionally going to slow down and explain things that you already know, so that laypeople can keep up and learn what its like to work in a hospital.