Alabama ICU nurse describes his front-line pandemic experience to the Global Workers’ Inquest

Jennifer E. Engen

The World Socialist Web Site spoke to a critical care nurse in rural Alabama, David, about his experience throughout the COVID-19 pandemic, during which he has worked in multiple states.

In this testimony to the Global Workers’ Inquest into the COVID-19 Pandemic, David describes the inadequate response to the pandemic from the hospital level to the federal government, the consequences of which are felt by both patients and healthcare workers. He discusses conditions in the hospitals, for-profit health care and the psychological impact of the pandemic upon front-line workers.

Alabama, with a population of 4.9 million, has recorded 1.3 million official COVID-19 cases and 19,502 deaths and has the third-highest per capita death rate from COVID-19 in the US.

Emma: Can you describe your position as a critical care nurse and what your job entailed both before and during the pandemic?

David: Critical care and intensive care units are synonymous. We deal with a broad range of patients – heart arrhythmia patients, ventilated patients, and post-op surgical patients. We work with patients who have had brain, heart and vascular surgery. We handle a variety of different medicines and drips, usually involving hemodynamics and supporting blood pressure.

During COVID, we got the worst of the worst. Early in the pandemic, a COVID patient regardless of status came to the ICU. Later it changed, and the stable patients were put onto the floor, while ICU would get patients with respiratory problems that looked like they would or had already progressed.

Normally, the ICU standard across the US is a 2:1 patient ratio where every nurse has two patients. But with COVID, this quickly went to three or four patients per nurse, and that was a lot to deal with. The little hospital here tried to keep ratios down, but staff started getting sick and we started running short.

Eventually we reached a point where the administration was telling staff that if they tested positive for COVID, it’s OK for them to continue working if they’re working with COVID patients. They encouraged them to keep working while infected. It was ludicrous.

Even when I was working in a larger hospital which had more staff available, they encouraged staff who were infected with COVID to work. Or, if they had to be out, they would call them back in after a couple of days or tell them to come back as soon as they were “symptom free.” At one point, over 130 staff were out with COVID.

You stated that turnover is very high among nurses. Can you explain why and elaborate on what conditions are like for nurses?

To me, nurses are viewed as dispensable by the administration. Turnover is extremely high. Nursing school and actually working on the job are two totally different things. School doesn’t prepare you for the reality of what you’re getting into. I’ve talked to a lot of young nurses, even before COVID, who realize that this wasn’t what they signed up for.

There is a wide chasm between the staff and hospital administration. The hospitals are basically economically driven, and the administration is hammered to save money every which way they can in order to make money for the hospital. They want to keep wages low, and if they can get away with not adequately staffing the units, they’ll do that. Whatever it takes.

Every hospital advertises that “our patients come first” but it’s not true. The bottom dollar is number one. I figured out long ago that the healthcare system in the US is a sham. It’s all about money for the pharmaceutical and insurance companies to the detriment of staff and patients.

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