chapter one

the danger of change

New books always make me a little nervous. An unopened book holds all the hope in the world until, with bated breath, you meet the first page. In those first lines you often either realize you’ve wasted $9.99 in the Kindle store, or you find yourself settling in, patiently wading through the planting of characters, setting of scene, and foundation-laying of your next favorite story.

You’ve become an adventurer. You’ve let yourself into the front-yard garden and found it enchanting enough to tread down the lane, where you let yourself into an empty house. There you wait, contentedly, for the rest of the tale to grow up around you. You’ve committed, so slowly you’ve hardly noticed what’s happened, until you’re in the thick of it, lost in the magic. It is then that you realize the most important thing: chapter one was just an invitation, and this, now, is what really means something. Chapter two.

Here I am, a newly minted MFA student very wary of my own chapter two- this part of my journey that will mean something more. This undertaking that sounded fun a month ago as a hazy theory is now taking shape in real time, and I’m starting to see a future where I’m stretched and tired, overwhelmed, and likely in over my head.

It’s all so very different than the projects I’ve taken on before; moving from the task-oriented type-A-friendly world of nursing to a place where philosophy, psychology, spirit, and story are what counts – it’s significant, to say the least. I’m walking straight out of the land of flashcards right into a world of vulnerability. Imposter syndrome settles in like a cold as I google “what the hell is literary fiction,” transition from APA to MLA, from symptoms to syntax. I may have seen death in the flesh but, somehow, this feels more dangerous. It’s risky, this road; I’m unsure, insecure, unprepared, and, worse, I care more.

More than anything, I don’t know how to be in this world- I’ve never sunk into this side of my mind so purposefully, where learning is less about tasks and grades and more about craft. Truth. Love. What does this new style of living look like on me? Who will I become when I stop stuffing creativity into her cupboard under the stairs and let her out to see the stars? I guess we’ll see.

In the meantime, I carry on with the revolution armed with a new planner, a new haircut, and an old mantra: I can do hard things and these hard things are good. I keep reminding myself, too, that as hard as it looks, this still feels like coming home to a part of myself, and I imagine that is one of the keys to a good life- to come home to ourselves in more and more beautiful ways until we are home forever in the land where beauty multiplies endlessly. Once again, C.S. Lewis wrote it best: “I have come home at last! This is my real country! I belong here. This is the land I have been looking for all my life, though I never knew it till now… Come further up, come further in!”

And then, a bit of truth from the same bit of childhood magic: “…for them it was only the beginning of the real story. All their life in this world and all their adventures in Narnia had only been the cover and the title page: now at last they were beginning the Chapter One of the Great Story which no one on earth has read: which goes on for ever: in which every chapter is better than the one before.” 

Into the garden I go, coming home to an empty house, ready to see what grows in this place I’ve planted- a place held together by the author of the Great Story, the Great Story in which I will be writing a chapter. Further in we go.

a nation under god

authentic christians are anti-racist

My fingers have been tightly wound around the narrative I wrote for my own life, and God has been patiently uncurling my fingers, one by one. Dream bigger, He seems to say. Dream bigger, then bigger, then bigger. Now go.

I go, with sparkles in my eyes, and imagine myself stepping out into the wide world as a Joan of Arc. I want to be unafraid. I want to face those looking down on me, telling me I’m too young or inexperienced, too naive or out-of-touch, then surprise them with my wisdom. I want to stand my ground, confident in who I am and what I’m about, not shaken when the questioning starts or gaslighting makes my knees weak. I want to pick up my sword, my words, my voice, and fight for justice. I want to fight like God is behind me, working to save a nation, even when the sparkles are gone and all I’ve got left is a mess.

That being said, while Joan of Arc might not have had a Facebook account, I certainly do. And lately I’ve found myself doing what I’ve avoided for ages- engaging in the dreaded Facebook debate. Because somebody has to speak up, and sometimes that somebody is me.

In the process, I’ve discovered a handful of things that are starting to- for lack of a better phrase- piss me off. 

Firstly, primarily, mostly, I am sick of people who call themselves Christian spending more time arguing about protecting police than listening to or caring about people who have been marginalized. I’m frustrated, even dumbfounded, that the need to become anti-racist has become less important than the need to maintain neat politically conservative borders. Digging those heels in over whether or not Black people deserve to be heard is NOT the place your feet should be planted. 

I am sure, entirely sure, that Black people are more tired of this bizarre behavior than me. I offer my voice for those too weary to speak. 

Here it is, most clearly: Your ‘blue lives matter’ flag waves proudly in false righteousness- you might think you are innocently supporting the force, but I’m here to tell you that your timing is off. You think it means nothing, the blue stickers and posts, but right now it sends the message that your priority is more for the police than for the people who the police have harmed. That support right now is inherently political and has the capacity to be significantly damaging. Sure, shifting the focus to blue lives might be appropriate on some days, but today is not that day.

Beyond that, if we keep spending our time debating and trying to disprove racism instead of actually demonstrating real, active care for the Black community, it will only serve to further ostracize that community from our Christian spaces. They are going to feel more unwelcome in a church they should comfortably call home because we were too busy fighting to hear their stories.

We don’t listen, and we harm them further. On top of the years wasted where they were unable to join orders, take vows, or attend seminary. 

On top of the years they were, and continue to be, enslaved, taken advantage of, and neglected, while people of the Church look away.

On top of generations of artwork in cathedrals, museums, and homes that fail to depict the beauty of God reflected in dark-skinned faces.

On top of a disproportionately white canon of saints- not because saints of color didn’t exist, but because our Church has been complicit in a world of white supremacy. 

All of this pain should be ringing in our ears, calling us to action, but black voices still cannot be heard because we have hidden in our prayer groups and Bible studies to complain about the “secret liberal agenda” and anti-racist “propaganda.” We’ve wasted time instead of listening and believing, acknowledging our failings and trying to do better. Defensiveness has become the last flag waving- it’s a big one, and it’s red. 

At the very least, I will stand up. You will hear my voice- the voice of a Catholic. A Christian. A woman. White, weak, and flawed, but here. I am here and I will say, then say again, that Black lives matter. If you want to call yourself a Christian, a real one, it’s best you start acting like they do too, and start fighting like God is behind you. 

St. Joan of Arc, pray for us.

unbiased loving

an aspiration

“To love at all is to be vulnerable. Love anything and your heart will be wrung and possibly broken. If you want to make sure of keeping it intact you must give it to no one, not even an animal. Wrap it carefully round with hobbies and little luxuries; avoid all entanglements. Lock it up safe in the casket or coffin of your selfishness. But in that casket, safe, dark, motionless, airless, it will change. It will not be broken; it will become unbreakable, impenetrable, irredeemable. To love is to be vulnerable.” Thank you, C.S. Lewis.

I’ve been thinking about these words lately, especially in the quest to untangle the biases woven into my heart and surroundings. There’s a lot that needs to be uprooted; this has become a season for removal and replanting. A season of making space for those who have been pushed aside. They are real people, those voices crying out from the books and podcasts and blogs. They are flesh and blood, with hearts exposed. How brave, to be so open, especially after so much pain.

That vulnerability deserves to be met with something even greater than dismantled bias. That is the minimum, and we must go beyond it- we must actively support and embrace a future where those most marginalized are free to lead beautiful, messy, wonderful lives. 


In the meantime, I’ve noticed that I hold a little bit more bias than I thought, in a lot more places than I thought. It’s at work, with patients who I assume will irritate me before I’ve spoken to them. It’s on dating apps, as I swipe by men with certain careers before I’ve seen their profiles. It’s in social situations, when I wander closer to the girls who look like me. I’ve done it at home, at church, in stores, online. It’s everywhere.

I’m beginning to wonder if the ideal, someday, would be for us operate with no bias at all. Is it possible to encounter each new person, each new situation, without considering the experiences behind us? Without letting the negative lessons we’ve learned about one person influence our interaction with the next person? Harder still- is it possible to untangle those predispositions when we meet the same person, but in a new moment? To perpetually offer the benefit of the doubt and maintain a disposition of charity, a complexion of peace?

I’m not suggesting a boundary-less life or existing blind to the behaviors of those who have hurt us. I’m sure it is appropriate to form opinions and act according to whatever information we are presented with. However, this intentional living, perhaps, does not exclude unbiased loving. Whatever we’ve chosen to move towards or away, we can do with a spirit of love. We can act with generosity and hold a heart for goodwill, whether that is from near or from far. We may have chosen to distance ourselves from someone or something in self-preservation or self-love, but we can still find peace, forgiveness, and hope.

I’m sure it’s the way God meets each of us, in each of our moments. It’s the way He meets me- not as the isolated, flawed piece of me that snapped at my sister an hour ago, or yelled at the guy who cut me off- but each moment, fresh, as if it’s the first most lovely moment He’s encountered me for all that I am at my worst and my best, and in that meeting He has still found me good.

He offers a blank slate, over and over and over again; His love always available, always renewable. Maybe it’s better than a blank slate- instead, it’s love like a fire in the winter, shade in the summer, the warmth of friendship in loneliness. As good, and always as good, as the first leap into a pool on a hot day or the first sip of coffee in the morning. It’s the first page of your favorite book, when somehow you’ve forgotten the plot points, so you relive it, in all it’s goodness, over and over and over. 


This love is lovely, in theory. It works for God. In practice, for humans, it’s harder. 

Hard to become anti-racist, in a world that’s pumped it into our veins.

Hard to do at work, to meet the next patient, who acts like the last patient, with fresh, kind eyes. 

Hard to do with new friends, when you’ve been bullied or burned by old ones.

Hard to do with men, when the ones before insulted, disappointed, cheated, or lied.

Hard to do with yourself, when the world has found that you aren’t quite enough.

It’s all hard. And it’s a surefire way to get hurt, this constant vulnerability. Ask C.S. Lewis. Ask Jesus. Ask your teachers, your nurses, your parents. There’s no guarantee that your openness will be matched; do it anyway. Bring your scraped knees and hearts to the source of the most perfect eternal, renewable love, then pull yourself up and offer love again. It’s the least we can do, when we’ve been given so much. 

This life isn’t for hiding or isolating, but for picking up our tired selves and meeting another moment, another person, or our very selves, with love, again. And then again.

It’s not easy. It’s messy. But it must be done, this unbiased loving. It’s the only way we’ll be free.

in service of justice

a disposition towards peace; righting the wrong of racism

When I was small, the most coveted crayon was the one we called “skin color.” We didn’t ask for it by name as we filled in our princesses; there was no mention of peach or tan, but somehow we still understood that the crayon in question wouldn’t be brown. Maybe because we were young and only thought of “skin color” as “our skin color,” or maybe, already, we thought that the default tone for skin should be white. Perhaps it was bias, already poison in our air, sinking into our hearts and lungs as insidiously as cancer. 

Whenever it started, it remains true that biases, untruths and prejudices snuck into our minds and remained a poisonous undercurrent for years. We grew up, learned in school that the civil war was over ages ago, that segregation was gone. We wondered what the problem still was.

Of course, there were many problems, but we were blind. We were handed down privilege and twisted patriotism; a lethal combination when met with willful ignorance, refusal to face discomfort, laziness, and self centeredness. The cost was high. It still is, as evidenced by the continued injustice and wrongful murders of those in the black community. 

Finally, today, we are late, but we are here. We are coming to terms with the reality that the problems we thought were gone never left- they only changed shape.

To the black community, I am sorry. I have failed you in my willful ignorance. I am sorry for the ways I’ve hurt you by my actions and inaction, the words I’ve spoken and the words I’ve failed to say. I am sorry for my bias. I’m sorry for not showing up sooner. You’ve deserved better. 

To the white community, don’t start in my words. With all humility and all respect, turn to the black community first. Listen to their words. Read their books. See their films. Hear their stories. I’m here, not as a leader, but as a small voice in the background using the tools I’ve been given to point towards truth. Members of the black community know those truths better than anyone; they live it. Open your heart. Believe them. And, seriously, please stop getting lost in debates over whatever conspiracy you think has infected the media, the country, the church. Do not turn this movement into a platform to rail against. This is more than an agenda. This is about human lives. 

Black persons deserve to live and do so abundantly; historically, they have not been afforded that freedom. They have been told, implicitly and explicitly, that they are not good, they are less-than, and they are not safe because of the color of their skin. They have been told this by governments, social structures, workplaces, judicial systems, healthcare providers, neighborhoods and friends. Centuries of these injustices have been inflicted on the black community with no promise of escape; the current system has had held the power to effectively traumatize an entire population, and to do so for generations. It must stop. 

It is time for black individuals to live in the safety that has eluded them for generations. They must be secure in their right to breathe, followed by their right to live abundantly and joyfully. They deserve to become who they were made to be, authentically alive, beautifully whole, untangled from the lies and traumas that have been inflicted upon them. They deserve to be set free, truly free, in every sense of the word.


If you have begun your journey of learning and hoping for this freedom, as I have and continue to do, I’d like to offer my thesis for moving forward in the work for justice for our black sisters and brothers:

We must remain people of peace.

To be clear- peace is not the absence of discomfort or a return to a quiet status quo. Peace, in this context, is a sense of being and operating that is moved by the Spirit and acts with eyes trained towards the hope in a well ordered world. In this world, the kingdom of God come to earth, ills are healed, injustice rectified and people are seen, loved and well. I cannot call myself a Christian, a feminist, or even a person of goodwill if I am not working for a world established in loving harmony. 

In pursuit of this harmony we must first be open to learning, then always open to learning more. In the learning, this spirit listens. It creates a space for taking in and then a time for pondering. Nothing of quality can come from what we see or hear if we don’t personally encounter and internalize what is being shared; peace will weave it together. 

This peace will allow us to incorporate new thought and root out wrong. Where the spirit burrows into our hearts, we will be ready to follow it towards introspection and humility. 

This peace will, at times, fuel anger; it will spark a heart that grows justly enraged at evil. This spark then follows through to movement- it doesn’t sulk, it doesn’t sit. It acts.

This spirit that moves to action is anchored, always, in goodness. It does not allow us to be self centered, working only to soothe our trouble consciences. It won’t allow us to walk away when the burdens are many. It does not tire. 

This spirit of peace is thoughtful. It allows critical reflection and thorough engagement with injustice from a deeply rooted place. It is intentional, as well, with both skills and time. 

This peace allows rest. If we are to prevent burn out, if we are to remain present and able to serve those who have been overloaded and overlooked for centuries, we must continue to restfully connect with the eternal source of our peace in prayer. Then, refreshed, we can show back up for more.

This peace will breed authenticity; when we do show up, we do so as integrated, whole humans, not half-selves participating for performance. It allows space to for mental, physical, spiritual and familial care, so that we may then serve thoroughly with our best selves and efforts. Our closest friends receive that effort, and it is time for our alienated black brothers and sisters to receive the same care.

Let this peace first form your own heart, then breathe life into your home, your workplace, and your world. Let this peace move you to service of God, especially in service of His black children. 

It’s time we were people of His Kingdom. Passed time. 

Let peace sustain the fight. 

further up and further in

to the next right thing

Today is a daydream. Today I am simply a girl in a sundress, free to soak in gardenia-scented breezes and the birds singing praise to the spring. I’d like to stay here forever and let the days melt into each other like butter, golden and slow, because I’m dreading tomorrow. Tomorrow my alarm will ring until I crawl out of bed, pull on scrubs, and make my way to an alternate reality where the threat of a murderous virus has crept into my city. A pandemic has turned entire countries into war zones and we hold our breath as we wait for it to take us next. In the meantime our hours get cut, supplies rationed, processes changed, and rumors are spread. We live in the calm before the storm and I tick through the hours of my shift; I dream of a life where art and words and beauty weave the rhythm of my days instead of alarming machinery, upset patients, and the buzz of danger overhead. Some of my co-workers are proud to serve, but the state of the world has not reinvigorated my own love of nursing service. Rather, it has reinvigorated my desire to live authentically, invest in what I love, and protect what I care most about. I continue to practice the compassionate art of nursing and find myself yearning, instead, for the compassionate art of storytelling.

I am not ungrateful for the road I’ve been on; providing nursing care is a gift. I consider it a privilege to help new life into the world. I am glad to hold the hands of sick women and am always willing to advocate for patients in need, victims of abuse or victims of grief. I will happily bear cheerful news and offer condolences when news is unwelcome. In reality, some of these nursing days are good. Other days, especially lately, it’s become clear that the business of healthcare has outweighed its heart. I’m getting tired. More often now, I wonder why I’m here.

In an effort to redirect my future I comb through my past. I think back to my childhood and hear my mother, also a nurse, explain that the profession, above all, is a calling. I thought I heard that call. Maybe I still do. I’ve always appreciated how well nursing practice incorporates creative thinking, compassion, and technical skill. Sometimes, though, I consider my mother’s childhood, and there the doubts return. For a myriad of reasons, both cultural and practical, she grew up encouraged to pursue work she could lean on in case her husband failed her. Echoes of that encouragement lived in the back of my mind as I sorted through my own career goals; first to be rejected was pre-medicine.It would certainly be too hard to balance all that work with mothering, and how could I ever find a decent husband doing so much studying? I then passed up English, followed by theology, then psychology, because hobbies wouldn’t pay bills. Thus, in the service of practicality, another nursing student came into the world. 

Unfortunately that advice wasn’t entirely faulty; my nursing job did serve me well when I couldn’t rely on my husband. I married young, just after college, and was promptly carried off by his military career. Nursing provided some consistency in the chaos and I heard over and again how lucky I was that my job traveled so well. I agreed, thankful for the flexibility and the paycheck. I dove deeper into the field, supposing myself wise for working towards a masters before we began having children. Of course, life is never as neat as we hope for; my best plans were thwarted when my husband realized he didn’t want children. Thankfully, nursing was as reliable as ever when I realized I didn’t want him. I left and was indebted, again, to the job that traveled well.

Today, finally, in the absence of one dysfunctional marriage and many imagined children, I am free to envision what I want out of life for my own sake. There are things in my heart peeping out from the shadows, waking up with the spring to remind me of what I used to love. I easily recall the first book report I ever did and the vivid detail of my fifth grade English class. I remember ruining my eyes at seven reading Harry Potter by nightlight, poring through Lord of the Rings at eight, and my dad pulling me from the depths of teenage depression with The Right to Write. I recall the first book I ever scribbled out, a ten year old’s saga complete with fairies, and the newspaper I haphazardly started in high school. I used to tell people my dream was “to publish a book,” and it was writing that earned me a full tuition scholarship to college. I think back to nursing school and find that, of all the things I should have been proud of, the day my freshman English professor read my story aloud to the class was the highlight. Most recently, it was writing that helped me through divorce and brought me home to who I’m meant to be. Writing has been faithful.

Where writing has followed me, it is time I followed it. I am being pulled somewhere new and, hopefully, towards a more authentic version of myself. So far I’ve found that at my most wholesome, authentic core I am blissfully naive, enchanted with stories, and hoping to be in the service of beauty. In that service, in my most sparkling dreams, I join the class of authors who’ve told stories well through their novels, articles, television shows, films, poetry and music. The writing world is broad, the list endless. So endless, in fact, that I am not quite settled on where my writing voice will feel most at home in the future, though I do know where I’d like to begin. At this beginning, I hope for the chance to explore a world I did not allow myself to seriously consider in the past. Put simply, I want to write and I want to be given the tools to do it well. I am ready to learn. 

Naturally, there is also the possibility I find a way to weave my current profession into a writing career; I have found no better place to learn of humanity than entering into another’s experience of birth, life, sickness, and death. Either way, storytelling has my heart, and I want nothing more than to do it to the best of my ability in any of its forms. The unexpected nature of this journey has only proven that I must, we all must, invest in what we love. Destabilizing as it may seem to consider such drastic personal changes, all we can hope to do is take the small steps before us and move slowly in the direction of those passions. 


Further up and further in, friends.

The best is yet to come.

dear nursing students

what you should know before your heart is on the line

Healthcare is a business. 

It’s best you understood this unfortunate truth now. I didn’t. I was idealistic, hopeful, and optimistic. I went to nursing school believing I was called to be the hands and feet of altruism; subsequently, I sacrificed health, money, time and sleep in its pursuit. 

I am now struggling with the existential friction that comes from following that call directly into the mouth of a business structured not around purpose, but profit. Soon you will struggle too.

When you graduate you’ll be pinned. You’ll get your hands blessed and your boards passed and you will be proud. You will endure a grueling, stressful first year of work and feel like you’re lost in a fog. Eventually your eyes will adjust, you can see through the clouds, and somehow you will no longer be drowning. You will be swimming. It is then you will see what you were blind to before: healthcare is a business. 

You will start to feel it. 

Healthcare is a business, so you will often be short staffed. You will not be paid what you feel is reasonable. You will not have the support or supplies you feel are appropriate. You will also not be able to change it, as businesses aren’t run according to what you feel. You will begin to feel powerless. 

You will be taken advantage of. You are kind, hard working, and compassionate. Your work ethic does not allow you to stop doing your job; your workplace is aware of that. This is why you will continue to work short, get paid less than you deserve, and feel entirely, utterly replaceable. Because, to a business, you are. Nurses come dime a dozen and someone will fill your position as soon as you get frustrated enough to quit. Or you’ll go back to school, where you’ll feel like you have the control- the chance to provide the care you planned on. 

You’ll feel like the business cares more about customer service than anything else; this will start to sting. 

You’ll find patients who consider you waitstaff, hospital stays akin to hotel stays. This will feel wrong too. 

You’ll hear older nurses say it wasn’t always this way. You’ll see younger nurses lining up to take your place. 

You’ll be asked to do more jobs than your job, and jobs you aren’t prepared for, because that’s the way it’s been done. It was the norm, the standard of what was acceptable, and it shouldn’t have been. You’ll be expected to suck it up and keep working anyway.

You’ll get stressed. You’ll get burned out. You’ll be too tired to fix it. 

Your co-workers will become the reason you show up. They will see you through marriage, divorce, birth, death, and life. They will become your family. You will even find colleagues and doctors and managers who listen to you, try to help you, try to help nursing, and you will be grateful. Eventually, though, they too will come up against the impenetrable wall that is business.

You’ll still get to care for your patients; you’ll cry with them, laugh with them, talk with them, heal them. But there will be a day when your heart will get tired and the rest weighs too heavy. Your optimism will be met with a budget; you will be broken. You will want to leave, but you can’t, there will be no where else to go, because the rest of the system is broken too.

The choice, then, will be yours. You can clock in and out, care for your patients, laugh with your friends, and ignore the rest. You can try to fix what you can, wherever you can. You can reduce your hours, change your career, or move hospitals. Either way, as long as healthcare is a business, nurses will filter through as fast as their profit-producing patients. Eventually the business will wonder about their front-line turnover, but there will be no need for a fix; the ones who spoke up will already be gone. There will be another new nurse, another fresh face, and the cycle will continue.

I wish I knew how to break it.

nurses are going to burn out (or worse)

we are getting tired

The original version of this post was shared in early April, though I was asked to remove it by my workplace as they investigate potential privacy concerns. While it is challenging to thoroughly discuss the nurse’s experience without also discussing his or her patients, I have attempted to modify this piece to satisfy their needs; they advised me that sharing an edited version would be acceptable. I will also mention that, at this stage in my workplace’s management of COVID-19, not all of the following processes are still in place and are no longer of concern. However, I leave the post as intact as possible, as it is my continued belief that nurses should feel free to share of their experiences, past or present. It is my primary hope that in re-sharing this sliver of my experience someone else will feel comfortable enough to share theirs as well. It is only through open communication that nurses will be able to collectively advocate for improved workflow and, ultimately, improved care of their patients.

All too frequently, nurses are torn between customer service and nursing service, that endless rolodex of patient complaints and notes on our failure rolling through the back of our minds. We waste precious moments at the wrong bedside more often than we should, on more days then we should, unable to shake the conflict.

This day is no different. Once again, I find myself torn between a patient wiggling about in her stretcher, clamoring for my attention, and the guttural, maternal sounds that precede birth that echo across the hall.

I’ve been frozen in place two moments too long, the “patient experience” administrator who came around last week clouding my judgment, who wanted to make sure we were specifically asking every patient if they were “comfortable.” The endless supply of warm blankets and ice chips and phone chargers wasn’t enough evidence of our care, nor were our assessment skills, medication administrations, therapeutic conversations, education and advocacy. No matter, we aren’t scoring well enough on patient satisfaction. Using these buzzwords will hopefully remind our discharged patients that we did, in fact, care about them. Today this well-intentioned administrator hovers over my shoulder, whispering she’s uncomfortable in my ear, and I don’t know what to do. 

The spell is broken when a doctor pokes her head through the curtain asking for my help. I snap out of it, frustrated, and march after her. We messily deliver a baby who’s decided to slide into the world on the wrong unit, and what should have been a calm, straightforward birth has become a loud, crowded, hurried mess in a room without the privacy of a door, without the right physician, and without the right supplies. Births like this happen all the time, where nature gets the best of our attempts at organization, but it never gets less overwhelming. Not down here, anyway. The same thing happens the following week: one upset patient, one delivering patient, and a handful of frazzled nurses. 

Some days don’t feel this hectic. Some days our little OB-GYN Emergency Department is full of less pressing complaints, like those patients looking for STD testing or management of morning sickness. Some days we are urged along more quickly by pregnant women seizing, bleeding, or worse. Some days we have the staff. 

More often, especially lately, our nurses get sent home early because the budget doesn’t allow for them. This is fine on easy days, stressful on others.

Today is looking like one of those less-fine days as we consider the pandemic creeping through our city. We sense its approach and are growing concerned because now, on top of normal pregnancy concerns, we are starting to see pregnant women with respiratory concerns. And, unlike the adult ER on the other side of our hospital, we don’t have a separate unit to place our respiratory patients. Of the beds we do have, only two have doors. Our unit was simply not built for things like this. 

We are left with both practical and theoretical questions. Where are we supposed to put down the masks and shields we’re meant to be re-using? Why does it feels like those hacking coughs are blowing straight through the curtains? We’re confused; the PPE charts make it look like we don’t need shields and gowns until our patients are considered “Persons Under Investigation” for COVID-19, but we don’t feel comfortable waiting for the moment it’s official to start wearing protective gear. We’re also wondering why we can’t do any testing. At first it was because the Health Department wasn’t testing at night. Now it’s because we are only testing inpatients. We’re concerned for the patients we’ve discharged home; they might not be sick enough for admission, but they were certainly still infectious.

All these things run through our minds and our mouths when we have patients show up looking for COVID testing; their physicians sent them here, but they probably shouldn’t have, we aren’t testing anyone. Nevertheless, they are here, they must be evaluated, so who gets the room with the door? Which nurse is going to take care of the sicker looking one and who is going to pick up the rest? What do we do when too many sign in for one nurse to handle? My coworker dons and doffs gear, adjusts monitors, empties bedpans, then helps me juggle the influx.

As she’s handling masks and gowns and shields we chat about the rumors that staff have been taking protective equipment home. We discuss the new “PPE Steward” who comes around distributing packages of gear every day. Meanwhile, somehow, patients who have no respiratory complaints are wearing masks and gloves because they’re scared. How did they get those items? Do they know how to use them correctly? Don’t they know there’s a shortage? I’m scared. 

All this confusion is starting to make a stressful situation seem downright unmanageable and I’m sure it’s only going to get worse. I get a headache, realize I’ve forgotten to eat, and notice I’m starting to get irritable. Nature laughs again as, of course, this is the moment my performance evaluation is due.

At the end of it all I had concerns of my own- I didn’t like the inconsistent communication about daily guideline changes. I didn’t appreciate that we care so much right now about using the word “comfortable” when we can’t get straight what masks we are or aren’t allowed to wear. I don’t like that my “goal for the year” is to obtain a new nursing certification; I obtained a more challenging one at management’s request last year but now the “hospital initiative” is to have a different one, which feels like an unfair use of my time. Mostly, I’m tired of working short and I don’t think we are paid well enough. 

Somehow I make it to the end of the shift. I clock out and eat cold mac and cheese on the ride home. I strip in the garage then eat two bowls of cereal, half a bag of Cadbury eggs, bite off all my nails and watch four episodes of Girls. Eventually I fall asleep, wondering if this is what burnout feels like or if this is just a symptom of nursing in a pandemic. Maybe it’s both. Either way, none of it is good. 

This crisis has only begun to highlight those pre-existing systemic weaknesses nurses face on top of this threat to our health and that of the public. We are lost somewhere between strained nurse management and corporates who don’t understand patient care. I am left wondering who to rely on. I am dreading what comes next, because nurses are caring for the sick. We need to trust someone will be caring for us.