For nurses across the U.S., various words come to mind when describing the latest COVID-19 surge, from exhausting and mind-blowing to eerie and challenging.
No matter the word, one thing is clear: This surge fueled by the omicron variant is different from past surges. Nurses are facing an increased number of patients, often at a faster pace, and staff are experiencing the emotional, physical and mental toll of the pandemic as it enters a third year.
Still, nurses remain hopeful about the future, as they reflect on the teamwork, strength and resilience workers have shown.
Nurses shared with Becker's one word to describe the current COVID-19 surge and how the surge compares to prior ones. Responses were lightly edited for clarity and length. They are presented alphabetically.
Note: This piece was updated Jan. 14.
Veronica Brill, MSN, RN. Associate CNO for UVA Health (Charlottesville, Va.).
One word to describe the latest surge: Complicated.
How this surge is different: Every minute, every day, the operational situation is shifting. The shifts are not gradual — rather larger and faster than before. Despite vaccines and boosters, team members are being directly impacted, whether it's infection for themselves or their loved ones, on top of taking care of the skyrocketing patient volumes. This latest emotional rollercoaster has taken us from celebrating the holidays with loved ones, to feeling overwhelmed with COVID-19 volumes and seeing our fellow team members quarantined — all at the same time. On the flip side, the team is putting all the learned lessons on nimbleness, collaboration and gratitude into practice. There is a stronger sense of recognition that we are all in this together, we have been in a similar place before and we know we will get to a better place, together.
Megan Byers-Fowler, RN. Supervisor of Emergency Medical Services, Ochsner Medical Center-West Bank (Gretna, La.).
One word to describe the latest surge: Volume.
How this surge is different: This variant is so transmissible, so we are seeing more patients than ever before. In previous surges, outpatient clinic closures and elective procedures being canceled allowed staff from those areas to be redeployed to the ED staff to assist with the increase in patients. With this surge, clinics have remained open and elective procedures are moving forward, so we haven't had the increase in staff to assist our staff with the higher number of patients presenting to the ED. We have seen record-breaking numbers of patients for weeks now. Our ED team has had to come up with some creative ways to address the high numbers of patients with low acuity or just for testing. In response, we have created a COVID triage for all patients checking in with COVID-19 symptoms or for testing. Patients are quickly screened by a nurse or advanced practice practitioner to determine whether they need further treatment, allowing for more efficient patient throughput.
I think with each surge, front-line staff are a little more discouraged. We all hope this is the last one we ever have to go through, but with this one — it's like we are losing hope that we'll ever be "rid" of COVID surges and are concerned that these surges will become the new norm. I'm thankful for all of the nurses who are tired or feeling discouraged yet still come to work each shift to care for the people in our communities.
Kim Combel, RN. Operations Coordinator of Emergency Medicine, Ochsner Medical Center-New Orleans.
One word to describe the latest surge: Challenging.
How this surge is different: To me, this surge is different because we are seeing record numbers of patients in our emergency departments for both COVID and non-COVID patients. In general, this is typically a busy time of year in the ED. In addition, we are seeing many people with little or no symptoms come to the ED for COVID tests due to the limited access to home tests and/or long wait times for other community testing options. With access to testing increasing, we are seeing slight relief but still have very high volumes of patients per day for COVID testing and COVID symptoms.
One thing that hasn't changed is that we're all in this together — through every surge. In these unprecedented times, stress levels are elevated. It's important to be kind to one another and continue to work to conquer yet another wave of this pandemic.
Buddy Gager, RN. Singing River Health System, Mississippi Gulf Coast (Ocean Springs).
One word to describe the latest surge: Eerie. Right now, it's a lot like the calm before the storm. Sure, the omicron variant seems less severe, but Mississippi's nursing shortage has only gotten worse. Although we may be admitting fewer COVID-19 patients during this surge, the few who do require hospitalization could cause hospitals to become stretched to the brink due to limited staff. Every other hospital we've spoken with was already reaching capacity before the current surge even hit. Only time will tell who all will be left standing if we do not get the state to help us combat both the virus and the nursing shortage.
How this surge is different: I think we are headed into this fifth surge already broken — staffing levels across the region are increasingly becoming more difficult to manage after each additional wave. Mississippi's healthcare system is once again on the verge of collapse, as more than 2,000 nurses have left for higher-paying jobs in other states since the pandemic began. We lost even more recently who decided to try travel nursing when the fourth wave subsided since they didn't feel as guilty leaving their teams while things were more manageable here at home. That's where a nurse's heart comes in — you don't want to see your co-worker suffer as much as you don't want to see a patient suffer, and that is why many choose to stick it out. Now, with the fifth surge underway, I hope Mississippi nurses put their thoughts of resignation on hold and that those who left come back to help us fight because, even though it helps when one nurse chooses to stay, it just isn't enough.
Arianna Hebert, RN. Director of Emergency Medical Services, Ochsner Baptist (New Orleans).
One word to describe the latest surge: Mind-blowing.
How this surge is different: So many things are different with this surge. The biggest difference is how quickly volumes increased and how high the volumes have reached. We've learned a lot over the last two years and four surges. We watch the numbers closely. When they start to rise, we start preparing.
The first week of this surge, we saw about a 50 percent increase in volume with mixed acuity. This is the first time we're seeing both COVID-19 and the flu rise at the same time, so we knew volumes would be up. It has been closer to our "pre-COVID" winters.
One thing we realized was how quickly this variant is spreading and how much sooner people were becoming symptomatic after close contact with an infected person. During prior surges, patients would not test positive for as far out as seven to 10 days. This time, we are seeing people who are symptomatic and test positive within two to three days. Our volume of positive patients had doubled by the Sunday after Christmas and tripled by the following Monday. We went from seeing 85-95 patients per day to 240 patients per day in our 14-bed emergency department. Staffing is already tight, and we had staff going out on quarantine after testing positive. Fortunately, most of the patients we are seeing are much more stable than those we saw during previous surges, so it was a matter of figuring out how to efficiently flow patients and limit exposure to those who were coming to the ED for other medical issues. It was all hands on deck.
The teamwork, not only within the department but also across the campus and within the emergency medicine service line, has been inspiring. At Baptist, everyone remained calm and had a positive "let's do this" attitude. We got very creative with our space and shifted a lot of support to the front end for triaging and screening patients. We normally have one triage nurse, but we started running with 2-3 teams that would triage, swab and move the patients along to the next step of their visit. Each area had a team, so there was constant movement of people through the department. This helped to keep main beds available for the very sick and other emergencies.
Erika Johnson, BSN, RN. Medical/COVID-19 Intensive Care Unit Nurse at Tufts Medical Center (Boston).
One word to describe the latest surge: Exhausting.
How this surge is different: This surge is different than the last ones because staff is physically, mentally and emotionally exhausted from battling this pandemic for almost two years now. We have spent endless hours in masks, personal protective equipment and in COVID rooms. This is the third time the MICU has been moved out of our home location to create more ICU beds in the hospital. A lot of nurses have left the bedside or went to different specialties. One way this surge has been easier is we know how to take care of these patients better. Though there are still a lot of unknowns with COVID, we have a better understanding of what works and what doesn't for staff and patients.
Jeana Jones, BSN, RN. Nurse at Scripps Memorial Hospital La Jolla (Calif.).
One word to describe the latest surge: Strength. Behind the exhaustion, the frustration and the pressure of being a healthcare worker is strength. Strength is what you see in the heart of the healthcare workers who show up every day to work with their chin up, willing to take on the challenge of a new day.
How this surge is different: The difference in the surge we are seeing today has a lot to do with the attitude of the community, the increase in volume of patients and the staffing shortage. Last year, everyone was concerned, including the healthcare workers. We were all concerned for our lives, for our families and for our patients. That feeling in the community seems to have subsided, yet in the field of healthcare, it still exists. People now seem to show less regard and respect for their health and the health of those around them. A year ago, healthcare workers were regarded as heroes with pots banging, food being delivered and gratitude from the patients, which is no longer the case this year.
Now we are seeing another spike in COVID inpatients while struggling to maintain a full schedule of healthcare workers. Staff are now exhausted, frustrated and second-guessing their career choice, yet they continue to persevere and show strength. I would like to give a special shout out to those healthcare workers who have shown up day in and day out to their shifts with the care and courage we shared with our patients a year ago, when we were considered heroes. They are still heroes today, ready to face this challenge and continue to serve our community with grace and dignity.
Cynthia Le, CFNP. Nurse Practitioner at Singing River Health System-Mississippi Gulf Coast.
One word to describe the latest surge: Strength. The strength of all healthcare providers, inpatient as well as outpatient, to endure another surge. The strength to continue fighting another battle. It has not been easy, but we show up every day and give it our all.
How this surge is different: This surge has definitely brought on more — more patients, more hysteria, more work. Yet nursing and support staff remain the same or sometimes less. Even though we may be short-staffed sometimes, we are doing our best with what we have to provide care to our patients and communities. With time and diligence, we will survive this one just like how we have survived the other surges.
Susan Russell, RN. CNO and Patient Care Manager at Singing River Health System-Mississippi Gulf Coast.
One word to describe the latest surge: Exhaustion. Everyone is completely exhausted dealing with the unending need for more resources — whether that need is in terms of people, things or time. I often wondered how everyone endured four years of world wars, with the personal sacrifices, human and material losses and mental toll, but now understand then as now. There are no options other than carrying on — for them, until an armistice was reached, and for us, until the pandemic subsides.
How this surge is different: This surge is different since healthcare workers have weathered four surges before this one, and nothing that was in place before March 2020 in healthcare is quite the same. Team member turnover is reaching historic levels at a record-breaking pace, positions in all areas of healthcare are largely unfilled and now staff is calling out in vast numbers. The silver lining is we've become battle-proven and have a better idea of what this virus does, and of course, more tools in our arsenal, including vaccinations, monoclonal antibodies and new antiviral drugs coming soon.
Hector Sevillano-Torres, RN. Critical Care Nurse at Hartford (Conn.) Hospital.
One word to describe the latest surge: Resilience. As we enter the second year of the COVID-19 pandemic, I've reflected a lot on the ongoing challenges and broad range of emotions we have experienced as healthcare workers. We're fighting depression from the immense loss of human life we have seen. We've become frustrated that, despite what we have learned regarding the prevention of spread, we're still experiencing crisis-level hospitalizations across the country — the latest of which is all too reminiscent of the first wave. And many healthcare teams have become mentally and physically exhausted from a pandemic that has not gone away and has tested the limits of healthcare workers around the world. But what has remained abundantly clear to me as I look at the teams at Hartford Hospital is that we are resilient. What has been most prevalent (even to the virus) on these units is a dedication and perseverance that has resulted in high-quality care to the communities we serve. Despite the challenges, we have had a lot to celebrate whether it has been saving a life, introducing new therapies to advance our level of care, and even getting married and having babies. The teams I am surrounded by have done nothing but push forward and have displayed incredible strength and endurance. As we brace ourselves for the next surge, we rely on one another, and this shared experience to overcome all the challenges ahead so we can see a better tomorrow.
How this surge is different: Hope. We have so much more hope than we did in March 2020. Despite heading into a second year of a global pandemic, we have accomplished a lot in a very short period. As a result, there are now three authorized vaccines for people ages 18 and above (Pfizer-approved for ages 5 and above), a newly authorized oral antiviral for the treatment of COVID-19, and a much better understanding of what we need to do to maintain safety and prevent the spread of COVID-19. Hope is what has helped so many people adapt to the abundance of restrictions and new way of life. And hope is the reason why healthcare teams continue to do the best they can to provide high-quality care to the communities they serve.
Audrey Silver, MSN, RN. Emergency Department and ED Observation Unit Nurse Manager at Hartford Hospital.
One word to describe the latest surge: Unprecedented. This surge is certainly not something that I imagined occurring nearly two years into this pandemic. It has brought unprecedented numbers of patients into emergency departments, and this has become the most challenging time of many people's careers. However, it has also brought unprecedented camaraderie and interdisciplinary collaboration. It has forced us to constantly think outside the box and promotes an agility in operations that will only help us in managing the ever-changing healthcare needs of our community into the future.
How this surge is different: Our emergency department is currently experiencing extraordinary patient volumes, the highest in our department's history. Much of this volume is related to this new surge of COVID-19. Due to the transmissibility of omicron, staffing has been impacted. However, our staff's positivity rate remains below that of the state's overall positivity rate, demonstrating that personal protective equipment continues to be effective for maintaining staff safety in patient care settings. The last several weeks have challenged us in new ways that we never imagined. But the resultant teamwork has truly been exceptional and has made us all stronger going forward.