Feeling Smothered: One Morning in a COVID ICU

Paige Randolph, FNP-C

When anxiety sets in, I feel emotionally smothered. It becomes hard to concentrate, to feel emotion, or even think clearly enough to get through day to day tasks. From March to May of 2020 I was working in a major hospital COVID ICU with thirty-six beds. I have never been one to suffer any sort of mental health issues prior to that time. So for me, like many others, those few months forever changed me. 

I’ve seen so much death and heartbreak in my five years in the ICU, but I have never experienced more tragedy, loneliness, and hopelessness than I did that spring. One day in particular, I experienced all of these emotions at once like a full speed train coming right at me. I was taking care of the usual COVID patient: full blown ARDS, proned, paralyzed, on continuous dialysis, and showing little hope for extubation and recovery. This patient had kept me running all day between a low blood pressure all morning, CVVH clotting off frequently, multiple drips and experimental medications to manage, as well as battling low oxygen saturations throughout the entire shift. When it came time for me, three of my teammates (some nurses from other units, some physical therapists, or whoever was available in the hospital to help that day), and the respiratory therapist to manually supine the patient again, the patient’s O2 saturations continued to drop into the 70’s. So, we flipped them back over prone once again and they managed to come up to the mid 80’s. That was going to be as good as it was going to get for now.


I. WAS. EXHAUSTED. At this point I had been in the patient’s room, in full PPE (meaning gown, two pairs of gloves, N95 mask, and face shield), for about 6 hours straight. No break, no water, no bathroom, and no room for fresh air to breathe with my N95 positioned so tightly to my face. I started to feel lightheaded. All the sounds of the alarms of the ventilator, monitor, machines, and IV pumps got louder and I could feel my heart beating out my chest. I either started sweating profusely or was just now realizing how hot I was, having been in this PPE all day. I needed to get out of this room…right now. Now, the anxiety was not only smothering me emotionally, but it was smothering me physically in the form of PPE.

I banged on the glass door and put on the call light calling out for someone to come let me out because at that time you needed a second person to help you remove PPE properly to prevent contamination. I couldn’t wait, I needed this mask off my face and I needed to breathe again. I got out of the room and ripped each piece of PPE off as fast as I could, sprinted around the corner, and wept. The tears flowed freely as I asked one of my coworkers to go in and help the patient; they were still unstable and needed a nurse in the room with them at all times. The patient needed me to care for them still, but in that moment, I needed to care for myself more than anything. 

I now know I experienced my first anxiety attack that day. It was the moment I realized I was not okay. I was not okay with my patient’s oxygen saturations being 85% and that being “as good as it was going to get.” I was not okay with feeling like there was nothing we could do to save these patients. I was not okay with being the only person in the room as families said goodbye over Zoom on an iPad. I am still processing a lot of emotion when it comes to my experiences with COVID, as are many of my nursing colleagues, but for now, I am taking it one day at a time and focusing on rebuilding myself. 



Photo from @spotted.dog.photography

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4 thoughts on “Feeling Smothered: One Morning in a COVID ICU”

    1. Unfortunately, this type of day seemed to play on a loop every day in the ICU, no matter what hospital or demographic location we are in. I am doing better now as I have transitioned to my NP role and away from the ICU bedside but I still have bad days. I hope you, too, are doing well! If you don’t mind sharing, what are some ways you have learned to cope with these experiences?

  1. Your story is so personal and intense. I felt like I was there with you. You have been called to a profession that we don’t realize the emotional and physical tolls you experience. Thank you for your service Paige ❤️

    1. Thank you so much for the kind words! I think many of us in healthcare chalk up our emotions as “part of the job” and don’t always have the opportunity to share with the public the raw truth of our experiences.

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