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We Lift Bodies Into the Morgue

— The physical and emotional toll of the pandemic on providers often goes unseen

MedpageToday
A deceased COVID-19 patient is wheeled to the morgue by a male healthcare worker wearing a protective mask.

We are healthcare professionals with different medical practices, but one common denominator prevails: the worst part of our professional lives compels us both to combat misinformation, and make sure that Americans understand the importance of getting vaccinated.

Allow us to elaborate. Over the past 21 months, the coronavirus pandemic has become one of the deadliest disease outbreaks, surpassing the with over 700,000 deaths. You have seen the headlines highlighted on a daily basis, with COVID-19 cutting across America, decimating schools, churches, long-term care centers, and communities. You have also seen the stories that highlight the importance of following the data and science to prevent these tragedies.

What you may not see is the unspeakable grief experienced by victims and families -- the devastating well of darkness enveloping parents, partners, and children who suffer unimaginably.

As a critical care nurse and doctor this is what we see when we have to tell a mom or dad, spouse, or friend that their loved one is gone forever. This was difficult enough when the option for a vaccine was non-existent. To now witness the suffering and carnage in hospitals across our country nearly a year after vaccines were authorized, due to politicization of the pandemic, is almost too much to bear. This situation has destroyed families, undermined communities, and weakened the core of our democracy.

The impact on healthcare workers has also been profound. The physical, mental, and emotional toll on us has resulted in an entire set of "" that has burnout, workforce loss, and understaffing of healthcare systems. While caring for these critically ill patients clearly requires a multi-disciplinary effort, it's fair to say that nurses are the glue that holds the healthcare community together.

Yet the role of the bedside nurse in caring for these patients, and even the responsibility that exists after a patient passes, often goes unseen. Imagine the following scenario: A patient who you spent hours and sometimes days trying to save dies. What happens next?

In some cases, we have to disconnect the patient from the monitor and remove invasive devices. We then clean up the deceased patient. The body then has to be bagged, and recently, due to the unusually high number of people dying, we spend time walking around the hospital looking for body bags. We've even had to double bag bodies and put them on ice because the morgue has been filled to capacity. As if that isn't enough, at certain hospitals the job to place the body on a stretcher and eventually take them to the morgue falls on the bedside nurse. The nurse calls security to open the morgue, and completes all the paperwork.

This past week we were fortunate that the funeral homes had cleared out the morgue, and there was space for our recently deceased patients. The morgue table that was open was above shoulder height, and we often don't have a safe way of lifting up the body. We try to find the best way to move each patient, who can sometimes weigh over 300 lbs. Standing on the stretcher doing our best to reach the morgue table, staff in the surrounding areas stand by watching the nursing staff struggle to accomplish this task. So often, they lend a helping hand, even though this responsibility is not in their job description. Despite the beating we have taken as a healthcare community, the silver lining is all the beautiful souls we work with, who have stuck it out together through this pandemic, and who work as a team to keep each other afloat during each and every shift.

While handling the deceased has always been among our job requirements as bedside nurses, it would only happen occasionally. Now it's at least once a week, and sometimes, twice a day. That is our experience: we lift bodies into the morgue. At a rate that is abnormal.

As healthcare workers, we are far past caring if individuals believe COVID-19 won't affect them. It now affects us all, since many of our ICUs are full, primarily with unvaccinated patients. And it is not as if our ICUs were at zero capacity before the pandemic. The current situation has impacted the many patients who need those beds for other treatable diseases. Patients are dying because we can't deliver the type of high-quality care they need, in the time they need it.

This causes a lot of emotional turmoil for nurses and other healthcare workers. We have to make decisions about which of the five patients gets the open bed, and who receives care first when ICUs are understaffed and numerous patients are crashing at once.

It's hard to know where to go from here. The reality is that we, as healthcare workers, are limited by what we can do. We will be there day or night, weekdays or weekends, birthdays and holidays, but digging out of this pandemic requires all of us to be an active part of the solution. And we have abundant supply of the very solution that can prevent hospitalizations and save lives: a safe and effective vaccine.

Nursing was once hailed as "the most trusted profession," but now rampant misinformation has sowed distrust in nurses and put trust into the wrong hands. What is particularly frustrating about Americans' reluctance to take healthcare professionals' advice to get vaccinated is that they have full trust in us once they are in the ICU bed gasping for air as a physician or nurse asks if they would rather be placed on a ventilator, or face imminent death. Sadly, this is when it is too late.

Ending the pandemic requires Americans to unite in the way we have in response to other crises or tragedies. This is not a Republican issue or a Democrat issue, it's an American issue. The time for everyone to get vaccinated is now.

Emily Ballantyne, RN, BSN, is a critical care nurse. Joseph V. Sakran, MD, MPH, MPA, is a trauma and critical care surgeon at Johns Hopkins Hospital.