Mental Health: Reflecting on Life as an ICU Nurse During COVID

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By Medical Edge Recruitment

March 27, 2023



Reflecting on Life as an ICU Nurse During COVID-19: Mental Health

Medical Edge Recruitment provided this article.

Written by: Christine Purviance, BSN, RN, Director of Clinical Services at Medical Edge Recruitment

It has been just over three years since the first case of COVID-19 landed in the United States. Hospital admissions and total cases are trending down, and our lives seem to have returned to normal. Those who were unaffected have their sense of normalcy back—schools are open, mandates are lifted, and travel is unrestricted. A few more seasons and the pandemic will become another chapter in our history books that we will tell our grandchildren about, for most.

Public Perception

Nursing – a job once derived from compassion, caring, and respect quickly turned into a political narrative with false accusations of deceit at the start of the COVID-19 pandemic. With so many false truths and accusations across social media, and the world, nurses took the brunt of the emotional attacks. We were accused of killing the same patients that we were so desperately trying to save. We would have given anything to show the public the reality of the crisis we were facing. Some of us were called liars when we tried to tell our loved ones that COVID was real and that we were witnessing death daily. “You signed up for this” were the words spoken to us as COVID penetrated hospitals while we begged for more PPE.

Our Reality

While most of the world dismissed that COVID existed, we were zipping up body bags like it was trending. We felt uncertainty and fear—we feared infecting our children, husbands, sisters, brothers, and parents, and uncertainty if we would get infected ourselves. We learned quickly that death was impending when patients made it to the ICU. Ventilated, sedated, paralyzed, prone. Each patient started to look the same. For what felt like an eternity, we cared for the same patients for weeks and sometimes months as they slowly died alone.

I remember it like it was yesterday; after having three days off, I came back to find that the unit I worked on had lost three-quarters of our critically ill COVID patients. They had all been on our unit for over a month. We had been doing everything we could for them while they fought for their lives, hooked up to endless monitors and life-saving equipment. For weeks, a dozen medications seeped into their veins–pumping their hearts just enough to sustain life, receiving high doses of sedation, continuous pain medications for comfort, and drug-induced paralysis in hopes they could oxygenate better. Nothing helped. It was at that moment when I saw how many patients we had lost despite our best efforts that I realized the devastation COVID-19 would have on so many lives and that we would never be the same.

Our backs had always hurt, but now our souls and hearts hurt, too. With the need for nurses increasing dramatically, hospitals scurried to find anyone who could work. We were overworked and undervalued; many of us felt like we were just another warm body to our employers.  A pizza party does not fix the trauma someone experiences when they see hundreds of lives die in their care. Where was the support from our employers during such a traumatic time? Why did so many nurses lose their benefits and PTO? The lack of support we experienced is just scratching the surface of the real impact the pandemic had on nursing. While many of us had turned to travel nursing to earn a fair and decent wage, thousands of us have left patient care for good because we have finally realized our worth. It’s time we share our truth and gives others the real nursing perspective during COVID.  

Perspectives from former COVID ICU Nurses

Amanda, RN

“I would not have become a nurse if I knew a global pandemic was in the future,” Amanda, an ER and ICU nurse, says. Amanda has been a nurse for four years and enjoyed her work pre-pandemic. Amanda describes her mental health as good before COVID. She was hardly anxious and really enjoyed being a nurse. Fast forward, Amanda describes how she had to start taking antidepressants during the pandemic, is a very anxious person now, and turned to alcohol a lot during the pandemic. “It was so surreal. It almost felt like we were soldiers going to war to fight this unknown and dangerous virus. I saw so much death and suffering; it was exhausting, overwhelming, and traumatic.” She says that one of the hardest things for her and her colleagues was the skepticism that non-healthcare workers had regarding COVID. “It felt like a slap in the face. We were stacking bodies on top of each other, holding our patients’ hands as they died alone.” Amanda left the bedside three months ago and says it was the best decision she ever made.

Lisa, RN

Lisa, a former ICU local travel ICU nurse, exclusively took care of critically ill COVID patients during the pandemic. “It was surreal, heartbreaking, and one of the most difficult times of my life,” she describes. She isolated herself from her mom, husband, and friends as she “witnessed death several times per day, nearly every day.” Lisa sought help during the pandemic for nightmares and intrusive thoughts from a therapist who provided coping mechanisms like self-regulation techniques, journaling, meditation, and self-compassion. Lisa says, “my mental health is definitely not what it was pre-pandemic, but I am much better now, maybe even stronger.” Lisa encourages others to not wait to seek help. She suggests finding a therapist, a self-help book, or a resource that works for you. “When your mental health improves, a cloud is lifted…healing begins from within through the practice of self-compassion.”  Lisa left the bedside in February of 2021 to pursue higher education.

S.M., RN

S.M., an ICU, OR, and PACU nurse, describes working as a nurse during the pandemic as “crazy!” S.W. had been a nurse for 12 years when the pandemic started. When asked about how she felt about her employer, she states she feels like politics got in the way of patient care. She describes her mental health as good prior to the pandemic, but now she feels that she has more depressive days. After working through the pandemic, S.W. has not considered leaving the bedside and still loves what she does.

Resources and Help

The data and evidence on how COVID impacted the nursing profession, and mental health is limited, likely due to the recency of the pandemic. However, according to a recent survey [AS1]  of critical care nursing burnout and mental health during the pandemic, 44% of critical care nurses experienced moderate-to-severe depression and anxiety, and 47% were at risk for having post-traumatic stress disorder (PTSD). Of the nurses surveyed, 84% experienced moderate levels of burnout and moral distress. COVID-19 has impacted every nurse across the globe in one way or another.

Many of us are doing well, but some of us are still struggling. If you, or anyone you know, needs mental health support, it is never too late to ask for help. Mental health therapy has never been more accessible and can be done from the comfort of your own home through virtual appointments. Below is a list of mental health services available for anyone:

Moving Forward

The realization of our value after the pandemic has shifted nurses’ attitudes across the nation. From travel nursing for adequate pay to remote nursing jobs with less liability, thousands of nurses have left their role, left nursing altogether, or pursued higher education. The future of nursing is uncertain, given the evolving impact of the pandemic, but we hope that sharing our reality and experiences can open the minds of those who weren’t in our shoes. The need for nurses is great, but the need to support and retain our existing nurses is greater.


Guttormson JL, Calkins K, McAndrew N, Fitzgerald J, Losurdo H, Loonsfoot D. Critical Care Nurse Burnout, Moral Distress, and Mental Health During the COVID-19 Pandemic: A United States Survey. Heart Lung. 2022 Sep-Oct;55:127-133. doi: 10.1016/j.hrtlng.2022.04.015. Epub 2022 Apr 29. PMID: 35561589; PMCID: PMC9050623.

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