Surviving the surge: ICU nurses on the most difficult year of their lives

The Intensive Care Unit on the ground floor of MLK Community Hospital is calm on this warm, spring day in South LA. A handful of nurses sit behind monitors, separated from their patients’ rooms by a long panel of Plexiglas that stretches the length of their work station. They rise periodically to check patient vitals, moving purposefully in and out of rooms.

“Things are almost back to normal here,” says ICU nurse Amanda Hamilton as she surveys the calm. “We’re all trying to settle into it. But we were at such a high level of stress, just go go go every day, I think we’re all still kind of in shock.”

Just months ago, the hospital was the hardest-hit hospital in one of the hardest-hit regions for COVID-19 infections in the world. During the worst of the surge, hospital leadership made the decision to expand the ICU to another, larger floor of the hospital to accommodate the overwhelming number of severely ill patients.

Patients were arriving in critical condition at a pace unlike anything the nurses had seen before. And they remained in the ICU, fighting for their lives, for weeks on end. 

A personal connection

For ICU charge nurse Maria Arechiga, the work of healing is personal. She grew up just two miles from the hospital and graduated from nearby Compton High School. She often recognizes her patients, or finds outs that they have some local connection.

“I’ll see friends’ relatives. I’ve seen high school classmates,” she says. For those who recognize her, or even those who just see her as a familiar face from their community, her presence brings a sense of comfort.

“The fact that I speak their language, it’s a feeling of ‘you understand me, you understand where I come from.’ It helps a lot, I think.”

Nina Tacsuan, another ICU nurse, grew up just south of the hospital, in Long Beach. Her community was composed of immigrants and first-generation Americans, with similar demographics to South LA, and the street she grew up on was Martin Luther King Jr. Avenue. When she became a nurse at MLKCH, she felt right at home.

Personal connections made it both easier and harder for the nurses to provide the critical emotional support that COVID-19 patients required. Isolated from friends and families, patients relied on nurses in new ways. The nurses gave it their all, whether it was bringing a sweet treat from the cafeteria, wheeling patients outside to soak in the Healing Garden’s sunlight, or even just staying for a while to talk. Anything to keep their patients motivated.  

Says Nina, “I put a lot of effort into taking care of our COVID patients [because] if I was in their position, I would want somebody to treat me just as well as if I was their family.”

Turning to one another

Outside the ICU, it was almost impossible for nurses to convey to others what they were experiencing. Whether it was helping to translate difficult conversations, comforting grieving family members, or setting up iPad sessions where family members said goodbye to their loved ones—they all took their emotional toll.

Nina recounts one patient in particular, a man around her age with a wife and young child. “It was around the peak of the surge, or a little after. I took care of him when he was intubated. And I really started to get this sense of, ‘I hope he doesn’t die. If he dies, it would break me.’”

She tears up as she recalls the joy she felt when she saw that same patient, alive and walking, in MLKCH’s outpatient recovery clinic. But the experience shook her.

Caring for the sickest and most vulnerable patients required great personal sacrifice. “My own family wouldn’t see me, nor did I want to expose them. A lot of us sacrificed our own relationships,” says Amanda.

The team has long been tight knit, with many of the nurses working together for years prior to COVID. Many, including Amanda, Nina, and Maria, have been with the hospital since the very beginning, when it opened its doors in 2015.

But the intensity of the surge cemented their bond. They talked openly in the break room about what they were seeing, and encouraged one another to seek mental health resources when needed. They anticipated each other’s needs and helped one another.

“I saw my colleagues struggling,” says Nina, so she often pulled extra shifts on her days off. “I didn’t want to just sit at home, I wanted to come in and help them out.”

Moving forward

Many became ICU nurses for similar reasons: being able to make a difference in someone’s life at a critical juncture between life and death. Their work has never been easy. But the last year tested them like nothing before.

“I don’t think we could have made it through without each other,” says Amanda.

But they did make it through. And they’re certain that this—in the ICU, saving lives or even grieving lives lost—is where they belong. For now, although COVID remains on everyone’s minds, they’re focused on getting back into the rhythm of things and continuing to serve the community.

“We all grew a lot,” says Maria. “There’s a new level of expertise and respect we have for one another.” The earrings she often wears, small gold discs handmade by herself, are stamped with a reminder and a mantra: I am strong.