Editor’s note: Sara McDonald is a nurse at St. Luke’s in Boise, Idaho. She wrote this poem as “a response to going home after the hardest shift I have ever had. ... I literally ran from room to room for 13 hours, just trying to keep people alive until morning.”

Onto the next

I am a covid veteran

This is a different kind of war

A war some don’t believe in

A war some mock, a “hoax”

The trauma is real

The dying is real

Running down the halls one room after another

“Put your mask back on”

“Stop pulling on lines”

Mitts

“You have to keep your mask on”

“Your daughter is coming in the morning, don’t you want to see her?”

The goal is to keep that one alive

“Long enough”

For his daughter to be here when they turn the oxygen off.

“Let’s just get him to morning.”



There’s that name I will never forget

the first in a growing line,

they declined for a time the use of their O2 device

I had to take it

I gave it to another,

This one lives

That one dies



They all suffer



The look in their eyes As they learn the rules of an unfamiliar game

From room air to nasal cannula

NC to oxymask

Non-rebreather

Highflo

Bipap

Max it out

“I can’t breathe!”



I know you can’t breathe



I know



“I know it’s uncomfortable,”

“I know it’s blasting air in your face.”

“I’ll gladly take it off, just do me a favor,

change your code status first.”

“I have a line of people waiting for that machine, if you aren’t going to keep it on”

“I need you to change your code status first”

“What else can be done?”

“Intubation is next”



That look on their face

“That’s where we are”



The look on their face

“That’s where you’re at now”



The look on their face

“This machine doesn’t go any higher”

“Intubation is next”



You don’t like that option



You didn’t realize



None of them realize



They would be so acutely aware

cognizant

oriented

at the moment facing that decision



I stand anxious,

waiting

I need them to make it faster

I realize what a cruel thing my impatience in this moment is, but

I need them to make it

faster

I have another one crumping three doors down

I am still not able to be more places than one, at any given time,

Much as I try

As if I want to share my time between two atrocious scenes



So?



“I want this off my face. It’s blasting me”

“I can’t breathe”



ok

“I need you to understand what will happen if I take that off.”

No sugar coating,

no lies,

no time for gentle deliveries



First you’ll panic, gasping for air

You’ll be agitated.

You’ll start pulling at lines, and thrashing about like a fish out of water

In this case, a fish suffocating at the bottom of an ocean of air,

Surrounded by it, yet out of reach

“WATER WATER EVERYWHERE, BUT NOT A DROP TO DRINK.”



The panic



We’ll hold onto you,

Mitts if we must

keep you from hurting yourself on equipment

manage self-damage

You’ll struggle

You’ll ask for the equipment back, but it’s already been cleaned,

passed onto the next



You’ll grow tired

You’ll thrash less

You’ll stop talking

You’ll shift to a soft blue hue

You’ll fall asleep,

so tired,

just a rest

The blue will deepen



You’re not done, but you’re holding still,



Onto the next

Someone else is crashing

Thrashing

Pulling on lines

“Take slow deep breaths”

“Keep them slow”

“Try not to panic” (are you telling them, or yourself?)

“Try not to panic. Take some slow deep breaths.”

Stable

Back to the previous room



Agonal breathing, sporadic, gasp

A deeper blue

They’re still alive



On to the next…



On to the next…

On to the next…



On to the next, until morning



We just have to make it ‘til morning

We just have to make it, while mourning

We just have to make it, still mourning



We just have to make it



Onto the next

This story was originally published October 5, 2021 at 9:30 AM with the headline "‘Onto the next’: Idaho nurse’s poem about what it’s like to care for dying COVID patients."