Kelsey Vandersteen, 36, is a trauma ICU nurse at UW Health in Madison, Wisconsin. Many people know her as @nursekelsey on Twitter where she candidly writes about the realities of her job and life during the COVID-19 crisis. Vandersteen recently talked with TODAY about how she works to prioritize mental health.
I've heard of more burnout from my co-workers in the last two months than I heard in the entire last year because it felt like once we got to a year, yes, things were better, but they were also still seeing packed bars and seeing people traveling without full precautions. It’s extremely frustrating. We watch people suffer and struggle to breathe. We watch people die. We watch our co-workers being emotionally destroyed by that.
The job became significantly more stressful when the pandemic started. People were dying at an unforeseen, unbelievable rate. It's extremely hard when your job is to provide comfort and healing to know that you're doing absolutely everything you can for 12 straight hours, running yourself ragged and they're suffering and dying anyway. I felt very helpless for a lot of that time.
Some patients would come in feeling very short of breath before they would have a breathing tube put in. They'd be begging for you to save them. They would ask you, “Am I going to survive?” And statistically, for a while, no, they were not. It was very clear for many that as soon as they got a breathing tube, that was pretty much a death sentence.
They would say, “Tell my mom this. Make sure my son knows this” and you relay that message to their spouse. Those are the hardest.
I struggled significantly last fall, which coincided with the COVID surge. I lost 30 pounds in less than two months. I didn't eat, I didn't sleep, I paced my house. I eventually reached out to my primary care physician and said, “This is not normal. I cannot maintain this. I am losing my mind.” They got me started on anti-anxiety meds and I started therapy. I feel significantly better now.
I got help earlier than many of my co-workers who are still really struggling with flashbacks — they hear alarms overnight in their sleep, they remember certain patients. I personally feel like I'm doing OK, but I didn't use therapy, sleep meds or anxiety meds before. Now I take them every day.
I don’t think there's more awareness and care in the medical community about nurses’ mental health. We've always had an employee assistance program available to us, but you often have three appointments and that's it. All they do is kind of stir up the muck, make you realize how awful it is, and then be like, oh sorry, you've run out of sessions.
The public is probably more aware about nurses’ mental health now than before the pandemic, but I still also feel like we're viewed as martyrs or that we asked for it — that we chose this job and we should just kind of buck up and take it. I also don't think there's a lot of awareness of how dark a lot of what we see is, particularly the front-line COVID units. Nursing is hard no matter what, but the COVID units are particularly difficult.
It's really hard to go to a job where there’s so much death and to not bring it back home. The rest of the world is still stressful. This there's still a pandemic happening. Not everyone is vaccinated yet.
Besides therapy and medication, I do a lot of running. I write in a journal every day about the three best things that happened that day. I also journal about the hard parts because getting it out has helped rather than to just stew on it.
My dog brings a lot of puppy energy, which is gets me out and gets me outside. There's a lot of comfort provided in food being made for me and in making food for others. I’ve always really liked wearing color. Other people comment that they love the tie-dye and if I can make them happy with something that also makes me happy, it's a true win-win.
We are having an uptick in our COVID ICU patients right now. It's a lot of people in their 40s and 50s who didn't have a chance to be vaccinated yet. They can linger on machines deeply sedated for weeks to months, and then there'll be some massive complication or we'll say there's nothing else we can do, and they're allowed to pass. We've gotten enough treatments in place that people aren't dying as quickly — they're lasting and lingering longer and still dying.
I do see myself staying with nursing, but I reached out for help before I fully broke and I don't know if others are doing that. New nurses who are struggling with their mental health should know it’s not because they aren't cut out for nursing, it's that this is an extremely difficult time to be in health care.
They should definitely talk to the other, more experienced nurses on their unit. Therapy is helpful. Medication is helpful. Be honest if you're not sleeping.
We can't take care of anyone else until we can take care of ourselves, so destigmatizing mental health support is huge.
This interview was edited and condensed for clarity.