Fatigue on the Front Line

Two years into the pandemic, alumni nurses and Wheaton’s nursing students reflect on the cost of caring.

By Grace Kenyon | Arts Editor
April 21, 2022
Front desk of Bolingbrook Christian Health Center, where many Wheaton students have volunteered. Photo by Grace Kenyon.

In the early months of the COVID-19 pandemic, the public was quick to applaud the bravery of healthcare workers who had plunged headfirst into the reality of a new and deadly virus. There were signs plastered with “HEALTH CARE HEROES” and spontaneous balcony performances in their honor. In my neighborhood in northern Colorado, someone started a nightly ritual that we referred to as the “8:00 howl,” when we would walk outside in our socks and cheer for frontline workers from our front porches. Some people bought red, white and blue lights to display outside to recognize doctors and nurses. The sentiment was clear and the solidarity was palpable. 

 

As we limp past the pandemic’s two year mark, the applause has ended and the lights have been taken down. Healthcare workers are tired. I spoke with Wheaton students and alumni who have worked in clinical settings throughout the pandemic. Here, they share their experiences and the toll that combating COVID-19 has taken on their well-being.

 

Jonathan Kim, a junior nursing major, volunteers at Bolingbrook Christian Health Center. He is one of a couple dozen Wheaton students who volunteer at this clinic weekly, providing care for mostly uninsured patients. As we sit in a booth in Lower Beamer discussing his work at the clinic, Kim lights up as he describes the joy of fellow volunteers who continue to give even when they are fatigued. He says healthcare workers — like the rest of us — are tired of virus surges and never-ending regulations. But volunteers like Kim don’t have the luxury of backing down. The mounting toll of the pandemic has killed 985,000 people in the United States as of early April.

 

We’re tired of people who seem to act like the pandemic is over,” Kim said. “Maybe it’s over for you, but it’s not over for us.” He says healthcare workers no longer feel encouraged by society, like they did at the beginning of the pandemic when everyone rallied around them.

 

“People seem to have forgotten,” Kim said.

 

Kim is taking a public health class taught by Allison Ruark, an epidemiologist (scientist who studies patterns of disease) who joined Wheaton’s Applied Health Science faculty in 2020. With a background in HIV research, Ruark is familiar with the toll that infectious diseases can have, but she watched with interest as many Americans contended with these realities for the first time in 2020. 

 

Something that the pandemic has revealed to her is that people, rather than equipment like respirators and masks, are the invaluable resource that keeps healthcare running. “[Healthcare workers] are bearing the burden of this situation while the rest of America has largely moved on,” Ruark said. “We’re asking a lot from healthcare workers to carry that burden.”

 

Ruark, who teaches a course called Introduction to Public Health that covers epidemics and pandemics, says that she sees a parallel between the call of healthcare workers and the way that early Christians cared for the sick.

 

There were plagues in Roman society and everyone was fleeing the cities,” Ruark said. “No one was willing to stay and care for the sick except Christians. The last thing [early Christians] were worried about was protecting their own lives or rights. They were just asking how they could love.”

Lauren during a work day. Photo submitted by Lauren Gross Frye.

Alumni Lauren Gross Frye (‘14) has worked as an emergency room nurse in downtown Chicago since graduating from the accelerated nursing program at Rush University in Chicago. Even though she has worked throughout the pandemic, she says that this past winter’s Omicron surge was the hardest one. During Omicron, waiting rooms were overflowing with severely ill COVID patients at the same time that public support for mask mandates and social distancing was waning. When I spoke to Frye in mid-February, the Rush ER was seeing 75 or 80 people in a waiting room built for 15 or 20. By April 13, Chicago’s hospital capacity dashboard reported 83% of ICU beds in use, but only 2.4% were used by COVID-19 patients.

 

While Frye admits that the new virus was scary back in 2020, the first wave of the pandemic generated a lot of camaraderie between hospital staff. Besides the COVID patients, the hospital was relatively quiet since people weren’t coming into the ER for other ailments. But as the pandemic continued for years, healthcare workers grew more and more burnt-out. Many left the field, and their departures placed additional strain on those that remained.

“A lot of people feel like health care is on the verge of collapse because doctors are quitting, nurses are quitting,” Frye said. “People are leaving healthcare. They’re done with it.”

 

Part of their frustration is that the vast majority of severe cases of COVID and resulting deaths have occured in unvaccinated patients, which means that many deaths were likely preventable from a healthcare standpoint. Another issue is the low pay. Nurses in the US make an average of $75,000 per year while working long hours. According to Fyre, there has recently been a move from 8 hour to 12 hour shifts, particularly in hospitals. 

 

She says that many nurses are realizing that they can be paid more for doing less stressful work. “My husband works from home on his computer all day and sips coffee, and then I’m here at work getting screamed at, getting cussed at,” Frye said. 

 

She has a nurse friend who recently changed careers to work at LinkedIn because she’ll make twice as much money working from home. This mirrors a nationwide trend of nurses leaving high-stress assignments or switching careers completely. In one recent survey, around one third of nurses reported that they intended to leave their job by the end of 2022.

 

The low pay — combined with the government’s attempt to address staffing shortages — has turned into a vicious cycle, nurses say. In response to regional surges, the federal government and other large agencies hire nurses to travel to areas of high need. But these “travel nurses” can make almost three times as much as the typical hospital nurse while doing the same amount of work. As a result, many nurses are quitting to “go travel,” leaving their home hospitals short-staffed and dependent on travel nurses who lack familiarity with the hospital, the patients and the procedures. This creates an environment where miscommunication is prevalent, causing more stress for staff and lowering the quality of care for patients.

 

Frye will graduate as a Family Nurse Practitioner with a Doctor of Nursing Practice (DNP-FNP) in April and will most likely move to outpatient work. “I realized [during the pandemic] that I can’t do this long-term. I can’t keep the same level of compassion for sick people that I would want,” she said. “Nursing is not sustainable right now.”

 

Compassion fatigue is a well-documented psychological phenomenon that is common among professionals like healthcare workers who are asked to confront trauma regularly. It is akin to the kind of burnout that many are experiencing as the pandemic wears on, but causes psychological symptoms like insomnia, mood swings and other symptoms associated with depression and anxiety disorders. 

 

Nursing students are another group of people who are beginning to wrestle with the high cost of caring for others. Wheaton’s liberal arts nursing program typically includes three years on campus followed by two years at a partner nursing school. The program started in 1982 and each year sees between 10-20 new students enroll. Outside of this program, there are typically between 40-60 students planning on pursuing nursing through other types of programs. I spoke with a few nursing students who know that they are preparing to enter a changing industry. 

 

“We’re stepping into an environment that looks a lot different than it did when I first decided I wanted to be a nurse,” said Haley Morgan, a senior nursing student. 

Morgan studied at Wheaton for three years and is in the middle of her first year of nursing school at Carroll College in her home state of Montana. She does clinical rotations — which is when nursing students are given the opportunity to shadow and assist nurses in a real medical setting — at a small hospital in Helena called St. Peter’s Health Regional Medical Center. 

 

Completing rotations during the pandemic has been stressful, but Morgan says she knows why she chose this work. “You’re in such a vulnerable position as a patient,” Morgan said. “To be able to show [patients] the love and the compassion of Christ is such a beautiful thing.”

Haley Morgan working with Carrol on a lab project. Photo submitted by Haley Morgan.
Haley Morgan working with Carrol on a lab project. Photo submitted by Haley Morgan.

Christina He and Hannah Hurst are also senior liberal arts nursing students. After studying at Wheaton for three years, they currently attend nursing school at Elmhurst University in Elmhurst, Ill. They work at Elmhurst Memorial Hospital and Glen Oaks Hospital, where the two are each assigned a nurse to lead them on their clinical rounds. Speaking together on a call from He’s apartment, He and Hurst shared both the difficulties and blessings of being nursing students during a pandemic. 

We’ve had very positive experiences, overall,” Hurst said. “But there is a lot of burnout that we’ve seen and the nurses are very tired. To take on nursing students who don’t know a lot is an added burden in some ways.”

 

He has also witnessed the exhaustion firsthand, recounting an experience where her assigned nurse ignored her for the first part of her shift because it was early in the morning and there was so much going on. “We’ve definitely talked about not taking things personally,” He added, speaking about conversations she and Hurst have had in their nursing classes.

Christina, Hannah and Katie Bristol (another Wheaton nursing student). Photo submitted by Hannah Hurst.

Nursing students can be a good resource for understaffed hospitals. Students might not be qualified to do most medical procedures, but there are small tasks that they can do to help support overworked nurses. He mentioned an incident when her assigned nurse was busy because one of her patients had to be moved to the ICU. Amidst the chaos, another patient — an elderly woman — had spilled something on herself and was quietly asking for help. He and Hurst were able to change her clothes and bedding and talk with her for a few minutes.

 

“The hospital can be pretty lonely, especially nowadays when the nurse is constantly busy and moving,”  He said. “I can tell patients really appreciate it when we talk to them for even five minutes.”

Hurst recounted a similar experience. “The patients just want to talk and to be heard,” she said. “I had a patient whose back was very itchy and I just sat there for a while and scratched her back.” It was the kind of thing that nurses often do if they have the time. In an understaffed hospital, only Hurst had time.

 

Some clinics that serve under-resourced and uninsured patients closed or limited their services during the pandemic, but Bolingbrook Christian Health Center fought to stay open. The center runs entirely on volunteer effort, relying on Wheaton students like Kim who volunteer to help with paperwork, check in on patients and run COVID screenings. They assist a team of medical professionals — also volunteers — who roll into the clinic after their normal shifts are over.

 

Susan Davis (‘91), the executive director of the center, is a graduate of Wheaton College who worked with her husband and members of her church to establish the clinic while she was completing her nurse practitioner program in 2003. She had always felt drawn to overseas missions, but she realized that the Chicago area — with its large population of uninsured patients — was a mission field in and of itself. 

 

Today, the clinic operates out of an old elementary school building owned by The Compass Church in Bolingbrook, a town about 25 minutes south of Wheaton. The clinic provides primary care, lab work, and limited gynecology, cardiology, physical therapy, and optometry, depending on what type of physicians volunteer their time. The pandemic has not spared the clinic, and neither has the fatigue, but Davis testifies that God has provided resources and people to fill holes gouged by pandemic shortages.

 

“[God] gives us little ways to mimic him, and as we do, he gives us more strength to do other things,” Davis said, recounting the small ways that God has provided for the clinic over the last two years. When the clinic was running low on equipment, volunteers 3-D printed face shields and patients donated masks. When Wheaton students weren’t allowed to leave campus to volunteer during the 2020-2021 school year, students from other Chicago area schools stepped up in their place.

 

As a clinic run by volunteers who have many other responsibilities at school and work, the team at Bolingbrook has been mindful of the possibility of burnout. Davis encourages all volunteers to take breaks and make sure their work at the clinic doesn’t become all-consuming, and yet the volunteers continue to pour in. Some work even more hours than before the pandemic.

 

While keeping the clinic running during COVID wasn’t easy, Davis says there has been joy in the midst of the difficulties. “There will always be that group of people who will run towards the crisis, and for some of those people this [clinic] was where they ran,” Davis said. “They wanted to serve, and they wanted to be in it.”

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