*3.5. Everything Is Not Okay*

Many individuals described the difficulties in caring for very ill patients, the loss of life, and how it was impacting the nurses' ability to cope. Nurses reported nightmares and difficulties with sleeping, depression, anxiety, and fear as they watched the suffering and took the emotional toll home with them. They expressed that they were not able to get away from COVID. As Emma noted,

"You leave work and you get in the car and the radio's on and all anybody is talking about is COVID so then you have to turn that off. And then you call somebody to decompress while you're driving home and all they want to talk about is COVID. And then you get home and you turn on the TV and it's COVID."

Participants also worried about their patients long after their shifts ended. Irena admitted, "I'm not doing okay. I'm like, I'm not sleeping. I'm having trouble eating. I'm worrying about my patients all the time. Like I drive home and I am just sobbing like the whole way home. And I just, I don't know what to do." Nurses expressed that the situations they were experiencing are hard to handle emotionally. Layla put it this way: "So I think it is incredibly depressing. Not only from the work aspect, but then trying to go home and pretend everything's fine, it's okay, when it's not." They had difficulty processing the events they had seen and moving on with their lives, and noted that their families were not able to fully understand what they were going through. As Amy described,

"Being a nurse is hard every day. There are people who die every day and you can't come home and talk to your significant other and spill out all on them, because they didn't sign up for that. That's not fair. And you can't come home and be negative ... and it doesn't feel like they even understand or comprehend or can really be there for you because they don't."

Nurses not working with COVID patients were not immune to the stress as they experienced guilt that their co-workers were overwhelmed and they were not there in the middle of it trying to help them. Karen summed it up: "I almost had some guilt that I know some of my classmates are working on the COVID units and they're just stressed and overwhelmed and I just felt like I needed to be a part of that, too." Irena shared with the authors a blog post that she wrote prior to her interview regarding her experience (see Box 1).
