Exhausted COVID-19 nurse's viral photo shows what it's like 'staring down a tsunami'

NASHVILLE, Tenn. - Kathryn Ivey graduated nursing school in the middle of a pandemic. 

Four months into working in the intensive care unit and attending to COVID-19 patients at a Nashville hospital, she posted on Twitter about her experience. 

The Nov. 22 post includes two photos of her — one fresh-faced in March, shortly before graduating, with the caption "how it started." The second was her after a 12-hour night shift. She had tired eyes, disheveled hair and marks on her face from the personal protective equipment she wears for work. It's captioned "how it's going." 

While the tweet was a lighthearted take on a Twitter trend, it was also a snapshot of a much darker reality. It struck a chord. As of Thursday, her post had received nearly a million likes.

"I love being a nurse," Ivey, who is 28, wrote in the post. "Didn't exactly expect to be a new nurse in the middle of a highly politicized pandemic but life comes at you fast and even in a pandemic, there's nothing else I want to do. Caring for the sickest of the sick is an honor, and I treasure my patients."

Ivey, who did not disclose which hospital she works at, said she graduated in May and has been working full-time since July. Shaking off the dust on Wednesday afternoon from three 12-hour shifts in a row, she told The Tennessean more about her first months as a nurse. 

'Staring down a tsunami'

As Ivey finished her last few classes and worked as an intern at another hospital this spring, she and her classmates felt the weight of the pandemic bearing down on them. 

"It was very surreal. It felt like we were staring down a tsunami," she said. 

But she said her goal in life was always to help people, which is why she shifted gears at age 24 to start nursing school. She had previously earned a political science degree but felt like she was at a dead end.

As it became evident that COVID-19 would change everything about the field Ivey was about to enter, she was scared — but also inspired to dig in even more. 

"I have never wanted to be at work more," she said. 

She said she rotates into the COVID-19 unit several times a month. On Wednesday, she finished two straight weeks of three-days-on, one-day-off overnight shifts. 

Ivey said she's exhausted by the intensity of her work as cases, hospitalizations and deaths continuously break records in Tennessee and nationwide — but she also said she is not as fatigued as her colleagues who also worked during another surge this spring. 

'A really dark version of Groundhog's Day'

Ivey wishes those who don't take the virus seriously could see what it does to the patients she cares for daily.

She said the same scenario keeps unfolding: a patient struggles to breathe with lungs so damaged they cannot make use of the oxygen doctors and nurses administer, then cardiac arrest and sometimes death. 

Some days, Ivey said multiple patients will "code" in a single shift, meaning go into cardiac arrest. Sometimes she sees the same patient code multiple times.

On Thursday, Tennessee reported its highest-ever daily increase in its death count at 93. 

"Nurses are not good at feeling helpless," Ivey said. "This level of death, it's new. It's different." 

Nationwide, hospitals are struggling with shortages as ICU beds run low and staff runs even lower. In Tennessee, ICU beds reached a new all-time low this week with just 9% available across the state.

In Middle Tennessee, only 5% of ICU beds are available. 

For Ivey, especially as a new nurse, she said it's difficult to have all the training and theoretical knowledge but still feel like it's not enough. 

"The look that a person gets in their eyes when they can't breathe, it's like a wild animal. And to not be able to do anything about it is just horrible," she said. "It happens over and over and over again. It kind of feels like we're living a really dark version of Groundhog's Day." 

She said she felt decisive and timely public health measures to limit the spread of the virus and lighten the load on the health care system have fallen short in the U.S.

"Honestly, more than anything else, I'm really, really angry," Ivey said. "It didn't need to be this bad."

Ivey said she's also angry at the lack of care people have when their actions could ultimately result in someone's death. She's frustrated when people don't take basic precautions like wearing a mask, social distancing, washing their hands and staying away from crowds whenever possible. 

A 'hype playlist,' lots of coffee and finding balance

Even though her work has been grueling and heavy lately, Ivey said she's finding ways to stay balanced.

She leans on friends and family for support. And she keeps a steady stream of coffee pulsing through her veins. 

"I'm a French vanilla creamer girl, all the way," she said. 

She sheepishly admitted that "Cotton-Eyed Joe" by Rednex is on the "hype playlist" she listens to as she gets ready. She sticks to fun songs that make her happy and make her want to dance. Since she works from 7 p.m. to 7 a.m., she uses the playlist as a way to tell her body it's time to wake up. 

"My circadian rhythms are more like a circadian jumble," she said. 

She listens to podcasts on her way to work to keep herself from ruminating about what may face her once she walks through the hospital doors. Lately she's been into one called "This Podcast Will Kill You," hosted by disease ecologists and epidemiologists Erin Welsh and Erin Allmann Updyke. Each episode explores the history, biology and danger of a different disease. 

"I am a huge nerd," Ivey said with a laugh. 

The oldest of four, her entire family is living at home together in Murfreesboro for the time being. Even though some of her siblings were out of the house before, the pandemic upended plans and brought them all back under one roof.

"My poor parents," she said.

But Ivey doesn't mind — she's just thankful that everyone is together.

Follow Rachel Wegner on Twitter @rachelannwegner.