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This day was just one of many, many days like this at many different hospitals. Recent years have been marked by chaos stemming from total mismanagement of staffing ratios, resulting in poor patient care and ultimately deaths.

On my first day in this particular ER, the unit had been without pulse oximeters, which measure oxygen levels, for several hours. I had two patients go to the ICU, both incredibly unstable, one with respiratory failure with COVID-19 and one with SVT (a dangerous heart rhythm).

There were only three nurses working in the emergency room. An entire ICU floor had been closed due to a staff COVID-19 outbreak, which meant there were seven ICU patients stuck in the ER. I said a prayer and placed two triage monitors in the rooms of my impaired patients so I could see their oxygenation.

I spent days in the unit with no break to eat or go to the bathroom. At the end of just three days, I developed a urinary tract infection and lost a few pounds from my already small frame.

These are just a few examples of what ER nurses face every day in hospitals across the United States. That’s why we’re quitting smoking en masse. And so much of our system was broken even before COVID-19 hit. The pandemic made everything much clearer.

I want to help my patients – when I graduated from nursing school I dedicated myself to saving lives – but I refuse to be responsible for the systemic failures of the facilities to which I am forced. I refuse to watch my patients die due to utter chaos that could otherwise be avoided, while sadly being told to keep quiet while the ship we’re on sinks. When we ask for help, administrators threaten us and tell us to remain “professionals” in the face of extreme emotional turmoil.

We are understaffed, under-resourced, and physically and emotionally exhausted. We keep giving and giving, even when there is literally nothing left to give, because we want to help our patients, even if it means hurting ourselves. I’ve seen horrible things and I’ve seen people die, but what I think has traumatized me the most is what I now know about the inner workings of the health care system, which prioritizes finances over lives, while the public continues to mistrust and suspicious.

Where do we go from here? How can we transform this system in the wake of such an incredible catastrophe? Are we failing because health care is still a “for-profit” enterprise? Are we failing because so many other social structures are collapsing and everything is intertwined? Where has humanity gone in the world? I don’t have the answers. I don’t even know what’s next for me. But I know that things cannot continue this way, not for me personally and not for our country. We need to have this conversation before it’s too late. I pray that it isn’t anymore.

Sally Ersun is a pseudonym used by the author to protect her privacy.

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