Girlynda Gonzales, MSN, RN, CCRN, NEA-BC
The grief for so many is real, but let us not be afraid to write the beauty of this time into history, too.
I’m a nurse and healthcare leader; 2020 was the hardest year of my life. In fact, every one of us — inside and outside the walls of a clinic — sits on a continuum of pandemic-provoked grief. But as we transition through the stages of our pain, we also transform. And the gift of transformation may just be the most beautiful legacy of this crisis.
We saw the courage of our peers. I remember the initial, foreboding email notifying me that my health system had admitted its first COVID patient. I was in Chicago at the time, with a group of women healthcare leaders. Sharing the news with them, we sighed that all-knowing sigh; the storm was coming. And when the storm came, my staff ran into it. They put the needs of others before their own. Nurses, respiratory therapists, and physicians stepped into danger and uncertainty — without even having all the facts. In the absence of a playbook, we faced this unknown disease together.
We saw the light of ingenuity. Innovation was everywhere. At my hospital’s respiratory isolation unit, mirrors were placed in hallways to assist staff with proper donning and doffing of PPE. Glass windows between spaces were repurposed so we could communicate through gestures and dry erase markers. Ventilator controls and infusion pumps placed outside rooms minimized the use of PPE and exposure. Pool noodles were split open and laid lengthwise to keep intravenous tubing clean and elevated. Disposable food containers enabled clinicians to take N95 masks on and off without touching the outside surface of their masks. Use of technology exploded, enabling telehealth and visitations.
We saw love. Those empty streets, stadiums, and subway platforms weren’t displays of a world coming to an end, they were acts of love coming to the fore. The negative space demonstrated kindness for our elders, our neighbors, and countless essential workers.
We saw the gratitude of strangers. Appreciation came in the form of posters, snacks, handwritten cards, and spontaneous applause. Staff offered to work overtime, forfeit PTO, and serve on units outside their normal domain. Clinicians traveled across the country to work in hotspots and relieve overwhelmed colleagues. We shared ideas, pictures, and encouragement via emails and texts. And that support continues — from 4,000 pounds of See’s Candy to an ice sculpture from the community.
We saw wellness elevated. Malcolm X wrote, “When we change the ‘I’ for the ‘we,’ illness becomes wellness.” Our own emotional wellbeing has never been so important. With new responsibilities for at-home childcare, elder care, and round-the-clock work coupled with an inability to take vacation or enjoy typical outlets to unwind, we’re utterly exhausted. And unfortunately, most interventions in the workplace are designed to relieve acute pain, not the chronic stress of more than a year in the trenches. There has never been a moment in our lifetimes like we are in now, when caring for ourselves has gone from luxury to imperative. And our employers are stepping up.
“What if the darkness is not the darkness of the tomb, but the darkness of the womb?”
Valarie Kaur, Sikh Prayer for America
I posit that this nadir we faced down may just be our rebirth. Philosopher and scholar Joanna Macy writes of bardo, a Tibetan Buddhist concept of the gap between worlds. In this gap, she invites us to gaze into what she calls mirror wisdom, saying, “Don’t look away. Don’t avert your gaze. Don’t turn aside.”
Just as we’ve seen love and light, we’ve seen extraordinary darkness. To be sure, 2020 has also revealed the very worst parts of humanity, and nowhere more clearly than the disease of racism — an even greater pandemic.
But during COVID, we’ve learned how to love. And now, we can use this bardo to learn how to see — the light and the darkness. Joanna Macy notes that there are three options for change: to accept business as usual, unravel completely, or welcome a “great turning.” Through the third path, we embrace “cooperation versus competition and respect versus exploitation.” In this way, we emerge from hardship fortified by creativity, compassion, and resilience.
In the workforce, that third path may look like a re-evaluation of the skills our people and systems need to function best — like more emotional intelligence, more collaboration, more wellness, and less ego. It can look like focusing on the right care at the right time with better access and affordability. Could we also address our provider shortages through the very innovations in technology that kept us connected to our patients during COVID? And we can start bringing the practices of behavioral health into all patient and staff care. The opportunities for rebirth and reimagination are limitless.
What I saw in 2020 was a nation with an incredible capacity to innovate, introspect, and inspire. I now challenge us to recover from this moment by heeding the call of poet Amanda Gorman:
There is always light. If only we’re brave enough to see it. If only we’re brave enough to be it.
Girlynda Gonzales, MSN, RN, CCRN, NEA-BC, is a fellow of The Carol Emmott Foundation and the Vice President of Patient Care Services at John Muir Health