Former COVID ICU Nurse Speaks up on Provider Mental Health Needs

When the COVID-19 pandemic began, Scotti Petersen, BS, BSN, RN, was placed in a situation she’d never imagined in her seven years as an ICU nurse: watching patients die and not being able to do anything to stop it.

“I spent 2,500 hours in the COVID ICU,” she said. “I only saw one of my patients make it home.”

As a nurse trained in trauma critical care, Petersen was skilled in extracorporeal membrane oxygenation (ECMO), which is a type of life support. ECMO machines add oxygen to the blood and pump it back into the patient’s body.

“It’s not a cure — it just buys you time for a cure or time to heal on your own,” she said.

Petersen, along with a small group of nurses, was assigned to sit by a patient’s bedside for 12 to 16 hours a day, unable to leave.

“Because of the way ECMOs run, if the circuit trips for any reason, your patient dies before you can get back in the room. We were told by the hospital administration that we could leave the room to use the restroom or eat. But if the patient died when we were out of the room, then that was going to be on us,” she said.

The experience of sitting with a patient on ECMO was heartbreaking and difficult, she said.

“With ECMO, a lot of the time patients are awake and they can interact with you. Their families are on Zoom, so you get really close to them and their families, and you know their stories,” she said, adding that she helped many patients text their loved ones goodbye.

“You’re sitting there and watching somebody suffocate for about 40 days. As I was in those rooms, it literally feels like you start to suffocate with your patients and you’re watching them slowly wither away in front of you.”

This took a physical and emotional toll on Petersen. Eventually, she left bedside care and sought therapy. Her therapist diagnosed her with post-traumatic stress disorder (PTSD). She began writing to process her feelings about what she witnessed during those 2,500 hours by the bedsides of dying patients. She also knew she needed a path forward in healthcare and applied to the nurse anesthesiology program at Johns Hopkins University.

Due to her decision to leave the profession and the price of ongoing mental healthcare, she had an unstable living situation and financial constraints. Although she received a formal medical diagnosis of PTSD, her employer covered no part of her leave or the treatment she requires and continues to receive. PTSD was not considered a work-related injury, Petersen said.

Petersen learned of a scholarship where the award was $500—money she desperately needed. She had to make a video teaching a skill or technique not taught in textbooks. “I went rogue and decided the skill that we all need to learn is to admit when we are not okay, and to speak up when we need help.”

While she didn’t win the contest, the scholarship board released the video, and it reached thousands of people. Soon, she was receiving messages on Instagram from people reaching out to her to say they were going through the same thing and were struggling, too.

“I forgot what it feels like to help people. That’s why I got into healthcare in the first place,” Petersen said. “For two years, despite all my knowledge and experience, all I could do was watch people die. So, I think that maybe, through this video, I can feel what it feels like to help even one person again, and that’s to me worth more than $500.”

Petersen just finished her first year at Johns Hopkins, which was all didactic education. She hasn’t set foot in a hospital since spring 2021. While she’s nervous about the clinical portion of her education, she’s working hard to get to a point where she can walk into a hospital again. She knows she wants to continue her career in healthcare, though, and is eager to become a CRNA.

“Even on my hardest day, I absolutely loved being a bedside nurse. But I needed to see people survive,” she said. “I needed to find a way to continue in healthcare because it’s something I’m so passionate about, but I needed for patients to come in and trust me and know that their trust is not in vain. That I can wake them back up and I can get them home to their families.”

Especially during May, which is Mental Health Awareness Month, Petersen encourages CRNAs, nurse anesthesiology residents, and other healthcare workers — especially those who cared for COVID patients — to talk about their mental health and seek help if they need it. She wants those who served on the frontlines of the pandemic to own their collective trauma and mental health while removing the stigma and shame.

“I want more of us to start talking about it. So many of us are not dying of COVID but of the aftereffects. And we’re going to lose so many more of our coworkers if we don’t keep pushing to tell our stories.”