In the spring, Michelle Schultz had a particularly difficult COVID-19 patient. The man, who was in his 60s, had come to the emergency room short of breath a few days before. Even though his oxygen levels were pretty low, he refused medication and wanted to leave the Indiana hospital without a mask on. The nurse and some of her colleagues tried convincing him to stay, but the man insisted he felt fine. Besides, he said, COVID-19 is a fake virus hospitals are using to make money. As he put on his MAGA hat and walked out the door, she worried about what would happen next. Would he infect others? Would he go to bed and not wake up?
“We never have had people who thought we were lying to them,” said Schultz, who asked to be identified by her middle name to protect her privacy. “It feels like the public doesn’t trust us anymore.”
On November 14, a South Dakota nurse named Jodi Doering wrote a viral Twitter thread about her experience treating COVID patients in intensive care units who called the virus a hoax (“Their last dying words are, ‘This can’t be happening. It’s not real,’” she told CNN.) And while her story was criticized for being extreme (and possibly misrepresentative), she highlighted a real crisis in hospitals around the country, especially in red states where governors have refused mask mandates and the president’s false claims about the virus are taken as gospel. In interviews with the Cut, 12 nurses described dealing with COVID-denying patients, from ones who simply refused treatment to those who spit or coughed on them and recited conspiracy theories about the virus.
Nurses have been rated the most trusted professionals for almost two decades — now they’re punching bags for those who think they’re lying about the pandemic. Back in the spring they were applauded as heroes, but many have reached a breaking point and want to quit a job they love.
Like any nurse who works in ICUs and emergency rooms, LeToya Edmonds is used to dealing with people who are angry and in denial. But while those are normal emotional responses to a serious diagnosis, Edmonds says the hostility and disbelief from her COVID-19 patients in Lawton, Oklahoma, feels different.
“A lot of them make it into a political issue,” she said. “It’s really hard to care for patients like that.”
Gigi Perez, a nurse at a hospital in Lancaster, California recently treated a man for a non-COVID related injury who harassed her for wearing her N95. “You must be a Democrat or something,” he said and told her to take the mask off. “People are brainwashed beyond belief and choose to believe a politician over the people fighting the pandemic,” she says.
Before every shift Edmonds braces herself for ICU patients who watch Fox News and spew right-wing talking points. While many skeptics believe in the virus once they are diagnosed, others double-down. About a month ago, she politely asked a 70-year-old man with COVID-19 who had a fever and diarrhea to cover his mouth. He pointed to the TV, where he was watching Fox, and told her “the news says these masks don’t work,” before coughing in her face. A Florida-based respiratory therapist also described being coughed and spit on by patients who didn’t take the virus seriously. “It makes my blood boil,” says Edmonds. “It’s just a constant uphill battle.”
Even if patients don’t outright deny the reality of a virus that has killed more than 250,000 Americans, many patients and their family members still don’t take it seriously. Nurses say they’ve never seen so much pushback, from people disputing their test results, refusing treatment like plasma therapy or oxygen, to leaving the ICU before they’ve recovered. Carla, a nurse at a family practice in North Carolina who requested a pseudonym for fear of losing her job, said a patient told her “I don’t believe in all this,” and “I’m not doing that shit,” after she said they needed to stay home for 14 days. She’s had others forgo procedures because of the requirement to take a COVID-19 test, which they called “stupid” and refused to do.
“I have cried quite a bit,” she said. “It’s almost like a grieving process. I’m grieving the loss of what I used to have: patients who listened and trusted me.”
Of course, the consequences are real. In April, Edmonds had a patient in her 80s who didn’t believe her COVID-19 diagnosis and refused any treatment. Even though she developed a slight fever, the family backed her decision to leave the hospital and put her in a retirement home; she died two weeks later.
Nurses are struggling with how to handle their resistant patients. Some say they counter the misinformation matter-of-factly with science — here’s how the virus works, here’s how we treat it — and if there’s pushback, they don’t engage or tell the patient they respectfully disagree. Others take a more emotional approach, trying to change minds with blunt descriptions of all the death and suffering they’ve seen. And if the situation is dire, they are even more direct. Alex Inkhamheng, a nurse in Amarillo, Texas has told the few COVID-19 patients he’s treated who wanted to leave the ICU that they wouldn’t survive even a few steps without oxygen. “Sometimes you have to be brutally honest,” he said, since some patients will “die for what they believe.”
Earlier this month Ashley Bartholomew decided to be brutally honest with a COVID-19 patient in intensive care who criticized “fake news” about freezer truck morgues and downplayed the virus. Since it was the nurse’s last shift at a hospital in El Paso she let her professional guard down. Through tears, she told the roughly 50-year-old man that he was the only patient she’d treated that day who could speak, and that she’s never seen so much death in her 10 years on the job.
His attitude started to shift, she later wrote in a viral tweet thread, especially when she wheeled him out of the ICU past patients who were on ventilators. But her response was an act of desperation, a last-ditch attempt to convince someone of their own disease, rather than a sustainable or necessarily moral path forward (typically “we don’t tell our patients another patient just died,” she tweeted). And though Bartholomew had already given notice at her hospital — her family is relocating to another city for her husband’s job and she needed a break from nursing — the incident reinforced her choice and made her feel hopeless.
She’s not the only one ready to call it quits. Nursing already had high turnover rates pre-pandemic, but now healthcare workers say their mental health has slumped to a nadir. Some have even dealt with colleagues who downplay the disease’s severity: A few weeks before the election Inkhamheng says a fellow nurse told him that COVID-19 was no big deal–“just like the flu”–and that hospitals were inflating death rates for profit; Perez is now in quarantine because one of her co-workers didn’t wear a mask over his nose and then tested positive for the virus. And the aggression they face isn’t limited to hospitals: nurses say it’s a gut punch to watch people in their community packing into bars and restaurants. They’ve faced death threats for speaking out and one nurse told me her colleague was asked to leave a store because her scrubs were making customers “uncomfortable”; another said she was called “a bitch” after asking a woman to put on a mask in a Home Depot.
Edmonds has been struggling with depression and says the last few months have been the most challenging of her career. With the second wave crashing hard on her hospital, she’s been forced to juggle too many patients, and worries that if someone dies on her watch, she might have to deal with a family that doesn’t even believe COVID-19 is real. She no longer raises her hand for overtime time shifts; she’s too overwhelmed and worried about the situations she might walk into.
For the first time in her 22 years on the job, Carla, the nurse from North Carolina, is thinking about quitting. She regularly calls her family to cry on the phone.“I just don’t know if I want to do this anymore,” she said. “Which is really frustrating for me, because I love my job.”
Many of the nurses I spoke with predict a wave of resignations. (In Pennsylvania, 700 nurses recently went on strike, citing short-staffing, PTSD, and burnout.) This would put a huge strain on a system that’s already-on-the-brink and means patients could be treated by healthcare workers who aren’t necessarily trained to handle COVID-19. But Bartholomew says the blame should fall on political leaders and outlets like Fox News spreading the kind of disinformation that has turned hospitals into battlegrounds for partisan warfare.
“The pandemic of misinformation, on top of the COVID pandemic is too heavy for nurses to fight,” she said. “It feels like a slap in the face to call us heroes in the spring and not trust us in the fall.”