COVID Nursing and PTSD


  • Cassandra Alexander, RN


Content warnings: mental health and suicidal ideation

I didn’t want to be able to write this essay.

In fact, I would hazard that no one wants to be able to write about how their job gave them a debilitating mental illness that endangered their life and livelihood, but after living through nursing 2020–2021, here we are.

I volunteered to take patients with COVID on March 14, 2020, right out of the gate, the first ones that my facility thought we had, largely because like most ICU [intensive care unit] nurses, I believed myself to be both tough and invincible. I didn’t have kids or local family to protect, and I was full of that foolish spirit that makes some of us run toward danger a little harder than others, that I think a fair amount of people who work in healthcare will recognize.

And by April 2021 I was broken.

I don’t use that term lightly—up until that point I’d built my entire sense of self around being the strongest person I knew.

But on April 25, I texted my best friends in the world from work, to tell them how ironic it was that I was trying to keep people alive, when I wasn’t sure I actually wanted to be.

They alerted my husband, and I got off that day safely, started crying, and didn’t stop for weeks.

I have a history of depression and anxiety, which has been well handled over time by medication and therapy—so well, pre-COVID, that I’d stopped going to therapy back in 2018. Luckily for me, that meant that when I reached out to my old therapist (who I now pay for out of pocket) she knew it was an emergency and she wedged me in immediately.

It wasn’t until I was barfing the emotional contents of 13 horrific months on her—watching people die who didn’t have to, again and again, and being forced to listen to people say that what I personally was experiencing and what my patients were dying from was a lie—that I truly realized the mental trauma of everything I’d been through.And when she told me I had PTSD [post-traumatic stress disorder] it made a horrific, and somehow freeing, sense.

It wasn’t that I thought I was immune to mental health issues prior to that, so much as it was a “boiling frog scenario,” the one where as the water gets hotter, and hotter, the frog opts not to leap out because it can’t fully sense the danger.

COVID put me into a pot of boiling water with 3.7 million other nurses.

None of us had a choice.

None of us had an off-ramp.

Author Biography

Cassandra Alexander, RN

Cassandra Alexander is a professional author and registered nurse with 14 years of experience in burn care, critical care transport, and intensive care.

Artsy figures on background.



How to Cite

Alexander, C. (2021). COVID Nursing and PTSD. Patient Safety, 3(4), 12–15. Retrieved from
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