I imagine that nurses throughout the world are constantly being asked “How are things at work these days?”—with the implied question being “How are you holding up with your work situation?” While my colleagues and I in our pediatric hospital have not seen an overwhelming surge of COVID+ patients come through our doors, we have certainly seen some, with an uptick in our COVID+ census as the numbers throughout the country have increased.

When I pause at this point in the conversation, the usual response I get is, “Oh, that’s so good to hear. You’re lucky.” And I agree and reflect this back to whoever I’m speaking with. My heart hurts for my fellow nurses in other parts of the nation who have been utterly overwhelmed by COVID and its cruelty. I recognize that I am indescribably lucky.

At the same time, though it’s hard to articulate why, even nurses who haven’t been hit by the surges seen in other hospitals bear layers of deep weariness by this point in the pandemic.

Patients, families, and colleagues are manifesting whole new levels of stress.

COVID+ patients and their family members are stressed, for obvious reasons. Non–COVID+ patients requiring ICU care are anxious about being in the hospital, and they are more alone in their suffering from other equally devastating diagnoses, as visitor restrictions are tighter than ever. Family members of patients are more stressed, and this can manifest towards staff at intensified levels. If there were struggles with depersonalization of care prior to this pandemic, patients now find their health care providers masked, hidden behind face shields or hoods, and a bit more hesitant about entering patient rooms.

My health care colleagues are anxious about exposure and perpetually trying to recall constantly changing guidelines about how to best protect themselves. We are distressed about our struggle to maintain the quality of care we always held up as our standard—trying to be quick as lightning in response to an emergency, but feeling delayed because of the need to don PPE; needing easy access to supplies, but also attempting to reduce unnecessary contamination of hospital supplies by stocking COVID+ rooms as minimally as safely possible; wanting to be present and compassionate, but feeling extra limited in our human connection with our patients.

The tensions and dichotomies are exhausting to constantly navigate, on top of our usual work.

All the configurations we had in our personal lives to cope with an already difficult job pre-COVID have been upended.

We’ve lost so many of our easy-to-access social networks, hugs and visits from trusted loved ones when we are hurting from a patient case, gatherings with friends to decompress and enjoy “normal” life. Those of us with children whose school got shifted to distance learning had to scramble to find safe childcare, and/or took on the stressful and unfamiliar role of homeschooling parent. Introverted parents such as myself lost our alone time to recharge. All the structures that we working parents had in place to precariously balance demands of home and work in pre-COVID times were undone. We had to muster new—and sometimes elusive—strength, not just for our patients but also for our families in new but profoundly limited ways.

We have felt disheartened that the public does not seem to regard us as their most trusted profession.

I didn’t realize how much I’d felt bolstered in my work by an underlying belief that the public really does trust us deeply, that it respects our work and thus our voice. While I don’t think this trust and respect is entirely lost, I have had to wrestle with the reality that despite nurses speaking, writing, and posting about the dire realities of COVID, considerable swaths of our nation’s population have continued to insist COVID is a hoax or at worst a minor health annoyance, nothing to be concerned about, certainly nothing to wear masks or alter personal lifestyle for. For the first time in my career, I’ve seriously questioned how much the public actually respects our work and our voice, and this questioning has been more deflating than I was prepared for, because the ultimate cost of our voices being disregarded has been too great.

Our work still matters.

I love being a nurse and still believe wholeheartedly in the importance of my role at the bedside, but I am weary and I want to recognize and validate the layers of weariness that rest on the shoulders of nurses everywhere in these times. We are doing hard work, the effects of which have always crossed over into our personal lives, but now more than ever. I am not looking to be a martyr, and I look for opportunities to rest when I can.

But I also recognize that since the days of Florence Nightingale, nursing has never fundamentally been about trying to do an easy job, but about doing a job in which every effort mattered, despite all imperfections and limitations. Today we find ourselves facing internal and external limitations like never before, and yet our work matters. This truth remains unchanged.