Our unit is quiet for once. No one says that “q” word in the hospital without being told off. Everyone working here shares the belief that if you remark on how peaceful the moment is, you’ve just jinxed it. The q-word said out loud feels like a harbinger of bad luck.

Every specialty in nursing has its share of that. And for the nurses like me working in psychiatry, bad luck looks like an influx of agitated, psychotic and manic patients all at once. Bad luck is discovering a patient trying to hang themselves in the bathroom we swore was “un-loopable.” It’s discovering a patient has smuggled a lighter onto the unit, and discovering which cavity he used. Bad luck is threats, staff injury, patients fighting, people disrobing uncontrollably in the hallway, having to medicate someone against their will.

But today, the psychiatric unit in my New York City hospital really is — amazingly — quiet. The unit is suddenly an oasis away from covid-19. Our superstitions are on pause while we think about how relatively good we have it right now.


To begin with, patients here are medically stable. There are no IV poles, no bed alarms, no ventilators. Now, however, even the usual chaos and clamor is contained. The dining room is closed and patients eat alone in their rooms. There are no visitors. No patients are playing cards. No one loudly demanding to be discharged. Grooming group is canceled. The patient numbers here are low and there is skeletal staffing. The TV news is on in the dayroom, where they also have access to the Internet, but hardly anyone goes in there.

Everyone on the psychiatric unit is disheartened but so far healthy. The unit used to be considered the most dangerous in the hospital. Those who don’t understand the joy and pain of working in psychiatry don’t always understand the function of the unit. They see it as a locked box of angry people held against their will; a recipe for tension and hostility.

There’s also a preconception that psych is a place where “burnt out” medical nurses go to take a back seat and finish out their careers. But in general, nurses drawn to psychiatry are patient empaths, thrill-seekers and people who also aim to heal themselves through their insight into others.


Our medicine counterparts in surgery or the intensive care unit are impressed by the nurses with brawn enough to work with this population. They know that psychiatry and medicine are inextricably intertwined; that one needs the other. But most of them never wanted to come here, and avoided it like the plague.

Before we knew how serious this pandemic was, psych nurses would make this joke among ourselves: “Bet they’re wishing they chose psych today.” I said something like that to a much-loved assistant nurse manager the week before we knew how serious it was. It was the week before we wore masks. Covid patients were still in the single digits. Upper management were still in their offices. He laughed in his good-humored way. He was walking briskly toward the emergency room as a code wailed overhead. He was the first to go. To become a symbol of all nurses and their struggle for adequate protection. I feel so guilty.

No one uses that joke anymore.


Patients, too, feel a heavy change, but they don’t all know the extent of the pandemic. They ask us wonderful and heartbreaking questions about what is happening outside. They ask about covid, and coronavirus, President Trump and if you can get sick from takeout food.

We give them responses from the nursing textbooks about hand-hygiene and the transmission of viruses. What we really want to say we hold back. It’s against the rules in nursing to overshare or do harm by inciting fear. But it’s starting to feel a little like paternalism, which is also against the rules.

We try to hide some of the terror and desperation everyone feels outside — and even elsewhere in the hospital — and the bizarre reality we’ve accepted in this city. But the patients on the North side of the unit can look down out of their windows and see a mysterious tent set up on the street. The patients on the South side can look out of their windows and see the butt-ends of the refrigerated morgue trucks in the loading dock below.


The hospital needs all the warm bodies of health-care e-workers it can get. This is not yet a psychiatric crisis, but a physical one. No one group of nurses is better than the other, but each has its own energy. There are strengths and pitfalls to every specialty, and we are just not in the body business. Some psych nurses and nursing attendants have been “floated” to other floors, medical units under dire conditions, something managers now refer to as “deployment.” They’re pulled out of our oasis as the crisis consumes the hospital.

One day, some of the staff that remain on the island of psychiatry are directed to go to a recently-closed unit and gather up all the medical equipment we can find. We’ll bring it upstairs to the top floor. That’s the covid unit. The unit where people are dying every hour. The unit where nurses struggle to manage an overflow of sick patients while we, by chance, are still grasping to hold on to the limbo we’re in.

In search of medical equipment for those nurses and patients upstairs, we explore the empty units in silence. One week ago, it was a rehab for people with substance-use disorders, with AA groups, yoga classes and a soda fountain. Now it’s a “nonessential” ghost town. We round up the code-cart, the EKG machine, the glucometer, the tucked-away PPE, the blood-pressure cuffs. We strip the place bare.


I think of the nurses who used to work on this unit. It feels like we’re violating them by being here. They were technically “behavioral health” nurses, too. They’ve surely been reassigned to medicine, redeployed, recycled. Floating closer to covid. Where in the hospital are they now? Wherever it is, I think we’re all going there soon. Standing in the abandoned detox room, I swear it’s the last time I’ll ever say it. But it’s quiet.

Not long after we cleared out the rehab unit, a piece of paper circulated, a “read-and-sign,” asking nurses on our unit to acknowledge that we are in a state of emergency and that as such we may be asked to perform duties outside our normal job functions. Failure to do so may result in disciplinary action.

Those of us who are here, who have taken our nursing oaths and who listen to the news, are insulted. I throw mine straight into the confidential bin, where we put documents with private patient-information to be shipped out and shredded, where it will never be retrieved. This desperate contract won’t change what we’ve already come to terms with.


And of course the line between covid and non-covid patients keeps blurring. A patient on the psych unit is mildly symptomatic and tests positive. There’s nowhere else for him to go, so he will stay here. Soon the hospital starts to treat all patients as potential covid patients. Nurses start to treat each other like covid carriers, passing anonymously in the hallway, draped in PPE. We misunderstand each other through muffled masks, but console each other later over the phone. Covid is everywhere, shadowed by trauma and grief.

My last day as a psychiatric nurse comes and goes without me knowing. The next morning I’m pulled off the unit to a medical floor, away from the shrinking oasis — I hope not forever. The others give me the eyes that say “it’s your turn.”

I am pretty sure they will be next.