Toni Wilburn, RN, thrives as a critical care nurse. And after 30 years in the profession, Wilburn thought she was prepared for anything.

Toni Wilburn, RN

But even this nursing veteran, who is a critical care nurse at Piedmont Fayette Hospital in Fayetteville, Ga., admits she never imagined a time when nursing would be so difficult.

“I have never worked this hard,” Wilburn said. “And I pride myself on giving great care and trying to go above and beyond. I hope that when we are beyond this — and I know we’ll get beyond this — that it will just be one of those once-in-a-lifetime experiences.”

Wilburn isn’t just experiencing the COVID-19 pandemic and going through the motions. She is excelling during what is arguably one of healthcare’s greatest challenges. She has used this time not to wither under the pressure, but rather to excel as critical care nurse, team member, and patient advocate.

Her hard work hasn’t gone unnoticed by her patients and colleagues. In May, Wilburn was honored with The DAISY Award for Extraordinary Nurses.

Tough days for a critical care nurse

When Nurse.com interviewed Wilburn in July she was volunteering to work extra shifts. The pandemic had slowed in early July only to resurge after businesses and life resumed some degree of normalcy.

“As healthcare providers we knew as things started opening back up that people wanted to let their guard down,” she said.

There are no light days on the ICU during the pandemic. Critical care nurses often juggle three patients on ventilators, while managing other duties such as dialysis.

“Not only were you providing that higher level of acuity care for one patient, you were stretched with trying to provide that for three people,” Wilburn said. “Basically, you were fighting all day long for them to live.”

In addition to caring for patients, it became critical to care for and communicate with families, who weren’t allowed at the bedside.

Wilburn said the responsibility to connect with families was personal. She, too, had family members who were hospitalized for COVID-19 and couldn’t visit them.

“Who wants to be at home while your mom or dad or brother or sister is fighting for their life in the ICU, and you can’t go and visit?” she asked. “I just tried to wear their shoes, taking myself completely out of the equation. I’d just imagine how they felt. I took time to answer their questions, to listen to them, to give them all the information that I could possibly give them, to of alleviate the anxiety I knew they had.”

She also stayed connected to sedated patients by greeting them at the start of her shift, explaining what she was doing and why. Wilburn said one can’t assume a sedated patient has no idea about what’s going on.

“I’ll always talk with the patients and maintain their dignity throughout all of this,” she said.

Wilburn said she is not afraid of contracting COVID-19, but she’s vigilant, cautious, and aware. Her faith helps her to cope and inspire other nurses to persevere.

Looking out for new nurses

New ICU nurses, according to Wilburn, are shocked when they’re barely through orientation and are knee-deep in caring for COVID-19 patients.

Wilburn takes it as her responsibility to help and encourage them.

“Some of them just couldn’t do it,” she said. “They resigned. We were constantly encouraging even the seasoned nurses. People got overwhelmed. They felt like they were in this by themselves and wouldn’t make it out.”

Being there for others seems to fuel Wilburn. No matter what is going on in her world, she said, she is more than willing to help an overwhelmed nurse and encourage that colleague to keep going.

“I am staying positive, even if I’m not feeling it that day,” she said. “If I’m sitting down and you’re still running around crazy, I’m going to be with you.”

The patients give Wilburn purpose. They’re not just patients with COVID-19; they’re mothers, fathers, sisters, brothers, friends, and loved ones.

“They had a life before they came here, and they didn’t ask to come here,” she said.

Wilburn described a recent experience that highlights her connection to patients and colleagues. She was caring for an 81-year-old patient with COVID-19 who was not expected to live much longer. The patient’s sister, who couldn’t be by her side during the pandemic, gave permission to the staff to decelerate care. Wilburn, a nurse she was training, and a respiratory therapist were the only people in the room. Even the chaplain was outside the patient’s door for safety.

Wilburn could tell the nurse was nervous about witnessing the patient being taken off life support. Wilburn explained the process, and to ease the nurse’s anxiety she told stories.

“At that time, I had no idea how long it would be before she passed away,” she said.

Wilburn started singing a song she sang as a child with the verses: “I’ll fly away, oh, glory, I’ll fly away. When I die, hallelujah, by and by, I’ll fly away.”

“I sang all the verses I could remember then would start all over again,” Wilburn said. “We held the patient’s hands. I could look up at the monitor and could see her heart rate dropping until she finally did transition on.”

Wilburn takes comfort in knowing the patient was not alone when she passed away.