Allison Johnson describes days in the COVID-19 intensive care unit at Johnson City Medical Center as a battlefield.

Johnson shared her experiences on the front lines of the pandemic during Ballad Health’s weekly coronavirus briefing on Wednesday and thanked those who have been helping health care providers by taking precautions to limit the spread of the virus.

The nursing director in the COVID-19 ICU at Johnson City Medical Center said days are busy in the unit and have seemed to grow longer. Those days often include several discussions a day with family members about the end of life of loved ones.

The nurses and other caregivers in the unit build each other up as they go through the difficult days of seeing the suffering of people with the virus and the heartrending moments for patients and their families, she said.

Driving home is when Johnson said she tries to reflect on the day and pray for her patients and team. However, last Friday, her thoughts kept returning to a social media post she had read that left her with a feeling of unease. She contemplated what she could say or do to help that person and others in the community realize the seriousness of the virus for patients and health care workers.

“I wish you could see what we see. I wish you could see what we feel. Every day is like a battlefield,” Johnson said were some of the words that came to her.

“With love in our hearts and our armor of PPE (personal protective equipment), we do our very best so our patients know we smile,” she continued. “We hold their hands, we dry their tears as they come to terms with a diagnosis that is so dire. The heartbreak is palatable and we feel the anguish of those they love when they are told there is nothing more to do, short of a miracle from up above. Some days we cry on the way to work, others just on the way home when you are doing the right things, but yet you feel so all alone.”

When health care workers see social media posts that express defiance in not taking precautions or a belief in science, it undermines their calling, but they try to brush it off, she continued.

“Sometimes we just can’t, and our walls feel like they are falling,” she said. “We are depressed, disheartened and tired to the bone as we skirmish with more than just the virus. Skeptics of science and misinformation are worse than this global health crisis.

“It is a good thing for you that we are resilient. We pray, we laugh, we build each other up and our teamwork is second to none,” Johnson continued. “We will fight to the finish, united as one. We won’t stop until our work is done.

“We need your support and covet your prayers. Please open your minds and hearts to believe,” she said. “We are doing our part, but until you do yours, there won’t be a moment of reprieve. I started by saying I wish you could see what we see, but honestly, I don’t wish that at all. I pray that you and yours stay healthy, and we never see you in one of our COVID halls. I ask that you pray for our patients, our team and our community in the days ahead.”


Lisa Smithgall, nursing executive for Ballad Health, said that Johnson’s experiences reflect those of the frontline medical personnel who care about their patients and are feeling the physical and emotional strains of the pandemic.

Nurses have been dealing with this for eight and half months and it looks like it will get worse before it gets better, she said.

The frontline caregivers are exhausted and the health system is looking at how it can support them and help them to not be overwhelmed by all the challenges, Smithgall continued.

In addition to looking for ways to provide emotional support for nurses, the system has provided pay increases for nurses working in COVID units and has made psychological support services readily available, according to health system officials.

Prior to the pandemic, a nursing shortage existed not only in this region but across the United States. Ballad Health has continued its efforts to encourage young people to consider nursing and other direct care positions as a career.

To help in the pandemic, the health system has hired contract nurses to help provide support for its frontline providers. The health system has received applications for new temporary positions that have been created to support those working in the COVID units, and several have already been hired, Smithgrall said.

Nursing programs will be graduating students soon, and Ballad Health has already hired about 100 of those graduates, she added.

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