For months, health experts have been warning that the Delta strain of COVID-19 is more dangerous, contagious, and making people sicker.
Hospital staff are being pushed to the brink as case numbers soar across NSW, and more patients are sent to the ICU as the virus robs them of their ability to breathe.
Three respiratory nurses working in the coronavirus ward at a major Sydney hospital spoke to Nine.com.au about their experience dealing with surging cases, sicker patients, and staff shortages.
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"I had to tell a man that his wife had died in intensive care at the weekend over an iPad," Liz* said.
"Even though it's not an ideal situation, we usually do always have a Mandarin-speaking nurse around, I didn't have that, and it was just … oh my gosh it was awful."
The patient's first language was not English and due to weekend staff shortages and a lack of interpreters, hospital staff needed to use a translation app until a social worker arrived.
"That's how we're communicating with a lot of our patients right now, via an app on an iPad," Liz added.
"We've also had to witness people saying their last goodbyes via this (video)."
Liz has been working as a nurse for over 15 years, first training overseas and then moving to Australia in 2009. She specialises in respiratory.
"It's my art, I love it, at the moment I can't see myself anywhere else," she said.
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But the pandemic has completely changed the sort of patients she sees, their ages, and the condition they are in when they come to the hospital.
"We don't know what we're going to encounter every day or how many patients we're going to see," she said.
"Obviously, our respiratory workforce wasn't enough to cover this pandemic, we've had to open two wards, what we call a mega-ward."
This means staff are redeployed from other parts of the hospital. But often they do not have the same level of training or expertise and need to be supervised.
"Everyone in our hospital supposedly has the same level of training PPE use, but we've noticed we've had to do a lot of stepping in and educating and supervising," Dana*, who has worked on the respiratory ward for three years, told Nine.com.au.
The patients are younger, and much sicker
Another hallmark of the Delta strain is that it is infecting younger people without any pre-existing health conditions.
While all deaths from this pandemic are tragic, the nurses say the cross-section of people getting incredibly unwell are totally different in this wave.
"I've sent people in their 20s down to intensive care… who are still down there," Liz said.
"It's a long process, it's a long recovery for some people, and this is a person without any past medical history, no health conditions."
Patients with young children are separated from their families, often unknowingly infecting their kids and loved ones.
"Pretty much everyone, their whole family catches it," Becky*, a third-year nurse told Nine.com.au.
The patients are also deteriorating quickly and often without much notice.
"They could be fine in the morning, they could be not needing any oxygen, their breathing is normal, and after eight hours they're hypoxic (low blood oxygen) and in respiratory distress and you're sending them to ICU," Dana said.
"Everyone's experience varies completely, of course there are still a lot of people getting it who have minimal symptoms, don't end up in hospital but you just don't know what you're going to be.
"You could be absolutely fine; you could be in ICU intubated in a few days.
"It's such a gamble,."
'They are just terrified'
Coronavirus patients also pose a risk to the nurses. A huge part of their job is the compassion and comfort that comes with the medical treatment. But this is now dangerous for hospital staff.
"I think one of the hardest parts is, obviously we avoid spending a lot of time in their room, so we can't do that thing that we usually do where we sit and have a chat and get to know each other, and it's a bit of a comforting interaction for them to feel supported and that you're interested in them, and keep an eye on them," Dana said.
"They are just always terrified, they're always terrified.
"You go in there and them look miserable, they're scared, they don't know if they're going to be okay, they're bored as hell because they are literally stuck in one room and can't do anything."
For some, the sickness, the isolation, or both becomes too much.
"They verbalise that they would actually just rather die," Liz added.
"We've had a few episodes where we've had patients that just want out, they just want out, they'd rather die."
More jobs, less time
With coronavirus wards kept separate from other parts of the hospital, respiratory nurses have taken on jobs usually completed by other staff.
"We've got a lot more jobs since the pandemic," Becky said.
"We're doing food service jobs, secretary stuff."
This is due to the increase in patients, and staff not wanting to come into the unit.
"We're essentially doing several jobs as well as being a registered nurse," Liz added.
One thing in common
The nurses said the people who are really sick or dying in the ICU all have one thing in common: they aren't vaccinated.
"All the sick ones are unvaccinated," Dana said.
There was a resounding message from the three women: "get vaccinated".
* The nurses' names have been changed to protect their identities.
