Critical care nurse Abby Pelletier gets up for work every evening and walks into a waking nightmare.

A traveling nurse from Madawaska, Pelletier has been stationed in the intensive care unit at a hospital in Lufkin, Texas, for the past month. Her patients are unvaccinated, younger than ever and on ventilators. Too many of them are dying.

Pelletier left her job at Northern Maine Medical Center in Fort Kent earlier this year to travel for Krucial Staffing, an agency that sends its emergency response and health care workers to places in crisis across the United States. But while she relocated to Texas, things got worse at home. Aroostook County had the highest transmission rate in the state for almost a week earlier this month, and last week, Maine broke state records for hospitalizations and COVID-19 patients in critical care.

Pelletier is worried that another delta variant surge in Maine could overwhelm hospitals and get hundreds more sick just like in Texas. And with a little more than 40 percent of Aroostook’s population still without even one dose of vaccine, Pelletier’s plea to fellow northern Mainers is to get vaccinated.

Abby Pelletier is a critical care nurse stationed in Lufkin, Texas. Credit: Courtesy of Abby Pelletier

“Coronavirus, this delta variant, does not care what your age is. It does not care who your mom is. It does not care how much money you have, where you’re from, who you are. It doesn’t care,” Pelletier said. “We cannot have the attitude up north that it’s not going to happen to me … by then it’s too late.”

In the ICU, Pelletier deals with the sickest COVID-19 patients. Many of them are on ventilators, which means she rarely gets to talk to the people she treats. Even so, watching so many people die has changed her.

“Before you go into work, you just disassociate and do your job,” she said. “Try to do the best you can and help people survive.”

One of her first patients was a pregnant 30-year-old on a ventilator with COVID-19. The child was delivered via cesarean section, but the mother died before she ever got to meet her baby.

The young people are especially haunting — some of her patients are in their early 20s, and she’s watched them say goodbye to their families as they’re put on life support. Pelletier is only in her late 20s herself.

All her patients, she said, are unvaccinated.

Pelletier has watched in frustration as vaccines — something she views as a basic public safety measure — have become a matter of political discourse. In Maine, Gov. Janet Mills’ controversial vaccine mandate for health care workers, which will come into effect on Oct. 29, has been widely criticized by anti-vaccination activists. And right now, a federal judge in Maine is hearing a case on whether the mandate is constitutional.

Misinformation is the second deadly pandemic, Pelletier said. She doesn’t blame patients who have been misled by certain news outlets and social media platforms, and said it’s devastating to watch them suffer because they were lied to.

“They cry and they beg for us to not intubate but we have no choice. They know they won’t get off the ventilator, but they want to live,” Pelletier said. “I’ve had people before we intubate or get [them] on life support say, ‘If you give [me] one dose will it help me? If you give [me] the single dose Johnson & Johnson.’ I really wish it would, but it won’t.”

Misinformation about what’s in the vaccine is particularly insidious, Pelletier said, and one of the major concerns she hears from people who are unwilling to take the shot.

Her response: wait until you see what nurses administer to ICU patients to keep them alive: paralytics, sedatives, antivirals and antibiotics. Between medication and nutrition, Pelletier estimated that most of her patients are on a minimum of eight IV drips at once.

Pelletier encouraged people to look into the years-long history of mRNA vaccine development – which enabled infectious disease specialists to produce the COVID vaccine so quickly when the pandemic struck.

“Whatever reason you have not to get [the vaccine], I guarantee you a 10-minute walkthrough of what I’m seeing and the people I’m taking care of… I guarantee you’ll find a bigger reason to get it,” Pelletier said.

Pelletier works 72 hours a week and said the burnout among her fellow nurses is troubling. Hospitals can’t afford for the nationwide nursing shortage, which began before the pandemic, to get any worse.

In 2020, the Texas Department of State Health Services projected that the state would be short 37,000 registered nurses in five years. At the hospital where Pelletier works, staffing shortages already mean that most nights, critical care nurses treat far more than their allotted 1-2 patients.

As a result, traveling nurses have become the backbone of hospitals grappling with the worst of COVID-19. But that isn’t a long-term solution. Pelletier hopes to take a break and return to Maine in the next few weeks — the intensity of her job paired with the 2,000 miles separating her from her family are beginning to take their toll.

While health care workers have been commended widely for their role in combatting the pandemic, Pelletier said the best thing anyone could do to support her would be to get vaccinated and wear a mask. It won’t just save people from COVID-19, she said, it will ensure nobody dies because they couldn’t get a hospital bed.

“We’re not the front liners anymore, we’re the last line of defense,” Pelletier said. “You guys are the front line, in the community.”

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Hannah Catlin

Hannah Catlin is a reporter at the St. John Valley Times/Fiddlehead Focus in Madawaska, Maine.