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Nurses have had an up-close view of the pandemic deaths in the U.S.

RACHEL MARTIN, HOST:

More than a million people have died from COVID-19 in this country. So many of these deaths happened in hospital rooms witnessed by those at the bedside, often nurses. They have seen this tremendous loss up close. NPR's Will Stone brings us some of their reflections.

WILL STONE, BYLINE: There's not a whole lot that can surprise Mary Mills. She's been a nurse working in the ICU for 40 years. It's a career that started with the HIV/AIDS pandemic and is now coming to a close with the coronavirus.

MARY MILLS: This was sort of beyond anything I would have expected. I was proud to be there to do my part. But I'm tired. I think I'll let the younger kids do the next pandemic.

STONE: Mills has been here in Seattle caring for COVID-19 patients since the very beginning of the pandemic. That lightness, even a touch of humor in her voice, it's her way of lifting some of the darkness and exhaustion of being around so much loss the past few years.

MILLS: It just kept going, and so many people died, and, in my case, you know, tons and tons of people way younger than me.

STONE: Mills says it was sometimes hard to even remember what it was like caring for people who did get better. Those early days of the pandemic were filled with fear and sorrow. But Mills says over time, that turned to disbelief.

MILLS: Death isn't the hard part as much as unnecessary death.

STONE: People who refused to take the virus seriously, who wouldn't get vaccinated even after hundreds of thousands had already died - Mills says nothing prepared her for some of those patients.

MILLS: We lost young, pregnant mothers. We lost babies. And that's really hard. That's supposed to be a joyful, healthy time of life. And it's tragic.

STONE: This is what most Americans have never seen up close during the pandemic. In many ways, it's nurses like Mills who've shouldered the collective trauma of witnessing all this death. Beth Wathen says it has felt disorienting at times, the disconnect between these daily tragedies and how things look when their shift ends.

BETH WATHEN: And to walk out the door of the hospital and feel like the world has moved on, it's like living in two different worlds at times for many nurses.

STONE: Wathen is president of the American Association of Critical-Care Nurses.

WATHEN: If only they could see what we see in the ICU. For the patients who have died of this disease, it is a terrifying, lonely, tragic death.

STONE: Burnout, moral distress - Wathen says it's hard to find the right words to sum up how nurses are feeling, nurses like Jessica Scarlett, who spent the pandemic taking crisis assignments at hospitals dealing with a surge of COVID patients.

JESSICA SCARLETT: The personal factor, you know, the human factor, seeing so many people die, you know, they're helpless.

STONE: Scarlett's been a nurse for many years, but she says all this death has changed her. She doesn't sleep well anymore. Her bubbly disposition isn't quite there. And the memories of the patients she's lost keep returning. She says one of the worst things is that it can feel like much of the world, even her own family, just doesn't understand.

SCARLETT: I think there's no face to COVID. They hear a number, but they can't see it. And I think people forget. They forget.

STONE: Reaching a million deaths is surreal to Dr. Jennifer Adamski. She's a nurse practitioner who's on the flight team at the Cleveland Clinic, where she's cared for some of the very sickest COVID patients.

JENNIFER ADAMSKI: Every patient that has died on my watch, it comes home with me. You remember it. We wouldn't be good providers or nurses if we didn't allow ourselves to feel that.

STONE: As painful as it is, Adamski says that is part of the job. Will Stone, NPR News. Transcript provided by NPR, Copyright NPR.