Nurses come from all walks of life and perform jobs too diverse and complex to even catalogue. Today, when a global pandemic is taking hundreds of thousands of lives and wreaking havoc with the health care system, this army of devoted caregivers marches on in the service of others, intrepid and unfazed—as they always have done. In emergency rooms and intensive care units, in nursing homes and home care environments, our nurses administer to the sick, the scared, the lonely, and the bereaved. During a crisis their roles become more vivid, better understood, newly appreciated. But, as these over 400 Salute to Nurses letters attest, many written before the Covid-19 outbreak, nurses are every bit as important to the lives of their patients year-round, day in and day out, as they are during a pandemic. To all the nurses and medical professionals who are always on the front lines of health care, we salute you.

Bethany Poindexter, RN, Emerson Hospital

Bearing Witness: Bethany Poindexter

The front line in the war against the Covid-19 virus starts in hospital emergency rooms like the one at Emerson Hospital in Concord, where Bethany Poindexter works as a clinical resource nurse.

Poindexter’s job is a busy one. She runs the ER’s day-to-day operation, deals with patients and doctors, fields staff questions and concerns, and insures everyone is informed and following safety procedures.

But things in the ER have changed in the past few months. While the number of people seeking emergency treatment has remained much the same, the type of emergency room patient has changed substantially. No longer are doctors and nurses seeing primarily patients with heart attacks, sprains, appendicitis, or other routine difficulties. Now, most of their emergency room patients are seeking treatment for Covid 19.

That change has created an unusual dynamic in the ER.

“A lot of patients don’t want to come [to the emergency room], even patients with broken bones,” said Poindexter. When they do, “you can see the nervousness on their faces.”

Poindexter understands why they are scared. She is scared too, afraid she might expose her two children and husband to the virus even though she is confident that the hospital has implemented procedures to keep everyone safe.

One of the toughest jobs, she said, has been handling the onslaught of phone calls from anxious citizens and family members concerned about the virus. Within days of getting that first phone call, the hospital established a call center staffed with nurses to answer questions about Covid-19.

“Before the hotline got set up, the phones were really wild,” Poindexter recalled, adding that the calls ranged from worried to incredible, including one from a woman who wondered if the virus could be contracted through a video phone call.

Nurses may be well-versed in soothing the distressed, but there is also an emotional toll on them that few outside the medical field understand. Watching a patient die can have a heartbreaking effect on a nurse who has given her all to save the person.

There is also the pain of watching families saying their last goodbyes to loved ones. Particularly now, when—and if—families are allowed in to bid farewell, bearing witness is excruciating. Poindexter recalled how one woman, crying over the body of her dead husband, couldn’t even wipe her tears because of the face shield she had to wear to protect herself from the virus. “It’s hard to pull yourself together after that,” Poindexter acknowledged.

Virginia “Ginny” Caples, RN, Cambridge Health Alliance

Infection Control: Virginia Caples

Virginia Caples never thought of a career other than nursing. “I can’t ever imagine not being a nurse,” said the 58-year-old Lexington resident, an infection control nurse with the Cambridge Health Alliance. She also never thought she would be facing a virus that has killed millions worldwide.

Known as “Ginny” to family and friends, Caples is trained to deal with infectious diseases and teaches others to work safely around them. Today, her infection-prevention job takes her to hospitals and clinics in Everett, Cambridge, and Somerville where she manages patient care, handles supply issues, and trains and supervises staff members on how to keep themselves, their patients, and their families safe from the coronavirus.

Her colleagues at Cambridge Health Alliance appreciate what a good listener and how understanding Ginny is, qualities especially valuable during the current health crisis. As one staff member put it: “She is always calm and reassuring, even when dealing with an impending pandemic.”

Christine McCarthy, RN, Massachusetts General Hospital

A Sad Stillness: Christine McCarthy

Christine McCarthy cannot hug her 86-year-old aunt, injured in a fall, who is now undergoing rehabilitation at Massachusetts General Hospital, where McCarthy works in the Medical Intensive Care Unit. That’s because the two women are separated by a thin wall of glass, a barrier that keeps her aunt protected from exposure to the Covid-19 virus, while McCarthy confronts it head on every day.

Almost all of McCarthy’s patients have tested positive for the virus and many are undergoing extracorporeal membrane oxygenation (ECMO) therapy—a procedure in which a patent’s blood is removed, infused with oxygen, and returned to the body—a “last resort” treatment that has shown promising results for Covid-19 patients. “There are more patients, sicker patients, and it’s escalating every day,” McCarthy said in early April, two weeks before the number of confirmed Covid-19 cases in Massachusetts was expected to peak.

Patients are also getting younger, like the woman in her early 30s who has been in treatment for nearly four weeks. Her latest contact with her family had to be via text message: She wrote, “They are intubating me now.”

“It’s just heartbreaking,” McCarthy said of the quarantine that has kept family members apart from their loved ones. “The lack of families is noticeable. There is a stillness in the hospital without visitors.”

The work is mentally draining. With 12-hour shifts that often morph into 15-hour days, it’s physically enervating too. Add frequently changing treatment guidelines, which alter as knowledge about the virus evolves, and life in the ICU can be frantic.

Yet for McCarthy and many nurses, there is no place they would rather be. “When we’re not at work, all we think about is work,” she said. “We want to help. It’s exhausting, but this is where we want to be.”

Brad Robillard, RN, Brigham Health

Waiting for a Cure: Brad Robillard

As a nurse at Brigham and Women’s Hospital in Boston since 2013, Brad Robillard is part of the hospital’s “float pool,” which means he works where he is most needed. Today, that means he is spending most of his time with Covid-19 patients.

As hard as the job is, Robillard looks to the bright side. It can be incredibly rewarding when patients recover. He recalled a Covid-19 patient taking his first steps after being on a ventilator and confined to a hospital bed for three weeks. “It’s a slow road to recovery, but some patients are getting better,” Robillard said.

Still, his latest assignment poses unique challenges. “Six months ago, we didn’t have to worry about infecting our family and coworkers. That can be a little nerve-wracking,” he admitted.

To ease those worries, the 33-year-old husband and father said Brigham and Women’s has strict policies on using protective gear, which provides a standard of safety he appreciates. “I feel like being on the Covid unit is one of the safest places to be because everyone who comes in is treated as a positive patient, but in a supermarket, you just don’t know,” he explained. Indeed, he picks up his groceries curbside rather than going into the store.

Robillard is comforted by the aptitude of his colleagues. “I’m thankful I work with a bunch of people who are levelheaded and really can take on any challenge,” he said.

And he is eager to see a cure. “I just hope pretty soon we can put this behind us and do regular things—like watch sports,” he added with a laugh.