When the coping skills that saved you refuse to stand down
When my therapist first suggested I might have PTSD, I rolled my eyes.
PTSD?
I wasn’t in a war.
My childhood wasn’t violent.
No one abused me.
I was an ER nurse during the pandemic.
And in emergency medicine, we are tough.
We handle what comes through the doors. We don’t fall apart. We move. There isn’t time to process the last dying patient because the next one is already being wheeled in. The overhead alarm doesn’t pause so you can feel your feelings.
Grief is postponed.
Emotion is compartmentalized.
Efficiency is survival.
And during COVID, survival mode wasn’t occasional. It was constant.
The Brain That Saved Me
In the ER, you are always scanning.
Where’s the next ‘fire’?
Who’s crashing?
Who’s about to crash?
Some days I was assigned to the “front” – responsible for the lobby and hallway patients. Sixty people at a time. All technically triaged as non-critical. But any one of them could turn on a dime. I watched vital signs, scanned faces, medicated symptoms, drew labs, started IVs – always listening for the subtle shift that meant someone was about to decompensate.
Other days I had four patients.
But they were all critical.
There were no ICU beds. The hospital was full. So we kept them alive in the ER — for days sometimes — doing ICU-level care in rooms never designed for that kind of stillness or focus.
We functioned as a machine. Nurses, doctors, techs. A team. Everyone had to do their part. If someone fell short occasionally, we picked up the slack. But if someone consistently fell short, the entire system suffered.
That mentality saved lives.
It also rewired my brain.
The Family I Never Finished Grieving
There was a family where both the father and the brother died.
The mother was upstairs, intubated.
I never found out if she lived.
You don’t realize how hard things like that stay with you.
There was no closure. No debrief. No space to sit with what we’d just witnessed. We walked out of one room and into the next crisis.
We were proud of being able to do that.
But pride doesn’t mean it didn’t leave a mark.
When Survival Mode Follows You Home
Years later, I started noticing something uncomfortable.
I am still looking for fires.
If there isn’t one, my body searches for one.
Everything feels urgent.
Everything feels high stakes.
Everything needs to be handled now.
But I’m not in a trauma bay.
I’m in my kitchen.
With my children.
And children, unlike ER teams, are not high-functioning trauma units.
They are not going to anticipate needs.
They are not going to execute efficiently.
They are not going to do their “fair share.”
And why would they? They’re children.
But somewhere in my nervous system, inefficiency feels dangerous.
In the ER, if someone consistently didn’t pull their weight, patients suffered.
At home, when my kids leave dishes out or forget their responsibilities, I don’t just feel mildly irritated.
I feel destabilized.
That reaction doesn’t belong to this moment.
It belongs to another one.
Lowercase ptsd
I think we misunderstand trauma.
We think it must be capital-T Trauma.
War. Violence. Catastrophe.
But sometimes it’s lowercase.
Sometimes it’s prolonged exposure to death.
To uncertainty.
To moral injury.
To functioning at maximum capacity for months without pause.
Studies continue to show elevated rates of PTSD symptoms among healthcare workers following the COVID-19 pandemic. Many of us functioned at crisis capacity for months without structured decompression. We were applauded for resilience — but rarely given space to process.
Sometimes it’s teaching your nervous system to override grief because there isn’t time to feel it.
And then forgetting how to turn that override off.
When my therapist said PTSD, I resisted.
In ER culture, we are strong. We can do anything. We don’t crumble. We move on to the next patient.
But maybe strength and trauma are not opposites.
Maybe you can be incredibly competent – and still impacted.
Coping Skills That Outlived Their Usefulness
Hyper-vigilance kept me sharp.
Control kept things running.
Compartmentalization kept me functional.
Those skills were brilliant adaptations.
They saved people.
But now?
Hyper-vigilance steals presence.
Control creates tension.
Compartmentalization blocks connection.
The same brain that could manage sixty unpredictable patients struggles to sit on the floor and build Legos without scanning for what’s about to go wrong.
I don’t need to triage my living room.
I need to be in it.
Learning to Exhale
The hardest part hasn’t been accepting the word PTSD.
The hardest part is teaching my body that we are not in that building anymore.
There is no overhead alarm in my house.
No code being called from the hallway.
No patient crashing in my child’s messy bedroom.
There is just life.
Slow. Imperfect. Human life.
Maybe healing isn’t dramatic.
Maybe it’s quiet.
Maybe it’s noticing when I’m rushing for no reason.
Noticing when I’m expecting trauma-team efficiency from children.
Noticing when my nervous system is braced for impact.
And gently reminding it:
We are safe.
There is no fire.
You can stand down.
I thought PTSD belonged to soldiers.
I didn’t realize it could belong to the nurse who never stopped moving.
But maybe lowercase trauma counts too.
And maybe healing is simply learning how to exhale – years after you were first told to hold your breath.
If You’re a Healthcare Worker Reading This
If any part of this feels familiar – the scanning, the urgency, the inability to slow down – it is not a sign of weakness. It is from being chronically, almost pathologically, STRONG.
Prolonged exposure to crisis changes the nervous system. That’s not a character flaw. It’s physiology.
If you suspect you may be carrying post-pandemic ptsd, consider speaking with a therapist trained in trauma-informed care. Modalities like EMDR, somatic therapy, and nervous system regulation work can be especially helpful for healthcare professionals.
You deserved support then.
You deserve it now.
Amy Dinaburg – Philosopher, Retired ER Nurse, Sharing insights on healing, resilience, and finding light in life’s toughest moments.
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