A second winter of COVID is descending upon the United States.

This time there is widespread access to vaccines, but there's also the new omicron variant, a much more infectious form of the coronavirus that's surging.

Health care workers in hospitals are seeing the worst of the pandemic every day. But is anything all that different with this latest variant? To find out, All Things Considered spoke with three nurses from around the country to talk about their experiences.

Kathryn Ivey is an ICU nurse from Murfreesboro, Tenn. David Manzini is a travel nurse based in San Antonio, Texas, when he's not on the road. And Mary Joy Garcia is president of the Philippine Nurses Association and a nurse in New York City.

Here's how their hospitals are doing nearly two years into the pandemic, what they are seeing in new omicron patients, and their thoughts on the wave of burnout affecting the industry.

Kathryn Ivey, 29, ICU nurse in Murfreesboro, Tenn.

In Tennessee, only 51% of the population is fully vaccinated. The low vaccination rate is something Ivey laments.

"It means that we don't have as much protection from having a vaccinated population," she said. "I just wish that we had the same protection that some bigger cities do."

The case numbers in her area have started climbing again in the last couple of weeks.

"We've filled the ICU back up. We're back to having ICU holds in our E.R., as well as on some of the medical surgical floors. People who have had to be intubated on the floor and there's nowhere for them to go," Ivey said. "The surge is starting to hit, but it's nowhere near its peak yet."

Ivey started her nursing career during the pandemic but said it's been rewarding and she doesn't regret choosing this profession.

"I think in some ways it's easier because I wasn't a nurse before the COVID era," she said. "Somebody has to do this job."

But that doesn't mean some things aren't frustrating. Ivey said she was still seeing issues around vaccine misinformation and masks.

"I have had to tell multiple visitors in the last week who have been waiting outside their family member's room while we're starting CRT or putting in a central line, they're standing out there with no mask next to a COVID positive room," she said.

"I have to tell them, there's a big old sign that says, 'wear a mask everywhere'. You know, I've had to tell multiple people, please wear a mask in the hospital if you won't wear it anywhere else.

"It gets really old, really fast."

David Mancini, 33, travel nurse based in San Antonio, but currently working in a Washington, D.C. emergency room

Mancini says the staff shortages and burnout across the industry have made travel nursing a more popular choice.

"That's why travel nursing is booming right now," he said. "We're filling in across the country for people who are done with the job."

He said that while the case numbers in D.C. have increased, the patients don't seem to be experiencing as much critical illness as before.

"That's not to say that COVID doesn't still negatively affect a lot of people in severe ways, but it's interesting that I've seen people with symptoms of more like the common cold or the flu," Mancini said. "They're still very sick, but they're not being hospitalized. They're not being intubated at the same rate that they were before."

From his own observations, Mancini said the sickest people were those who were not vaccinated.

Even with the rise in cases, Mancini said other surgeries and treatment had been able to go on as scheduled in D.C..

"In the emergency room, we aren't admitting patients for COVID at such a high rate that we were before," he said. "I can't speak to the ICU, but in the emergency room we are full to the brim of people who are COVID positive. But that doesn't necessarily translate into a full hospital being admitted. So we still have room for heart surgeries and people with other health complications."

For Mancini, being able to help has kept him going.

"I really enjoy being able to handle a critical patient and know that I made a difference," he said. "It's cool to be able to be the one to jump in, and if I can figure this out and titrate this medicine the right way and I'm on top of this and my full attention is on this patient, then I have made a difference in this patient's care."

Mary Joy Garcia-Dia, 55, nurse at a New York City hospital and president of the Filipino Nurses Association of America

New York is also seeing an increase in cases and hospitalizations, Garcia-Dia said, but lessons had been learned from previous surges that were helping the health care officials in the city cope.

"I think from here in the New York area, the health care systems have really learned a lot," she said. "And some of the measures that I have seen in just conversations with nurse leaders around in our area is how they try to be more flexible in limiting elective surgeries. So this way, they can better prepare themselves in case there's an anticipated surge just similar to what we have experienced last year."

But even as they're adapting, Garcia-Dia said burnout was affecting the industry as a whole.

"What we would want people to understand is that this is really causing a lot of mental distress to many of our nurses," she said. "And that's in fact supported by the survey that was done by the American Nurses Foundation. Like, more than probably 30% are contemplating leaving nursing, either because they want to retire or because they're just tired and exhausted."

Garcia-Dia said she finds strength through prayer.

"I find comfort in care," she said. "Of course, you know, that's really cultural, and I am so blessed to have a prayer group who has been praying since the start of the pandemic up to now. Praying the rosary, and that fills me with comfort."

Copyright 2021 NPR. To see more, visit https://www.npr.org.

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