As the pandemic drags on into its 19th month, COVID hospitalizations — after first shooting past 8,000 in New Jersey, then dropping, then rising dramatically last winter, then falling again — are once again going back up.

Nurses in hospitals and medical centers across the Garden State frequently worked with less than adequate personal protective equipment in the early months of the health crisis.

They are now more knowledgeable and much better prepared to deal with COVID, but the pandemic continues to be a source of trepidation and exhaustion.

Mary Ellen Levine, the president of the New Jersey State Nurses Association, said the pandemic has been a series of twists and turns, highs and lows for nurses and “there really is this overwhelming sense of just not really feeling they were ever out of it. They’re really wondering if it ever left.”

She noted with the rise of the Delta variant and the growing number of breakthrough cases there is more concern among vaccinated nurses.

Levine’s daughter Jennifer has been an emergency department nurse in a North Jersey hospital for about two years. She said starting her career right as the pandemic began was nerve-racking.

“It was super scary at the beginning, mostly cause people were looking to us, look for us to have all these answers that we didn’t have, we were kind of learning with everyone else,” she said.

She said over the past year and a half nurses have gotten a much better grasp on COVID but it’s still exhausting.

“The PPE all the time, keeping everyone in isolation as best as you can — we thought we’d be over it, we thought we’d kind of move past it and it’s disappointing that we haven’t yet,” said Levine.

She pointed out having the number of COVID patients in the ER continuing to grow lately is challenging because they must be kept separate from others getting emergency care for different conditions.

Levine, who became interested in following in her mom’s footsteps as a nurse after working with her local volunteer ambulance when she was a teenager, said having good co-workers around her is helpful in maintaining a sense of balance and optimism in what are sometimes difficult and trying situations.

She said her message to New Jersey residents is, if you become sick and need treatment in the ER, please have patience.

“We’re trying to juggle isolation patients and COVID patients and regular ER patients, and it’s a lot to juggle and everything changes every single day,” she said. "We’re all I think feeling a little bit fatigued at this point. Hopefully we can return to a time when we’re not so busy and not so overwhelmed in the hospital.”

Her mother said efforts continue to provide nurses with opportunities for a variety of wellness programs, to give them a chance to take care of themselves, discuss concerns and refresh their attitudes so they can put their best foot forward.

You can contact reporter David Matthau at David.Matthau@townsquaremedia.com.

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The following is a roundup of breweries around the state with scenic, dedicated outdoor seating as weather allows.

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