I still hear my ventilator alarms in my sleep. But what stays with me is the silence.

For a long time, our ICU felt sealed off. No families. No clergy. No one at the bedside except us. When someone was dying at 2 a.m., it was machines, medication drips, and a screen propped up so a family could say goodbye from somewhere else.

We filled in the gaps. We had to. We became the daughter who couldn’t get there, the person holding the phone, the one who stayed in the room when everything slowed down and stopped. We were the witnesses.

Now it’s 2026. The signs are gone. Visitors are back. Masks are mostly optional. On paper, things are normal again. But something hasn’t reset.

I notice it in how I work. I still cluster my care so I don’t have to go in the room more than I need to, even though there’s no PPE barrier anymore. A daughter asks if she can help bathe her mom, and my instinct is to say, “I’ve got it,” and gently move her aside. I tell myself it’s quicker. Sometimes it is. But that’s not the whole truth.

During COVID, we learned how to keep people out. We had very good reasons. It kept people safe. But we never really learned how to bring them back in.

Before all of this, families were part of the rhythm of care. They asked questions. They noticed things. They helped in small ways. They were sometimes overwhelming, but they were also part of what made the care human. Then they disappeared. And we adapted. We got used to the quiet. We got used to being the only ones in the room. We got very good at managing everything ourselves. That way of working didn’t just disappear when the policies changed.

New nurses came into the ICU during that time. Many of them never saw what it looked like to care for a patient with family fully present at the bedside. Their first experiences of death and crisis often involved a screen instead of a person. We didn’t always teach them something different afterward, because, if I’m honest, we were still trying to figure it out ourselves.

Even among staff, things shifted. We used to talk more. Debrief more. There was a sense that you didn’t carry everything alone. Now the work is tighter, more efficient, more documented. But also quieter.

And then there are moments that don’t quite leave you. I remember one patient in particular. He was dying, and his family was on an iPad, thousands of miles away. They asked about the prayers that should be said at the end of life. There was no chaplain available, no imam allowed in at the time. It was just me in the room.

I didn’t know exactly what to do. I looked it up as quickly as I could, how to position him, what to say. It felt inadequate, trying to piece together something sacred under that kind of pressure. But there wasn’t anyone else. So I did what I could. I turned him as best as I could. I held the iPad so his family could see him. We read together, me quietly following along, them guiding me from the other side of the screen.

At one point, his daughter asked me, “Are you Muslim?”

I paused. There wasn’t a simple answer to what I was doing in that moment. I wasn’t the right person for that role. But I was the only person there. So I said, “I’m his nurse.” That was enough for her. She nodded, and we kept going. I don’t know if I did it perfectly. But I know it mattered that someone tried.

That’s what the pandemic asked of us. To step into roles we weren’t trained for, because there was no one else to step in. Over time, that stopped feeling unusual. It just became part of the job.

Now families are back. Support services are back. But I still catch myself acting like I’m alone in the room. It’s not just about habit. It’s about how quickly those patterns took hold, and how little space we’ve had to unlearn them.

Sometimes letting families back in feels harder than keeping them out. It means slowing down. Explaining things. Letting people do parts of care imperfectly. Letting emotion into the room again. But that’s also what care used to look like.

I’m trying, in small ways, to shift back. To pause when someone wants to help instead of stepping in right away. To make room, even when it’s not the fastest option. To remind newer nurses that families aren’t interruptions, they’re part of the care. Because if we keep working the way we did at the height of the pandemic, even when we don’t have to anymore, then something important stays lost. The doors might be open again. But that doesn’t automatically bring people back into care in a meaningful way. That part has to be intentional.

I still think about that question: “Are you Muslim?” And my answer: “I’m his nurse.” That answer carried a lot during those years. Maybe more than it was meant to. Now the challenge is different. Not how to be everything for the patient, but how to make sure we’re not the only ones.

Viksit Bali is a nurse.