ST. CLOUD — It was sometime during the fall three years ago — in some of the darkest days of the COVID-19 pandemic before vaccines were available — when the leadership at St. Cloud Hospital chatted with a few nurses during rounds.

Writing down thoughts and feelings, they said, is known to help people cope with anxiety, fear, anger, sadness — things certainly experienced by the nurses in Medical Unit One, which was the designated COVID unit.

"We were pretty tired and getting pretty burned out with everything that was going on," said Lisa Kilgard, a nurse in the COVID unit. "So I thought journaling might help a little bit."

Kilgard and two other nurses — Amanda Shank and Nicole May — started collecting stories from staff in the COVID unit and then, as other colleagues became interested, from anyone who worked at CentraCare, which runs St. Cloud Hospital.

The result is a book released this fall titled, "Just Breathe: COVID Stories From the Heart of Minnesota in the Words of Caregivers," which is available on Amazon. It has about 100 stories — some short poems or vignettes and some a few pages long.

Some stories chronicle patients who said they didn't believe in COVID-19 and then suddenly couldn't breathe on their own. Some capture memories of staff wearing the air-purifying respirator suits that earned them the nickname of "beekeeper" or "astronaut," and some detail the painful dissolution over how health care workers went from being the heroes to the enemy as some people grew tired of pandemic restrictions and started calling it a hoax.

All of the stories give outsiders an inside look at what it meant to be a frontline worker at the time.

"No one, unless you're in the health care field, understands what we were doing and what was going on," Shank said during a recent interview. "I really just wanted to document this. Because even when I try to think back — I don't really want to — but when I do think back to how it used to be and what was going on, it's not as vivid in my mind."

Shank said she recently reread her submission and started crying. She recommends reading the book in small doses, as some pieces are haunting:

"We are no longer the front line; we are the last line of defense between the patient and the grave," wrote a nurse who signed her submission as Mary H.

"This was a time when every critical care nurse looked at their patients and knew with certainty that at least half of them would die," wrote nurse Katie P. "And they weren't good deaths. They were hypoxic deaths. Zoom goodbye deaths. Dragged-out deaths."

But the stories also showcase hope, resilience and appreciation for colleagues who helped them get through a rough few years.

One of Kilgard's stories captures the fleeting yet explosive joy felt when a patient was well enough to leave.

"We all were excited when we were able to have discharge parades for our longer stay patients. As unlucky as they may have been, they really didn't know how lucky they were," she wrote. "Administration staff would come to the unit and line the hallway and cheer as the patient left the hospital."

And for the patients whose bodies couldn't bear the brunt of the disease, the nurses tried to make death as peaceful as possible, Kilgard wrote.

"I never let go of your hand," she wrote of one such patient.

Shank said she hopes the book is healing for the families of patients who died and helps people remember the humanity that was lost — and found — during the three and a half years.

"It's a book of healing and understanding and remembering," she said, "so we don't forget this."