Overwhelmed is how nurses describe their jobs right now during this fourth COVID-19 surge.
It's not just from an overload in cases, as nurses say they're overwhelmed by increased aggression from patients.
"We are doing our best to keep our head above water and our patients' heads above water," said Clinical Assistant Professor at University of Texas at Tyler's Barbara Chapman.
Chapman is also a member of the Texas Nurses Association COVID-19 Task Force Member.
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Chapman says the job has become increasingly difficult as aggressions towards nurses increase.
Patients who are frustrated with long wait times to get a hospital or clinic room or annoyed by COVID-19 protocols, like wearing a mask, are taking it out on front-line workers, who are currently short-staffed.
"Nurses have often had outbreaks from patients where they appear to be violent or hostile for different reasons when they come into the hospital but this is different," said Chapman.
Nurses are reporting more verbal and physical attacks, as well as attacks online when posting about their job, or about vaccines or even CDC guidance.
The Texas Nurses Association offers a list of resources for nurses but the UT Tyler Health Sciences Center is about to become one of the first universities to offer free virtual visits with its trained mental health professionals to North Texas healthcare workers on the brink of burnout.
It's an expansion of the school's program originally launched to help overwhelmed teachers.
"This is a good place for healthcare workers or educators to come and just be able to talk and it's free," said Chapman.
The Texas Department of State Health Services doesn't regularly track incidents of aggression against hospital staff.