A South Dakota nurse whose tweets went viral over the weekend says the hardest part of her job is convincing some critically ill patients that they really do have COVID-19. “Their last dying words are, ‘This can’t be happening, it’s not real,” Jodi Doering said on CNN. “Even after positive results come back, they don’t believe it.”

South Dakota is one of the nation’s worst coronavirus hot spots, but Gov. Kristi Noem has downplayed the threat of the virus and refused to put a mask mandate in place. Doering says some of her patients are also in denial, willing to believe almost anything else has made them so sick. “People want it to be influenza, they want it to be pneumonia, we’ve even had people say, ‘I think it could be lung cancer,’” she said. The nurse said that when she offers to hook some patients up with family by FaceTime for a last conversation, they say, ‘No, because I’m doing fine.’” She said the attitude is taking a toll on health-care workers. ‘It’s like a movie where the credits never roll,” she said.