A few years from now, students entering the health care world will look back and study how our world dealt with the COVID-19 global pandemic. By then, hopefully, we will know most of the unknowns we are still dealing with today; the science, what we got right, what we miscalculated, what we could have done better. There will be medical journals and scientific explorations of the virus, but what these records may not capture is the courage and teamwork of millions of health care workers and how they poured themselves into caring for the critically ill in one of the scariest times of our generation.
“When COVID first came out and got to the US, I was terrified. Lots of anxiety, lots of the unknown. Who was going to take care of all these patients? Who was going to help with all this stuff? And how fast it was developing,” shares Valerie (Val) Mcsherry, RN, a 15-year veteran with UnityPoint Health – Trinity Regional Medical Center. Her concerns were valid; however, Val also states, “It’s a virus, it’s scary, but we have to do what we have to do to take care of these people.”
When COVID-19 started to hit the news early winter of 2020, initially it seemed to be a crazy thing just happening China. But then it began to spread through Europe and soon it hit the west coast of the United States, and then this scary life-threatening virus became real. To make matters worse, the media was all over the place with information from a man-made deadly virus with intentional spread to just another influenza virus being hyped-up by the press. Regardless, we knew one thing – COVID-19 was in the U.S. and more than likely, we would see it.
“At first I was thinking, I don't know really what to think of it because I haven't dealt with it,” states Laccey Crimmins, RN, and working on her masters to be a nurse practitioner. “After talking with family that was working in New York and in Washington state, I kind of was like, “Gosh!” They were telling me, "We just can't keep up. We can't keep up. People are really sick.” Then you start seeing the CDC and doctors and news coverage and they're saying the same thing. And I'm like, “This is bad. Hopefully it doesn't come here because we're rural, we're not nine million people in Iowa, we're three million people.” So, when they started canceling school and doing all of that stuff around here, I knew this is serious.”
Most health care workers in middle America were experiencing the same concerns, including Trinity’s Kylie Roe, also an RN working in the nurse float pool. “When I first heard about COVID spreading, I was definitely a little nervous and there was always some fear and worry in the back of my mind, but I kind of mentally prepared myself early on, thinking that, ‘Eventually, it's going to be everywhere. I'm going to have to take care of those patients, and that's my job. Somebody has to do it.’”
And that’s how our nurses and doctors faced it – head on. As Heidi Lennon, Acute Care RN at Trinity states, “I knew I would care for them at some point. I was nervous about it, but I know these people need care too, just like anybody else. I'm not going to say, ‘No, I can't do that,’ just because of what they have. That's not me. I'm going to take care of them regardless.”
So how do you prepare for the unknown? From news reports across the ocean, the virus spread easily and rapidly with no known cure. Unfortunately, one ‘known’ would stand out to the United States, gross amounts of personal protective equipment (PPE) was a must to keep care givers safe and the majority of our supplies came from China – and at the time, they weren’t planning on sharing.
In order to compensate for the possible shortage PPE, as well as what types of PPE offered the best protection for front line staff, leading scientists within the CDC, WHO, as well as state and local healthcare officials were constantly evaluating and analyzing data about the virus and providing recommendations. As fast as the virus moved, so did their guidelines.
“It seemed like things were changing on a daily or sometimes hourly basis of what precautions we needed to take, what we were watching for, what we were screening for,” explains Diane Walstrom, RN, a nurse with Trinity for 13 years. “Our manager would meet with us sometimes several times a day just to update everyone on what was going on and the changes, making sure that we all had our PPE.” The team would also get counts of how many gowns, gloves and masks they had on hand. Which Diane admits, prior to COVID-19 they had all taken advantage of always having enough PPE and now they were much more aware of the need to conserve.
The rapidly changing environment seemed like a whirlwind for the healthcare industry, the benefit of living in rural America, we were allowed time to prepare as best we could before any positive patients to enter our facility. As Diane shares, “I feel like we were very well prepared. Much more than on the coast because we had all this extra time to talk about it, and plan for it, and train. We had time to make sure that we were putting our gowns on correctly and taking our gowns off correctly and touching things correctly so that we weren't spreading things to other people.”
Even though it was early March that our community officially started to close business doors and sending people home to work, our health care team in partnership with Public Health officials, had the foresight to start planning for a possible pandemic all the way back into late January. This gift of time helped our key team players to become familiar with evolving guidance and resources necessary to care for patients suspected or positive for COVID-19. It also allowed staff to practice, plan, and talk through management of patients. When the first patient was admitted, our team was able to safely care for that patient because of the planning and training done with frontline staff.
While all training beforehand made our team well prepared, nothing can ever replace actual experience. “I put my PAPR on and made sure I had everything connected and gowned up, garbed up,” states Heidi, “When I started walking down the hall, you get a little nervous. You kind of feel your anxiety rise a little bit and started sweating. But I mean, they're just like any other patient. They need care, and once you get in there and you start taking care of them, all those feelings disappear. You're not worried about that anymore. You have your appropriate gear on. You know you have what you need. Just take care of your patients, just like you would any other patient.”
“The first time I went in the room, I guess I was just double checking to make sure my gear was on right and I was sealed, my mask was sealed,” states Laccey sharing the same emotions, “I had my eye shield and my two pairs of gloves and walking in there…I didn't feel bad for myself, I felt bad for the patient. Especially when none of the patients can see what you're saying. It's hard to hear. It's a barrier on top of being sick and not feeling good. So, I felt worse for my patient than I did myself,” she continues, “I really didn't think about, I wasn't really scared like, ‘I'm going to get it!’ I just kept thinking, ‘I hope my patient can hear me okay. I hope they can understand what I'm saying.’ I guess I was worried more about that than the virus at the time. And maybe it was me distracting myself, but I felt safe. I felt like I had all the gear I needed, and I was protected.”
Diane also shared about the morning of her first experience, “I had actually known prior to coming to work that day that I was going to be probably taking care of a COVID positive patient. I received a message telling me what department to work in, and I knew that if that department was open, that meant I was probably going to have a positive patient. I remember leaving for work that day being a little more apprehensive than what I normally am. We had had possible patients, but no one actually positive. And I was just so nervous for my patient. We're being told that these people are very sick, that they can decline and become much sicker very quickly. So, how sick is this patient going to be? What am I going to have to do? And then that extra concern of knowing what am I doing, am I using my proper PPE? How protective am I? Which I'm always conscious of that, but not to this extent.”
She continues, “I will say, I did stop and hug my kids a little longer that day and give them a couple extra kisses. Because I know what we hear in healthcare, and the percentage of nurses and doctors that are getting this and hospitalized with this. I do remember just spending a little extra time with the kids that morning, just thinking if something should happen, I may be far away for a few weeks.”
Just like many frontline team members, Val stayed away from family members to keep them safe, “I haven't spent time with my family since the beginning of March because I have an unhealthy mother and I have a little baby niece. So, it's sad. But I know that that's the right thing to do is to stay away from them as much as I can.” But it wasn’t just their own personal struggles dealing with the virus and keeping their families safe as they cared for COVID patients. Frontline staff would soon find themselves replacing the family members of their patients when all visitors were restricted for all patients.
“With them not being able to have family, you try to be more like a family member to them,” states Heidi, “You stay with them longer. You talk with them more. You make sure they're comfortable, have what they need. Just empathize with them. I mean, this is scary for them, and a lot of them are really sick. They decompensate pretty quickly. So, you just try to be with them as much as you can and make sure they have what they need. Keep them calm. Try and listen to their fears, listen to their concerns, and just be there for them.”
“Sometimes it's kind of being pulled in multiple directions that we're not used to because we're used to having the family members here to hold their hand and give them a hug,” further explains Diane. “I also feel sad that they don't have their family members here to do that. I have had my own family that has been in the hospital, and that have been in care centers, I know I'm very appreciative of the nurses that are there doing what I want to do. I love that part of it, that I'm able to give that to my patients. But at the same time, it's probably the hardest thing that we have to go through is telling people that they can't have their loved ones here or that they can't be here with their loved one.”
Keeping family members at home in the loop is also a crucial part of patient care includes Kylie, “By relaying the information, transferring the phone calls in to them, just making sure that everybody stays updated along this whole thing. Because it's scary for everybody not being able to see their family members when they're sick..”
Val echoes Kylie’s sentiments in communicating with family members, “Your very patient with the patients and you sit down, and you talk. And the family members, same thing. You talk to them on the phone. Some phone conversations could last a really long time, which is something we wouldn't normally do because we're so busy. But in this time, we know that we have to take the extra time to make them feel more comfortable with what's going on at the hospital and that they're in good hands with us.”
Even though it has been extremely difficult for both patients and families not to be able to be together, today’s technology has also filled a gap. “I guess the biggest thing I've done to help my patients is, which is really nice is having social media, iPads, Zoom, FaceTime. I feel that if loved ones can see each other and speak to each other, that's so much more reassuring than just talking on the phone,” explains Laccey.
Although presently, COVID-19 is still very much with us and number of cases are still emerging our team remains hopeful. Some cases have been intensively difficult, and some have been extremely gratifying.
“One of our patients that recovered from COVID was on the ventilator for at least two weeks,” states Val. “The patient was then extubated and was doing pretty well. I went into the room to help get the patient up for the very first time. The patient smiled at me when I walked into the room and I said, ‘Do you remember me?’ And the patient shook their head, yes. And I thought, ‘wow’ because when people are on the ventilators, you never expect them to remember you or remember things you say, because they're either sedated or somewhat sedated. So that was really neat.”
Sharing her sentiments, Kylie agrees, “It's just a huge honor. It makes you feel really good when you take care of somebody and you see them declining and declining. Then all of a sudden, they get better. It's an awesome feeling, knowing that you were part of that.”
Learn more about how we are keeping you and our team safe during the COVID-19 pandemic.