There’s light at the end of the tunnel with the expected approval of a coronavirus vaccine, and that gives local nurses hope.
But the increased number of patients, along with the extended care required, is taking its toll on an institution not staffed or structured for these extremes, according to Emilie Westra, RN, inpatient manager for the North Ottawa Community Health System.
“We are all working long hours, picking up extra shifts where we can, and pulling nursing staff from other areas of the health system to help, but it’s tight,” Westra said. “I know all hospitals are experiencing the same issues. At no other point in history have we all had so many people needing hospital care at the same time, for so long.”
Then there’s the balancing act of the extra time required to put on more PPE (personal protection equipment), as well as give isolated patients attention and help connect them with family via Face Time.
Inpatient nurse Heather Herrera said donning the extra PPE is one of biggest challenges of working with COVID-19 patients, but they’ve become adept to suiting up quickly.
“It’s worth the time and frustration to make sure we are keeping each other and our patients safe,” Herrera said.
“Another challenge is seeing how quickly this disease can take hold and become severe, requiring breathing assistance in the form of a BiPAP machine or worse, a ventilator,” Herrera added. “Patients must be monitored very closely.”
Herrera said when patients come in for care, nurses see fatigue, moist (non-productive) cough, spiking fevers and difficulty breathing.
“Most patients only require standard nasal oxygen and medication,” she said. “But we see a good amount of patients who deteriorate quickly and must be moved to our ICU for more complex care, such as being put on a BiPAP (helps push air into lungs) machine or ventilator.
“In the beginning of the pandemic, we saw more elderly patients. Now, we are seeing younger patients in their 50s and 60s without many underlying conditions. Many of these patients had been already diagnosed with COVID-19 but thought they could beat it at home, only to find they couldn’t without help. That’s when they come to us, through the emergency room.”
Still, Herrera said the care they are providing is not highly technical.
“By and large, patients are administered medication and oxygen, and then monitored until they gain strength,” she said. “The part that gets tricky is helping our patients manage isolation, which takes time and patience.”
Because the patients are contagious, their room doors have to be kept closed and any interaction is limited, Herrera said.
“When a patient is with us three to five days, or longer, that time can feel like an eternity. Not being able to peek out into the hallway and see activity, or talk with loved ones can cause confusion and disorientation in some patients,” Herrera said. “Keeping them calm, assisting with Zoom calls and face time to connect families, and reassuring them that they are not only being care for, but cared about, matters. A lot.”
Herrera noted that, being a smaller hospital, staff is already good at those little things.
“Perhaps a takeaway from this disease is reminding us all at how important human connection is to the healing process,” she said.
Westra said that compassion has always been the driving force in the field of nursing – compassion for your patients and your team.
“We are wired to give, and give,” she said. “And these extreme conditions, constantly dealing emotional situations, including death, follow you home.
“The vaccine is giving us hope. But until then, we need the community to make good choices to lessen the impact of what’s happening now, and protect us from the surge that experts predict is on the horizon.”
Herrera said the closest thing to the coronavirus pandemic that she’s seen was the H1N1 pandemic 10 years ago.
“It was similar in that it was a communicable disease that we were learning about on the fly,” Herrera said. “But it was nowhere near the scale of COVID-19, especially here in Grand Haven.
“Still, we are trained and prepared to adapt. We have done an excellent job adjusting our staffing, logistics and operations to scale up as best we can. The community’s compliance with mask wearing, postponing large gatherings and getting tested has most certainly helped us fare better than other communities, and we need that to continue.”
Westra said she is inspired by her colleagues’ dedication.
“I am lifted up every day by smiles and talent surrounding me,” she said. “Seeing how people have stepped up and done the extraordinary for this community is tremendous.”
Herrera said that she is inspired by “our patients’ resilience.”
“And I have witnessed unfathomable strength in families who lost loved ones,” Herrera said. “We have felt those emotions along with them and we are inspired by their perseverance.”
Westra said they appreciate the community’s support and asks for it to continue.
“When we see people out and about wearing their masks, it helps,” Westra said. “When we read posts on Facebook thanking our hospital for the care they received, it helps. When we receive kind notes from recovered patients, it helps. When we receive thoughtful donations of meals and snacks, it helps. Knowing we have thousands of people rallying behind us, makes all the difference during a long shift and among difficult conditions.”