To frontline health care workers like Hunter Hall who are witnessing individuals’ last breaths day in and day out, the mounting death toll from the pandemic doesn’t just represent wave upon wave of sadness and compounding grief.
It’s also exacting a personal toll that feels like failure.
“We put in all our effort, especially for nurses who are with the patient all day. We really take it personally when all our hard work ends up for nothing,” said Hall, a cardiovascular intensive care unit nurse at Hillcrest Medical Center. “Because our patients are sick for longer than other patients, we get attached — they kind of become our family. And we feel like we’ve failed.”
As a significant portion of the population continues to resist basic safety measures like mask-wearing and social distancing and pandemic fatigue sets in among others, nurses and doctors battling against the novel coronavirus say they feel increasingly isolated in the endeavor.
And Tulsa-area hospital executives have been issuing public warnings about their staffing challenges driven not only by the recent surge in new patients, but also frontline workers pushed to the brink eight months in and counting.
“There definitely are people out there who are struggling with coming to work,” said Dr. Dennis Blankenship, who teaches at the Oklahoma State University College of Osteopathic Medicine and is a practicing emergency room physician at OSU Medical Center. “Because of the difficulties with those jobs on the COVID units, nurses, staff, etc. look at it and say ‘I could go work at a different place and not have to endure the stress and the risk.’”
Hall works with COVID patients who are on ECMO, short for extracorporeal membrane oxygenation, the most aggressive life support option for critical patients.
A patient’s blood is pumped outside of the body to give the heart and lungs a break in an effort to allow them to heal. Inside the ECMO machine, carbon dioxide is removed and then rewarmed, oxygenated blood is pumped back into the body.
“ECMO patients are the sickest of the sick. It’s basically your last chance, your last option, before death,” said Hall. “With ECMO, you have to be within a certain age to be a good candidate for it, so we’ve seen a lot of younger people. We’ve seen parents of like 6-, 7-year-olds.”
And even for patients who survive a serious bout with COVID-19, full recovery is far from guaranteed — and that includes a baffling array of younger adults and those without previous health challenges, Hall added.
“I feel like people think ‘Oh, these people go into the hospital, they get better and they come out,’” he said. “Just because they lived, it doesn’t mean they’re going back to normal.
“These people’s lives are not going to be the same now — if ever. They might not have COVID anymore, but they are extremely ill.”
Hillcrest went from a single ECMO operating under the watchful eye of a couple of nurses at a time to multiple ECMOs running around the clock, with much higher staffing demands to keep up.
“As the pandemic has progressed, it feels like everyone at the hospital is worn out and tired because we have to think about it all the time,” Hall said. “As the numbers have increased, it has been draining and frustrating seeing the lack of concern — people’s attitude that if it doesn’t directly affect them then it must really not be that bad. That is what is most frustrating for me.
“We never, as nurses, ever get away from that worry — we’re worried about our communities, and we’re worried about the people who are not following safety protocols. We worry about our families, and we worry about your families.”
Blankenship recalled how at the beginning of the pandemic, he wrote letters to his own children in case the worst were to happen to him. But these days, he is more concerned about just getting infected and having to miss work because of the burden that would place on his fellow physicians, because they’re already stretched so thin.
“In the ER, there’s no putting up a ‘closed’ sign,” Blankenship said. “Right now, there is constant psychological worry of day-to-day coverage of your shifts. Privately, within our groups of emergency medicine, surgery, etc., we’re so afraid of getting it or having to quarantine and creating that pressure within the group. It puts so much stress on everyone else to pick up a share of the work.”
What would nurses and doctors do if they were in positions of authority?
Hall said he can’t understand how this public health crisis ever became so politicized — or how many people still aren’t heeding pleas to wear face coverings to protect themselves and others.
“Why don’t we have a statewide mask mandate? I’m literally in the hospital trying to save lives, and we can’t even get the state to listen to what science is saying,” he said. “Wearing masks cuts down on the rate of spread.
“Especially to the nurses I’ve talked to and the way I feel — it makes me sad for the community and it makes me sad for the individuals who decide not to wear masks. If they could see what I see every day, I think they would think and feel differently.”
And Blankenship said it would be addressing the amount of community spread he is seeing because so many people are not following proper protocols for quarantining or isolation when they’ve been exposed or infected.
“There is a ton of misinformation out there about quarantining or what to do if you have it,” he said. “People will be three or four days into this and take a test and it’s negative and think they’re done. That has been the most frustrating thing to me.”
Blankenship said he can appreciate as well as anyone outside the medical field how the pandemic is wearing on people, but there is no getting around the collective effort it will take to overcome it.
“As I watch my family and my colleagues and friends and neighbors — it’s hard for everyone,” he said, “but the way we get through it is together. It’s something all of us have to do; we have to make those sacrifices to reduce the numbers of infected.”
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“I feel like people think ‘Oh, these people go into the hospital, they get better and they come out.’ Just because they lived, it doesn’t mean they’re going back to normal.”
ICU nurse Hunter Hall
“Why don’t we have a statewide mask mandate? I’m literally in the hospital trying to save lives, and we can't even get the state to listen to what science is saying. Wearing masks cuts down on the rate of spread.”
Dr. Dennis Blankenship