COVID-19 toll intense on Adena frontline healthcare workers

Nurses, others plead with public to observe safety recommendations

The casualties of COVID-19 extend beyond the patients themselves.

Their families, unable to be in the hospital room to offer comfort, suffer. So, too, do those frontline healthcare workers who are in the room, fully invested in trying to provide what’s missing for the patient.

“The best way to describe it, we are the family for these people,” said Adena respiratory therapist Jennifer Lower. “Their families can’t come in, can’t hold their hand, can’t tell them they’re going to be OK. So we put on a brave face, we go in and tell them those things, we hug them, we cry with them. When we walk out, we have to have our moment, too. We find a room and we cry. We get so close to these patients and we have to tell them goodbye sometimes. We are who they have.”

Lower, like many others with shared experiences working with COVID-19 patients at Adena Health System, expressed frustrations the Coronavirus has produced on so many fronts. Frustration for families who can’t be with loved ones sometimes fighting for their lives. Frustration brought on by physical and emotional exhaustion. Frustration over trying not to take the mental toll of the work or the virus itself home to their own families. Most importantly, frustration when seeing those in public not wearing masks, not social distancing, not practicing good hand hygiene and choosing to attend large gatherings.

Registered nurse Madison Francis is among those sharing in those frustrations. When she reports for work, she first has to brace for the reality that someone is likely to die at some point during her shift, courtesy of the Coronavirus.

“I would say before COVID-19, I had not dealt with patient death as much because we have a palliative floor, so usually end-of-life is sent to that unit,” Francis said. “I’m a float pool nurse, so I go everywhere in the health system, but unless it was something tragic, like a code where we lost a patient, I never really dealt with death that much.

“Since the pandemic hit, I do post-mortem care and I much more regularly have seen a patient pass during several of my shifts.”

As a float pool nurse, Francis has the opportunity to work shifts away from the COVID-19 unit. She knows, however, that those assigned to that unit permanently don’t have many opportunities to get away, and she doesn’t know how they deal with the daily stress while performing their jobs at the high level needed by patients. That stress is now being shared by other healthcare providers within Adena Regional Medical Center in Chillicothe, Adena Greenfield Medical Center and Adena Pike Medical Center in Waverly as the volume of COVID-19 patients has required their placement to be distributed throughout the Health System.

The same story is being played out in hospitals across the state, and while it may not seem possible, the ongoing holiday season may push that stress even higher as those fatigued by ten months of pandemic living and those who don’t believe the virus is as serious as it is being portrayed decide to ignore repeated public safety guidance. The result: The largest surge of new cases and hospitalizations since the pandemic began.

Nurses and physicians – often thought of when one mentions “front-line workers” – are not the only Adena Health System employees feeling COVID’s impact. Consider: 

• Phlebotomist Crystal Greene, who is among those who draw blood for testing. Maintaining the optimism that “together we are stronger than the virus,” she nevertheless feels numb and exhausted and doesn’t want to talk when she goes home after trying to be that friendly face patients need to face another rough day or night. “When I took my position in this field, I knew there would be times I would have to give more than just my 100 percent and I was prepared for that – or so you think you are. You become more than just a caregiver, you’re now someone’s ‘person’ because their loved one can’t be in the room with them due to restrictions. You go above and beyond your position because sometimes other caregivers need a helping hand, too.”
• April Thomas, a central processor in the lab at Adena Regional Medical Center. Saying she and many of her co-workers are beyond stressed and tired, Thomas notes they have been processing COVID-19 tests since the start of the pandemic – which can include anywhere from 100 to 200 specimens daily – in addition to normal daily specimen processing. The volume over such an extended period of time, and with testing only continuing to rise as cases are surging, is draining. “I don’t know if I am coming or going anymore,” Thomas said. “There have been a lot of days here lately that I sit on the edge of my bed and contemplate if I should come to work because I’m tired and stressed out, but I put on my big girl pants and come because I know that patients need my help.”
• Nichole Dailey, a phlebotomist who says working during the pandemic is one of the most stressful and frightening things she and her family have ever been through, especially as she’s seen several of her fellow phlebotomists test positive for the virus. “I worry every single day when I am working the COVID unit that I will get it or that I chance bringing it home to my fiancé and my three young boys,” she said. 

Nurse Practitioner Laura Arnett can sympathize with concerns about family transmission. Pregnant with her second child, Arnett was working in the emergency room around the time she contracted COVID-19 in October and attempted to quarantine herself in her home’s basement to protect her husband and baby – noting how heart-wrenching it was to hear her child crying and not being able to respond. Despite her efforts, they both caught the virus anyway, and while they can all count themselves among the “recovered”, she still experienced dizziness and shortness of breath a month into her recovery.

Arnett’s mother-in-law, Valerie Arnett, babysits Laura’s son. She, too, experienced a fever, shortness of breath, cough and headache for about 10 days before being admitted to the hospital on Halloween. After her discharge, she was right back in the hospital two days later when her oxygen levels dipped dramatically. She learned she not only had COVID issues, but pneumonia as well, and began what would become a five-day stay without the ability to have family with her due to visitor restrictions.

Being left alone with her thoughts only compounded her stress, she said.

“I was petrified, I was in tears,” she recalled. “It’s like you know you have it but it’s eye opening because there’s people dying of this and you have it. I had visions of a ventilator in my head – you do that, you go there. It was really scary.”

About a month removed from her hospital stay, she still has bouts with dropping oxygen levels and any exertion – just climbing some stairs or carrying her grandson, “things we take for granted” – leaves her trying to find her breath.

These are the faces not represented in the oft-reported Coronavirus numbers, the lives impacted by the decisions made by friends, family and strangers around them. They share a frustration over those who choose to ignore safety precautions, tell them masks don’t work or even deny the existence of the disease – until it’s too late.

“I had a guy who was passing – he was a do not intubate and could not breathe on his own anymore so he decided on comfort care,” Francis recalled. “So we give medications to make him comfortable so he’s not gasping for breath and he told me he did not believe in this virus – he did now, at that point – but he said he just couldn’t believe he didn’t believe in it until now.”

Francis says like many of the nurses, she does everything she can to keep a patient’s outlook positive and hope alive – a difficult task for the several who come in asking “I’m not going to make it, am I?” That effort, especially in situations in which she recognizes the odds facing a patient are pretty long, can be mentally taxing on healthcare staff who get to know COVID-19 patients pretty well because of hospital stays that can stretch over weeks.

Losing those patients can take its toll, and trying to prepare the patient’s family members before allowing them into the room in an end-of-life situation requires additional strength. 

“A lot of times when the family comes, we all walk back with them because the family is able to be there when we withdraw care,” Francis said. “While we gown them up, we tell them stories about our interactions with their loved one before they were intubated or before they weren’t able to talk anymore.” 

Francis, who tries to protect her own family by making sure she changes clothes and showers before leaving the hospital then putting her scrubs in a special bag and washing them as soon as she gets home, says it didn’t have to be this way but that misinformation has led some people to disregard suggested safety protocols. It’s not just a disease impacting the elderly population, masks don’t weaken the immune system, those dying don’t necessarily have a number of underlying conditions, she said, addressing just a few of those misinformation items widely circulating on social media.

Laura Arnett agrees, and urges people to consider the toll it’s going to take on their family if a loved one needs to be isolated in the hospital due to a Coronavirus diagnosis. Valerie Arnett, speaking from experience, said people should also ask themselves how they would feel if they were the one isolated facing an uncertain future.

“You think about a lot of things – your priorities and how you want to handle things,” she said. “It’s really scary, and you don’t know if you’re going to die, you really don’t.”