Juggling the needs of three to four COVID-19 patients at a time, patients who need constant physical and emotional care, has taken a toll on Lea Croft, a registered nurse at St. Charles Bend.
Like many of the nurses she works with in the progressive care unit at Central Oregon’s largest hospital, the pandemic’s late summer surge has left her exhausted, said Croft, who spoke as a member of the Oregon Nurses Association. Some COVID-19 patients can be in the hospital for up to a month, she said.
The delta variant, which is as contagious as the chicken pox, is making patients sicker than the original strain of COVID-19. On Monday, St. Charles reported 75 COVID-19 patients, and 10 were in the intensive care unit with seven on ventilators.
“Traditionally we try to keep to three patients until this last crisis,” said Croft, who has been a nurse at St. Charles for six years. “The ratio changes depending on how much care is needed. We don’t have a lot of options. As more patients need progressive care, our staff ends up stretched thinner.
“There’s a lot of stress.”
For two months now St. Charles Health System has said that staffing challenges have made it more difficult to handle the surge of patients coming from the delta variant. Most of the COVID-19 patients, according to St. Charles, are among those who are not vaccinated. The hospital has said that about 65,000 people in Central Oregon are unvaccinated or have not been exposed to the virus.
As the intensive care unit fills up with patients sick from the delta variant, more patients are being moved to the progressive care unit, said Croft.
When the pandemic began 18 months ago, nurses at St. Charles dealt in a lot of unknowns. There were shortages of personal protective equipment; they didn’t know how contagious the virus was, and they feared for their own health. There was no vaccine then. No cure. Just illness.
Now there’s just moral fatigue and compassion fatigue.
And a feeling that patients have ignored the one thing that could truly help them: getting vaccinated.
“The vaccine is the only thing we know that will keep people out of the intensive care unit,” said Croft, 37. “It all feels very unknown.”
There’s still no clear path to recovery for patients, Croft said. There’s best practices that are employed, but each patient responds differently to the pneumonia that develops in COVID-19 patients.
Most of the treatment methods are still experimental, Croft said. Patients are turned on their stomachs to allow as much oxygen as possible into their lungs. But unless they’re sedated, it’s uncomfortable for patients to stay in that position for long, she said.
Jake Newton, a registered nurse on the COVID-19 medical floor, said asking patients to lie on their stomachs is hard when they’re not sedated, which they only do to patients in intensive care. It works because gravity shifts the organs forward, allowing a greater surface area on the lungs, said Newton, who is also a member of the Oregon Nurses Association.
At the beginning of the pandemic, patients were in their 60s and 70s. Now, they are in their 30s and 40s — and the delta variant is hitting them harder.
They have trouble breathing. Walking across the room can feel like going up three flights of stairs, Newton said.
Some patients never recover.
“We’re in the worst surge we’ve seen since the start of the pandemic,” Newton said.
And then there’s the isolation. Many patients are in the hospital without the support of family or friends. They lay in their beds with only digital images of their loved ones to keep them company.
“It’s not uncommon that a COVID-19 patient only sees their nurse throughout the day,” Croft said “With this new strain, the hospital is cutting down on visitors. We encourage the patients to reach out on their cellphones or on iPads.”
And those patients are having very serious conversations with their nurses who are helping them get their affairs in order.
Recently Croft had a conversation with a young mother in the unit hospitalized with COVID-19 who had to face that she might not get better. She might not survive, she said.
Those are hard conversations to have, Croft said. The suddenness of the disease makes it hard to plan for death, unlike cancer or heart disease.
“Early on we felt for everyone, and we were all in it together,” Croft said. “Now it feels like a choice. Most of the people coming in don’t have a lot of knowledge about the vaccine and that can feel a bit frustrating.
“It’s a heavy burden. This surge is worse than anything we’ve ever had before and we were already stressed. The emotional toll it’s taking is palpable.”
Medical professionals have an additional fear of bringing home the virus to their own families or themselves, Newton said. Donning and doffing the personal protective equipment takes time, and is something that must be done before entering a patient’s room, he said.
Sometimes there’s success, Newton said. Patients get to go home, even if they’re toting an oxygen tank. But it’s a short reprieve for nurses.
“We’ve been doing this for so long now,” Newton said. “It’s very tiresome. And while it’s great to send people home, you know that there’s another one coming in. There’s not been any let up. We hold on to the positive moments, but it gets harder as the days go on.”