Another Christmas of death and distress in America’s intensive care units


INDIANAPOLIS – Of all the Covid patients Ronda Stevenson treats over Christmas, there is one she can’t help but think about. He was hospitalized for 10 months, and during that time his 7-year-old daughter was never allowed to visit him, barred from entering the hospital by age restrictions that keep families separate. Situations like this make even veteran healthcare workers cry.

Ms Stevenson, an intensive care unit nurse at Eskenazi Health in Indianapolis for seven years, cries as she speaks of her patients and their families, clearly highlighting the pandemic’s heavy toll on already depleted hospital staff.

“We are understaffed,” Ms. Stevenson said. She added: “It’s getting more and more difficult.”

Instead of taking vacations this weekend, overworked hospital workers across the country are working 16-hour shifts. Some have been at work every day for weeks. Party meals have been replaced by protein bars and sports drinks.

This Christmas weekend, as the United States faces a new wave of disease fueled by a proportion of the population that remains unvaccinated, frontline workers are once again sacrificing time at home with their families to caring for Covid patients. In Indiana, which has one of the highest hospitalization rates and the lowest vaccination rates in the country, the situation is particularly acute.

“A lot of people including myself had scheduled time off, but they are now being asked to come and take shifts to cover each other and meet the increasing demands for patient care,” said Dr Graham. Carlos, Executive Medical Director. in Eskenazi, which is at full capacity and has a backlog of emergency room patients.

He fears it will only get worse. “If the numbers stay as they are, a tidal wave of infections is going to hit hospital systems, putting us in dire straits,” he said.

Almost two years after the start of a pandemic that shows no signs of slowing down, doctors, nurses and other frontline workers have already faced the emotional toll of mass death in their hospitals. They endured the frustration of begging the public to take precautions just to watch epidemics unfold as people ignored the cry for help. They suffered the moral distress of not being able to provide patients with the ideal level of care.

But this season, the system is under further pressure: Many workers who persisted in the first year of the pandemic have quit their jobs due to burnout and anxiety. And with the Omicron variant dramatically increasing the number of cases, caregivers who stay behind also contract infections, straining staff levels in unpredictable ways.

“It’s the worst I have ever seen,” said Maureen May, a nurse with 37 years of experience who is president of the Pennsylvania Association of Staff Nurses and Allied Professionals. She canceled her own vacation plans to take a shift on Christmas Day so a coworker could be away.

Amid urgent concerns over hospital staff shortages, the Centers for Disease Control and Prevention this week shortened isolation periods for infected health workers, allowing them to return to work in seven days, instead of 10. President Biden also said 1,000 military medics, nurses, paramedics and other medical personnel would be deployed to bolster the hospital workforce in the coming weeks.

At the IU Health Methodist Hospital in Indianapolis, the National Guard assisted in tasks such as transporting patients and cleaning up. Now a team of 20 from the Navy is arriving to help supplement the medical staff, who are partly depleted because around 350 workers across the hospital system have been released with Covid or because they have been exposed to the virus.

The hospital staff shortage comes amid a patient crash that has forced the hospital to open units that have not been used for years. Patients across the hospital system are cared for in non-traditional spaces, while others wait in the emergency room for rooms to become available.

“In my career, I have never seen ERs as busy or full as they have been in the past two months,” said Dr Mark Luetkemeyer, chief medical officer at IU Health’s University Adult Health Center.

The tension touched every corner of the hospital. Todd Walroth, Pharmacy Director for Clinical Services and Critical Care Pharmacist at Eskenazi Health, describes long days, including 18-hour shifts. His family sometimes dines at 10 p.m. – with his young children until after midnight, then sleeps late in the morning – so he can spend time with them.

His team is facing not only staff shortages, but also drug shortages. “We’ve had some really, really tough days trying to make sure, for example, that our patients who are on ventilators still have pain relievers and sedatives and that they are comfortable and calm and that their pain is controlled. “, did he declare. .

Across the country, there are around 70,000 people hospitalized with Covid, up about 50% from early November. Health experts fear hospitalizations may increase with the rapidly spreading Omicron variant.

At Eskenazi Health, critical Covid patients in intensive care are those who did not receive the vaccine, Ms Stevenson said. In Indiana, only 52% of the population is fully vaccinated.

She herself had been reluctant to get the vaccine and did not do so until she had to for her job. Since then, she has grown grateful, as she watches so many unvaccinated patients enter the intensive care unit.

“We hear a lot of ‘Oh yeah I should have been vaccinated’,” she said.

The government and medical leaders have pleaded with the public to get vaccinated to limit the spread and damage of the virus.

The Omicron variant has spread rapidly across the country in recent days, even as hospitals struggle to deal with the effects of the Delta variant which was previously the most dominant strain. While the latest wave and the emergence of Omicron have led some cities and states to reimpose some virus restrictions in recent weeks, much of the country continues to live near normal, raising fears that Christmas gatherings and New Year’s Eve no longer fuel the spread.

With the burden on hospitals potentially increasing, there are also concerns that the pandemic’s relentless toll on medical staff will cause fundamental challenges that could persist well beyond the pandemic. Surveys have detailed widespread burnout among workers, and a study this month found that the impact of such burnout was just starting to be felt, with 20 percent of physicians and 40 percent of nurses stating that they intended to quit their jobs.

Those who are still working are wondering how to get out of this.

Dr Carlos said that recently, after working three straight weeks in intensive care, he was asked to take a Saturday shift at a large hospital in Indianapolis. He had promised to do Christmas shopping with his eldest daughter that day. And at home, the gutters needed cleaning.

Dr. Carlos ended up refusing the shift. But as he did his Christmas shopping, he was consumed with guilt that his decision was causing more work for his colleagues. This feeling wasted time.

“I hate this feeling,” Dr Carlos said. “When I’m at work until 9 am, I feel guilty for not being home. And when I take a day off, I feel guilty for not being there.

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