CORONAVIRUS

Frontline health workers challenged 'physically, mentally, emotionally' throughout pandemic

As months progress, many providers reach burnout levels of stress

Patient care technician Rachel Zimmer looks through the window into a patient's room in the intensive care unit at Unity
Patient care technician Rachel Zimmer looks through the window into a patient’s room in the intensive care unit at UnityPoint Health-St. Luke’s Hospital in Cedar Rapids on Wednesday, Dec. 23, 2020. The hospital is currently caring for 24 COVID-19 patients. (Andy Abeyta/The Gazette)
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CEDAR RAPIDS — Sarah Eberly always has loved the fast paced nature of the intensive-care unit.

Though the medical staff at UnityPoint Health-St. Luke’s Hospital’s ICU often sees the sickest patients in the hospital, they generally are able to recover. It’s always a celebration when someone graduates from the unit, said Eberly, an ICU nurse.

But since the beginning of the pandemic, that standard patient outcome has been reversed. By the time a patient infected with the novel coronavirus needs the ICU, they usually are required to be placed on a ventilator.

In many cases, it’s very hard for a patient to recover in that scenario. Eberly said she’s held the hands of patients as they died “more often than I would care to admit.”

“When you start to see the same patient type coming in every day and just not getting the outcome you’re wanting, it takes a toll on you,” Eberly said.

“We’re not seeing as many people get out of the hospital as did in spring. It’s tough. It’s tough to hold a patient’s hand in the last moment of life.”

In the nine months since COVID-19 first appeared in the state, the toll it has taken on the health care workers on the front lines of the pandemic has left a lasting impact.

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The recent arrival of two vaccines proven to be effective against the virus have provided much needed hope for many, but for many, it has shifted their perspective on their field of choice. For some, it has changed their approach to their profession and for others, it has given them confidence in their ability to provide patient care.

“It challenges you physically, mentally and emotionally over such a long time,” said Sara Butler, critical care nurse practitioner at Mercy Medical Center’s intensive care unit.

“It’s remarkable, everything we’ve been through over the past nine months.”

Survey results nationwide have found startling numbers of health care providers experiencing extreme stress, anxiety and exhaustion as a result of the pandemic. One survey conducted by the not-for-profit Mental Health America found about 76 percent reported feeling exhausted and burned out and about 75 percent were feeling overwhelmed.

In the spring, when positive cases were first appearing at area hospitals, Nursing Supervisor Celsey Huber volunteered to take time away from the orthopedics unit at St. Luke’s to care for COVID-19 patients in a new unit opened by the hospital.

Staff assigned to the new floor came from various parts of the hospital, all affected by the postponement of elective procedures early in the pandemic. Even with the fear of the unknown, Huber said there was a sense of camaraderie among the staff.

And again in November, when record-breaking numbers of new cases drove an alarming number of patients into the state’s hospitals, the orthopedic floor was converted into a COVID-19 unit. Huber found herself managing COVID-19 patients again.

The lingering, unanswered questions about the virus and the risks it posed to front line health care workers and their families caused much stress in the early days of spring. Huber said she would cry on her way to work her first week on the COVID-19 floor, grappling with these unknowns.

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But by November, even as the hospital’s staff and resources were stretched by the hundreds of patients, Huber said that anxiety had “greatly decreased.”

“We had more understanding of what we know and what we don’t know, and that alleviated our anxiety,” she said. “We have a healthy respect for COVID-19, but also a healthy respect for what we can do.”

‘You worry about people’

But it still posed an incredibly challenging time for hospital workers.

At its height in mid-November, more than 1,500 COVID-19 patients were admitted to hospitals across the state, prompting these facilities once again to suspend elective procedures and prep the next phase in their surge plans.

Health care leaders pleaded with the public to take safety measures seriously or risk local hospitals becoming overwhelmed.

Butler said hospital staff were working long hours, taking extra shifts to ensure all patients were taken care of. But despite that, the sheer number of patients made it difficult for Butler to feel as if she were doing her best.

“I might be lying if I said I was doing all right,” Butler said. “You worry about people and about how you can manage your work life and personal life.

“I don’t think I was completely burned out, I was just concerned about how we can keep doing this for so many months. How can we sustain this?”

Working in St. Luke’s ICU, seeing what she calls “the worst of the worst” of the pandemic, Eberly said some days it’s hard to tell that people care. It’s disheartening to see people not wearing masks, not maintaining social distances and otherwise not following recommendations from public health officials.

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Eberly said the new COVID-19 vaccines are just a small indication that Iowa may be reaching the end of the pandemic, but adds health care workers still need encouragement for the long months ahead, until the population reaches herd immunity.

“If you have a loved one or a friend who’s working in health care on the front lines, send them a thank you,” she said. “You don’t know how much that’s appreciated.”

Comments: (319) 398-8469; michaela.ramm@thegazette.com

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