IOWA CITY — In year 14 as a University of Iowa Hospitals and Clinics registered nurse, Laramie Wall is deeply rooted — having served in an array of units and posts, including his current split position in the cardiovascular intensive care unit and heart and vascular center.
From southeast Iowa, Wall, 39, earned a UI bachelor’s degree in science and nursing before jumping straight to UIHC — where he’s now getting an up-close take on the COVID-19 pandemic from inside Iowa’s largest health care system.
And these last few months, Wall said, have been unnerving, unprecedented, but also an inspiration that has him uninterested in swapping front-line health care for a safer career.
“This has definitely been a challenge, and it’s been a very unique time to be in health care — for certain,” he said. “But I still really like my job. And I still really like the people I work with. And while I think the university was stuck in a very tough spot — like every other health care facility in the world — I mean, it’s still a top-notch organization.
“I do think they did the best they could with the situation they were given.”
Wall — whose nocturnal shift often spans 7 p.m. to 7 a.m. — recalls the trickle of coronavirus news at the start of the year, as UIHC experts began preparing for potential COVID-19 spread into Iowa.
That was before Iowa had any positive cases. Before just a few emerged locally, tied to a cruise.
But in the weeks and months that followed, Wall said, he has vivid recollections of the hospital’s massive shift into pandemic response mode. And he remembers the moment when he realized everything was going to be different indefinitely.
“For me, it was probably the first day I went to work after they had closed most entrances, and they put the temperature checkpoint in,” he said. “It was that first day going to work, and the line to get in.”
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UIHC not only closed entrances and enacted strict screening mandates, it rolled out new and expansive personal protective equipment guidance, scrambling for supplies, and opened a COVID-19-specific flu-like clinic.
It amended most of its clinical guidelines and codes, processes and workflows, training and education to some degree, restricting visitors, halting elective surgeries and moving many routine clinical visits online.
As more coronavirus patients required hospitalization, Wall said, UIHC did what it could to isolate them and prevent any spread — improving its techniques as it went. One COVID-19 patient required extracorporeal membrane oxygenation — known as ECMO, among Wall’s specialties — putting him in direct contact with a pandemic patient early on.
“It was stressful,” he said of that work. “We didn’t have a lot of information.”
Although much remains unknown about how exactly the novel coronavirus spreads, why it affects some more than others, and who’s most at risk, even less was known earlier in the pandemic — and Wall said coming to work took on a whole new meaning. And feeling.
“It was odd walking into the building,” he said. “There was this low level of dread — just that knot in your gut, because you had no idea where this thing is going to go.”
With a partner and two young daughters — ages 2 and 3 — Wall expressed serious concerns he might contract the virus and bring it home.
“We did a good job of working at home when possible and isolating,” he said. “But I was worried about being a vector for transmission.”
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His partner — a UI Health Care application developer whom he never officially married due to employer rules forcing couples to split maternity and paternity leave — continues to work from home, according to Wall. And while others a decade younger might be taking a more lackadaisical approach to precautions, Wall said, he’s “definitely still in the concerned-about-it camp.”
“Nobody in the country was prepared for this level of disaster,” he said, noting UIHC didn’t always have him feeling protected early on, as gowns, gloves and masks were in short supply.
In the months since COVID-19 hit, Wall said, he’s treated a few coronavirus patients — and he’s keenly aware of the flawed comparison with the seasonal flu.
“I think anyone who’s comparing this to the flu, just doesn’t have any concept of what they’re dealing with,” he said.
From his vantage point though, at least right now, Iowa City is among the better places to be — not just because of the quality health care and lower urban density.
“It’s such a gigantic small town,” he said, boasting of its well-educated, literary, cultural, musical makeup. “I really do love it.”
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