(Madison, WI): It’s never completely quiet. Sometimes it’s just the distinctive rhythmic sigh of the ventilators, beep of the tube feeding machines, or the click of a door closing shut; and other times the alarms of a code, crinkling of a PPE paper bag, and frantic feet.
In the heart of Madison, the ICU staff at UnityPoint Health – Meriter are both exhausted and determined to help patients beat COVID-19. Coming and going from shifts, they are greeted by the masked and the maskless outside, but inside, on this floor of the hospital, everyone’s learned to read each others eyes. And those eyes tell heartbreaking stories.
For one day, for only a few hours, we documented our ICU. Just a brief moment in a battle that is still raging to stop a deadly pandemic.
COVID has not followed any normal rules.
“We have always cared for the sickest of the sick in the ICU. We have cared for patients during their most vulnerable moments. What’s different with COVID is the sheer number of patients who are so close to death. At shift huddle, the mood is dark, because we know the chances of patients getting better and living a quality life is slim.” When the fall surge hit, it was like nothing our veteran staff had ever seen.
The act of preparing to enter a room is fraught with challenges, and in some ways, feels like a race. A patient is coding; “Hurry!” The internal dialogue checklist on repeat: gown, gloves, N95, and face shield.
Personal safety means limiting exposure, even with our steady supply of PPE, but often the need to keep a patient alive means hours on end sweating, and managing multiple equipment alarms in a single room.
The Health Unit Coordinator on duty fields family calls, feeling helpless explaining to family members the necessary visiting policy restrictions, offering a zoom call as if that can adequately replace being with a loved one in a time of need.
In the zoom call a nurse tries to carefully explain the patient’s status and turns the camera towards someone who is paralyzed, with tubes attached to every orifice. The nurse watches, heartbroken, as a family tries to sing happy birthday through tears, and the patient is too delirious to recognize the voices.
This is where we are, and the emotional toll is real. Our mental health specialist normally spends her shifts with patients and families in crisis, now it’s the staff that she supports in order to cope and grieve the loss they are seeing.
Going home isn’t a reprieve. Being exhausted and frustrated results in snippy arguments at best, and ostracized family members who think COVID-19 is fake at worst. Through all of that, our staff try and stop their mind from floating back to the unit, and the code they saw last. The tears are unstoppable.
“I think to myself that we just need to hang on a little while longer, and then another surge hits.”
