This is the second story in a three-part series about the COVID-19 pandemic in Nebraska. Read the first installment here. Look for the third part on Sunday.
By Chris Bowling
When Amanda Pappas thinks about how bad the pandemic could get, her thoughts turn to nightmares.
The COVID ICU nurse talked to a doctor recently who wondered whether hospitals would need to commandeer the CHI Center in downtown Omaha. These days it’s common to see people waiting for a bed in the emergency room.
Pappas wonders will they need refrigerated trucks to hold all the dead bodies? Will she ever have to help move someone out of the hospital because their life is less worth saving than someone else’s?
Meanwhile, she sees the pictures of people in packed bars, dining without masks or walking around grocery stores with their noses exposed.
“It just feels like a slap in the face to all of us that are overworked and tired,” Pappas said, who transferred to the COVID ICU in August, “just taking care of these patients all the time for them to act like it’s not that big of a deal or some people are still claiming that it’s fake.”
Mindy, a COVID ICU nurse in Council Bluffs who asked her last name not be included, tested positive for COVID-19 on Nov. 14. She’s worked to exhaustion and broke down crying while praying with patients who are dying alone. She feels like they’re not getting the help they need from the public, the government or even her own hospital.
“I feel like we’ve been — sorry — we’ve been shit on,” she said.
Lisa Ulrich Walters, president of the Nebraska Center for Nursing, said the pandemic is having a huge impact on an already-stretched-thin nursing population. The organization, established in 2000 to address the state’s nursing shortage, projects that the state has about 4,192 fewer nurses than it needs — that number is probably higher because many nurses work less than full time.
Walters said they don’t keep track of how many nurses have left the field in recent months, but she and others interviewed for this story said hospital units have felt the impact of nurses quitting or transferring.
And while Ricketts has reiterated his support to frontline health care workers and added funds to help bolster infrastructure and hire more traveling nurses, the emotional effects can not be easily remedied.
“They’re just doing what has to be done in the time of an emergency,” Walters said. “But at some point in an emergency with that high adrenaline, usually it’s short-lived, you have to stop to process it, deal with that situation, and this isn’t OK. And so the risk is that people end up with post-traumatic stress disorder.”
The emotional toll health care workers have taken over the past nine months sting even more because of the efforts taken to make sure something like this wouldn’t happen.
Cawcutt said planning for the pandemic began in January. At that time, officials at UNMC and Nebraska Medicine knew they’d probably need more beds than the 10 in the hospital’s biocontainment unit.
They didn’t imagine having 10 COVID units across the medical school’s campus. That includes an entire tower dedicated to COVID, three separate COVID ICUs and one unit for people to die in peace. But staff has managed to adjust, bringing in beds, adding additional teams to handle the patients.
Doctors like Davidson have also become more adept at treating the illness. Drugs are more available. Steroids give people’s bodies a better chance at fighting the complications of COVID-19. But maybe the most telling experience health care workers have picked up is being able to tell when someone cannot be saved.
“You get them and they’re on a ton of oxygen, but they’re able to speak with you,” Davidson said. “You see them every day. You watch their oxygen levels progress, and you see, and they know … They know that they’re at risk to die, and they’re scared to death. You’re scared with them.”
In Nebraska, about nearly one in four people hospitalized with COVID die. Some are discharged without ever needing a ventilator. Some leave with holes in their throats where a tracheostomy tube allows them to breathe. Some tell doctors not to resuscitate them if they go into cardiac arrest.
Others don’t understand what doctors are trying to tell them. Davidson has spent hours shouting through a face mask and face shield, over the whine of machines, to patients, trying to explain that a person will die if they don’t let the hospital push a tube down their throat.
Sometimes these conversations take place through a translator. The patient looks at him, speaking a language they don’t understand, dressed like a visitor to an alien world, telling them they will die. They don’t believe him. And then, many of them die.
“If you see one of our COVID patients suffer and pass away,” Davidson, “I just have to believe that you would not be a person, politician or whoever that would continue to believe that general public health, COVID mitigation efforts are wrong.”
Some wonder if it’s possible for the message to ever get across. For months the language has stayed the same — wear a mask, wash your hands, socially distance, stay home if you can — and still people fight it. Some don’t even accept the science after it’s too late.
When a friend of Warchol’s had to tell the family of one man that he had died of COVID-19, they responded:
“There’s no way he could’ve died from COVID, because COVID isn’t real.”
contact the writer at firstname.lastname@example.org.