Sanford Worthington nurse says staff are 'running a marathon every day' to care for COVID-19 patients
Kaitlin Bullerman says taking care of patients with COVID-19 is emotionally intense.
WORTHINGTON — They work from early in the morning to late at night or overnight. They are scheduled for weekend shifts and holidays and — in the midst of a pandemic — they are all putting in a little extra to care for patients hospitalized with COVID-19.
Kaitlin Bullerman has worked as a nurse for eight years. As manager of in-patient services — overseeing the medical-surgical, pediatric and intensive care units at Sanford Worthington Medical Center — these past nine months have taken Bullerman and fellow medical professionals on a rollercoaster of highs and lows with still no end in sight.
“This year is unlike anything else that I have personally experienced,” said the Adrian woman who, in addition to being a full-time nurse, is a wife and mother to two young children. “The intensity of caring for COVID-19 patients — emotionally and physically — it’s just so much different than how we’ve ever delivered health care historically.”
Sanford Worthington has capacity for about 40 patients, with two intensive care units. While the number of COVID patients varies from day to day, Bullerman said the range is typically 10 to 15 patients at a time.
The unit is busy due to a surge in newly diagnosed COVID-19 cases locally — a trend seen across Minnesota and the United States as people spend more time indoors.
Bullerman calls it the second wave.
The first wave happened in March, April and May, when the local hospital and clinic cared for patients with more severe cases of the novel coronavirus.
“In our summer months, we still continued to take care of COVID patients, though not as many,” she said.
Through September, October and November, cases ramped up again.
“This second wave, we’re caring for a lot more COVID patients than we were this spring,” Bullerman shared.
The stark difference between the two waves is not only in numbers, but in the ages of patients. This spring, the local hospital saw more individuals hospitalized between the ages of 30 and 65. This fall, it’s been the older population — people ages 65 to 95 — who are admitted most frequently.
“This spring we did see people in the 95-year range, and this fall we’re still seeing some of those 35-year-olds, but by and far the age population that it’s affecting has shifted,” Bullerman said.
COVID-19 patients in the Worthington hospital are battling COVID pneumonia — found to be much worse than a viral or bacterial pneumonia diagnosis. Bullerman said COVID patients need greater amounts of oxygen — sometimes 10 to 15 liters — and stay in the hospital longer, from 10 days to two weeks. That compares to a two and a half- to three-day hospital stay for viral or bacterial pneumonia.
Patients needing an intermediate level of care stay in Worthington, while those requiring more than what a bi-pap machine can provide — such as intubation and being placed on a ventilator — are transferred to Sanford in Sioux Falls, South Dakota.
“We’re doing everything we can to be able to provide that care close to home for our patients here in the community, but we understand our resources here and we lean on our medical system to assist us with that higher level of care,” Bullerman said.
“One of the advantages of being part of a larger health system is that when patients need a different level of care, or we need additional resources for our staff, we are able to turn to our network and find what it is we are in need of,” added Jennifer Weg, Sanford Worthington Medical Center executive director. “For the most part, however, we are doing all we can to provide the best care for each patient right here in Worthington to keep them as close to home as possible.”
While some people continue to scoff at wearing masks or think COVID-19 is a hoax, Bullerman said it’s very real for hospital employees, families of employees and for the patients who are in the hospital.
“These nurses come in and it’s such an intense work emotionally and physically,” she said, adding the staff are giving everything they can to care for patients. “That’s one of our biggest challenges, I think, is that our nurses are stepping into so many different roles.
“Every person on the entire health care team — the physicians, respiratory therapists, physical therapists, speech therapy — everybody’s had to learn this new way to deliver health care to their patients,” she added.
From the time they step out of their vehicle in the hospital parking lot, medical staff are masked and ready for their shift. They are temperature-checked and symptom-screened before being cleared to enter, and once at their workstation, they get a new mask to wear for the day — different from the one they wore into the hospital.
Those caring for COVID patients can wear hospital-issued scrubs, which are laundered for them in-house. Then they don personal protective equipment (PPE) — a full-face shield over an N95 respirator, a full-length disposable gown and gloves.
“This has to be done for each patient that they see throughout the day,” Bullerman explained. “They spend hours in this PPE. They might just get it off and then a call light goes off and they have to go back in there.
“They’re running a marathon every day,” she said. “It’s intense work.”
Oftentimes the COVID patients are short of breath, and when they get up to walk, “the nurses are right there by their side, sweating in their PPE, and giving everything they’ve got to help (patients) while their family members can’t be with them.”
That’s another aspect of COVID, the families.
“A lot of times when people are in the hospital, their family members are in the room, assisting them with things or hearing what the doctor has to say,” Bullerman said.
With visitors kept away, nurses and patient techs are calling families to keep them informed of their loved one’s health, often making those calls instead of grabbing something to eat or drink or taking a bathroom break.
“We’re doing everything we can to paint the picture for them of how their loved one is doing since they can’t be here with them,” Bullerman shared. Helping patients connect to family through Facetime and other video calling platforms has been added to a nurse’s job because “they care that much,” she said.
For some of the elderly patients that have been admitted at Sanford Worthington, a human connection with family is something they haven’t had for months due to visitor restrictions at long-term care facilities. They face a lot of unknowns, and they are scared.
The nurses often imagine the patient as their parent or grandparent, or perhaps sibling, that they are caring for. It brings empathy to the patient’s situation, and brings out a strength in the nurses.
“They’re scared to be here and they’re putting all of their trust in us to help them. It wears on people emotionally,” she said. “That’s nothing we weren’t doing before, but it’s a whole new thing when we’re dealing with an unknown virus. It is emotionally intense.”
Protect the vulnerable
Bullerman said the best thing the public can do to curb the spread of COVID-19 is to follow the guidelines set forth by the Centers for Disease Control — wear a mask when unable to socially distance, and stay away from larger gatherings.
“We want to make sure we protect the vulnerable population this holiday season,” she said. “Whatever we can do to protect them — sanitize your hands, disinfect high touch areas … it’s those basic things that if all of us can do it, it will really help.”
“This is not the time to let our guard down,” added Weg.
She said the medical community has learned a lot about treating patients for COVID-19 since the onset of the pandemic.
“New therapies are becoming available at Sanford Worthington. These therapies show great promise in keeping patients well enough to where they do not need a hospital and they can recover at home,” Weg said. “Because of these advancements in treatments, fewer patients need a ventilator as part of their care.”