Life at a hospital can be scary these days with the continuing rise in the number of COVID-19 cases locally and throughout Alabama.
For the nurses on the frontlines of the coronavirus fight at Southeast Health in Dothan, the fear and anxiety can take a toll, but it doesn’t stop them from wanting to help others.
Their message to others is clear: Stay home.
“Everybody is anxious, and everybody is nervous,” said Joni Eubanks, a nurse at Southeast Health since 2005, who is now a clinical supervisor with the hospital’s critical-care unit. “… We do this by choice because this is the career we chose; this is the career we love. But, yet, if more people would just follow the guidelines set out by the CDC and stay home — that could flatten the curve to this and it wouldn’t be so much.”
The critical-care unit treats COVID-19 patients who have difficulty breathing and need more oxygen than is typical on the hospital’s inpatient floors. They are the patients who need noninvasive breathing therapy through nasal tubes or even intubation and a ventilator.
Cause for concern
As of Tuesday afternoon, Southeast Health reported 42 patients with COVID-19 at the hospital plus another 12 patients who tested positive and had been treated and discharged. In all, 241 people have been tested at Southeast Health with 137 of those tests coming back negative.
Nine people had died at Southeast Health due to COVID-19, an illness caused by a coronavirus first identified in December in China before spreading around the globe.
“It’s very much as bad as it’s made out to be. It is terrifying,” Eubanks said. “You walk into the room not knowing; everybody could be exposing everybody to it.”
Eubanks, 37, and other nurses at the hospital said the illness is new territory for everybody in health care. They worry that people in the community had not taken the illness seriously enough despite state health orders to close nonessential businesses. On Friday, Gov. Kay Ivey issued a stay-at-home order.
“It has been stressful, chaotic, and downright just unbelievable what we’re facing every day,” said Kysha Howard, a nurse for more than 17 years who oversees inpatient care units on different floors of the hospital.
The inpatient units, known as “acute care,” normally treat patients after a surgery, injury or illness with the goal to get the patient home after a couple of days in the hospital. These days, one of those inpatient units has been designated as a COVID-19 area.
Hard to predict, treat
Howard said that while most COVID-19 patients show the typical symptoms of a fever, cough and shortness of breath, some patients have reported vomiting and having diarrhea. Or, they’ve had no fever but just a cough.
And, as expected, the most severe COVID-19 cases are patients who have other chronic illnesses.
“What we’re seeing, the scariest thing, is these patients can be fine, vital signs stable one minute, and within five minutes they’re completely crashing and needing to be intubated,” said Howard, 38. “So this disease is not following a set pattern. It’s just all over the place; it’s unpredictable, which makes it difficult for us caring for these patients.”
Eden Bates, 23, commutes from Colquitt, Georgia, for her job as a nurse in Southeast Health’s emergency room, where she has worked since September 2018. A single mom of a 19-month-old daughter, Bates’ parents help her with the child when she’s working.
Life has been nerve-racking since the first COVID-19 case was confirmed in the Wiregrass, but Bates said she feels the nurse educators and supervisors stay well-informed on the latest guidelines from the Centers for Disease Control and Prevention.
“Just knowing that anybody who walks through the door could have it,” Bates said. “But I feel like we’re doing everything that we can to keep ourselves safe, keep the patients safe and that’s comforting.”
In the emergency department, everyone wears a mask, even patients, regardless of what symptoms they arrive with. Patients are asked about any recent travel outside of the Wiregrass and have their temperature checked. Those with potential COVID-19 symptoms are isolated.
Throughout the hospital, similar precautions are taken with masks, gowns and face shields.
While media reports can make people worry about shortages of personal protective equipment, hospital staff members are doing all they can to cut down on its waste and unnecessary use, Bates said.
Once their shift is over, nurses continue to take precautions at home. Their routines are similar. They remove their scrubs first thing when they get home, if they haven’t already changed at the hospital. Clothing immediately goes into the washing machine. They sanitize their shoes and wipe down any door handles or surfaces they touch. Then, they take a shower. All of this is done before interacting with their families.
“I limit my exposure to anyone outside the house,” Bates said. “I have a baby at home so I’m trying to not go out as much as I normally would. If I’m going to get groceries, I wipe all those down with Clorox wipes; let that dry, spray everything down in the house — just doing, again, what the CDC is recommending. Not really exposing myself to anyone that I don’t have to be exposed to, just going out for necessities.”
For Howard, her husband has things waiting for her when she gets home so that she doesn’t have to go searching through their home.
“I can just go directly to the shower before I can even interact with my family,” she said. “That’s our new normal.”
Howard has a 20-year-old son, but she has nephews that she would often keep before the pandemic.
“I’m not able to get them or see them,” Howard said. “I have to Facetime them because it’s so uncertain what we’re taking home. I don’t want to expose them to something I may inadvertently take home so I just let them stay home and Facetime.”
Coping with worry
Despite all the precautions, Eubanks still worries about exposing her family. She gets through it with her faith, praying multiple times a day, she said.
“As nurses, we are isolated,” Eubanks said. “We’re away from our parents, we’re away from our grandparents, we’re away from our children, and we’re away from our spouses — all by choice to take care of people, and we’re sacrificing all that. Yet, when you go out in the community, not everybody else is doing that.”
The strain can take a toll emotionally, especially since patients rely more on nurses for emotional support since they are not allowed visitors unless in extreme circumstances.
At work, the nurses support each other, visit with spiritual support staff and event support lines that were in place before the pandemic. There’s been a lot of support from the community. Local restaurants have brought food for hospital employees and groups have left messages for staff to see as they enter and leave the hospital.
“Nursing is not something you turn on and turn off,” Howard said. “Most of us that came into this profession we did it because we have a true passion for helping people, and although this is unprecedented what we’re seeing now, this is what we do.”