Karina Molina loves being a nurse, but ever since the third wave of COVID-19 hit — bringing a record number of cases to her state of Kentucky — the idea of going to work fills her with dread. “My anxiety is so high every time while I’m getting ready,” Molina, who works at two emergency departments run by the University of Kentucky, tells Yahoo Life. “I don’t know what to expect. ... It’s overwhelming.”
The Texas native works the night shift as a charge nurse, a job that requires both treating patients and overseeing the other nurses in her shift. Last week, Kentucky recorded more than 20,000 cases of COVID-19, bringing its total to over 160,000. It’s one of many states where hospitals have exceeded 70 percent capacity. “Our volume has skyrocketed,” Molina says of the patients coming into her ER. “It’s just been really straining and draining on our staff.”
One of the more troubling things she has witnessed is that some individuals, even while battling the virus, still believe it’s a hoax. “We can only tell people it’s real so many times. We’ll have patients come up positive and they’ll say, ‘You're just trying to take our money’ or ‘You didn't do it correctly,” she says. “People have said, ‘No, I’m not going up to the COVID unit. I don't have it.’ How do you argue that? How much more real can it get?”
On top of patients who don’t believe in the virus, Molina has had to deal with an influx of “ER boarders” — individuals who have been admitted to the hospital but, because there are no available beds, must remain in the ER. “They’ve run out of rooms upstairs, so they’ve had to start double-bedding COVID-positive people. They call them bunk beds,” says Molina. “They're not actual bunk beds, they’re just two people in one room ... but the nurses who bring them up tell me some of them could hold hands if they wanted to.”
Although ER boarding is not uncommon, Molina says they have gone from averaging 30 boarders a day to as many as 60, forcing ER nurses to perform duties outside their scope. “We're a jack of all trades; we're not specialized,” she says. “We’re trained to think differently — to fix you right now. We’re not trained to think about the long term. We’re here to stabilize you, but we don't think about what happens if you lay in bed and don’t move around, or if you don’t get the protein you need. We’re not trained for that.”
Dr. Thomas Benzoni, an emergency medicine physician in Des Moines, Iowa, is experiencing many of the same things Molina is — some of which he blames on individuals who don’t believe that the virus is real. “It’s maddening that people could do something about it and choose not to. It’s like if you have an infection and don’t take the antibiotics. It doesn’t make sense,” he says. “And the warped logic that I’m seeing used. ... In the old days, that would warrant you an antipsychotic and a psych bed.”
For doctors like Benzoni, those who believe the virus is a hoax or avoid things like personal protective gear are a direct threat. “We’re immersed in it. So my colleagues will keep getting sick, and a number of them will unfortunately die,” Benzoni says. “It's already happening around the nation and it's just going to be happening more in the Midwest because that’s the choice the Midwest has made.”
Much like Molina, the other big issue he’s facing is working at a hospital that’s running out of beds.
With more than 215,000 cases in his state and intensive care units at 80 percent capacity, he says there are times when his 30-bed ER is half-full with COVID-19 patients waiting for a bed. “When you’ve determined the patient needs to be admitted but there aren’t any inpatient beds, they sit in my ER,” says Benzoni. “Now I'm taking care of patients who are admitted, which is not in my skillset, as well as the patients who continue to wait in the waiting room because they can’t get into the ER,” says Benzoni.
Studies are mixed on whether ER boarding leads to worse outcomes for patients, with one study from April finding no link between in-hospital mortality and extended emergency room stays. But whether or not the patients are worse off, Molina says there’s no question that doctors and nurses are being pushed to the brink. “We train our people to let themselves be hurt before their patients are hurt. ... So people will continue to care for their patients, even if they themselves are not being cared for,” says Benzoni. “That’s a maladaptive strategy. It's also extremely dangerous for leadership because that means they’re working in a feedback-free zone where they don’t know things are going wrong on the front lines until it’s too late.”
Dr. Vineet Arora, a hospitalist at the University of Chicago Medicine and founder of IMPACT (Illinois Medical Professionals Action Collaborative Team), agrees that forcing health care workers to take on extra responsibilities in an already-stressful time is a recipe for disaster. “The really important thing that people might not understand is that there’s just no way to ramp up a trained, qualified workforce in health care,” Arora tells Yahoo Life. “You can’t just makeshift doctors and nurses.”
She notes that unlike the spike in New York in April, the entire nation is in need of more doctors and nurses. “It’s really difficult to bring in traveling [health care workers] right now because everybody is searching,” she says. “There was a whole plane of California health care workers that went to help New York. Those are the types of things that people would love to see right now, but it probably won’t happen.”
As cases continue to rise in the majority of the U.S., doctors and nurses have begun leaving the medical world, saying that the profession has become untenable. Molina says she is seeing it firsthand. “Our nurses are fatigued, they’re tired,” she says. “We have nurses looking for other jobs. We’ve had some really good nurses leave the profession in general. It’s really sad to see.”
Benzoni worries that the problem is just going to get worse. “The available fuel is there, the tinder is there, the fire is already going,” he says. “You got dry fuel. That's how fire spreads.” Arora adds that states need to realize the worst is already here. “Hospitals are members of the community,” she says. “When a hospital is hurting, the community is hurting. That’s why it’s a crisis.”
Molina says she will push on despite the challenges but hopes that people will think about health care workers the next time they choose not to wear a mask. “We really rely on each other to just vent and kind of keep ourselves going. It’s been emotionally draining, physically draining, mentally draining,” she says. “We're tired, and we need everybody to do their part to bring the numbers down.”
For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.
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