For a while now, amid the growing spread of COVID-19, I’ve been wondering how to better advocate for the nurses and doctors, therapists and technicians, and housekeepers working at Mercy Hospital Washington. Since July, I’ve watched as our numbers of COVID patients have increased, first slowly and now rapidly.  We’ve now reached volumes so great that we’ve implemented overflow strategies while trying our best to meet all the community’s health needs. 

And although we’re not perfect — who is? — the co-workers who start and end their day at Fifth Street and State Highway 47 are as hard-working and caring as anyone you and I will ever meet. 

But there is a breaking point. I’ve been losing sleep worrying about burnout and overload for a team that has, for months now, accepted what we call “heavy shifts” that are emotionally and physically demanding. I see the fatigue on their faces when I round to thank the team for the extraordinary efforts they are making. It’s not uncommon in hospitals for clinical teams to have days with heavy shifts. But the teams can usually depend on some lighter shifts ahead to break up the heaviness. Not lately. COVID-19 patients just keep coming. Many in our family at Fifth Street and Highway 47 are working on reserve power to make it through the day, caring for very sick patients, knowing it’s all waiting for them when they return the next day. And, yet, they keep coming back.

I think about all this as I hear projections that COVID hospitalizations are likely to double in the next two to four weeks in the absence of serious mitigation strategies implemented right away by states, counties and cities throughout the Midwest. I think about this as our hospitals in St. Louis are filling up as well, cutting off our ability to transfer patients when we hit capacity.

Few have it as emotionally wearing as those caring for COVID patients who now make up more than a quarter of our adult beds at Mercy Hospital Washington. Our brave co-workers change in and out of PPE dozens of times a day, their faces and bodies sweating underneath their protective clothing, entering rooms to care for contagious, sick patients. Donning. Doffing. Donning. Doffing. All day long. All night long. Often for up to 12 hours, sometimes more. 

Arguably the toughest assignment is given to those caring for COVID patients who have little to no hope of making it out of the hospital alive.

Miranda is one of our courageous ICU nurses doing just that every day she comes to work. We’re lucky to have her as part of the family. She gave me permission to take excerpts from a recent Facebook post in which she describes the “silver lining” in her job and what keeps her coming back. Tell me this.  After you read Miranda’s story, are you not moved in some way to do your part to stay home more often, stay masked and socially distant when you do need to go out?

You see, nurses like Miranda are on the receiving end of your choices in the community. The Mirandas here may be caring for one of your loved ones if you don’t stop and help. Recently she posted this:

“I can promise you this is not what I signed up for when I became a nurse because, to me, being a nurse is providing care that helps improve a patient’s situation. I never thought in my wildest dreams I would be going to work every day to experience Russian roulette with every COVID patient I take care of. But like with all things you find the silver lining and the meaning behind things you go through in life.

“I have met some of the most wonderful people ever and their families are just as wonderful. You develop a sense of family with them and you will never forget. You may forget their names, but you never forget their situation — all the pictures on the hospital room walls, the tape recordings that family have recorded to be played in the room for the patient to hear their voices. Flowers, balloons, plants, and all their personal belongings that really allow you to indulge into their life and see them as a father, grandfather, brother, sister, mother — instead of just a body lying unresponsive while a ventilator keeps them breathing.

“Every single patient under my care who loses their life, I lose a little piece of me. It breaks my heart and, yes, I cry every time. I have not hardened to it, to see the look of defeat in the patient’s eyes or in their family’s eyes, it is the most terrible feeling in the world;  it’s a mixture of your heart racing, feeling like you’re going to puke and the tears just fill your eyes. In full PPE, you’re able to hide some of your reaction, but once you leave that room, sometimes it’s hard to hold it in.

“To feel their pain and suffering, to watch a 60-year marriage come to an end, to watch a daughter hold the hand of her father knowing in her heart it was the end but praying to God for a second chance and for any sign that things have changed, to see a son cry so hard and have to leave the room.

“I vow for no one to die alone and not feel loved. I will be that nurse to offer my hand and sit for however long it takes in a COVID patient room to offer them support during their last hours and last breath of life.  Then to do what I consider the worst part of my job — listen to the heart for one full minute to make sure that indeed they have passed along and to mutter through my crackly voice and teary eyes, ‘I’m sorry for your loss.’

“This is life now and this is my job.

“So, like anything, life and work must go on.  We adapt and move forward. But I’m asking you to think about those patients fighting the fight against COVID.  Think about those families who are also experiencing loss and please, for the love of anything on earth, stay home as much as possible and wear the mask. Do it for them, not us … we nurses will struggle but we will conquer alongside our doctors and all the ancillary care team.”

This coming Monday, the Washington City Council will again consider a mandatory mask ordinance for a time until the spread of the virus slows down from its recent sharp increase.  Today nearly 1 in 3 people tested for COVID in Franklin County is positive, and the experts are predicting this rate will cause COVID hospitalizations to double within a month in the absence of a serious mitigation effort.

And while a mask mandate is hard to enforce and won’t stop the virus completely, it’s our best chance in the short run to slow down the hospitalizations. It’s our best chance to reduce deaths at the hospital where Miranda and her fellow caregivers arrive to comfort the sick each day and night, and look for silver linings and vow to not let anyone die alone.