When Jennie La Dage, RN, of Patagonia, comes home from working a 12-hour shift at Northwest Hospital in Tucson she takes her clothes off in the garage and puts them in a plastic bag with her scrubs. She leaves her shoes and bag outside, doesn’t wear her wedding ring or other jewelry, goes into her guesthouse bathroom and takes a hot shower. She puts the clothes into a two-hour cycle in hot water and wipes her car down with bleach before she goes into her house to be with her family.
La Dage is just one of many healthcare workers living an entirely new reality since the onset of the COVID-19 pandemic. The most striking change she said is “being terrified of going to work. I’ve been a nurse for ten years and love my job, love going to work, but now I have a lot of fears around going to work.”
“For now, I feel like my workplace is assessing the risk and protecting its workers, but if I go and I don’t feel safe, then I will quit, which is terrible. I don’t want to quit but I’m not going to risk my family,” La Dage said. Some people believe that healthcare workers signed up for this, said La Dage, “but I didn’t sign up for going to work and being unprotected.” She would be most comfortable with a full protective suit, which is not available. Healthcare workers are wearing thin gowns, and because of the anticipated shortage of personal protective equipment there is “a lot of compromise on how we have been trained to work with infectious diseases. It should only be single use of all personal protective equipment (PPE).”
The hospital has changed too. There are no visitors allowed, each person who enters must have his or her temperature checked, and only one entrance and exit is open. The policy on masks has been updated so that every healthcare worker is expected to wear a blue surgical mask all the time. N-95 masks are to be worn all the time in the ICU, which has been split into two sections, one for COVID-19 patients and one for others. But there is a problem with wearing the N-95 all day said La Dage. “If you have a good seal, the longest I can wear mine is 20 minutes because you’re breathing your own air.”
Though there is no shortage of PPE as of now, the hospital is trying to repurpose N-95 masks to get three uses out of them, according to La Dage, which indicates a need for conservation of a precious resource that protects healthcare workers from contracting COVID-19 from their patients. A nurse is constantly touching surfaces in a hospital, from door handles, to medicine dispensary, to charting, LaDage said. Following the CDC recommendation to wash hands after touching surfaces has led her to have to cracked, bleeding hands.
The COVID-19 pandemic is “horrendous and really scary, not anything like I have experienced,” especially imagining being with a COVID-19 patient who can’t have any family there or if the outbreak leads to rationing care to favor patients most likely to live, as it has in other places like New York.
She wishes that people were better educated about staying at home and social distancing because if there is a big surge of COVID-19 cases it will ‘break the system.’ “People don’t stop having heart attacks or car accidents. They will still need healthcare, but resources will be diverted to the pandemic.” This can be avoided if we practice social distancing properly, had better testing and if there were a nationwide shutdown to slow down the spread of the virus, said La Dage.
Karina Hilliard is an Emergency Medical Technician (EMT) with both the Sonoita and Patagonia Fire Districts. The “hardest part is taking someone to the hospital,” said Hilliard. The EMT’s have to call ahead of time so that someone can meet them outside the hospital and screen their temperature. The EMT’s have to prioritize if a patient’s needs can be met at a hospital that doesn’t have positive COVID-19 cases. Disinfecting the ambulance has become more specialized. They have to use a special spray to kill anything that may have been aerosolized and wipe down anything that they touch (steering wheels, door handles.)
The EMT team receives a daily update from their base hospital, Banner University Medical Center in Tucson. Their protocol to wear PPE has changed and, though there is no shortage yet, they are reusing their N-95 masks. The EMTs wear safety goggles, masks and gloves and have been instructed to put a surgical mask on all their patients.
For now, because the team of EMTs is so small in Patagonia, they have broken up the response to calls so that everyone is not on call at the same time, said Hilliard. “We are all learning together, it’s so new,” and we are “so appreciative of the donations of masks and food from our community,” said Hilliard. “My morale is good”, said Hilliard, but I really miss seeing my friends and colleagues when I’m not working.
Susan Lange, RN, who works with Patagonia Assisted Care Agency, expressed a similar wish for the community to take the CDC recommendations of social distancing and wearing a mask when out more seriously. She said, “when I go out and see people closer than six feet apart, I try to educate them, but most people get irritated with me.”
Lange is afraid that people will get relaxed because the numbers of cases are so low, but our “count is so inaccurate because we haven’t tested enough people and because people can have the virus but are asymptomatic.” Most importantly, she said that even if you think you are not at risk of getting sick, think globally and think of the community.