KAWARTHA LAKES-Tara Smith and Rebecca Karkoulas have both worked at Ross Memorial Hospital in Lindsay for close to 20 years. We asked them to provide a first-hand account of what it has been like working in the hospital throughout the pandemic in order to provide some insight to residents.
Here are their stories in their own words:
“COVID-19 has affected every aspect of our work. Simple tasks that would have taken mere moments now take triple the time with added isolation precautions.
Frontline workers have picked up countless overtime shifts, adding to the burnout as they are not getting a break away from the hospital and a time to rejuvenate. They continue to do it, though, out of devotion to their colleagues and patients.
I can say that I truly believe most, if not every nurse in our ICU, remembers the names and case of every COVID-19 patient. In my experience, the length of stay for a COVID-19 patient that successfully recovers is the longest length of stay for any diagnosis. So much care goes into their critical, acute and recovery stages. Deep lasting therapeutic relationships are made with these patients and their families due to the severity and labile course of the disease.
I want the public to know that in our Intensive Care Unit, we do our best at all times to give the best possible care we can, but it is taking a toll on the frontline staff. COVID-19 is real. It is very disheartening to hear some references that it is ‘fake’ or ‘made up.’ Looking into the eyes of someone who is about to have a breathing tube put in, while they’re struggling to get their breath, the silent pleas to save them and knowing that we will try our hardest but can’t guarantee it is a sobering experience.” Rebecca Karkoulas, RMH Intensive Care Unit, Registered Nurse for 18 years
“Being a Registered Respiratory Therapist during the pandemic has been eye opening and exhausting. As RT’s we’ve often been in the shadows as, until recently, we have been an unknown profession for the most part. Often our patients don’t remember us because we enter their lives when they are at their sickest and most vulnerable.
We’ve had to take steps to expand our knowledge and learn new ways to treat and ventilate our COVID patients. We are busy in ICU with the sickest patients, but also called throughout the hospital to assess and treat patients in the ER, COVID unit and beyond. For many parts of our day, there is only 1 RT in the whole hospital. Time management and triaging situations has never been more crucial. We’ve had more ventilated patients than we ever have in my career. It has been the busiest and most stressful time I’ve experienced in 18 years.
Thankfully, everyone has been so willing to change shifts on the fly so we could put more RTs on nights or weekends, or wherever we are needed. Although we’re a small department of nine team members, we’re very close-knit and would not want to leave a colleague struggling.” Tara Smith, RMH Registered Respiratory Therapist for 18 years
Nitty-gritty, operational details at Ross Memorial:
“A typical day when assigned a COVID-19 patient starts with a report and review of patient’s history and clinical course. Review of diagnostics (X-ray) and labs (blood work) can be indicators on patient’s clinical status and clinical direction. Having just recently cared for a positive COVID-19 ventilated patient, I can tell you the next step is gathering a team of providers to assist with the process of proning. This was a “new to us” treatment that was rolled out early in the pandemic after studies showing positive clinical outcomes of early proning in the setting of ARDS (acute respiratory distress syndrome) secondary to COVID-19. The process involves turning the patient to their stomach (prone position) and adjusting the bed to have head up and feet down for best possible expansion and gas exchange in the lungs. Because the patient is on medications to sedate them, on a breathing machine, and multiple lines and cables for monitoring, it takes an entire team (five minimum), including a Registered Respiratory Therapist managing the airway to successfully turn the patient over. Once completed, the patient remains in this position for 16-hours with a team going into the room every two-to-three hours to then position the head side-to-side to avoid skin breakdown on the cheeks and face. This is a lengthy process and for the primary nurse, such as myself recently, I was in the room for a full hour doing my initial assessment, care, medication administration, and repositioning. That is a very long time closed behind a large glass door, with full PPE on, and a loud HEPA filter humming – it is very isolating.
Continuous monitoring of ventilator compliance, vital signs, and response to treatment occurs with the nurse stationed outside the patient’s room for close observation of clinical status. Because the patient is on airborne precautions we require strict adherence to PPE, which includes an N95 mask, goggles, gown and gloves. The team makes every effort to bundle care and enter the room as little as possible. Some strategies we have utilized throughout the pandemic to assist in this includes extension tubing for our intravenous infusions allowing the pumps to be managed from the doorway.” Rebecca Karkoulas, RMH Intensive Care Unit, Registered Nurse for 18 years.
Thank you to Tara and Rebecca and all of our healthcare heroes who have worked so hard throughout this pandemic!