This is part of our occasional series called Portraits in Healthcare to capture the changes happening in healthcare due to COVID-19 as experienced by providers.
In April, Intermountain Healthcare in Utah sent a collection of 100 doctors, nurses, respiratory therapists and pharmacists to Northwell Health and New York Presbyterian Hospital, both systems in New York that have been slammed by the novel coronavirus. Among those doctors was Dixie Harris, M.D., a pulmonary critical care physician who has extensive experience in the intensive care unit. Harris worked the night shift at Southside Hospital in Bay Shore for two weeks. This story has been edited for length and clarity by FierceHealthcare.
I think this disease is a lonely disease. People are masked and gowned and your family can’t come in.
I am having an internal struggle with not having families at the bedside. I understand there are reasons for it, but I think there is a cost. There is good data that show an increase in survival when family is at the bedside. Nobody in this life wants to die alone, and really you are.
Because of the need for more intensive care unit (ICU) capacity, there are two patients in a room.
We are trying to keep patients on high-flow oxygen and off ventilators, but when they are on high-flow oxygen they are awake.
In one room, a code was called because a patient stopped breathing and we tried to resuscitate the patient. But another patient was literally three feet away and awake.
I held the hand of the patient who was wide awake and acted as a barrier so he could not see what was happening next to him, and I talked to him.
When I got to Southside, the patient volume didn’t surprise me. What really hit me was the calmness and grittiness of the people there that have been doing it there for five weeks. Many of them hadn’t taken one or two days off for five weeks.
The minute they found out where I was and my purpose there, everybody said thanks for coming. They still had so much common courtesy despite what they had gone through.
One of my colleagues said it is like we showed up in the fourth quarter. We came in as a relief team and let Southside workers sit on the bench for a little while and get some air before they had to go back again.
The other thing that surprised me was just seeing in person ways of making an ICU bed in areas that previously would be inconceivable. Southside went from 36 ICU beds to 150.
The boardrooms in the hospital, for example, are nice with a couple of big tables and kitchen areas. They converted their boardroom into a medical unit. They thought, "We are not having boardroom meetings right now, and we are going to make use of this space."
There is a cost to fighting COVID-19, not just the emotional cost or physical cost in the hours and wearing personal protective equipment. There is a mental cost because things are changing all the time. This week we are doing early intubation and then decided we shouldn’t early intubate on ventilators. I saw practice of these patients change drastically in the two weeks that we were there.
I am still running in my head my experiences and have had several debriefs with Intermountain since I got back.
I am grateful for Intermountain giving me the opportunity to do this.