BISMARCK, N.D. (AP) - It was quiet in the COVID unit.
Nurses — all wearing masks — routinely geared up in layers of protective equipment to monitor a patient’s condition or help facilitate a call with a pastor to say a prayer. Other staff sat behind computers or answered the phone. A lone bouquet of “get well soon” balloons hovered nearby.
It almost felt like business as usual.
But a lull late one morning doesn’t mean treating nearly two dozen COVID-19 patients has been easy for staff at Sanford Health Bismarck.
Connie Stewart, the unit’s director, said staff have “totally adapted” to a year she says is unlike any she’s seen in her four-decade career in health care. But that adaptation hasn’t come without an emotional toll, The Bismarck Tribune reported.
“It’s a whole new challenge,” Stewart said as her eyes teared up. “When you think you’ve seen everything, you haven’t.”
North Dakota for weeks led the nation in the number of COVID-19 cases per capita, prompting Gov. Doug Burgum in November to enact statewide business capacity requirements and approve a state health officer order mandating masks. One month later, cases across the state and in Burleigh-Morton counties are down about 60%, which health experts in the state attribute to the state measures.
Burgum at a public briefing praised North Dakotans for the drop in active cases but cautioned that there was still work to be done regarding the number of people hospitalized from or dying of COVID-19.
“Our hospitalizations and our deaths remain far too high,” he said.
The Sanford Health Bismarck unit opened in September with 14 beds, six of them for intensive care. Now it can hold up to 22 patients in 11 rooms, and it has space for outpatient infusions of remdesivir, an antiviral medication used to treat COVID-19.
Nurses Tara Canright and Kimberly Stearns have worked in the unit since it opened, and Canright has been assisting with COVID-19 patients since March.
Stearns, an ICU educator, starts her day at 6 a.m. with reports on patients and assessments, starting with the most critical patients first. The rest of her shift varies depending on what her patients need and ends around 6 p.m. or 7 p.m. Canright, who is the unit’s clinical leader, assigns patients to nurses and assists with admitting and discharging patients, as well as caring for her own patients.
Sanford nurses have been supplemented with traveling nurses and nurses from the Department of Defense, Canright said. About 15 employees work per shift.
Each nurse typically oversees three or four patients, Stearns said, but that ratio can change depending on the care a patient needs. Nurses have to don personal protective equipment, including a yellow gown, gloves and goggles, to enter a patient’s room. Instructions on how to properly put on and take off PPE are posted on a wall between rooms.
Patient rooms have negative pressure to ensure any airborne virus particles don’t spread throughout the unit. The rooms are sealed off with clear sliding doors; some have signs posted with safety precautions. Some staff wear a helmet that covers most of their heads to help filter the air they breathe.
Canright said she sees patients with underlying conditions decline rapidly, and that the virus affects each person differently.
“Whether it’s a young patient or middle-aged or elderly, they can get better and walk out of here, or they can take a turn for the worse,” she said.
The worst days are when the unit loses a patient, Stewart said, in part because loved ones can’t say goodbye like they normally would.
No visitors are allowed unless a patient is receiving end-of-life care. Visitors are allowed one at a time and must wear full PPE. The rooms in the unit have phones, and patients can use an iPad to talk with loved ones who can’t be there in person. Canright said that on one of her shifts, a chaplain sat with a patient who died so the patient wouldn’t be alone.
“We may develop a good relationship with some of these people who come in here, and we may be off for a couple days, and we come back and that patient has passed away or they’ve been transferred up into the ICU,” Canright said.
When Canright finishes her shift, she changes out of her hospital uniform — a set of pale blue scrubs — and washes her hands before going straight home. She washes them again when she arrives and showers before having any contact with members of her family. Stearns does the same. The two said they limited their Thanksgiving gatherings to immediate family only and plan to do the same for Christmas.
Through all of the upheaval the pandemic has caused, Stewart said, she is proud of how the nurses and hospital staff have adjusted to treating COVID-19.
“We are here to care for the community, and we will flex and adapt to do whatever we need to do that,” Stewart said.
lex and adapt to do whatever we need to do that,” Stewart said.
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