A nurse speaks

And we should listen

Arkansas is in a bit of a pickle at the moment. This covid-19 mess has gotten bad enough that Gov. Asa Hutchinson went on television last week to remind us about it. Yes, this thing is getting beyond tiresome. But we all need to be smart until the vaccine is widely available.

The governor has been delivering the same message for months. But he’s just a politician. (As certain protesters are quick to tell you.) We decided to speak with an emergency room nurse who works in Arkansas, in a rural area. She’s on the front lines of this crisis, every day, so it’s hard to find a more authoritative voice about what covid-19 is doing to thousands of Arkansans every week.

The hard-working young lady typically works as an ER nurse, but has other roles as well.

“I work directly with people sick with coronavirus every shift,” she said.

She has to be careful about where she goes and who she sees, even when she’s not at work.

“I am very close with my grandparents, but they are both in the high-risk group, so I have not been able to visit,” she said. Many of us understand.

Every night when she goes home, she begins a cleaning regimen that includes disinfecting her shoes outside to protect her family (which includes two young daughters), double-bagging her uniforms to wash, and going straight to the shower. Imagine disinfecting your shoes.

Being a rural hospital means not having as many resources as a metro medical facility. And while she said her employer is equipped to care for covid-19 patients, staff members have to be judicious with what’s available.

“We do not have an intensive care unit. We have two ventilators for emergency use, a couple bi-level positive airway pressure machines and Airvos,” she said. Those are machines that deliver oxygen to patients but are less invasive than ventilators (no intubation).

“We have not run out of these devices when there was need [for] them yet, and I hope that day never comes. If it did, we would keep the most critically ill in the emergency room until there was available space in an ICU to transfer them. If we had no other choice, we would call our local EMS to come lend a hand in monitoring these patients and use the ventilators they have on hand,” she said.

Those are situations we’re praying don’t come, but as too many Arkansans continue to flaunt their defiance of medical guidelines designed to prevent the spread of covid-19, we’re inching closer and closer to them.

Being an emergency room nurse, the lady sees what’s going on behind the scenes in this crisis, stuff most folks might not think about since their mental picture of an ER still includes George Clooney in scrubs. She told us her hospital is dealing with limited personal protective equipment. Gowns and masks that would normally be single-use are being reused. And medical staff members are getting sick as well.

An additional challenge of working in a small town: Many of the nurse’s coworkers know patients outside the hospital.

She went on to discuss the challenges of being an ER nurse. They’re supposed to be adept in triage, able to assess multiple patients at once, and to categorize them in order of severity. It’s a task we’d certainly never want.

“What about two people in respiratory distress due to covid-19? Our ER is staffed with two people: the doctor and the registered nurse. We do our best to treat the sickest patients first, but it’s not always easy. Please be patient with us,” she said.

When it comes to decreasing ICU bed availability statewide, it’s important to keep in mind there’s more to this challenge than finding space. The nurse said some emergency rooms have become temporary ICU holding areas for critically ill patients while they wait.

“I have also had to transfer a patient to a hospital out of state just to receive the care they needed,” she said.

Beyond bed space, there’s the medical staff to consider. Working overtime during this crisis has taken a serious toll on the mental and emotional health of nurses and doctors. Our friend says she’s experienced more grief, sadness and disappointment than she has at any other point in her career. Despite that, she’s not leaving. Not her patients. Not her job. Not her duty.

While medical outcomes can be discouraging, and hospital staffers are overworked and exhausted, there are patient victories that outweigh the bad stuff, she told us.

“We are saving people, and that’s what I signed up for. I think that’s what my peers would say too. We are tired. We are battered. But we are still here,” she said.

While both metro and rural hospitals are facing unique challenges during this pandemic, small-town hospitals are looking at limits in terms of equipment availability and staff.

While the governor begs folks to follow covid-19 medical guidelines, nurses and doctors are responsible for treating those that do and those that don’t. The nurse said she finds herself wondering who will come to her ER next week because they caught coronavirus when it could have been prevented.

“Will I know them? What if they’re really sick? What if they aren’t, but they live with their frail mother who won’t be able to fight it? These are thoughts that constantly cross my mind,” she said.

The No. 1 thing she said folks need to know about medical staff during this pandemic is, while they care about you and won’t stop fighting, they want you to make good choices. It’s not a political gambit, she added.

Our friend says she pictures this pandemic as a hydra with many heads. It’s as if no two people will exhibit the same exact symptoms.

“It’s not always limited to coughing and trouble breathing. For some it attacks the digestive tract in the form of nausea and diarrhea,” she said. “A person might think they just have a stomach virus when it could be covid-19.”

That adds to the challenge of trying to track and prevent its spread. Some people lose their sense of smell and taste. We don’t know enough about the virus yet.

Our friend and source wants the public to be mindful and considerate of others. Some folks ignore their safety because the mortality rate is around 1 percent. And while those sound like pretty good odds, what people don’t consider is the larger percentages of victims who will be left with permanent heart damage or suffer weeks on end alone in a hospital room where their loved ones cannot follow.

Then there’s the surviving family and friends of people who die, forever left with holes in their hearts that no nurse or doctor can mend.

“From an emergency nurse’s perspective, please be kind and be safe out there,” she said.

If listening to the governor’s pleas doesn’t convince folks to take this virus seriously, then consider the words of this ER nurse. She’s from right here in small-town Arkansas, went to high school with a graduating class of just over 100 people. She’s honest, loyal and knows more about this topic than the average bear.

Some may not want to listen to medical experts in Washington like Dr. Fauci. Some may not want to listen to medical experts in Little Rock who work with the governor. But consider the words of a small-town nurse who sees the pain, suffering and death this virus has brought every time she goes to work.

Wear a mask and social distance. Or you may find yourself in a hospital bed under her care.