As COVID-19 pandemic hits 2-year mark, strained health care workers look for ways to cope
Sanford Health and Essentia Health offer assistance and are seeking new methods to support their employees, who have taken a heavy toll during the pandemic.
FARGO — Much of the last two years of the coronavirus pandemic seems in retrospect a blur of frantic activity for respiratory therapist Dawn Aberle.
She works with COVID-19 patients who require help breathing from ventilators, and has seen some of the sickest patients battle a disease that makes X-rayed lungs look like bundles of glass.
The pace has often been so hectic that there’s been little time between patients in the COVID-19 unit at Sanford Broadway Medical Center. But one encounter with a patient, a woman in her 60s who was suffering from COVID-19 at the same time she was grieving the loss of her husband from the disease, stands out.
“I was able to sit with her and talk with her about her and her husband,” Aberle said, recalling a tender moment with the distraught woman during the fall of 2020, arguably the worst point of the pandemic. “It meant a lot to me to be able to spend time with her.”
Human moments like that were hard to manage when the pandemic was raging like a wildfire. “It was kind of running from thing to thing,” said Aberle, who has been a respiratory therapist for nearly 22 years.
The pace isn’t as frenetic now as the pandemic has spanned two exhausting years — a public health emergency was declared in North Dakota on March 13, 2020, two days after the state’s first COVID-19 case was confirmed in Minot.
But health care workers on the front lines have had to cope with high patient volumes even as COVID-19 infections are sharply down as the omicron wave fades.
“I think I definitely leaned on my co-workers who had been there,” Aberle said. She has felt the strains herself and seen them in her colleagues as they have worked many extra shifts as they have handled the nation’s worst public health crisis in more than a century.
“It’s difficult to see,” she said. “With COVID, it’s such a long-term inflammatory process. It is a lot for the hospital to handle.”
It’s also a lot for health care workers. Recently, for the first time since the pandemic began, Alberle spoke to a counselor, an option Sanford Health has offered since the early days of the prolonged crisis.
“It was just my personal point where I realized that I wanted it,” she said. Aberle dislikes the term burnout, which many have used to describe the physical and mental fatigue associated with having to function at a high level for a long time.
“It just sounds so negative to the person or people that they couldn’t handle it,” she said.
Earlier in the pandemic, Aberle was frustrated by how measures to mitigate the spread of the virus, such as wearing masks, and the vaccines became controversial political issues.
“I had a personally hard time dealing with the politics and the chatter outside the hospital,” she said. “I’m better at dealing with it now. I just had to let that go.”
Those who have been vaccinated have less severe illness than those who aren’t, even if they require hospital care, Aberle said. Most of the patients in intensive care weren’t vaccinated. The subject never comes up in discussions.
“It’s a moot point,” Aberle said. “You just try to give the best care to everyone.”
To help stay healthy, Aberle got an exercise bicycle to use at home. She finds it therapeutic to talk with co-workers who have dealt with the same struggles, collegial chats she thinks of as an informal support group.
The biggest surprise? During the pandemic, people have become aware of what a respiratory therapist does. “I usually get like an ‘Oh,’ and that is kind of humorous to me,” she said, recalling the reaction when her occupation comes up in conversation.
Although patients are grateful, “It’s a tough time to be a respiratory therapist,” Aberle said. “There’s plenty of time for reflection when this is totally done.”
'A new era'
Dr. Nancy Sudak became Essentia Health’s chief well-being officer last fall, in the midst of the pandemic.
The position is a nascent movement in health care, a trend Sudak believes will become the standard of care as health organizations are faced with the imposing task of maintaining the well-being of their employees.
A big part of the job, she said, is to “influence a culture of compassion,” for the employees themselves, each other and the patients they serve.
Essentia’s west market, dominated by Fargo, recently reported 650 job openings. Sanford reported 1,700 vacancies in its Fargo service area. The vacancies leave big holes that administrators say will take a long time to fill.
“These losses have been profound and will affect health care for some years to come,” Sudak said. “It’s a new era for health care workers,” who have many career options available.
Last year, about 12% of Essentia’s employees accessed counseling available through an employee assistance program, and about 300 completed mental health first aid training. Sudak is launching a variety of initiatives, including colleagues caring for colleagues and rooms that allow quiet time for employees.
Similar efforts are being made at Sanford, including the availability of counseling in-person or online. “That has been very well utilized,” said Dr. Doug Griffin, medical officer and senior vice president. “It’s been several hundred employees over the pandemic.”
Besides offering competitive pay and benefits, Sanford is striving to find other meaningful ways to make the work environment more attractive and supportive, he said.
“I think that’s very important,” Griffin said, adding that the effort is still in its early stages. “I don’t have an answer.”
'COVID is so uncertain'
Katie Cardinal, the charge nurse on the COVID-19 unit at Sanford Broadway Medical Center, has learned to live with the unpredictability of the coronavirus.
Admissions of COVID-19 patients are markedly down as the omicron wave fades, but the pandemic has shown that another variant of the virus can surface and with it, another wave.
“COVID is so uncertain,” she said. “I don’t dare hope any more. I just take what comes.”
A native of Fertile, Minnesota, Cardinal is a travel nurse, but has been with Sanford for a year and a half. Before accepting her current assignment, she worked in a variety of settings, including a nursing home, kidney dialysis unit, psychiatric unit and other hospitals.
But nothing in her 15-year nursing career compares to the challenges of the pandemic. COVID-19 patients’ condition can deteriorate swiftly, with no warning.
“I’ve gotten a lot stronger and more confident as a nurse,” Cardinal said. “I’ve become more of a leader. I actually think I’ve changed a lot. I think most of it’s positive.”
Still, she added, the strains of the job are wearing. “It definitely does take a toll,” she said. “Some of it’s really hard not to bring home and internalize.”
She tries not to internalize what she witnesses in the COVID-19 unit and is conscious of taking care of herself. “It’s important to recognize it and face it,” she said.
For the past half year, she has seen a counselor to help her cope. She also meets with fellow nurses and caregivers for a meal. They talk about what they’re dealing with at work.
“Because then we don’t bring it home to our families and loved ones,” Cardinal said. “A lot of times at work we’re so busy we don’t even talk. Some of the girls, I don’t even know where they're from.”
Cardinal has two young daughters, ages 7 and 9. “On my days off, I spend 100% of my time with them,” she said. “My home is an absolute mess because when I’m home with the kids we play.”
Some of Cardinal’s most difficult moments have involved elderly patients who are dying from COVID-19 and their families want medical interventions to continue, even though they are fruitless and will only cause the patient more suffering.
“The families just can’t let go for whatever reason,” she said. One such case involved a woman in her 90s who had Alzheimer’s disease and was badly confused. "She was just fading before our eyes,” Cardinal said.
The woman coded, but efforts to resuscitate her failed. “It was bad,” Cardinal said. “There was no getting her back. She was gone.”
On the other hand, patients who win long battles against COVID-19 are triumphs, and boost the staff’s morale. Cardinal remembered the joy on the unit the day a man in his early 20s was released after 105 days in the hospital.
“Cases like that are definitely the shining light,” she said.