A local emergency room nurse and instructor at Snow College Richfield, Rebecca Chappell, spent two weeks in New York City, New York, treating COVID-19 patients at the New York-Presbyterian Queens Hospital.
Chappell was one of 100 Intermountain Healthcare providers to volunteer for the humanitarian effort and make the trip east. Chappell left for New York April 16, and returned May 2, with a unique and informed perspective of the crisis at hand.
“I’ve been interested in doing something like this for a long time,” Chappell said. “When I received the email from IHC looking for volunteers, I jumped at the opportunity. Within a couple days, I received a call and the wheels for me to go were in motion.”
IHC sent two waves of medical workers to assist in various hospitals in New York, which has the largest concentration of coronavirus infections in the nation. The IHC groups went to relieve exhausted medical providers who had been inundated with COVID-19 patients since the beginning of the pandemic. According to Chappell, typical shifts for the nurses in New York were three 12-hours shifts per week. Upon the onset of the coronavirus breakout, nurses were working five 14-hour shifts per week.
Chappell thanks, and is very grateful to, her students and colleagues at Snow who finished her classes for her and the Sevier County Sherriff’s Office for granting her husband time off to care for their son while she was in New York.
On the ground –
Upon arriving in New York, the hospital’s nursing management briefed the arriving medical providers on what they would see, where supplies were located and trained them on the computer system so the traveling providers could take over and relieve their staff of the strain, and take some much needed time off, according to Chappell.
“When we toured the ER, I was a little taken aback at first,” Chappell said. “We had been told we would see and treat a lot of very sick and dying patients. The ER was inundated with patients. It took your breath away. ERs typically have one patient per room in an ER, they had two patients per room, patients on gurneys in the hallways and a makeshift Intensive Care Unit they had made four days before.
“The hospital had 118 ICU beds prior to the crisis,” Chappell said. “Within three weeks they had 286 – over two and a half times their normal census. Nurses typically have five or six patients at a time; they were caring for 10-15 at a time during the initial inundation, which is an unprecedented thing. And, ER nurses do not typically care for ICU patients.”
Chappell said she worked the night shift – 11 of her 14 days in New York.
“We were there to do a job and wanted to relieve their staff,” Chappell said. “We knew we were there for two weeks and tried to use our time wisely. While on shift, we took very few breaks due to the amount of time and effort it took to gear up in all of the personal protective equipment. The PPE consisted of N95 masks; in fact we doubled the masks. We also wore gloves, gowns and eye protection the entire time we were taking care of patients.”
The medical providers in New York were very grateful for the help and genuinely nice while training the traveling providers, according to Chappell.
“Considering they’ve been worked to the core for weeks on end prior to our arrival, they were nice, friendly and very helpful in training us,” Chappell said. “I’m not sure I would have been that way if I had experienced what they had over the previous weeks. It seemed as if what they had gone through brought them all closer together. It was nice to see their closeness and still in good spirits.”
Treating a pandemic –
For patients still on ventilators at the three to four week mark, some families made the difficult decision to let their loved one pass. Other patients were taken off the ventilators to see if they could transition to breathing on their own since there simply wasn’t anything else that could be done for them at that point, according to Chappell.
“It was really different out there,” Chappell said. “We have taken advantage of healthcare in the fact we are allowed family and visitors in the hospital when we are sick. During these times now, we cannot expose others to the virus. Police officers were posted at the hospital and only the sick patient was allowed to enter. Pretty much all of the patients were sick with the virus, all medical providers wore head-to-toe PPE and absolutely no visitors were allowed. If you weren’t very, very sick you didn’t go to the hospital. The bulk of the people in the hospital were basically on their deathbed.”
The typical patient was older, in their 70s, 80s or even 90s, and would come in with a lot of breathing problems and an uncontrollable fever. Approximately 40 percent were from care centers or nursing homes and already had lung issues or other medical problems, according to Chappell. In the ER, the patients were treated for their symptoms, such as shortness of breath and trying to stabilize their oxygen levels and fevers.
“It was heartbreaking knowing there truly was nothing we could do for some patients,” Chappell said. “We would have to call the patient’s family and let them know the patient’s oxygen was extremely low and their heart was going to stop and there was really nothing we could do. In that situation, the family would normally rush to the patient’s bedside, but in this situation that wasn’t an option.”
Chappell worked in a critical area in the ER, the sickest of the sick. Most of the patients were being put on ventilators, receiving CPR, admitted and sent to the ICU.
“The problem with the coronavirus is that you feel kind of sick and you don’t really realize it, but then all of a sudden you get really short of breath and a fever,” Chappell said. “People don’t necessarily recognize the symptoms before they get really sick. We were doing CPR two to three times a shift. There were a lot of very sick and dying people. Yet, not to the extent the news portrayed. At the hospital I was at, there was one day when the nurses said approximately 30 people died. There were not refrigerated box trucks outside waiting for bodies. There was not a massive amount of bodies everyday and the mortuaries seemed to be handling it okay.”
A ghost town and a rally cry –
New York was completely shutdown, according to Chappell. There were no stores open, no museums, no restaurants, the World Trade Center was closed – there was no being a tourist. Also the weather was cold, windy and rainy. However, the parks were open and people could walk through them if they opted to brave the bad weather.
Chappell said it was amazing to see the community and country rally around the medical providers. Caregivers were being fed by food that had been donated every single shift. Celebrities donated money, food and posted personal messages on twitter accounts for the caregivers to support and encourage them.
A lot of the hospital staff had gotten sick early on and had to quarantine for two weeks. Most of their symptoms were mild, while a few were moderate. Chappell said, about half of the nurses she met had gotten sick at some point since the breakout began. Some of the medical providers that had gotten sick were just coming back to work when she arrived in New York.
“We were all tested upon our return,” Chappell said. “My test was negative. Anyone who tested positive followed the IHC and Centers for Disease Control and Prevention guidelines.
“I feel I was really blessed,” Chappell said. “Everything kind of fell into place for me to go and do this. I would absolutely do it again. It was a great experience and I was humbled by it.”