LANSING, MI – After wrapping up another 12-hour shift at Lansing’s Sparrow Hospital, Chad Larner got in his car, scrolled to find another true crime podcast episode and headed for home.
As he has often done throughout the coronavirus pandemic, the 48-year-old respiratory therapist turns to stories of serial killers to clear his mind of a day spent caring for coronavirus patients struggling to stay alive.
“I want to listen to something that kind of makes my situation not seem so bad,” he said. “I want something numbing that I can focus on and take everything else away.”
The 30-minute drive to Charlotte used to be enough to clear his mind. Lately, however, the exhaustion is spilling further into his home life. He’s finding it harder to recharge before returning to the COVID-19 unit.
More than eight months into the pandemic, the coronavirus isn’t slowing down either. Over the last week, Michigan averaged 7,025 new confirmed infections and 73 new deaths per day. Sparrow Hospital, like others across the state, has reached 90% capacity, including 111 coronavirus patients.
Hospitalizations statewide, which had dropped from nearly 4,000 in the spring to 300 in the summer, are back up near 4,000. And it’s getting worse.
“It’s probably because it’s been going on for so long and I’m so exhausted,” Larner said. “It’s just too early in this right now to feel like there’s a light at the end of the tunnel.”
As a respiratory therapist, Larner gets the call when someone’s having trouble breathing. That’s a common symptom for hospitalized patients with COVID-19, an illness that can lead to lung inflammation.
He likened his patients to individuals who just sprinted the length of a football field. The effort to catch their breath goes on and on, often requiring supplemental oxygen.
“We’re constantly on in a COVID world,” he said. “This is what we went to school for. This is what we’re doing. There’s no break whatsoever. We’re just, forging ahead.”
The front line
A soft chorus of beeping echoed through the empty seventh-floor hallway as Chris Hardigan pulls on a pair of blue surgical gloves.
It’s the same routine the fifth-year nurse has grown accustomed to over the last nine months. First, the double mask. Then, the gown, face shield and gloves.
As Hardigan slips into room 917, a negative air pressure machine pulls the contaminated air away from the halls of Sparrow Hospital’s first COVID-19 unit. Inside, a man in his 80s receives his medication as he and his wife, who was being treated in a separate COVID unit of the hospital, video chat.
After a few minutes, the nurse steps out, closes the door and systematically removes his PPE.
Gown off first, then the gloves. Clean face shield. Wash hands again.
“Early in the spring, it was kind of chaotic,” he said. “We didn’t really have a process in place. We’ve definitely streamlined it over time.”
Sparrow has four units dedicated to COVID-19 patients, including 7 West, where Hardigan has been staffed since before the start of the pandemic. His unit has room for 30 patients, and lately, it’s been full every day.
Patients who end up in the COVID unit are there because either they need supplemental oxygen or are experiencing a fever that won’t drop with over-the-counter medicines. Nurses in the unit monitor them and try techniques to assist and improve breathing before the need for ventilation.
The floor is typically staffed with 7-9 nurses each during the day and night shifts, plus a few patient care technicians who assist nurses, take patients to the bathroom, and stock PPE carts.
By largely dodging the first significant wave of cases that struck Southeast Michigan in the spring, Sparrow’s staff was able to improve its treatment techniques and gather supplies to prepare for a potential surge.
This time around, health care workers have a better indication of what the course of the illness can look like, and they’re able to detect signs of deterioration before a patient becomes critically ill.
One of the more challenging aspects of the job for Hardigan has been seeing the fear in his isolated patients who can’t have visitors, and talking on the phone with their family members, who feel powerless waiting at home for updates.
To help, nurses set up video chats with patients and their families. Those interactions “absolutely” bring a sense of ease for both sides on the call.
“It’s been hard, but it’s also been incredibly rewarding,” Hardigan said. “This is what we trained for; this is our purpose in a way.”
A worsening second wave
As the day shift comes to an end, a group of fresh caregivers gather at the floor’s central command center for a meeting before beginning their rounds.
The evening caregivers, wearing various shades of blue and green hospital scrubs, stand a few feet apart as a department manager runs through the pre-shift briefing. Included is a rundown of the night’s attendance -- nine nurses, two patient care technicians, 28 patients -- and a reminder to work on proning patients, or flipping them on their stomach to help improve their breathing.
After the run-down, personnel disperse to their respective areas to begin nurse-to-nurse reports, vital checks and assessments. Throughout the night, they’ll check on patients, help them get to the bathroom or get ready for bed, and respond to emergencies as they arise.
Tanya Glew, 46, had one year of nursing under her belt when the coronavirus first hit Michigan in March. The 7 West charge nurse is tired.
In the early days, she recalled her coworkers coming in with smiles on their faces. As time has gone on, she said the smiles have faded as fatigue has set in.
“We still have that now, but not as much,” Glew said. “We’re very, very tired. And it seems a little defeating at some points too.”
At first, the coronavirus was scary because of all the unknowns. While caregivers have met this second wave with more knowledge of the virus, it’s different this time around.
“The patients are a lot more sick than the first time around, we have a lot more of them and they’re younger,” Glew said.
She didn’t see any hospitalized 20-somethings during the first surge. She’s seen a handful in recent months, which especially hits home as a mother of four.
She could be their mother. And with most of them being college students far from home, she takes on that role while they’re in her care.
She doesn’t know why patients need oxygen assistance more often than in the spring, but over the last week and a half, she’s had at least one patient per shift who needed to be intubated.
“It’s a lot,” she said. “You hate to see these people who are completely fine and then they just can’t keep their oxygen up and then they have to go up to the ICU and be ventilated.”
Caring for the caregivers
Almost daily, Carly Hundt gets a text message asking if she’s interested in assisting another hospital as a traveling nurse.
As a 36-year-old department manager for Sparrow’s 7 West COIVD unit, she gets it. Hospitals across the country are experiencing the same strains on staffing numbers as in-patient beds fill up, including a limited number of respiratory therapists, nurses and patient care technicians.
“We’re going through this and Detroit is going through this and California is going through this,” she said. “I do feel like our organization is doing everything they can, but there’s a limit for everything. That’s why we have to be thoughtful about what we’re doing.”
Early in the pandemic, Sparrow lost healthcare workers who became too overwhelmed. That’s not as common anymore. But with fewer caregivers to pull from elsewhere around the country, it’s more important than ever to keep current staff healthy in all capacities.
“We have had caregivers get sick, yes, and that’s really our biggest concern moving forward,” Hundt said. “That’s why we really do preach making the good choices, not just here, but outside of work.”
Some nurses lean on fitness, yoga or meditation to refresh in their time off. Others look to making silly videos with their family or taking long, scenic drives to unwind.
As manager of 7 West, Hundt is responsible for keeping morale up and making sure nurses have the supplies and emotional support needed to do their job safely.
“I take care of the people who take care of the patients,” she said. “In the spring, it was just a lot of managing emotions and I had a lot of people really fearful. I don’t think people aren’t fearful now. I think that fear changed from ‘Am I going to survive?’ to ‘How is this going to impact my family and my life?’”
These days, caregivers are somewhat numb. They’ve lost sense of time. Even the optimists try not to think about when they’ll reach the end of the tunnel, because even an end to the pandemic doesn’t mean patients will stop coming.
“I dream of summer and we’re just starting fall,” Hundt said. “I don’t feel like any of this will let down until summer and then I guess I worry about the impact it has on people and whether or not we’ll be, I don’t know, like whole at that point.
“The longer this drags out and the harder it is on our team, the bigger the impact on what we look like at the other end of this.”
‘I’m not a hero’
Since the early days of the pandemic, many Michiganders have shown their appreciation from afar for front-line workers.
Whether it’s lawn signs, sidewalk chalk or window art, the message is clear: In the face of this health crisis, those at the front lines are heroes.
“To me, that’s about as high of a gratitude as you can get,” Hardigan said. “We appreciate the gesture. That’s awesome to hear. I don’t think we sit around actively thinking about it when we come to work, but it’s nice to hear.”
Few outside the medical field would argue the sentiment. Inside Sparrow’s COVID unit however, the tireless nurses appreciate, but shy away from that title.
Instead, they push the spotlight toward their colleagues and support staff who help maintain hospital operations. From techs and respiratory therapists to desk staff and those who clean patient rooms. Call a nurse a hero, and they’ll point to someone else.
“I’m not a hero,” Larner said, pausing as his voice shook with emotion. “People I work with are. I do what I’d want someone to do for my dad. I’m not a hero.”
“We are, but like, I don’t know,” Hundt said. “In this organization, I couldn’t count on both of my hands how many key people and professionals there are. It’s not just us. There’s all these people pitching in and pulling us up.”
Early on, the appreciation and sense of unity was more common. It hasn’t completely disappeared, but as days turned to months and seasons changed, the message faded.
Larner doesn’t see the signs much anymore. He doesn’t feel the same rallying around a common enemy. And he gets it. Much like him, people are exhausted.
Though it’s becoming more and more difficult to recharge before returning to work, Larner said he and his colleagues will continue to rise to the challenge.
“As a person doing it right now, I feel like we’re at that critical point … It feels like it’s as bad as – it’s the nightmare that it is,” he said. “But I’m under no illusions that it can’t get worse, and it very well might get worse.
“And we’ll rise up to it. That’s what we do.”
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