Inside the ICU: An exclusive look inside Providence Sacred Heart Medical Center’s intensive care unit
You have heard about it. But, do you believe it?
You have heard about the severity of COVID-19 and the Delta variant. You have heard about the crisis in our local hospitals; the nursing shortages and the lack of supplies.
Maybe you do not believe it because you have not seen it.
4 News Now’s Robyn Nance and photojournalist Brian Belanger were granted exclusive and unprecedented access into Providence Sacred Heart Medical Center’s intensive care unit.
Here is what they saw on Tuesday, September 7, 2021.
The PRONE team, which is made up of nurses and respiratory therapists, gets started around 11:00 a.m.
Their job is to turn COVID patients onto their stomachs. These patients are unconscious, on ventilators and unable to breathe on their own.
They are completely helpless.
“What we’re trying to do by proning someone, is recruit those alveoli to oxygenate better,” said ICU nurse Eric Custer. “And just kind of open things up as much as possible.”
Proning is something that hasn’t been done but maybe four or five times a year, but since COVID began, it has been happening multiple times a day.
“It’s incredibly labor-intensive,” said nurse Hanna Rothstrom. “They stay prone for about 16 hours, so she’ll stay in that position for 16 hours, unprone for the rest of the eight and then do it again.”
It takes this team 20 minutes to get one patient in the proper position. Once she is stable, they strip off their gear, sanitize, go to another patient and start all over again.
“It’s really your last-ditch effort to try to save someone’s life,” Custer said.
Right outside of that patient’s room, a hospital bed is wheeled down the hall.
“So, we just brought a woman in her early 70s up from the emergency room. She had been waiting in the emergency room for 16 hours and because we didn’t have a bed available… we just now got her up and she had to be emergently intubated, meaning they’re going to put in a breathing tube to help her breathe,” said ICU nurse manager Deb Gillette.
Gillette has been a nurse for nine years. For the past 18 months, she has led a team through the unimaginable.
“We have 54 beds for adult critical care at Sacred Heart; 26 are in our general medical neuro-trauma ICU and 28 are in our cardiac ICU but we have had to use the cardiac ICU beds also for COVID patients,” Gillette said.
These are the sickest of COVID patients. Their bodies are shutting down.
Beyond the ICU, there are two other floors dedicated to COVID patients who are not this sick and needing ventilators.
CAREGIVER STORIES: Caregiver Stories: Nurse Manager Deb says COVID surge is mostly preventable
“All of our beds have capability to have ventilators in them, but we only had four negative air-flow rooms and so we used those special isolation rooms to prevent those infectious agents from spreading,” Gillette explained.
Special fans and HEPA filters used in negative airflow rooms act as a vacuum. They do not allow potentially contaminated air from leaving the room and you can hear the suction when a door is opened.
If more patients need the negative airflow rooms, Sacred Heart may have to reconfigure certain wings of the hospital and bring in equipment it does not currently have.
“We reached a point two weeks ago, or maybe last week, we had one bed left on the entire second floor that was a negative airflow. Now, upstairs on some of our medical floors, we have patients that would have met ICU criteria weeks ago,” said nurse Jeremy Mullavey. “They’re maxed out on the settings and all that they can do upstairs. They would have been brought down already, so then you a reach a very difficult decision, right? Who comes down? Who gets the bed? When and why?
Mullavey said they recently reached a situation where only one ventilator was available in the hospital.
“So then again, who gets the vent?”
A group of providers has to make those hard decisions. Gillette is the one keeping these rooms and the unit staffed. She is working with caregivers who are pushed to their limits more than ever.
“Today we were short maybe nine critical care nurses to start. We’ve had staff here for 16 hours,” Gillette said. “They are exhausted, mentally, physically, emotionally. It’s very draining.”
You can hear that exhaustion and frustration in the nurses’ voices.
“Seems like in the community, people are still not believing this is real,” Mullavey said. “We see people die all the time here.”
“It’s hard. It makes you sad. It makes you mad. Sometimes it just makes you feel numb,” said nurse Emily Crews.
“That’s really hard when you’re doing a Zoom meeting with 15 people and they’re saying goodbye to their loved ones,” Custer said.
These three nurses love their jobs but are starting to lose hope.
“If you’re intubated with COVID, the chances of survival are very, very small,” Custer explained.
“The young people, the people with families, with lives like my own, who went to work every day and are never going to go home to their kids, their moms, their dogs,” Crews said. “And just knowing you did everything and it wasn’t enough. And at the end of the day, you zip up the bag and you have to go home and try to pretend life’s okay.”
Life is not okay for those working tirelessly, short-staffed and dealing with so much loss.
“I came home absolutely exhausted. My wife’s asking me as I’m trying to fall asleep how my day was… that’s when I honestly broke down a little bit,” Mullavey said. “I just relayed to her how the end of my day was. I ended my day putting two patients in body bags and the family of one of those patients still didn’t believe that this was real.”
Remember early on in the pandemic when the community rallied around first responders, treating them as heroes? It is a much different situation now.
“I think that it was well-intended, but it ended up creating sort of this ‘They’re heroes, nurses signed up for this, they want to be heroes.’ And it kind of diminishes the fact that we’re all just human and I’d like to, just like anyone else in the world, go to my job and go home,” said Crews.
These nurses are trying to release the pain of the job.
“You’re there for families at the hardest point. You’re there to be a bridge for them to say goodbye to their loved ones or be a part of that,” Custer said. “It’s an honor, a blessing and heartwrenching all at once. Makes you go home and grab your kids tighter, tell your wife you love her that much more. Enjoy ice cream.”
As each of these nurses tries to grapple with what goes on inside the ICU, they also have different feelings about what happens outside the hospital’s walls.
“The biggest part of that frustration is people not following the science, nor believing the medical community is actually trying our best to give these patients a fighting chance,” Mullavey said.
“We’re really trying here and the best thing our community can do is get vaccinated. We really have nothing else,” Crews said. “That’s kind of our, that’s our only solution and the more that people do that, the less time we’ll spend in here and the less time at home I’ll be thinking about these people who are never going home.”
“I’m here to help you in the hardest moments of your life. That’s what I’m here for,” Custer said. “Everything that’s happened before then, it’s on you.”
“The vaccine is our hope. The more people that get vaccinated, the less patients we have in the hospital,” Gillette said.
4 News Now only spent three hours in the ICU. It was just a snapshot in time as compassionate professionals did everything they could to save lives.
“We’re seeing more patients in their 30s, 40s, 50,” Gillette said. “The vast majority of our patients today are in the 30s to 60s.”
Right as she said that, a chime went off indicating a baby had been born – a true testament to the life and death that happens in hospitals on a daily basis.
4 News Now allowed Providence Sacred Heart Medical Center staff to review footage before airing, not to change content, but to make sure patient privacy is protected.
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