Part 4: Wisconsin nurse treating coronavirus patients in New York
Editor’s note: This is the fourth in an ongoing series of stories profiling Wisconsin resident Elizabeth “Buffy” Riley and her three weeks working as a nurse in New York. Read Part 1, Part 2, and Part 3 of the series here.
This Easter Sunday was unlike any Elizabeth “Buffy” Riley had experienced in her 62 years.
Her day began in an intensive care unit with 10 patients hospitalized with COVID-19, each of them requiring a ventilator to stay alive, each extremely ill. The room was a whir of activity, machines blinking and beeping, alerting Riley and other medical personnel about the status of those being treated there.
Then, not long after she arrived, it happened, a scene that had become all too familiar to Riley during her 10 days at Woodhull Medical and Mental Health Center in New York City. One of the patients had stopped breathing, his lungs ravaged by the deadly virus.
A code blue was called, prompting Riley and other available medical personnel to rush through the crowded room to attempt emergency resuscitation efforts.
“One epi (short for epinephrine, a medication used to get a heart beating)!” one nurse shouted amid the frantic hustle to get to the patient as quickly as possible.
Her words were quickly followed by a flurry of exclamations from others, each intended to help save a life.
“Has it been three minutes yet? Two epi in! What time is it? Get me an epi drip! Bicarb! I need bicarb!”
Despite efforts to save him, that patient died. A short time later there was another code called, and a while later, a third. Each one prompted another explosion of motion, excited yells and calls for help, medical professionals trying their damndest to stave off death.
This Easter morning, a day of hope and resurrection, was anything but that. Despite the best efforts of Riley and other hospital staff, none of those patients survived.
It was not yet 11 a.m.
After the third death that morning, as she surveyed the ICU — littered with spent syringes, cast-off gowns and gloves, bed linens and other items — Riley paused and felt the weight of the moment overwhelm her. Her heart raced. Her head pounded. Sweat dripped down her face, irritating the skin protected by a mask and faceguard.
All that work, those life-saving efforts. And it didn’t work. Not once.
“They’re dropping like flies,” a physically and emotionally exhausted Riley thought. “Happy Easter? This is more like hell. And I’ve got seven more hours to go today.”
Then it was back to work, caring for more patients severely ill with COVID-19. Riley stuffed the heartache she felt for those who had died. The spaces held by now-deceased people stricken with the contagious virus were quickly filled with new patients. Each required a ventilator to keep breathing. Each needed multiple medications. Each had a good chance of dying.
As she cared for her two patients, Riley had an up-close personal reminder of the looming specter of death. Overnight an elderly woman whom Riley had cared for the day before had died.
Now the woman’s body lay in the same room where Riley tried to keep others from that fate. In recent weeks there have been so many deaths because of coronavirus in the city that New York hospitals can’t keep pace with getting rid of the deceased bodies. In response, New York city officials have built temporary mortuary sites and have placed about 40 refrigerated semi-truck trailers at hospitals around the city to put dead people in.
As of Friday afternoon, 202,208 COVID-19 cases had been reported in New York, along with 10,834 deaths. In the United States, 603,050 people have tested positive for the virus and at least 25,263 have died.
Those dying at Woodhull are part of those figures. Hours after Riley began her work shift Sunday, the elderly woman’s deceased body was finally removed.
“There are so many deaths they can’t keep up with it,” Riley said. “It takes a while to find places for the bodies.”
‘These people die alone’
When she had decided a few weeks ago to travel from her northern Wisconsin home of Hayward to New York to work as a nurse in that city’s overwhelmed hospitals, Riley knew she would face challenges.
She had seen video footage of hospitals filled with patients too sick to breathe on their own, watched news accounts of nurses saying they lacked enough personal protective equipment to keep them safe from the deadly virus. She heard New York Gov. Andrew Cuomo call on nurses from across the U.S. to please help at New York City hospitals overrun with patients dying because of the coronavirus pandemic.
Riley felt compelled to go to New York, to help in any way she could. Activity at her workplace, Cumberland Memorial Hospital, in Barron County, had slowed significantly in preparation for a COVID-19 spike expected to hit Wisconsin near the end of this month. She asked hospital administrators for permission to go, and they granted it.
Riley has worked as a nurse for nearly three decades. She’s known as a straight-shooting, tough-yet-compassionate woman, a determined competitor who has finished a marathon and cross-country skied the American Birkebeiner race. She once worked in hospice care, providing comfort to people as they died. Those who know Riley figured if anyone could handle the adversity of COVID-19 in New York, it was her.
But after 10 days at the hospital, she wasn’t so sure.
“I don’t think there’s any way you could be prepared for this,” Riley said. “The frantic, nonstop pace, the long hours. And the death … It feels like this is going to go on forever.”
Sunday wasn’t the first day Riley had seen COVID-19 patients die up close. The first two deaths during her New York stint happened Wednesday, just a couple minutes apart. More people have died since.
But Sunday felt different, Riley said. Perhaps that contrast was due to three deaths so close together. Perhaps it was the cumulative effect of people dying daily. Throughout that day she stifled the urge to throw up, a situation she attributes to frayed nerves because of multiple deaths in a compressed time frame.
Part-way through Sunday Riley took on another patient, a critically ill elderly man. Four times that afternoon he coded, prompting life-saving procedures each time.
As she left the hospital for the bus that would take her back to the hotel where she is staying, an emotionally spent Riley met with her nurse supervisor. She said she didn’t know if she could continue. She didn’t know if she could face another death-filled day.
The supervisor acknowledged the traumatic conditions at the hospital and told Riley she was doing a good job. She told Riley she wanted her to continue to work at Woodhull if she could.
Later that night, at her hotel room, Riley spoke with her husband and other family members via Zoom video. She was so grateful to see them, but she broke down crying, overwhelmed by how much she missed them. She told them she feared she might catch the virus and have to be hospitalized herself.
Riley’s family told her they would come see her in the hospital if she became ill. But that would not be possible, she responded. They would not be allowed to visit her there, she said, because of concerns they could catch the virus.
“These people die alone, with us pounding on their chests and with loud noises all around them,” Riley said, her voice cracking with emotion. “I don’t want that to be my end.”
‘I can do this’
Since arriving in New York on April 2, Riley had experienced nightly nightmares. But as Sunday night turned into Monday morning she slept soundly, a fact she attributes to “bone-tired” fatigue and medication she took for a splitting headache.
When she awoke at 5 a.m. Monday, Riley felt refreshed but fearful of returning to the “protracted war” of the ICU. Then she checked her phone and saw a flood of messages offering prayers, support, love. She recalled the gifts of coffee and hand-sewn surgical masks a friend in Wisconsin had sent her. She remembered the encouraging words of her nurse supervisor the day before, and those of her family. And she thought about the reason she came to New York, her commitment to helping her fellow nurses and people stricken with COVID-19.
“I will be OK,” Riley decided. “I can do this.”
A short time later, as darkness transitioned to day, she boarded the bus bound for Woodhull.
Later Monday, at 7 p.m., she exited the hospital, having made it through day 11 of her work there. She and others faced the same difficult conditions, the same challenge of keeping patients breathing, as they had the day before. But Monday was a different, more hopeful time for Riley and others working in her ICU unit for one simple reason.
“Nobody coded today,” she said “Nobody died. So it was a really good day.”