They are often the last ones to hold a hand as COVID-19 claims life after life.
Jacob Luttropp had cared for patients who were dying before. A registered nurse at Marshfield Medical Center-Eau Claire, he had tended to their last needs and kept them comfortable as family members gathered for final goodbyes.
But many of the patients Luttropp treated in 2020 were different. They were dying too, struggling to breathe, their bodies wracked by the coronavirus that appeared early in the year and altered and ended lives worldwide.
Because of the contagious nature of the virus, coronavirus patients dying in hospitals are doing so alone, without the comfort of their families, without final embraces and goodbyes. Instead of their families, they are surrounded by nurses like Luttropp, who works in the COVID-19 unit.
During a year that has been unlike any he could have imagined when he graduated from nursing school, Luttropp sometimes found himself serving as a kind of stand-in family to patients seriously ill and dying of COVID-19.
He provided words of encouragement. He arranged final phone calls between those dying and their relatives. Sometimes he served as the voice for patients who could no longer talk, trying his best to relay their last messages to loved ones. He held patients’ hands as relatives said their final words through electronic devices.
“It’s very tough, because you don’t really feel like you know these patients personally,” Luttrop said Wednesday. “Then family members ask you to hold [a patient’s] hand at the end. All of a sudden everything else goes out the door, and we’re there for support. It’s like we are a family member.”
While serving in that role is an honor, Luttropp said, it also places a large emotional burden on caregivers. Dealing with many critically ill and dying patients, especially in late October and November when the virus surged across Wisconsin and many hospitals were full beyond capacity, felt overwhelming at times, he said.
“It took a toll on all of us, especially during the surge,” he said. “We were getting people who weren’t getting better. It’s hard to see that day in and day out.”
Since the coronavirus appeared in Wisconsin early in 2020 and forced the shutdown of most businesses in March, Luttropp and his nursing colleagues and other medical personnel across Wisconsin have experienced a year unlike any other.
They were asked not only to take on the role of family members at times, but to work extra hours, extra shifts, amid a life-threatening virus they feared they might contract, or bring home to their families or transmit to friends and loved ones. Most said they had adequate personal protective equipment to reduce their chances of infection, but others reported shortages of those materials.
During the coronavirus surge this fall many hospitals were packed beyond their capacity as patients requiring treatment for the virus were added to the already-busy list of medical conditions they provide care for each day. Some COVID-19 patients were forced to travel to other states to find hospitals with room to treat them.
At the same time, exposures to the virus meant some medical staff required quarantine or isolation, leaving fewer medical caregivers at a time when they were most needed. Nurses and others worked longer shifts to fill in, and took on other duties they hadn’t done previously, or not for many years.
Pam White, chief nursing officer at Mayo Clinic Health System-Eau Claire and four other Mayo Clinic-owned hospitals in northwest Wisconsin, traded her administrative attire for nurses’ scrubs and worked on the floor for the first time in two decades this fall to fill in during a shortage of healthcare workers at the hospitals who were quarantined because of COVID-19.
Like Luttrop, White said nurses and other medical staff members struggled from both the physical and emotional stress of treating COVID-19 patients, especially during the fall surge. Dealing with severely sick and dying patients and facilitating their end-of-life discussions is extremely trying, she said, noting she “has never been more proud” of the staff she supervises.
“The intensity of care and the growing needs of patients has been an experience no healthcare workers have ever experienced,” White said. “So many staff took on new and different responsibilities, and many are still doing that today.”
Crisis Hits Home
Elizabeth “Buffy” Riley knows that feeling all too well. In April the 62-year-old discharge planner and case manager at Cumberland Healthcare hospital in Barron County spent three weeks treating critically ill patients at a New York City hospital when that city was ground zero for COVID-19 cases in the US.
Nurses in the Brooklyn hospital intensive care unit where Riley was stationed scrambled from patient to patient, checking their vitals signs, ventilators and medications necessary to keep them breathing. All too often, even those efforts weren’t enough. Deaths happened frequently, and dead bodies sometimes piled up faster than they could be removed.
“I knew it would be bad out there, knew it would be hard,” Riley said Wednesday morning on her way to work in Cumberland. “But I had absolutely no idea how bad it would be. I still stop and think about it, how many people died.”
Working 12 hour-shifts or longer seven days a week was physically exhausting, Riley said. But even more daunting was the emotional strain of struggling to keep patients alive and watching so many of them die.
“My experience as a nurse had been that most people will get better,” she said. “But that wasn’t the case this time, and that took a real emotional toll on me.”
Riley also felt stress because of her ever-present worry about being infected by the coronavirus. She and other nurses at the hospital didn’t always have adequate personal protective equipment, which added to her worry.
During the end of her time working in New York Riley exhibited symptoms of COVID-19, and she subsequently tested positive for the virus. She returned to her home in Hayward, where she lived apart from others for a time until she finally tested negative. She was sick enough to spend one night in the hospital and experienced lingering health problems, including leg pain making it difficult to walk, attributed to the virus.
“I was so scared I was going to die,” Riley said. “I look back at it now and realize I wasn’t sick enough for that. But I think my fear was heightened by what I had experienced in New York.”
Such signs of stress among nurses and other medical personnel have become more common as the coronavirus pandemic drags on, hospital officials and experts said. Some have called for increased mental health services for those workers.
During media updates about COVID-19 during last month’s virus surge, state Department of Health Services Secretary-Designee Andrea Palm discussed the situation’s strain on nurses and other medical staff. Sharon Besterfeldt, a licensed professional counselor at Marshfield Clinic-Riverview Center in Eau Claire, said the stress people feel in general about the pandemic is exacerbated in hospitals where workers constantly deal with patients struggling because of the virus.
“We have been seeing more anxiety across the board,” Besterfeldt said during a recent interview. “Everybody is feeling more stress because of the virus, and for healthcare workers it is at a much greater intensity.”
Among the strains healthcare employees face, Besterfeldt said, is watching patients die from COVID-19, then seeing some people refuse to wear face masks in public or refrain from gathering with others. Other healthcare workers said such instances definitely bother them.
“It drives me crazy to see people not wearing masks,” Riley said. “Once you’ve seen people die from this virus, you want people to do what they can to prevent getting sick with it.”
‘Light at the end of the Tunnel’
Healthcare workers said they’re feeling relief of sorts as a predicted mid-December COVID-19 surge following Thanksgiving hasn’t materialized, and new case numbers are down significantly from November figures.
Hospitalizations of COVID-19 patients are down too. But even as those numbers have dropped, deaths attributed to the virus have remained relatively high. Healthcare providers are still busy caring for patients afflicted with the virus.
“This virus is not yet gone and is still having an impact,” White said, noting nine COVID-19 patients were in the Eau Claire Mayo hospital’s intensive care unit Wednesday. “I worry about what we may see after Christmas given the number of families who traveled and spent time together.”
White and others across the state and country see hope in the fight against COVID-19 in another form: two vaccines, developed by Pflizer and Moderna, released earlier this month shown to protect against the virus. Medical workers received the initial vaccinations and they were expanded this week to long-term care facility residents and staff.
The vaccines could be made available to the general public as soon as this spring, officials said, and represent the best weapon so far against COVID-19.
“This is a light at the end of the tunnel,” said Luttropp, the first Marshfield employee in Eau Claire to receive the vaccine. “The morale of hospital staff has definitely increased with the vaccine.”
White is similarly upbeat about the prospects of vaccines to protect against COVID-19. But vaccinations will be done in stages, she said, and it will take time for the general public to receive the vaccine. Complicating the matter is the fact some people say they don’t intend to be vaccinated.
Until mass vaccinations occur, White urged people to wear face masks in public and to refrain from gatherings to keep the virus at bay. Riley seconded that notion.
“I’ve seen too much sickness and death associated with this virus already,” she said. “I don’t want anyone else to die from it.”
Luttropp has seen COVID-19-related deaths too. He’s been there with them as they died, then put his emotions aside as he headed to the next room to treat another patient. At times the continued deaths seemed overwhelming.
But there are moments of hope, he said, in the form of music. Since the recent COVID-19 surge, the song “I Can See Clearly Now” by Johnny Nash sounds over the Marshfield Eau Claire hospital’s speaker system each time a patient hospitalized with the virus recovers and is released.
The upbeat musical notes are both a celebration of life and a symbol of gratitude. They provide a much-needed emotional lift in difficult moments, Luttrop said.
“That song was a response to the toll (the pandemic) was taking on our frontline staff,” Luttropp said. “It helps lift your spirits, and that’s exactly what we all need after this year.”