The intensive and critical care units of most hospitals have approached physical rupture in recent weeks, due to high space demands for COVID-19 patients. It was reported that NewYork-Presbyterian/Weill Cornell Medical Center in New York City recently transferred patients to other medical facilities, in order to provide dedicated care for the high numbers of adult COVID-19 cases. In these unprecedented times, we are witnessing an abundance of extraordinary acts from many people in many different places.
Dr. Serena J. Fox, MD, of Hillside is an attending physician in the MICU (medical ICU) and assistant clinical professor in a department of medicine, division of pulmonary, critical care and sleep medicine in New York City. She also served as a resident during the HIV epidemic at Maimonides Medical Center, and later worked in emergency services at NYU/Bellevue Medical Center.
The Jewish Link asked Dr. Fox to describe some of the extraordinary care and effort she has observed or experienced during the coronavirus pandemic. “I have encountered the failure of multiple organ systems before, however not with this level of acuity and the volume we are seeing, and never with this level of contagion or membership in a higher risk group.”
Fox stated, “Every single one of my colleagues is committed to every patient that comes through the door. I am especially in awe of the ancillary staff and nurses. They are working extra hours and shifts. Without critical care nurses who manage to bathe, position, administer meds, monitor IV drips and vital signs, and handle more patients than they were told was safe, no doctor could do anything meaningful.” She added, “Without respiratory therapists, environmental services, and nurses’ aides, we could not manage respiratory failure or keep the rooms and hallways clean. Without EMS, the fire and police departments, rail operators and delivery people, we wouldn’t get to the patients, and they couldn’t get to us.”
Dr. Fox described, “A young nurse who had been working extra hours and shifts, missing meals, and working as hard as she could felt ill and scared. We were able to focus attention on her as well as the patients.”
Being there for patients and families has never been more challenging. “There is nothing like the feeling of pulling together a team of dedicated and highly skilled caregivers. In the ICU, we also have the responsibility of caring for and accompanying loved ones on this journey. The most difficult and necessary restriction in this current pandemic is social distancing. We try really hard to let a family know in advance when their loved one is not doing well, so we can arrange for virtual or actual visits.”
She concluded, “You have to think of this as a respiratory illness that progresses to shock and multisystem organ failure. No machine or medication is a cure. It is a support that in the best scenario allows the body to fight the infection and heal enough to recover and restore independent existence.”
“The hospital is a ‘twilight zone’ of ventilators and quiet…with the combination of both the energy and fatigue of teams doing all they can—and then some—to help the patients and their families.”
Fox also added that she appreciated a couple of silly YouTube videos that someone sent, providing her the laughter she needed to “go back in.”
Wendy Shindler, RN, BSN, MPH, of Bergenfield is an oncology nursing professional at Hackensack University Medical Center. She has also worked in ER and trauma care. “I see patients who are nervous to come in for chemotherapy, or for scans and tests. I reassure them that there is a tight screening process, and it makes them feel safer.” Shindler emphasized that all patients are prescreened. “If they have respiratory symptoms, they are placed in isolation and treated with utmost care, screened for temperature and provided with masks and instructions for correct use.”
As Shindler and many health care professionals expressed, one of the challenges on both sides is that patients are alone, with no family allowed to be present for support. That reality enhances the feeling of responsibility on the part of the professionals to assist by giving even more attention to that aspect of their care. “We try to help patients navigate the [isolated treatment/alone time] process via speaking or ‘Facetime’ phone calls with family during treatment.”
The Jewish Link asked about other challenges unique to the environment of COVID care, and Shindler explained, “It’s also harder to discuss, and hear, cases through the barrier of the masks; we learn to talk louder and clearer.” She added, “The camaraderie here is amazing. The doctors in our department produced a video for us, thanking us for all we do, and we have received Starbucks and Dunkin’ items to support us in our efforts.” In fact, she mentioned that while her own family is experiencing medical issues of its own, she continues to feel supported at work. “We are here for each other, through good and bad.”
Asked about a time when life will start to return to normal, Shindler remarked, “Life will be different. Maintaining the good handwashing habits will continue to help kill germs. People will still wear masks in stores or malls, restaurants might create more distance between tables, and theaters might need distance between seating.”
Nicole O’Hare, MA and x-ray tech at Friendly Urgent Care in Teaneck, spoke about how they are stepping up to meet the needs of the local community in COVID-19 care as a local provider for the new antibody screening: “We added staff to keep up with the demand of COVID antibody testing, and we limit the waiting area to two people, appropriately distanced and sanitized.”
She noted, “We are an urgent care facility, and not in place of your personal physician.” Urgent care implies walk-in access to care, including x-ray. However, appointments are also available for antibody testing. Nicole added that one of their big challenges is educating patients about correctly applying precautionary and treatment measures, and filtering inaccurate information out from reliable medical recommendations.
By Ellie Wolf
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