Taking care of COVID-19 patients is an experience unlike any other in my career. It’s been physically, mentally and emotionally exhausting.
The ICUs are empty of visitors, which increases the noise of the machines. Our patients are isolated behind closed doors without their family or friends. Every staff member they see is covered from head to toe with a gown, gloves, mask and face shield. The gear is uncomfortable for staff and makes care of the patient more difficult. Communication troubles are multiplied behind layers of protective equipment.
When patients die, they do so without the normal gathering of loved ones at their bedside. Those who survive remain isolated due to the lack of family support at the bedside, and they see staff covered with PPE that makes one appear almost nonhuman.
Each of these patients requires more time as we coordinate our care between the patient – who typically is unable to interact with us – and via telephone with the family, who are unable to see their loved one.
Our COVID-19 patients on the ventilator have been among the most critically ill in the hospital. Unlike our typical older ICU population, our COVID-19 patients have been disproportionately young and previously healthy. They have prolonged ICU stays and are on the vent for far beyond the average length of time.
We have watched a young pregnant woman in her 30s survive on a ventilator for over three weeks under the care of eight different specialty teams. She was able to be extubated and discharged, still pregnant.
At the exact same time, we watched a different young woman in her 30s, who was equally critically ill, slowly improve over two weeks before acutely decompensating and dying, leaving behind two teenage children.
One of the most difficult things we have been dealing with is trying to stay up to date on this disease and its treatments. We are combating a disease with no known standard course of illness or effective treatment.
In the weeks since we started taking care of these patients, our understanding has rapidly progressed. We are now able to access multiple trial regimens and compassionate treatments. We have developed local protocols and are now able to follow guidelines based off of the experience of physicians from around the world.
Chloe Steinshouer is a critical care physician with Pulmonary and Sleep Consultants of Kansas.