Jill Saye, a manager of respiratory care services at Novant Health Forsyth Medical Center in Winston-Salem, recently glanced out her office window and saw a mass of people gathered on the sidewalk on a beautifully sunny day.
Several yards away – because of social distancing – were a Novant Health respiratory therapist, several nurses and a patient in a bed. She’d just been briefly wheeled out. It was obvious something unusual was happening.
When Jill asked her team about the situation, she was told the patient was not going to survive and because of the visitor restrictions, they brought the patient to the family and friends who were waiting for her outside. It was the last chance for the group of 20 or so to sing songs, say prayers and say goodbye.
The coronavirus pandemic has prevented hospital visits, which means respiratory therapists and other bedside providers take on the role of comforting the seriously ill. They see the fear and loneliness in patients’ eyes.
“That’s the emotional strain.” Saye said.
Helping patients breathe
Respiratory therapists are a key part of the battle against COVID-19. The virus can cause severe respiratory illness in both lungs, forcing a patient to be admitted for intensive care. Lungs fill with fluid and debris, sometimes causing severe pneumonia or acute respiratory distress syndrome (ARDS). In the most critical cases, lungs need help from a ventilator in order to do their job. Respiratory therapists are with patients during every phase of treatment.
Hundreds of respiratory therapists work throughout the Novant Health hospital system, routinely helping patients with asthma, emphysema and pneumonia.
They’re essentially managing a life-saving system every day, Saye said. A doctor usually sees a hospitalized patient once or twice daily, but a respiratory therapist works at the patient’s bedside all day. They operate under protocols, but are allowed autonomy to alter treatment due to their training and expertise. Respiratory ailments can often deteriorate quickly, forcing respiratory therapists to make quick decisions.
At Forsyth Medical Center, every respiratory therapist is on call during the coronavirus pandemic. The expected surge in COVID-19 patients will mean more than the standard three 12-hour shifts per week for them.
“The type of work they’re doing hasn’t changed, but the physical and mental strain has changed,” Saye said. “They are wearing full-level PPE (personal protective equipment) all day long. They’re asking themselves `Am I doing everything right? They see the strain on patients’ faces.”
The additional stress can weigh heavily on front-line healthcare providers, said Christina Long, a respiratory therapist who last week was promoted to supervisor.
“It can be a little daunting,” said Long, who has worked six years at Novant Health. “Am I keeping myself and my team safe? Are we taking the right precautions?”
Long, like others, also worries about potentially carrying home disease to her children and spouse.
“It can be mentally exhausting,” she said. “I know I’ve prayed a lot more lately. I got into this profession because I like helping people. When I need time, I just take a few seconds, count to 10, breathe deeply and thank the Lord I’ve been given the skills to help.”
Relying on resilience
Long and Saye agree that providers and patients have shown continued courage throughout the ordeal. If a therapist needs a break, they have an open invite from Saye to sit down, talk and vent. She looks for cues in the therapists’ body language and other nonverbal signs, her way of caring for the caregivers.
“They’re scared, too,” Saye said. “They’re strong and they are positive. Not once has anyone said `I’m not going in that room.’ They’re out there taking good care of patients.”
Said Long: “There is no negativity at all, from our team or the patients. It is a very rewarding job. Normally, people don’t know who we are unless they need us. But I’m thankful I was led to this path. It can be heartbreaking at times, but we make the best of what we can.”
Taking precautions and expecting a surge
Ryan Clayton, a night shift supervisor of respiratory therapists at Novant Health Forsyth Medical Center, said the work is stressful, but therapists also are dealing with an anticipated surge in coronavirus patients in the next month or so.
“We just don’t know exactly how bad it will get,” Clayton said. “We’re taking it one step at a time. We’re all supportive of each other and all help each other.”
Clayton said all respiratory therapists wear full protective gear throughout their work shift – an N-95 mask covered by a surgical mask, a gown, eye protection, gloves, a hair net and shoe coverings. He keeps a change of clothes handy to change out of his hospital scrubs when he leaves work. It’s a step to further protect his three children, including two newborns.
Clayton said respiratory therapists have taken on more of a patient advocate role, since family and friends can’t be bedside.
“We open our hearts a little more for patients now,” he said. “We’re getting a little more recognition. We’re usually silent heroes, I suppose.”
TOP PHOTO: Novant Health respiratory therapists Victoria Johnson (left) and Stacy O’Quinn, at Novant Health Forsyth Medical Center.
Novant Health team members are on the front lines in the battle against the COVID-19 pandemic. Novant Health Foundation has established a new fund dedicated to supporting our teams, as well as the overall response to the pandemic. Contributions will support team members and help fund testing and medication to support patient care, as well as medical supplies. To donate, click here.