WV’s COVID Crisis: Hospital staffing shortages and the toll it’s taking inside the ICU and beyond

WV’s COVID Crisis: Inside the ICU

***AUTHOR’S NOTE: Under ordinary circumstances, most hospitals would not grant media access to their ICU, nor would our news organization seek it. The extreme seriousness of the situation in hospitals across West Virginia led WVU Medicine officials and us to come to the conclusion that this information needed to get out to the public. While in the COVID ICU, our staff did not enter any patient rooms and did not interfere with patient care. All of the videos and still images associated with this series of reports were reviewed by WVU Medicine officials to ensure patient privacy.

MORGANTOWN, W.Va. – Just as many businesses throughout the pandemic have, hospitals caring for COVID-19 patients have been dealing with staffing shortages, particularly among nurses and respiratory therapists.

WVU Medicine officials explained to us that those shortages, combined with an influx of COVID patients coming into hospitals, have affected levels of care and are taking a toll on the medical professionals who are still on the front lines providing care.

“We are no longer able to expand and have that additional two ICU’s. In fact, we can’t even staff our overflow, because we’re short on nurses and respiratory therapists. We’ve lost a lot of nurses, a substantial amount of the workforce, in some ways up to 20%. We have over 50 open, full-time equivalent positions for respiratory therapy here at Ruby alone, which really impacts our ability to care for people,” said Dr. Alison Wilson, the Executive Chair of the WVU Critical Care & Trauma Institute, in Morgantown.

Some of the shortage can be attributed to “travel nursing,” with local nurses going to work at large urban medical centers for higher pay, said Dr. Wilson, “I can’t blame them.”

Despite the shortages at West Virginia’s larger facilities, like Ruby Memorial Hospital, in Morgantown, it’s the smaller community hospitals where the crunch is really felt, Dr. Wilson explains:

“They don’t have any relief. Our folks can go and maybe get a little break or take a couple of days off. Those folks don’t have any relief. And then you add to that, the stress of living in these small communities. These are their friends and neighbors. These are the people that they go to church with. These are the people who their kids play little league with their kids. And so the burden on those smaller institutions, let alone truly the lack of supplies such as oxygen is, is really hard on them.”

That’s not to say that it’s not taking a toll on staff at Ruby Memorial.

“It’s just such a slow road. Everybody is so sick and they’re on the ventilator for so long and there’s just not turning around fast. We don’t have any open beds and we don’t have any nurses. We don’t have any respiratory therapists and we need help. We need more staff and more resources. It’s just very frustrating because it’s such a long battle,” Miles Riley, a respiratory therapist, tells us.

During our time inside the ICU, we asked the doctors nurses and respiratory therapists we encountered what it has been like working in the COVID ICU throughout the pandemic:

“An emotional roller coaster, really. I used to be able to not ever show emotion or anything, and I can admit there was times that I would have breakdowns. I’ve seen my co-workers have breakdowns. It’s terrible, especially the last strand where patients didn’t want to die alone.”

Brittney Thomas, Respiratory Therapist

“Incredibly hectic and stressful. Everybody(patients) here pretty much has COVID in the medical ICU and you’re running into those rooms, after donning a whole bunch of PPE to protect yourself and your loved ones. It’s a big responsibility. That’s an uphill battle. This whole entire pandemic, a year and a half doing this, it is starting to feel overwhelming, very stressful. It’s kind of hard to see the light at the end of the tunnel that you just been battling so hard to get to.”

Miles Riley, Respiratory Therapist

“It’s real, it’s a real thing. And we see people die all the time and I don’t know why, but over the past few weeks I’ve had some heated discussions with people I’ve grown up with and friends of friends. And it’s unbelievable, some of the things that I’ve heard over the past couple of weeks, arguments of, the ‘so-called virus’ and it’s kind of demoralizing really, to be honest with you. Because we see it every day, and we hear, ‘oh, that’s just what you’re being told.’ Like, no, I work here every day. It’s me and a doctor. There’s no one else telling me anything. I see it. I see the guy that goes from his chair to his bed and his oxygen dropped, saturations dropped to 72 and he can barely breathe. That’s real. That’s not fake.”

Greg Kolar, RN/Medical Intensive Care Unit

“What’s really sad is to see the younger and younger people who for whatever reason had this conception, that they would be safe. And I think what really gets to our staff, and gets to me, is watching the young families and the husbands and wives bringing in children to say their last goodbyes to their mom or dad, because they’re not going to survive. We’re talking 32-year-olds, 45-year-olds, you know, we’re not talking, you know, 90-year-olds.”

Dr. Alison Wilson/Executive Chair of the WV Critical Care & Trauma Institute

“It’s definitely hard. It weighs on your heart very heavy. It’s one thing to say, ‘you gotta leave it, leave it here at the hospital. Don’t take it home with you.’ It’s very hard not to take it home with you. My staff will message me when they’re home. How’s this patient doing? How did they do? Everybody deals with things differently. When you see what we’ve seen over the past year, and when you see a lot of younger people closer to your own age, being so sick, it makes it very hard to find your why and why are we doing this? If people continue to be this sick and they don’t get better, that’s very challenging and it’s hard. It definitely weighs on your heart every day.”

Cara Hawkins/Medical Intensive Care Unit Nurse Mananger

We asked these ICU workers how they cope and found that they each have their own methods.

“It does impact things. My kids notice that my temper is a little shorter and, the house isn’t as clean. Yeah, it does take a toll,” says Dr. Wilson, who tells us she sits on her porch and pets her dog to de-stress.

“I have a small circle of people that let me talk. I’m a talker. So I definitely, I talk it out. Um, I have a, a very loving husband that listens to me talk, I’ve talked to my peers. I let I let my employees talk. Um, I found that that helps, uh, is talking about things,” says Hawkins, the Nurse Mananger.

“It’s been weighing on me. We’ve seen so many people who’ve been sick and it’s just really hard sometimes to stay upbeat when you see so many people that are sick. We’ve got a really good crew here and we lean on each other really, really well, so that helps,” ICU Nurse Greg Kolar says, explaining for him, it’s music and his motorcycle that further help him cope. “I love riding, I ride it to work. That’s my big decompression, being outside.”

A lone flower sits on a nurses’ station in Medical ICU

Looking for moments of hope, like when a patient is healthy enough to leave the ICU, helps too. Most of the patients in the COVID ICU are heavily sedated and incoherent, but passed one room where a patient was sitting up in a chair, enjoying a drink. Hawkins opened the patient’s door and exclaimed: “Congratulations! You’re graduating from the ICU!”

“That is an amazing feeling. I talked about the patients being too sick and people dying. Somebody graduating from the ICU is very important, because it means they’re getting out of ICU. They’re getting better. That’s very important to us. We celebrate that. We’re excited about that. That’s very important to me. That’s very important to my staff to see that, because that means their hard work was worth the effort. And it means they were able to help make somebody better. That is very important, especially at a time like this, that we see a lot of patients that don’t make it out of the ICU. So celebrating that as a win and a congratulations for patient is very important,” Hawkins explains.

***This is part two in a multi-part series. You can watch and read part one, here, where we learned about the strain the COVID pandemic is having on West Virginia’s entire hospital system. Throughout the series, we will hear from many ICU workers about what it has been like working throughout the pandemic and what role staffing shortages are having on the situation. We’ll learn more about a last ditch medical procedure for COVID patients, known as “proning.” We’ll also hear from ICU doctors and nurses about the majority of their patients who are unvaccinated. Additional stories will be posted on this website and will air during West Virginia Tonight, during the week of Oct. 4, on WBOY(Clarksburg/Fairmont/Morgantown), WOWK(Charleston/Huntington), WTRF(Wheeling/Steubenville), WVNS(Beckley/Bluefield) and WDVM(Hagerstown/Martinsburg).

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