PHOENIX (AP) – They saw the sinister photos: crowded hospitals, exhausted nurses, bodies piled up in morgues. It was far away, in New York, northern Italy, and other distant places.
Now, after three months of anxious waiting and preparation, Arizona nurses and doctors are on the front line as the coronavirus rips the state apart, making it one of the world’s hot spots. The drip of a few virus patients in March became a steady stream two weeks after Arizona Governor Doug Ducey terminated a stay-home order in mid-May and allowed most companies to reopen, and now it is a scourge with no end in sight.
An intensive care nurse in the Phoenix metropolitan area said she cries when she thinks of all the people who died from the virus in her hospital, or the times she grabbed the hands of a frightened patient during intubation. Medical personnel describe crowded emergency rooms where patients receive ventilators waiting for a place in the intensive care unit to open. There are tearful goodbyes through a patio window in Tucson.
Angela Muzzy, with 31 years of experience, said she tells younger nurses that they will remember their role in helping people during a historic national crisis.
“We are taking care of the doctors who have contracted this, we are taking care of the mothers. Last week we withdrew the life support of a 48-year-old mother and I stayed with her 17-year-old son when he passed away, ”said Muzzy, a clinical nurse specialist at Tucson Medical Center in southern Arizona, where the 20 of 36 beds ICUs dedicated to virus patients are full.
Hospitals across Arizona, a state of more than 7 million people, spent a six-week lockdown and nearly two-month ban on elective surgeries preparing for the surge that is now appearing. They honed emergency plans that require them to make sure they can increase capacity by 50%. They stocked up on masks and gowns, and trained professionals who typically work in operating rooms or other areas to care for virus patients. Dr. Lisa Goldberg, director of the Tucson Medical Center’s emergency department, said her staff conducted drills, trained, and prepared.
Meanwhile, Ducey, a Republican, argued that the closings he ordered had slowed the spread of the disease and hospitals were now much better prepared. While he emphasized the need for social distancing, he resisted wearing a mask himself in public even when the cases were mounted, rejecting calls from some cities to allow them to require masks.
When the surge in cases became impossible to ignore, Ducey was repealed on June 18 and allowed cities and counties to require masks in public, but did not issue a state order. Most have, including Phoenix, Tucson, and Yuma and the surrounding counties.
Today, hospitals across the state are filling up with patients, some seriously. The state had more than 70,000 confirmed cases as of Saturday, up from just over 20,000 on June 1. Thousands more people are reported every day, and 1,535 people have died.
This week, more than 2,400 people were hospitalized with coronavirus, compared to 1,000 three weeks ago. This week, more than 600 ICU beds were filled with virus patients, two-thirds of them with respirators and sedatives.
Arizona has just over 200 empty beds in the ICU, out of about 1,600 in the state. More are being added as hospitals prepare for an avalanche of patients as newly infected people slowly become ill. Roving nurses from other states are being recruited to support overworked staff.
“This is not a sprint, it is a marathon. In fact, it’s an ultramarathon, “said Goldberg.
Death is always present in ICUs, but with virus patients it is even more common and often exhausting and prolonged.
Ventilator patients place themselves in what is essentially a medically induced state of suspended animation while machines breathe through their virus-ravaged lungs. They are connected to multiple intravenous lines and drains, with a vent tube down the throat. They can stay in the ICU for weeks or months.
Nurses enter their units in 12-hour shifts, don gowns, respirators, gloves, and glasses, and enter an otherworldly setting. Patients are separated from their families, and often the whole of reality. They often turn on their stomachs for hours, a movement called pronation that has become a resource to help these patients breathe, but it is an exhausting task that can take six to eight nurses, respiratory therapists, and doctors.
For younger nurses, some of the most difficult deaths are from previously healthy young patients, including a woman under 25 who died in Scottsdale.
It deteriorated rapidly, said Caroline Maloney, a nurse at HonorHealth Scottsdale Osborn Medical Center with 28 years of experience working in the ICU. “And it was very emotional,” he said. “I know that a particular nurse couldn’t even talk about it.
“They are seeing this first hand, and it is puzzling for them to see when their peers are in a hospital bed and have to take care of them,” Maloney said.
However, he said his hospital is seeing “surprising results” and that most of his ICU patients are recovering.
For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough, that disappear within two to three weeks. For some, especially older adults and people with existing health problems, it can cause more serious illnesses, such as pneumonia and death.
Families of virus patients are generally not allowed to visit the patient, allowing doctors to organize phone calls and FaceTime links via tablets. The Tucson hospital is a rare case where families can visit loved ones, at least through a window. That’s because it’s an older facility and mostly one-story, with all of its ICU rooms at ground level. Each one has a small patio with windows.
It is where Muzzy often guides family members as they say goodbye to their loved one after making the decision to end care.
“I say it is physically, emotionally, psychologically, spiritually draining,” he said. “Our nurses, those who work 12½ hour shifts, endure this day after day. They are amazing. They are very strong “.
But not unbreakable.
An ICU nurse who emotionally recounted holding the hands of a frightened patient during intubation described the conditions to The Associated Press about her overwhelmed ICU in the Phoenix area on the condition that her name not be used because her employer restricts her speaking. with the media.
She facilitated FaceTime calls with distant family members, and dealt with a constant infatuation of patients, she was transferred from the crowded emergency room to the ICU, then back to the general nursing floor if they show improvement, or to the morgue if they don’t.
Like Maloney and Muzzy, he said his managers have installed robust security procedures for staff and have a lot of protective equipment, but he says the cost of sick and dying patients is becoming a strain.
“I don’t think there is a change where people don’t die,” he said. “It is horrible. The nurses are simply asleep.”
“I have never seen so many people die. Every day.”
In one case, a woman in her 40s went to the emergency room with coronavirus symptoms, was examined, and then sent home. Her family also became ill, and she returned to the emergency room when her condition worsened. Then she was taken to the ICU. Initially she refused to be intubated, and the nurse called the patient’s sister and boyfriend to provide updates.
“She said, ‘I am very afraid to intubate myself.’ I said I know. She said, ‘Will you stay here, take my hand? Promise me I’ll be fine, ‘”said the nurse. “And then it lasted two and a half weeks and we did everything … We did everything and she ended up dying. It’s something like that, all the time, all the time. “
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Hoffner reported from Yankton, South Dakota.
