When family nurse practitioner Kimberly Patton gets home from working at CapRock Health, she immediately puts her scrubs in her washing machine and goes straight to take a shower.
She said it’s an effort to protect her 2-year-old son, her husband and her elderly grandparents from COVID-19.
“I do always have a little bit of worry in my mind,” Patton said. “Even though I’m not sick, I don’t want to potentially get them sick.”
Patton is one of many health care workers across the Brazos Valley who said 2020 has been emotionally and physically taxing as they wade through the ever-changing landscape of the field.
For Patton, who works in CapRock Health’s Urgent Care facilities, the pandemic has meant many 12 hour shifts turn into 14 hours, and some workdays fly by without time to eat. And she said it’s made more difficult, largely due to the constantly changing understanding of COVID-19.
“Stressful would be a good description; frustrating at times,” Patton said. “We’re just having to be extremely flexible in how we do things and in our schedules, in our daily practices and in our daily life as well. It’s just been one big challenge.”
Since the start of the pandemic, Patton said, the urgent cares have seen a consistently higher number of patients. While the facilities continue to treat other conditions, much of her job these days involves testing people for the novel coronavirus and educating people about what to do if they have contracted COVID-19 or are experiencing symptoms. Much of this is done over telehealth calls to reduce contact with patients.
Hospitalizations continue to rise
Early on in the pandemic, area hospitals saw a drop in patients due to the statewide elective surgery ban that lasted about a month before Gov. Greg Abbott eased it.
Brazos County hospitals were at 82% capacity on Monday, and intensive care units were 69% full, according to the health department.
COVID-19 hospitalization rates in the trauma service area was above 15% for seven days as of Monday, forcing a reduction in local business occupancy capacity and postponement of elective surgeries.
The Brazos Valley Trauma Region is made up of Brazos, Washington, Leon, Madison, Robertson, Grimes and Burleson counties.
In the midst of it all, health care workers started receiving COVID-19 vaccinations the week before Christmas.
Fearing for family
Charge nurse Luke Wigley’s return-from-work routine is similar to Patton’s, the family nurse practitioner at CapRock.
Wigley, who is in the emergency department of CHI St. Joseph Health Regional Hospital in Bryan, said his work shoes never leave his car, and his scrubs have a designated spot in the garage. He disinfects everything he touches on his way to the shower and then again after he showers.
Many of the new precautions he has to take at work — such as wearing personal protective equipment with almost all patients instead of just some — and at home have become second nature at this point. But early on in the pandemic, Wigley said he was worried for the safety of his wife and his toddler son.
“Now, I have the same feeling toward my job that I did before COVID, but early COVID, I had a lot of fear that I would bring something home to my family,” Wigley said. “Things that I used to find a lot of enjoyment in here, I didn’t because I was scared for myself and my family, which isn’t something that I had ever felt before in this job.”
Changes in demand
There has been a steady increase in the demand for health care services since Abbott began reopening the state and allowing elective procedures and surgeries to return around May, Baylor Scott & White Regional President Jason Jennings said.
“We’re busier than we’ve ever been,” Jennings said in an interview before Christmas, “and that’s in addition to taking care of COVID-19 patients.”
The pandemic may have also changed the types of patients who seek assistance, according to CHI St. Joseph’s Dr. Bryan Pickett, who said he is noticing fewer influenza cases than normal for this time of year. Instead, he said he sees more COVID-19 patients, with “a decent amount” of those who are admitted to the hospital needing oxygen.
Pickett, an emergency physician and medical director of CHI St. Joseph Health College Station Hospital, said there is not a consensus on why that is, but mask wearing might be part of the reason, or, he said, it could mean that flu season will end up being in January or February this year.
‘It’s consumed us’
Jennings has heard many touching stories from frontline workers at Baylor Scott & White, including a time that a COVID-19 patient said he found comfort in the medical staff since the pandemic limited his ability to have his own loved ones visit him.
“One of our nurses entered his room to tell him goodbye and that he’s going to be discharged,” Jennings recalled. “He started to cry, and the nurse started to cry because [the patient] said, while his family couldn’t be here during this time, Baylor Scott & White, specifically our nursing staff, became his family.”
And the first day that frontline staff was vaccinated earlier this month was an emotional one, he said, with many of them unable to hold back tears of joy.
“It gives me chills when I hear stories like that,” Jennings said. “Seeing the financial bottom line of Baylor Scott & White is not why we’re here. When you choose a career in health care, you choose to serve your fellow man or woman. While we wish a pandemic never came, I could not be more proud of the Baylor Scott & White team.”
But even with these happier moments, he said, there have been many challenges for health care workers, from contending with the unknown of the pandemic to battling exhaustion. He said communication and ensuring frontline workers have what they need is a major part of helping combat those problems.
“While you take care of somebody in the hospital, and you go home, and you turn the television on or open up a magazine or newspaper — we all can’t get away from the pandemic,” he said. “It’s consumed us.”
Showing patients that you care has been hard when dressed “head to toe” in PPE, CapRock Urgent Care Administrator Amanda Spruiell said. But throughout the pandemic, she and others at CapRock try to “smile with your eyes” when testing people for COVID-19 to try to break down that wall.
“That way, you can still connect with the patient and offer compassionate patient care,” she said.
Telling families that they cannot be with their loved ones in an emergency has been a noticeably difficult part of working in health care throughout the pandemic, charge nurse Tyler Sheffield said. Sheffield works in the emergency department at CHI St. Joseph Health Regional Hospital in Bryan.
Sheffield said she sees patients with all types of ailments, and that there are “constantly” COVID-19 patients with varying symptoms and levels of how critical they are. Sheffield works with Wigley, who added that it sometimes feels like caring for COVID-19 patients is all they do.
But Sheffield said the emergency room team is naturally resilient, which helped it adapt to other challenges throughout the year.
“In general, I feel like our team has gotten a lot closer going through this,” she said. “It’s a very unique experience that we haven’t gone through before.”
‘Way more sad than good’
Wheelock deli owner and part-time nurse Honny Pils has spent much of this year traveling to other cities in need of people to treat COVID-19 patients. Earlier this year, she went to New York City, then to Houston, and just this month she returned home from Amarillo.
Pils has worked at CHI St. Joseph and Baylor Scott & White, but has said there are noticeable differences in the workload she handled this year, from an overwhelming number of patients in New York to the challenges that accompanied helping to create a COVID-19 unit from scratch in Amarillo.
She hangs on to happy stories from her work this year, like times that her patients recovered and were able to return home. But unfortunately, such stories seemed to be few and far between.
“There were some really good ones,” she said, “But there were some really sad ones. There’s no doubt there was way more sad than good. I think that’s the bad part about COVID, is it just takes so much from so many people.”
‘A whole new ballgame’
The pandemic caused health care institutions to implement telemedicine and new standards of interacting with patients who contracted COVID-19. Dr. Paul Goen, CHI St. Joseph medical director for emergency medicine, said he thinks that the field will never be the same.
“Medicine has changed, and I think it’s changed forever — as far as how we approach patients, how we protect ourselves and our patients from possible viral contamination,” Goen said. “I think telemedicine has really taken hold, and I think that is going to change how we practice medicine in a lot of circumstances. And I think that we will all look back on this year and think, ‘Wow, look at how we used to do things.’ It’s a whole new ballgame.”
A privilege to serve
There was added stress for all health care workers that came from contending with several process changes, and an evolving understanding of how to treat and test COVID-19 patients. But working with patients who have the novel coronavirus was something that Pickett said fits in with why he got into health care in the first place.
“I got into emergency medicine because I wanted to help people when they were at their sickest,” he said. “And so, although I’m seeing people who are struggling with COVID-19, that’s what I want to be doing is to be helping people in those situations.”
Despite the challenges that 2020 tossed at health care workers, Pickett said he is happy to play a role in improving the situation.
“It’s been a challenge for our entire community, but I think it’s a privilege to be able to serve in health care; a job as well, but a privilege,” Pickett said. “I’ve really enjoyed seeing our teams come together and really work hard to take care of the people of our community. From the health care standpoint, it’s definitely been a difficult year. We’re looking forward to a non-pandemic year.”