The nurses put themselves in protective clothing. They are careful about what they touch before and after entering a patient’s room.
They shower before work so they don’t bring anything to the hospital. They take a shower after work so they don’t take anything home.
The days seem longer. They are, in fact, sometimes, with seizures that last up to 14 hours.
Transitions finally end. But then, outside of hospital, the virus remains a major force in nurses’ lives.
“It feels like you can’t get a rest,” said Rebecca Williamson, director of the medical unit at Bozeman Health Deaconess Hospital. “Because no matter where you are, you are connected to all of this in one way or another.”
As cases rise again, workers at Bozeman Hospital are feeling the pressures of the epidemic. Williamson runs 110 nurses and works with other department directors in the hospital. She said working there for the past nine months has been the biggest challenge of her life. She said the hospital had enough capacity and great resources, but that the nurses and medical staff were emotionally and physically overwhelmed.
Hospitals in the state and across the country face similar problems, with most regions seeing a rise in virus cases greater than any spike since the pandemic began in March. As health officials continue to urge people to wear masks, social distancing, and wash their hands, health care workers continue to see the mess the disease causes every day at work.
Last week, Montana set a record for the number of people hospitalized in the state due to the virus, said Greg Holzman, the state’s chief medical officer.
“The current pressure on public health and our healthcare system at the moment is real,” Holzman told a news conference on Thursday. “Health care workers are becoming stressed and public health departments cannot keep track of contact tracing.”
Hospital capacity in Gallatin County is hovering around 80% over the past week, according to reports from the state’s coronavirus task force. There are a few counties that have reached capacity at some point in the last week or have patients occupy more than 90% of the household.
Meanwhile, nurses at Bozeman Hospital were quarantined because they were considered close contact with an outside-hospital person with the disease.
The hospital’s chief nursing officer, Dr. Mark Williams, said the exposure of health care workers to the virus outside of the hospital affects the number of staff available to treat patients in the hospital.
“It’s very frustrating for members of our healthcare team to witness the impact of COVID inside a hospital and then go out into the community and see what happens,” said Williams, which often appears to be somewhat neglected of personal health and safety. “
This week, hospital officials began requiring asymptomatic employees who would otherwise be quarantined to return to work to keep the hospital running. Health officials said these were not people who had tested positive for the disease. Emergency recruitment is done in coordination with the Gallatin City and County Health Department and guidance from the Centers for Disease Control and Prevention.
Kali Kogawa, who is leading the hospital’s COVID efforts, said these employees have been asked to return to the hospital after quarantine for seven days. And if they were prepared, she said, the hospital would take additional measures to prevent infection, including testing and checking symptoms every six hours and having staff eat lunch away from other staff.
Kogawa said the hospital had planned potential recruitment restrictions early in the epidemic.
“We are facing these restrictions a lot at the moment,” she said.
Hospital officials said it has the capacity to handle both COVID patients and those not infected with COVID and the team has plans if it reaches its capacity. They urge people to get care as needed. The hospital expansion that was built over the summer helped keep pace with demand.
However, concerns remained about the slight increase in cases in Gallatin County and across the country.
The hospital has enough beds to handle patients, Kogawa said, but it can be very difficult if it doesn’t have enough staff to take care of these patients. She said the nurses were burning.
“It’s very difficult everywhere for everyone,” said Kogawa.
Williamson said it was exhausting for nurses to keep up with the ongoing changes in policy and procedures designed to protect everyone from the virus – there have been 300 changes made in the past nine months. The majority of changes are done in daily practices in the hospital such as collecting samples, preparing for transitions, and keeping COVID patients away from patients without COVID.
“It’s not that we had to come up with huge complex changes that everyone has to memorize, but rather that everything normal has changed,” she said.
Williamson and other managers check employees frequently, making sure they are comfortable outside of work and allowing people to take time off as needed.
Williamson grew up in Ammon, Idaho. She said she became interested in nursing after seeing first responders helping people involved in farming accidents.
When she was little, she volunteered at a hospital in Idaho Falls and learned she wanted to do more. She became a certified nurse assistant after taking classes in high school. After school of nursing and before moving to Bozeman, Williamson worked as a nurse in the intensive care unit in Salt Lake City, Utah.
She had never imagined she would work through a pandemic, sacrificing long hours away from the family, but she said she was proud of what she does. She said it made her feel like a “team mom”, taking care of her staff and keeping them safe and healthy. Sometimes, she’ll send the employee a card to let him know she’s thinking about him.
Throughout the pandemic, nurses like Williamson have seen the effects of the virus in and out of the hospital “every day, all day.”
It’s been nine long months. Many nurses went without breaks. And health officials have advised that if we do not respond to the virus now, some of the darker days may be ahead.
“This was a marathon and it wasn’t over – there is no end in sight,” said Williamson.