Episode 77: University medical workers face the emotional toll of the pandemic

In this episode we hear from three medical professionals working on campus about their experiences and emotions around battling COVID-19 on the frontlines, almost a year into the pandemic.

Megan Germundson and Ethan Quezada

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MEGAN GERMUNDSON: Hi everyone, I’m Megan Germundson.

ETHAN QUEZADA: I’m Ethan Quezada, and you’re listening to “In the Know,” a podcast by the Minnesota Daily. 

GERMUNDSON: As of February 7, more than 450,000 people in Minnesota have been diagnosed with COVID-19 and nearly 25,000 of those cases have resulted in hospitalization. At the start of the pandemic, medical workers were called heroes and regularly applauded for their work on the front line. Now almost a year later, many hospital workers are still facing the exhaustion and emotional toll of providing medical care during a pandemic. 

QUEZADA: We wanted to understand how the pandemic is impacting the emotional health and wellbeing of medical workers in our community. So in today’s episode, we spoke with three hospital workers from hospitals around the University campus who deal with the pandemic every day at work. 

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MARIA: My name is Maria and I am a registered nurse, and I’ve been working with COVID-19 patients since the start of the pandemic. 

GERMUNDSON: Maria, who asked to only use her first name for privacy reasons, has been an RN at the University Medical Center for the past five years. I asked her how it’s been to serve the medical needs of the University community during the pandemic. 

MARIA: I think how I would put it is that it’s been a pretty lonely experience, for a lot of us. Yeah. Because one you’re taking care of patients who can’t have any visitors, so they don’t get to see their families. And then you’re trying to convince people or explain to people outside of work, who haven’t gotten sick yet, how serious this disease is. And, there’s only so much information that you can share to people outside of work because of HIPAA. And a lot of the times I’ve just kept to myself, I just said something along the lines of, yeah. It’s been pretty serious at the hospital, but I haven’t really expounded on the details.

GERMUNDSON: Maria told me that right now, families aren’t allowed to visit COVID patients unless they are either on end-of-life support or comfort care. And since family members don’t see how the disease progresses, by the time they are reunited it’s shocking for them to see how sick their loved one is.  

MARIA: They’re not the same person that they were when they first came in. Usually, they’re very sick by that point. And it makes it hard for family members to see that. And when people that haven’t had family members or someone close to them get sick to that degree, telling you that it’s not serious, it’s just like — what about the people that don’t get to go home? What about you know, the mother that can’t see her kids anymore because of COVID, because she had passed away at the hospital. 

GERMUNDSON: When you see people who aren’t following guidelines, do you say anything or do you just internalize your feelings? 

MARIA: I used to say something and then just, people just have made up their minds and no matter what you say to them, sometimes they’re just set in their own ways. So, I mostly internalized this, and how I’ve coped with all of this is just keeping busy all the time, even after work.

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GERMUNDSON: And I’m wondering too have you had to deal with any sort of abnormal situations with a COVID patient?

MARIA: We’ve had a ton of young patients come in too. Surprisingly young, college-aged students. And one of the cases that stood out to me was someone who was middle age, but no matter what I did, they were still short of breath. I’ve never had a patient where I give them more oxygen and their numbers would eventually go up, and they would be okay and not short of breath, but with a lot of our COVID patients, you can crank up as much oxygen as you want, and sometimes their numbers wouldn’t go up. They’d still be short of breath, no matter what you did. So in that situation, we just feel helpless. And with the coronavirus being so novel, it’s very scary as a nurse.

I’ve had patients break down in tears because they weren’t expecting to get this. And it’s been eye-opening for some of the college students that have gotten it, for the most part. I don’t think they were expecting to be hospitalized at all.

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GERMUNDSON: Have you felt like a real sense of appreciation?

MARIA: I do, with my patients that I have worked with. And sometimes it goes unspoken too. Sometimes you don’t have to say anything to them, and they know that you’re taking good care of them and that you care. One of the most memorable moments was trying to connect to a patient that didn’t speak English to their family. They had at least one family member that spoke English, and I was able to connect them to the iPad, and they were very excited to see their family member doing okay. When you update families, you’re hearing it from the nurse, and they don’t get to see the patient. So, there’s a disconnect there when they can’t connect to the iPad because they don’t have anybody at home that knows how to do that on their computer. 

GERMUNDSON: As a nurse, do you feel like you hold or you share a lot of the emotional burden aspect of taking care of patients? As far as talking to family members and just being with someone more long term?

MARIA: I do feel the emotional burden, but I try not to. They always say try not to take work home with you, but there are just some cases where you just go home and just sit there and stare at the wall and think about them. I mean there are days where I’ve had, long stretches of where I work and then I’ll go home and I’ll just sit there and stare at the wall for a while because that’s the only time where I get to sit down and actually reflect about my entire week.

GERMUNDSON: What sort of things do you want people to know about the experience of medical workers right now?

MARIA: The biggest thanks that they can give to medical workers and the biggest show of appreciation is to take precautions seriously and to social distance as much as they can. I mean, they can tell us that we’re heroes as much as they want, but what matters the most is keeping themselves and their loved ones safe.

GERMUNDSON: So, are you doing okay? 

MARIA: I am doing okay. I just… I’m just hoping that this will be all over soon, but I just know that sometimes… I just know that this pandemic could last at least another year, I’m mentally prepared for it. It’s just, I just hope that I don’t disconnect from my friends and family because of all this, the longer it goes on. But I also have a feeling that I’ll find ways to cope with it and to stay connected with my family and friends.

GERMUNDSON: Maria said that the simple act of seeing people out wearing a face mask, socially distancing or following other COVID precautions means the world to her and other essential workers. 

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QUEZADA: Hai-Thien Phu is a second-year medicine and pediatric resident doctor at the University Medical Center. In her residency program, she takes care of both kids and adults. Her work varies from month to month, giving her a broad scope of experience at the hospital. We asked her how it’s been for her as a resident over the past year. 

PHU: It’s definitely been disruptive to our training because a couple of reasons: a lot of our patients were afraid to go into seek care, right? So we saw a low-volume of patients and that included both the outpatient clinic world as well as the inpatient hospital world. And that is scary because a lot of these patients need the preventative health screening they need to have these check-in routine check-ins with their physicians from the clinic perspective, which they weren’t getting, just because of the fear of coronavirus.

And then in addition to the inpatient world, they were also afraid of the same thing, going into the hospital where it was associated with having coronavirus infections, they were scared to go in and sometimes they were pretty ill, but they thought, maybe I can manage this at home.

So when we do see them present, it was near the late stages of their illness. So it became more severe. As opposed to if we had caught it earlier on then we could have had a better course for them. Fortunately, most of them did well, but there were also those cases where they didn’t do well.

GERMUNDSON: I was wondering if there’s any memorable moment that you want to share?  Something that really impacted you? An experience that you had while on the job recently?

PHU: I’ll have to think about this, there were a lot of moments. The one that really sticks out to me the most is a COVID patient who was really young in their early 30s who didn’t have any other medical problems, otherwise healthy and was a construction worker. So, I definitely worked hard and was used to exercising quite a bit, too. And they came in with difficulty breathing and they were found to have COVID pneumonia and their course initially, they were doing well, and then at that seven to 11-day mark, which is when we expect people to not do as well, they started to go downhill, needing more and more oxygen support. 

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PHU: And they were just so young, and family members were surprised and really sad because they’re like this person is so young. Why? And then this person, unfortunately, had to be intubated and put on mechanical ventilation support. And then ultimately suffered from the complications of COVID, which are the hypercoagulable states, where they form lots of blood clots and they formed blood clots in their lungs. They formed blood clots in their heart, causing a heart attack and were essentially fighting for their life. In the end, they did need to be put on a tracheostomy and attached to a ventilator for a period of time because we just weren’t able to bring them off the ventilator support.

Fortunately, the heart did recover, which we thought was such a miraculous thing. And now, about four or five months later, they’re trying to take off the tracheostomy and allowing this person to just breathe with just some supplemental oxygen. And they’re actually doing pretty well, but this is a miraculous case because everyone was just so scared for this person who was previously healthy. No one would have thought it would have come down this road. And, like I said, we don’t know who this disease impacts. We thought we did, but we don’t. We only have guessed, and they are pretty sick. We try our best. We support them.

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PHU: We have some knowledge of what the disease does and the complications that it has. And we try to support that and treat as best as we can. This person was just amazing, and I’m so happy to hear that they’re doing well. And that just really moves me to tears because they had family, they had children that they were going to leave behind if things went in the wrong direction still.

But now hearing that their heart is starting to recover some and their breathing is a lot better, it makes me feel really warm that we tried our best for this person, and they’re coming through. Unfortunately, not a lot of other family members can say the same for their family members who have died from COVID, and all we can do is try our best to take care of those who are currently in our hospital right now and mourn for those who were lost.

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QUEZADA: Rachel Hedstrom is a second-year pediatric resident doctor. She works with Hai-Thien at the University Medical Center. She said she was lucky enough to start her residency before the pandemic. 

HEDSTROM: I at least got the first kind of more than half a year under my belt of understanding what it was like when our residency was “normal” and watching the year below me, they haven’t had that. They started residency not meeting their peers, not able to connect in person with people. 

QUEZADA: Rachel said that before the pandemic, all of the University residents in the pediatrics program would gather together on Fridays to learn and connect with each other. And in a career that can be so high stress, she says it’s important to make those connections. 

HEDSTROM: I feel really fortunate because I moved back to Minnesota for med school. I was in Virginia and came back and so I have friends and family and really good support here. And I have my husband at home with me, two adorable pets who are sleeping next to me. But I think a lot of my co-residents, my friends who moved either by themselves or just maybe with one person, it’s been really, really isolating.

And I guess I will share, this wasn’t in my residency program, but we worked pretty closely with family medicine residents that work with us through Children’s, and one of their residents actually committed suicide a couple of weeks ago. And so I think just as a group, we’ve all been thinking like, What can we do? Right. And, obviously, everybody’s reasoning is different. I don’t know the story. I don’t know the family, but I just know that there’s a lot going on with people that is definitely not on the surface because I know that this person was wonderful and came to work every day and took care of patients and probably smiled his way through.

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HEDSTROM: At least with pediatrics, I feel fortunate. Like we’ve been able to, you know, see kids, at least having someone with them. And then we work with medicine, pediatric residents who are able, you know, are on the adult side, are taking care of a lot of really sick people dying of COVID. And then on the peds side, you know, kind of from the start, all of us as a group have been like, how can we help? How can we help? And we’ve actually had lower numbers for the first part of the pandemic and kind of it’s picking up now. And like all the other winter viruses we’re not seeing which is phenomenal, but there’s also a lot of other things we are seeing like, Mental health visits. A lot of suicide attempts in teens. Our emergency room is filled with behavioral issues and depression and anxiety which has just exacerbated with COVID and not being able to see friends and go to school.

GERMUNDSON: What sort of fears or frustrations do you have?

HEDSTROM Initially when this all started back in the spring, I was really nervous for myself. I’m on immunosuppressant medication for Crohn’s disease, and we just didn’t have data and we still really don’t have data. But I was nervous to go to work. And my program director was amazing and super supportive. And she’s, hey, we don’t know what’s going on. If you need to work from home, let us know whatever you need. I think over time, I actually talked to a couple of my friends in residency, across the country and who are on similar medication.

I decided that I think what was important for me was just to be as careful as I could, but I actually, at that time really enjoyed having a place to go to work and feel like that I was doing some good and helping And so at first I was nervous for myself. I’m now vaccinated with both shots and my parents were both vaccinated, which is amazing. So, for the past week, I’ve actually been able to see them inside in person. But until then we were doing outside under the heaters in Minnesota. I think my initial fear was for myself, and I got over that pretty quickly.

We would get emails every day. Like you had contact with a COVID positive person in our inbox and you get enough of those. And you’re like, okay, like what I’m doing with PPE is clearly working, you know, you wear an N95, another mask, the goggles and a shield and a gown, and you’re pretty safe.

And I never had COVID. So I worked for almost a year now with COVID positive kids and their parents are in the room and likely have the same thing… and wearing good PPE. And I never got it; I got tested a lot. But so I think that was my initial kind of fear. 

And then frustration, I think it goes up and down sometimes it’s like almost the grieving process. Where you’re like, I don’t accept this, like this isn’t happening. Like waking up every day. Like you still have to go and change and get your PPE on. And you’re still, I still have three N95s  in my car that I go through and reuse since the beginning of this. 

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QUEZADA: In spite of all that she is surrounded by at work, Rachel said that she does see a lot of good coming out of this past year. 

HEDSTROM: We’re doing amazing things with telehealth that we didn’t think we could do this quickly. I think some really memorable things are like cases of patients you see where just heartbreaking in terms of like — I’ve had a couple of patients not have good outcomes and pass away. And the number of hoops we had to jump through to be able to have one more brother come into the hospital. It’s just super frustrating. I understand why we can’t do that for everyone, but it just feels so wrong. And then you hear from other friends that are working with adults. I mean, I have friends all over the country working in emergency rooms and working with adults who are just dying alone.

I think that is what has been really tough for people. I had a friend in New York in one of the emergency rooms there when this was all starting, and I just remember him saying we would have someone die in a bed and we were almost like, ‘Great, we need that bed.’ And that’s the wrong attitude to have, but that’s essentially where this brought us. We need to just save more people. We need to save as many lives as we can. And so that really stuck out to me. So I think overall, it’s just taught us that when something happens, we do have a lot of smart people, a lot of brains thinking about solutions for something. How amazing, we were able to get a vaccine in less than a year and roll it out and get into millions of arms already. Right? 

That’s incredible. And so I think we have to think about the good things because there are so many bad things that came from this. 

GERMUNDSON: what do you want people to know? I guess, about the experience of medical workers right now, what would you say to them? 

HEDSTROM: I would say to them, and I would say this to everybody about everybody, is to just give everybody a little more grace right now than you normally would. Things happen during the day that you just can’t predict that are happening to your loved ones working in healthcare. And I think, on top of that, things are happening in people’s home lives. People are getting sick, people are by themselves, people are isolating. And you just don’t know who’s needing help or just needing you to be extra caring in that moment.

Especially healthcare workers who at the beginning too, everyone’s like clapping during shift change and giving you discounts and like, ‘Yay, thank you. You know, you’re all heroes!’ 

We’re still working. Now I know a lot of people would love to think that. But a lot of people are still sick from it. But yeah I think just giving everybody grace, giving yourself grace, especially even if you’re not a healthcare worker, because I think that’s really the only way we’re all going to get through this.

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QUEZADA: Even though some people have now been vaccinated, the coronavirus pandemic is still very much ongoing. New, highly contagious COVID-19 strains are spreading in the U.S., with Minnesota recently confirming the first case of a COVID-19 variant originally found in Brazil. 

GERMUNDSON: In 2020 we saw a spike in the number of physicians experiencing burnout and increased stress and anxiety. At the end of an exhausting day, they are the ones who have seen the worst of the pandemic. 

When we, as journalists or as everyday worried people, turn to the experts and ask them what to do, they tell us the same thing every time: Wear a mask and keep your distance from others outside your household. As we heard from these healthcare professionals, being called a hero is nice, but for them, it’s better when people actually listen. 

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GERMUNDSON: We want to thank Hai-Thien Phu, Maria and Rachel Hedstrom for taking the time to share their stories with us. Thank you.

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MEGAN PALMER: In other U News: the Student Senate will propose a bill to demilitarize UMPD at the end of February; the U has so far administered 2,000 vaccine doses to healthcare workers and researchers; and Hennepin County has been using the University Inn to help homeless people who are sick with COVID-19. We’ll see you next week.