As the pandemic grinds on into its third year, with no clear end in sight, the stress on nurses and frontline health care workers is unprecedented.
Last week, more Mainers were hospitalized with COVID-19 than at any point during the pandemic, further straining a health care system so short-staffed that Gov. Janet Mills has deployed hundreds of members of the Maine National Guard.
Meanwhile, health care workers have been quitting hospital jobs. Those who remain are doing their best to provide care in circumstances they could not have imagined just a few years ago.
Cheryl Quint, an emergency nurse who has worked at Houlton Regional Hospital for the last 25 years, and president of the Maine chapter of the Emergency Nurses Association, agreed to provide her perspective on the toll the pandemic has taken on her and her colleagues.
The following interview, which took place in early January, has been lightly edited for clarity and length.
We’re going into the third year of this pandemic. How are you and your colleagues doing?
I think health care workers, especially ER nurses, we’re known for our resiliency and passion for what we do, because otherwise we wouldn’t be doing it. And I can honestly say that we’re physically and mentally exhausted.
I’ve been nursing for over 30 years, and I never thought that I would ever come to a point where I should feel this way. But it has completely drained us for so many reasons. I mean, let’s face it, the whole world has been impacted by the pandemic, in so many different ways. And, as health care providers, it’s been like a domino effect.
Coming from a small facility, we have to be able to stabilize our patients, and then, because we are limited with our resources, we work with other facilities to transfer our patients to get the higher level of care that they need. And we’re not able to do that. And it’s not just here in Houlton, Maine, it’s statewide, it’s national.
And it weighs on us as well, because we know our patients need that higher level of care and yet we can’t provide it. We pull everything out of our resources that we have where we’re at. But we just don’t have them. The patients are suffering and because of that the nurses and providers are feeling very burdened because we’re not able to give the care that we typically would be able to give our patients, so it’s really affected us.
Now we’re having to maintain these patients for sometimes hours, sometimes days before we can get them to other facilities for the care that is needed. So it’s been very hard. Nurses are burnt out. There’s nurses and providers everywhere just rethinking their careers because, you know, how do you go to work every day just knowing what you’re going to be coming up against those same challenges every day that you can’t fix.
Nurses are healers, they’re fixers, and we can’t do that right now. And that’s part of the struggle, you know, that we’re facing. So as a whole, yes, I think we’re really feeling the impact physically and mentally.
When you say you can’t deliver the care you want, what does that mean exactly? What type of things are you not able to provide that you’d like to?
If we have a trauma patient come in, if we have fractures that come in, if we have patients that are having a heart attack and they need to get straight to the catheterization lab, we can’t deliver that care at our facility. Typically, they go to Bangor for that.
We’ve had a couple of patients that we needed to transfer out, and it’s been a couple of days. Typically they would have gone by Life Flight or by ground crew, you want to get them there to have that procedure done as soon as possible. We don’t have the capability of managing those types of patients. I’m sure bigger hospitals are even feeling that because they don’t have the resources they need. There’s just no place to put these patients.
Some if it is due to COVID patients. Some of it is due to staffing. There’s been a nursing shortage for years, but not to this level. There’s just no staff to take care of patients. Our patient-to-nurse ratio has increased, and that’s another challenge as well. We’re trying to take care of these patients with the limited staff that we have and trying to provide a level of care that we’re used to providing and not being able to. It’s not untypical for nurses to go home in tears at night, because they’re frustrated, they don’t feel like they’ve given the care that their patients deserve. And it’s just heartbreaking to not be able to do that on many different levels.
So to be clear, you’re not talking about just COVID patients. You’re talking about people coming into the emergency room for other reasons, but because of COVID they’re not able to get beds or get transferred.
Absolutely. And that’s what I mean by a domino effect. We can’t even treat our regular public patients right now because there is just no room for them.
Are you having to deal with misinformation about COVID or the vaccine as part of your job?
I think it definitely has been a challenge to get education out there. There’s a lot of misinformation. We try to educate the public and all of our patients when they come in, but that has definitely been a challenge as well.
I’ve had many patients tell me ‘I wish I would have gotten vaccinated.’
Whether they’re vaccinated or not, I think the public, most of the public, have had their eyes opened to the fact that this is real and it is killing people. We’ve treated a lot of unvaccinated patients, young and old, and for whatever reason they didn’t get vaccinated, and that’s their personal choice. But I’ve had many patients tell me ‘I wish I would have gotten vaccinated.’ I think the more it goes on, I think it makes the public more aware, this isn’t going to go away. We need to do all that we can to prevent this from continuing.
Has the pandemic and being on the frontlines changed the relationships within your team and with your colleagues?
I think if anything, it has made our team even closer. Just because we have to rely on each other. Not only to get through our shift, but even after the shift. You need downtime, you need to be able to decompress. I think we’ve really gotten closer, as far as relying on each other and providing mental support for each other, not just at work, but at home too, because it’s affecting everybody’s homelife.
You come home after a long day at work, and you’re very stressed and tired. To come home and try to be ‘normal’ with your family, it’s hard. Because you don’t have anything left to give. You give everything you’ve got at work and you come home and you’re drained and you just want to shower and go to bed. That’s been a challenge for many. I don’t have little kids at home anymore, so it has not affected me as much, but I know a lot of my coworkers have younger kids at home. They’re wondering ‘am I bringing anything home with me?’ which is the top priority. And then, you wonder ‘have I given them what they need?’ Because you’ve got nothing left yourself.
How have the staffing shortages changed how you and your colleagues work?
We have a lot of open shifts right now in our facility, and I’m sure that’s everywhere. We’ve had some nurses leave. Maybe only a couple left because of the mandates, others are leaving for other reasons. We have always had available positions. But not to this extent.
We have several traveling nurses in our hospital right now. Before two years ago, we very rarely had to utilize travelers. Yes, we’re picking up extra shifts, some days we’re working short. So we’re doing what we can. Again, we’re giving everything that we have. That’s draining us as well. It’s to the point that some nurses are like ‘I can’t pick up another shift.’ They call and are like ‘I just don’t have it in me.’ Then you feel guilty because you know what your staff is going through at work, but you’re not going in because you just physically and mentally can’t.
This past summer I got vaccinated and cases were down and I felt, personally, like maybe we were getting close to the end of this. But obviously that wasn’t right. Did you guys feel that, that we’re kind of through this, and then have that taken away?
Oh, absolutely. You know, I think before the delta variant came, and the omicron now, I think we felt that. I think that we got very comfortable, you know, some of the guidelines were loosened a little bit, we were able to take our masks off a little bit more. You know, if we were by ourselves, things like that. And then it hit and it was like a war, and now we’re seeing numbers and patients worse than when it initially came.
What’s it like to go to work and be in this battle on the front lines and then go back to the ‘normal’ world and see people who are just sort of over it?
It can be very frustrating, but everybody makes their own choices. I don’t hold a grudge against anybody. If you choose not to wear a mask, that’s your personal choice. I mean, it does make it hard. Do I want to be mask free? Absolutely. I’ll be the first person in line to not have a mask on. But personally, I try to focus on taking care of myself and my family and educate people when I have that opportunity to do so.
But people are going to do what they want to do. So you can’t change everybody’s thought process on that. We never will. The only thing we can do is stay consistent in what we’re doing and support the guidelines and the mandates and do the best we can that way.