“We are on the verge of a patient care disaster here in Virginia. Let’s be clear: it is not just Florida or Alabama or California health care systems at risk of collapse. We run the same risk here in Virginia - and far sooner than the public realizes.”
With these words,Director of Engagment for the Virginia Nursing Association Kristin Jimison, , invited reporters to attend a virtual media conference.
The panel, moderated by Janet Wall and led by President Linda Shepherd, MSB, BSN, RN, of Johnston Memorial Hospital in Abgington, presented an honest, raw discussion of the day-to-day realities for intensive care nurses.Shepherd said the focus of the conference was, "the ongoing crisis that is impacting nurses across the Commonwealth."
The panel featured VNA members from all over the state: including Northern Virginia NVA Chapter President Melody Dickerson, VNA member Ashley Apple and several frontline ICU nurses and directors.
According to an April study, 4/10 nurses surveyed seriously considered leaving the profession "as a consequence of the pandemic," said Shepherd.
"Nurses feel disrespected by communities who initially hailed them as heroes but now refuse to adhere to the simple steps that would help ease their burden such as wearing masks and getting vaccinated," said Shepherd. "Our nurses are emotionally depleted and traumatized and experiencing pandemic related PTSD with little or no time to seek mental health services."
“I have never in all my career have seen patients this sick," said Johnston Memorial Hospital RN Aliese Harrison. Nor has she ever lost so many patients, over her 23-year career as an ICU nurse, she said. "This has been exhausting."
"This is real; these people are this sick...what can I do to convince people to wear masks...to get the vaccine if they can?" Harrison said. "Everywhere I go I still see people acting like nothing is happening."
"These people are way more sicker and they are younger...Just last week, I'm taking care of 40 and 50 year olds. They are dying- no matter what we do for them,” she said. "We have to start sedation. We have have to paralyze them for their lungs to even respond to the ventilator and allow the ventilator to breathe for them."
Nor do most Covid-19 ICU patients have serious preexisting health conditions as people tend to assume.
“Their comorbidities can be hypertension and overweight and that’s it....The single thing that is in common with all these people is that they are not vaccinated. I have not cared for one person this sick in our ICU that has been vaccinated.”
"We love caring for people. We love to get people better, but we can’t always. We are losing more people than saving that get as bad as they are when they get to my unit."
Ashley Fogleman is a relief charge nurse at Johnston Memorial Hospital Emergency Department in Abingdon, where Covid-19 is surging.
"With the increased ratio we are not able to provide the individualized care," she said. She does not get to know her patients.
People are impatient especially if they come in via ambulance. "If you are in the waiting room, chances are you are stable. There is a reason you didn't get a bed immediately."
She said that the people in the back are in far worse condition and thus they are being prioritized.
"We're still working hard and we're trying to save other lives in the back. We're all tired. Be patient with us."
Northern Virginia area
Melody Dickerson is the senior vice President and chief nursing officer at Virginia Hospital Center in Arlington and the VNA Chapter President for our Northern Virginia chapter
During the pandemic, Dickerson helped to set up the first drive-through COVID testing facility in the DC metro area. She hopes to dispell some of the misconceptions people have about Covid-19 preventative measures.
“There is still a lot of controversy over the masking and the vaccines. We know these things work. We’ve seen it with our own eyes. We haven’t had a patient to nurse transmission since we all started wearing masks."
Dickerson said nurses face much backlash over masking.“Civility has gone awry….Get the vaccine, wear the PPE and just be kind to one another.
Sheri Harsanyi is a assistant patient care director in the main ICU at VHC and has been an ICU nurse for over 35 years.
Harsanyi said at her hospital they regularly field calls from relatives of Covid-19 all over Virginia and beyond. They are looking for ICU beds that are unavailable at their own area hospitals.
Harsanyi said they are fortunate Arlington has a high vaccination rate. However, are now getting overwhelmed with surgeries and other procedures that had been put on hold, while still dealing with a surge in Covid cases.
She sees nurses are leaving the profession because the “work intensity." They suffer “emotional, physical and mental exhaustion,” she said.
She begs people to protect themselves and others. “We know that vaccines and prevent and decrease the severe cases,” she said.
And she needs people to give them some grace for all they do.
“We just ask a little kindness. We don’t need people to be angry at us at times. Say 'thank you' to a nurse.” She she has been humbled, witnessing her colleagues bravery and courage. “I couldn’t be more proud of being a nurse at this time.”
Dexter McDowell is the Patient Care Director at the COVID-19 dedicated unit at VHC. He said it is not uncommon for an ICU to have four Covid deaths a day since the Delta surge. "It is unreal.”
He said wearing a mask is important for everyone. Someone's child may have to quarantine from school and that could keep a nurse or doctor out of the hospital.
Ashley Apple is a family nurse practitioner at Kidmed Urgent Care in the Richmond area and previously worked during the pandemic in the ED at Bon Secours.
She said “Covid is different...We’ve held the hands of our patients, so they don’t have to die alone.”
She said there have just been “massive volumes of patients,” people 90 years old and 2-weeks old. She asked for the public’s help to help them. “Inaction is not an option.”
The nurses believe that if only people would listen to the recommendations of the healthcare professions things would improve.
“We were the number one trusted profession (in the country) and now no one is trusting us,” said Mesha Jones, RN, BSN, who works in the Charlottesville area. “We’re asking for you to be the front line and you take care of us (as we continue to take care of you.) Wear a mask, get vaccinated, wash your hands. It’s going to take a village.”
Before there was a vaccine nurses were risking their own lives caring for patients. That trauma never went away.
“I’ve locked myself in a bedroom. My family would talk to me through the door,” Jones said.
One of the reporters said that in some circles the nursing shortage has been attributed to vaccine mandates.
“I know unequivocally that has not been the cases,” said Jimision. “It has absolutely nothing to do with the vaccine mandate. It is really because of all these other factors that we’ve been talking about today.”
She also said 87% of hospital workers in Virginia are vaccinated, and 90% of nurses. There are so many job openings for nurses, they could easily find work elsewhere.
Shepherd also explain that nurses are not interchangable. “It takes special training to take care of critical care patients."
Covid-19 first ravaged cities where people came in from international airports and rubbed elbows on mass transit. Now it is rural areas that are seeing the brunt of Covid-19. This is the reason they want to stress the importance of vaccinations and masking.
“The rural areas area are being more heavily impacted by this. Your vaccination rates typically will correlate," Shepherd said.
Health reporter Monique Calello shared her frustration. Her county has the highest rates of Covid-19 in the state. She endeavors to warn people, but is being met with opposition.
“They are so vocal about being anti-maskers. I can’t seem to make a dent. What can I say to get them to even consider it? They don’t even want to look.”
“We nurses are just extremely tired, exhausted,” said Shepherd. “We have pleaded with them to wear a mask. We have pleaded about vaccines. Until someone has a personal experience of someone passing of Covid, sometimes it does not hit home. It is not a reality to a lot of these people. I’m not really sure (what we can do) except for what we are doing.”
Dickerson suggested “nonthreatening dialogue.” She’s talked to some people who’ve said they just haven’t gotten around to it. She does not yell at them, but tells them straight: “you could die.” Some people said even if you can reach just one person it is a victory.
And Dickerson wanted people to know that it is not just the old and infirm who are dying. “We’ve had pregnant women in the prime of their lives.” She said, they lose them and hope they can save the baby.
“Why would you not get it for all the children out there?” Harrison asked, knowing children cannot yet be vaccinated and babies are especially at risk.
The nurses talked about the mental toll this has taken on colleagues is more serious than people realize.
Many nurses cannot sleep at night. They lose weight because they can no longer eat. They are traumatized, anxious and depressed. According to the Trusted Health 2021 Frontline Nurse Mental Health & Well-Being Survey, there has been an average decline of 30% in mental health of nurses on a scale of 1-10.
But less than 1 in 4 nurses want to be called "heroes." according to the survey, they say it diminishs the reality of what they do.
The reality is they are working to save lives. They want the community to follow the guidelines: wear masks and get vaccinated.