“I don’t think anyone’s slept well since this began”: Despite risks, YNHH personnel have been working around the clock
“COVID-19 … sort of introduced this idea that suddenly you weren’t sure if your own health was in danger when you were caring for a patient,” said Elaine Fajardo, who is a pulmonary critical care doctor and the medical director for respiratory care at Yale New Haven Hospital.
As the coronavirus swept across the country, medical professionals have risked their own health to treat and save patients. Though they have been donning masks, face shields, boots and impermeable gowns to protect themselves from viral particles, doctors and nurses are in constant danger of exposure. Some procedures, including intubation, can spray the virus into the air, where it can linger.
But even if doctors had been rushed to put on their personal protective equipment or had not checked that their mask was on properly, Fajardo said that many still risked their own health to treat and save their patients.
“[Medical personnel] really showed their true colors and their true bravery,” Fajardo said. “I don’t think with our jobs we usually think of coming to work that way — that it’s a question of our safety or our own health … but people still come and they still take care of their patients in ways that are so heartwarming and considerate to them.”
The COVID-19 pandemic has placed an unprecedented strain on the medical system, and as medical professionals work to treat all those who come through the doors, their long shifts are a testament to their courage. At Yale New Haven Hospital, staff have been working upwards of 84 hours per week, providing clinical care and emotional support to patients isolated from their families.
Even as personnel may fear for their own safety or their family’s well-being, they have been passing in and out of the hospital’s glass doors to treat scores of ill patients.
“It’s heroic work, what’s happening in the hospital these days,” Nihar Desai, a doctor at the hospital, said. “When you think about the best and highest ideals of our profession — of compassion, sacrifice and teamwork — I think we’ve seen all of those on display these last weeks and months.”
Andrew Ulrich, professor of Emergency Medicine, said that even for people like him who have been practicing for a long time — who he affectionately dubbed the “gray hairs” — the pandemic has been unique in the severity and duration of its effects. The hospital, Ulrich said, is treating fewer overall patients than normal, but the patients it sees are more severely ill.
“The people who work in the ICU have a lot of grit and tolerance,” Fajardo said. “Having said that, it’s still very intense. These patients are really sick. Everyone feels all of the personal emotions around caring for somebody that doesn’t have loved ones at the bedside.”
The pandemic has forced the hospital to shut its doors to visitors, so sick patients have been without loved ones during treatment. The hospital’s nurses have filled much of this void, Ulrich said, offering emotional support to patients stricken with the illness.
Fajardo explained that staff members write encouraging messages on the glass doors of patient rooms and hold their hands as they receive treatment.
“A big part of this disease is about the unknown,” Ulrich said. “People are afraid of what it means and how it’s going to affect them, and our staff has been really good about explaining to patients what we know and don’t know and how we’re going to take care of them.”
The hospital began preparing for the pandemic months ago — almost quadrupling its intensive care unit capacity, acquiring more personal protective equipment and shifting staff members from its less-populated areas to its COVID-19 units.
Earl Campbell III has been a gastroenterologist for four years, but when the hospital added 84 new intensive care unit beds without an increase in the number of pulmonary and critical care doctors, he picked up a reusable elastomeric mask and went to work as an ICU attending.
Campbell has spent the last week caring for between seven and nine patients each day. Though he admitted it was challenging to use skills he hasn’t practiced in years — including being the primary provider for patients on a ventilator — he was driven by a desire to do his part to help amidst the pandemic.
“When a challenge arrives or people need help, it’s just a matter of stepping up,” he said.
Though he said he “definitely” feels concerned about contracting the infection himself, he dons his PPE — a mask, eye protection and a gown — and assumes the risk inherent to working in the COVID-19 unit.
The hospital has provided medical personnel with hotel rooms to isolate themselves from their families. Campbell has stayed there throughout his week as an ICU attending. Each night after his shift, he showers and changes into fresh clothes, talks with friends and reads to refresh his knowledge of the skills he now has to employ in the ICU.
Desai is not staying in a hotel and has an eight-month-old, three-year-old and six-year-old at home. When his shift ends each day, he must weigh his desire to interact with them against his goal of protecting them.
“You’re always concerned when you come home: What should I do?” he said. “Of course I want to see them, play with them and spend time with them, but I also want to keep a little bit of distance from them.”
Desai said these concerns are ever-present in the back of his mind. To counter them, he thinks back to his training and to his reasons for entering the medical profession.
He said that witnessing other healthcare workers’ dedication to their jobs helps energize and inspire him. Desai said that his colleagues have put aside their own anxieties to care for patients.
“You know that you have a duty to provide care and to work under challenging and uncertain circumstances,” he said.
Since the beginning of the pandemic, the hospital’s medical personnel have commonly been working 12-hour shifts for seven to 10 days in a row. Most arrive at the hospital before their 7 a.m. start time to don their personal protective equipment. They then participate in huddles with their units before making rounds to check in with each of their patients and handling patients’ needs that arise over the course of the day.
As a precautionary measure, the hospital has restructured its units to separate patients with COVID-19 from the rest. YNHH administration has also created new guidelines in the wake of the pandemic and expanded its ventilator fleet capability.
“From an administrative perspective we have been working really hard,” Fajardo said. “I don’t think anyone’s slept well since this began.”
But Ulrich said that due to its extensive preparations, Yale’s hospital system is prepared for the pandemic and has not been overwhelmed. “We got this,” he said.
Yale New Haven Hospital System has seven campuses across Connecticut.
Rose Horowitch | firstname.lastname@example.org