As COVID-19 hospitalizations continue to break records in Alaska, health care workers in the state’s emergency rooms and ICUs say watching patients die is becoming routine, and it’s taking a toll on their mental health.
“The range of emotions that I go through in an ER shift now is unbelievable: anger, sadness, compassion, empathy, disappointment,” said Matthew Kinsler, an emergency room nurse at Alaska Regional Hospital in Anchorage.
He said lately he’s taken to venting in the hospital’s supply rooms, where he’ll go to swear out loud to himself and throw things around until he’s comforted by coworkers.
At the ICU, where the sickest patients come, providers are used to losing patients, but the most recent wave of COVID-19 deaths is unprecedented.
As of Friday, 208 Alaskans were in the hospital with COVID. A significant percentage of those people will die. For the 27 of them who are on ventilators, the Centers for Disease Control and Prevention says about 50% die.
“I’ve heard many of our therapists say, ‘I feel like a failure working in this unit, because everything I know to do doesn’t work, it doesn’t make a difference,’” said Karen Good, who oversees respiratory care at Providence.
Good said it’s stressing family relationships and testing the patience of hospital workers who say that the suffering is largely preventable through vaccination.
Heidi Decaro, a respiratory technician at Providence’s ICU, said she’s had patients who don’t take COVID-19 precautions seriously or deny that the coronavirus is real, even as they are dying. It’s stretching her professionalism.
“You really do have to bite your tongue, because you are a professional first of all, but you are there to help them and so you have to work on building a relationship,” she said. “Because there’s already a barrier of: This isn’t real versus this is real.”
Decaro said it’s making her more irritable at home. After losing patients — she says four patients under her care died last week — she’ll snap at her family for small annoyances.
“People are dying out there — just do the dishes!” she said. “It’s the little things.”
Decaro said workers at the ICU say they feel isolated from the rest of the city, where life is going on as normal.
Doctors and nurses have publicly implored political leaders to impose restrictions like masking, but so far the governor and Anchorage’s mayor have said they’re doing everything they can.
“Everybody in the health care system feels helpless because we see the end result of something that could have been preventable,” said Javid Kamali, an intensive care physician at Providence.
Kamali, 56, has been a doctor for 20 years, and said that aside from seeing sicker COVID-19 patients in the hospitals, he’s also seeing younger patients.
“For the first time in my entire career, which spans about 20 years, I’ve had a whole ICU filled with patients who are younger than me,” he said. “That has never happened before”
He said unvaccinated patients in their 30s and 40s have died from COVID-19 in recent weeks.
Hospitals have been forced to keep people being treated for COVID-19 in emergency rooms instead of ICUs, where they could get better care. They’re being held for hours, or even days, taking up space for new patients who come in with less serious issues.
“You see your family, your loved ones, your friends, waiting in the emergency department waiting room with really bad abdominal pain, chest pain, shortness of breath — all of these awful symptoms that you’d want to get addressed immediately — are generally getting pushed to the backburner,” Kinsler said.
Kinsler said that ER nurses are used to stabilizing patients and moving them out of the beds. With COVID-19, he said, they’re forced to do a job they’re not as well trained for.
Nationwide, news outlets have reported patients dying while waiting for a bed in the ER, as the latest surge in cases keeps hospitals at or near capacity. When asked whether Alaska has gotten to that point, Kinsler gave an unequivocal “yes.”
“It’s there, absolutely. 100% there,” he said.
It’s especially hard to see patients come in one day and have their parents come in a few days later and die from the disease.
He said those patients often blame themselves.
“It’s pretty jacked up to say, you caused your parents to die because of the decisions that you made. But it’s an easy leap to make in the brain,” he said. “That is the most heartbreaking thing and I’ve seen it multiple times.”
One of the few comforts health care providers have is one another. They say they’re forging tighter bonds through after-work beers or hikes on days off, or bringing cookies to work to share.
Good said that if nurses or technicians blame themselves for losing a patient, physicians will often round up the staff to remind them of everything they did do.
“We help each other the best we can. We bring them snacks, we sit down with them, we wipe off the tears,” said Kamali. “But that’s pretty much all we can do.”
He said there’s something the public can do to help: get vaccinated.