May 14, 2020

This paid piece is sponsored by Avera Health.

It’s 7 a.m., and Abby Hatch is about to spend 12 hours caring for COVID-19 patients in the intensive care unit at Avera McKennan.

But first, she has to get ready.

She puts on a belt, equipped with a filter and hose, and hooks that up to a powered air-purifying respirator, or PAPR hood.

Then comes her first pair of gloves. Then a yellow protective gown. Then a second pair of gloves.

“And then you can go into a room,” she said. “It’s a lot, and it takes time. You definitely want to make sure you have everything.”

This has become a routine for Hatch, one of many nurses directly involved in caring for the sickest COVID-19 patients.

“Obviously, I was nervous at first,” she said. “You heard about New York and other places that were so overwhelmed. I think everyone has a natural tendency for fear. But our manager was so meticulous about making sure everyone had the safety measures they need. I knew we were going to take all the precautions. And this is kind of what we signed up for, to help people in their time of need.”

Hatch didn’t plan to be a nurse. The Sioux Falls native graduated two years ago from Augustana University and at one time thought about using her piano and vocal skills to be a performer. Her college roommate was a nursing major, prompting to her to consider the field as a way to help people.

“It was probably the best decision I made,” she said.

She began as a nurse on Avera’s trauma floor before moving to the ICU about a year ago. The biggest difference in recent months has been the absence of family visitors for her patients.

“We are calling families on the phone, doing Zoom calls, doing FaceTime, so that’s been really different,” she said. “And when patients are really sick, it’s hard with family on the other side to put their mind at ease. And if I was a family member on the other side, I would want to be updated a lot, so I totally get it.”

There are days when nurses might spend an entire shift taking care of just one very sick COVID-19 patient, she said.

Her care depends on how sick the patient is.

“Sometimes they’re mild and just need more monitoring,” she said. “Sometimes they are on a ventilator getting 100 percent oxygen and need to be put on their belly to help their oxygenation. Sometimes it’s a battle the whole day getting them the oxygen they need.”

Some patients have been there a month or more, she said.

“And sometimes they come in really sick and just need a little supportive care and aren’t with us very long,” she said.

The song “Here Comes the Sun” plays overhead each time a patient with COVID-19 is discharged.

“And everyone feels happy,” Hatch said. “As far as the spirits of the workers, we have an awesome team. Everyone has been able to have positive attitudes throughout the whole thing, even though we don’t know if one day we’re going to get absolutely slammed or be OK. But everyone has come forward with a helping hand.”

Avera McKennan CEO Dave Flicek saw that firsthand recently as he made rounds through the hospital.

“We have a resilient and amazing staff,” he said. “I got to talk to my ICU nurses and the floor nurses, and they got it. They just have a great attitude. They’ve figured it out. It’s just amazing inspiration. If they feel comfortable, our patients should feel comfortable.”

For front-line physicians, treating COVID-19 patients and looking out for their colleagues has been life-consuming.

Dr. Anthony Hericks can remember the moment when health care as he knew it started changing.

“I’d left the Summit League basketball championships, and my phone and email started blowing up that there were five cases of COVID in Minnehaha County,” he said.

Hericks is a pulmonary critical care physician who also serves as director of respiratory care services and director of critical care services. So COVID-19, an emerging disease that primary targets the respiratory system, has meant 16- to 18-hour days for the past two months, plus weekend work.

He also helped come up with the Avera surge plan in anticipation of an influx of patients.

“When I’m at work, I’m 6-feet tall and bulletproof. Whatever happens happens. You just do what you need to do,” he said. “But the other fear is what am I going to do for my family. Do I self-isolate in the basement? When do I wash my hands and shower and changes clothes? Am I putting my family at risk? Those are bigger concerns. If something happens to me, it happens, but if I’m the cause of contributing to others’ illness, I think that would be very difficult for me to handle.”

He has seen several COVID-19 patients when it has been his turn to serve on the floor as a physician, and he and colleagues have done other patient visits virtually to save on personal protective equipment and exposure.

“It’s been a huge struggle because as pulmonary critical care physicians, we’re hands on the patient, boots on the ground and the last ones to leave the case a lot of the time. And when you have to stand back and use your brain instead of your body, it becomes very difficult. So that’s been a struggle for myself and my partners.”

As of last week, things had started slowing down some. He hasn’t had to bring a computer home every night. But a typical day still finds him at the office by 7 a.m., home for dinner by 6:30 p.m. and then off to his home office to wrap up things for the day.

“The work is really nothing. It was time, but I think the difficult part was really the level of emotional stress and physical stress we’ve had to go through getting ready for this with all the unknowns,” Hericks said.

“We start every meeting off with a prayer. And those are very thoughtful about how we move forward. That’s probably what keeps me going. I think if we can provide that level of service to the community, we’ll get through this. There are just so many people who have stepped up and done what they needed to do. That’s what I’m most proud of.”

From her front-line role, Hatch sees it too.

“There have been so many roles in the hospital, not just nurses but respiratory therapists, physical, occupational, speech, housekeepers, the biohazard people and everyone who is still functioning and making the hospital function. They have been doing this and not getting as much recognition as the rest of the hospital,” she said.

“They do an incredible job, and they make our places safe and clean, and we wouldn’t be able to function without them. We don’t feel overwhelmed right now, and that’s just thanks to everyone working hard in keeping our community safe, and we couldn’t ask for more.”

As her shift ends, she changes clothes at work, putting her work clothes in a plastic bag that she then will leave in her laundry room at home. She showers and cleans all her work attire with disinfectant. She washes her face thoroughly, especially if she has had a mask on all day.

She tries to listen to music at the beginning or end of the day to unwind.

“And I listen to music as I go into work, just so I can breathe,” she said. “But I know as soon as I clock out, I’ve left everything at work. I’ve done the best I can for 12 hours. And I know someone great is going to pick up right where I left off.”