A look inside this southern Utah hospital's fight to save COVID-19 patients

A look inside this southern Utah hospital's fight to save COVID-19 patients

(Intermountain Healthcare)



ST. GEORGE — "It's just the little things that make a huge difference," Avery Broadbent, an ICU nurse at Intermountain Dixie Regional Medical Center, tells the camera.

"By not washing your hands even one time you can potentially change someone's life forever," she continues. "People die. Everyday. And it's all," she pauses as she fights back tears, "it's all preventable. All of it."

Broadbent's plea to Utahns to help stop the spread of the novel coronavirus is just one of several told during a video tour of the hospital's efforts against COVID-19 released this week.

Recently, false rumors claiming hospitals are not overburdened have circulated in the state and a group of conspiracy theorists even tried to get into Utah Valley Hospital to prove the ICUs are not overwhelmed. They were thwarted and hospitals have since upped security measures.

The state has seen a huge rise in COVID-19 cases, hospitalizations and deaths in recent months, leading Gov. Gary Herbert to implement a statewide mask mandate after months of leaving it up to local municipalities despite multiple calls for a mask order from doctors.

Thursday marked a grim milestone in the state's COVID-19 battle as the death count surpassed 1,000.

As of Friday, there were 568 COVID-19 patients hospitalized in Utah, 213 of which were in ICU units. About 92% of all ICU beds in the state were filled, with 55% of non-ICU beds occupied.

Since the onset of the pandemic, state officials have politely asked Utahns to do their part and please wear a mask. While most seem to comply in certain areas (Salt Lake County saw 94% of residents wearing a covering in October), other areas have seen rebellion in wearing a face covering with multiple protests being held across the state in response to mask mandates.

Southwest Utah, the region the hospital serves, has seen a total of 14,964 cases since the start of the pandemic and 107 deaths, according to the Southwest Utah Public Health Department.

Washington County, where St. George is located, accounts for the majority of cases and deaths, with 11,546 cases reported since the start of the pandemic and 3,303 considered still active as of Friday. A total of 88 people have died from the disease in the county.

Intermountain Healthcare has been at the forefront of the state's COVID-19 response since the early cases were reported in late February and early March; one of the first Utahns confirmed to have coronavirus was treated at Intermountain Medical Center in Murray after returning from a cruise ship.

Intermountain Healthcare President and CEO Dr. Marc Harrison was recently named as the third most influential person in health care in Modern Healthcare magazine's top 100 ranking.

The 9-minute video posted to Intermountain Healthcare's Facebook page takes viewers on a tour of Dixie Regional Medical Center as health care professionals explain why residents should take the virus seriously and show what a day treating COVID-19 patients looks like.

While some may expect to see the hospitals overcrowded with people, nurses running around, and general chaos, Dr. Patrick Carroll, medical staff director at the hospital, explained that's not how things run in a hospital. Additionally, most people in a hospital are typically visitors to patients — something that isn't allowed during a pandemic.

There are basically three levels of care provided in a hospital: conventional, contingency, and crisis care.

Since the pandemic hit Utah in March, hospitals have been running at the second level, contingency care, after being forced to transition from conventional in response to increased patient numbers.

"This is truly taking care of patients in a very nonstandard way," he said.

But the level of care hospitals want to avoid at all costs is crisis care, Carroll explained. And with the COVID-19 surge in Utah, it's getting too close for comfort.

The hospital has tents set up on its grounds to accommodate more patients if it gets to that point. Standing in the tent and surrounded by empty beds separated by about 2 feet, Carroll says they hope to never need to use this space.

But, they are prepared and will use it if they need to.

In the tents, nurses would be caring for several more patients than normal at a time, lowering the level of care each person would receive. "You can imagine that they're not able to provide the same level of care if they're taking care of many more patients — and it's not where we want to be," Carroll said.

"But we would like to stay as far away from crisis care as we're able to stay," he warned.

Dr. Brett Christiansen, an emergency room physician, answered common questions they receive about when and when not to go to the ER.

Is it safe to come to the ER?

Yes, the hospital is safe, staff assured viewers.

"I want the community to know we are here for you no matter what — whether you've got COVID, whether you don't have COVID — we can take care of you. We're a safe place," said Jennifer Little, a registered nurse in the ER.

Should I come to the ER if I have COVID-19?

Simply having minor symptoms of COVID-19 or testing positive while asymptomatic are not reasons to go to the emergency department, Christiansen explained. However, if someone is experiencing shortness of breath or feeling very ill, they should come to the ER for treatment.

Will I contract COVID-19 if I'm exposed to someone who tested positive?

What's different about this infection than other illnesses is the fact that it's novel and there is basically no immunization at this point, Christiansen said. Anybody can get sick.

That said, it's less likely someone will become infected after coming in contact with a positive case if social distancing and mask-wearing precautions were taken, he said.

While some demographics are considered to be at higher risk for developing complications related to the disease, anyone can suffer from serious symptoms — a virus does not discriminate.

"COVID is a big deal," Little said. "If you are me and you get to watch somebody that starved for oxygen, can't breathe, it's horrible."

Related

Even behind a mask and other layers of personal protective equipment, the concern in their eyes is clear as they make a direct and desperate plea to Utahns, begging them to take the virus seriously.

What used to be a 32-bed orthopedic spine unit has now been converted into a COVID-19 unit with all 32 beds filled with patients.

"This is time-consuming, physically exhausting caring for the COVID patients. It's emotionally exhausting. We are their only person that they have contact with during their hospitalization," said the unit's manager, registered nurse Emily Snyder. "So not only are we their care provider, but we also are their emotional support on a daily basis."

Makail Letters, a registered nurse in the COVID-19 unit, demonstrates to viewers how she puts on several layers of personal protective equipment before she enters a patient's room.

"In order to even get into a room, you're looking at at least 30 seconds, and sometimes life-saving events where we're all having to don this and hope that we get in there fast enough," she said.

Staff like Letters typically put that type of equipment on at least 75 times a day, and at least five times every hour during their 12-hour shift.

It takes time to get geared up before going into a COVID-19 patient's room, something Dr. Bryce Ferguson said can take valuable time away in life-threatening situations. Ferguson is the ICU medical director and said COVID-19 patients in the unit are in serious condition.

"The patients here in the intensive care unit are only the sickest of the sick. Their length of stay, or the time that they spend here in the hospital, is oftentimes much longer than a typical hospitalization would be," he explained.


People die. Everyday. And it's all preventable. All of it.

–Avery Broadbent, ICU nurse at Dixie Regional Medical Center


Some patients in the unit require high-flow oxygen to keep their levels up; and if it gets removed, their oxygen levels decline so rapidly that staff have only a few seconds or minutes to get the oxygen cannula back in. It can take up to 30 seconds before a staff member is fully equipped to enter a COVID-19 patient's room — something that adds extra strain and pressure on respiratory therapists.

"This has been one of the most overwhelming times for all of us," said Valeska Guerra, who has worked as a respiratory therapist for 15 years.

An anti-mask movement has taken hold in southern Utah, with several in the area refusing to comply with requirements and decrying the government for violating personal freedoms.

"I know sometimes we feel like everybody's trying to control us and tell us what to do," Guerra said. "It doesn't hurt anything to wear a cloth on your face. I know, personally, working here and wearing one all day every day has helped me or we would all be sick."

Health care workers on the frontlines of the pandemic have watched patients die since March.

A patient dying from COVID-19 had no family, so Broadbent and another nurse sat in the room with her as she died.

"We all just kind of held each other's hands," she said through tears.

Several couples have been admitted to the hospital with COVID-19 and most of the time, only one of them leaves, Broadbent said.

"It's awful," she said. "And you have the power to prevent all of that," she added, calling on Utahns to follow the safety guidelines.

Every single day, doctors and nurses call the patients' families and update them on their condition. On a regular basis, family members express sincere gratitude and thanks to the health care workers. Ferguson said he appreciates that gratitude and they all feel it.

But, there's one thing they really need from the community: compliance with public health guidelines.

"Will you help us? Will you please do all that you can to stay safe?" Ferguson asked. "Keep your mask on, stay socially distant apart while still expressing love for one another. Get your flu shot. Stay home when you're sick and please do your best to help us all as we work through this but most importantly, to help these patients who are here suffering. That would be the best 'thank you' that we could appreciate."

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