Friday, May 7, 2021
University of Arizona College of Nursing faculty and students with first-hand experience of the human cost of COVID-19 ran a vaccination clinic last weekend.
Led by Kristie Hoch, UA clinical assistant professor and program administrator of the Nurse Anesthesia Specialty, volunteer Certified Registered Nurse Anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs) administered vaccines to people at the drive-thru.
For about 150 years, CRNAs have been preparing patients for anesthesia before surgical procedures, said Hoch.
“We ensure patients are safe and comfortable during their anesthesia and this piece for us is part of ensuring our community is safe,” said Hoch, referring to vaccinations as part of that work.
Since the onset of the pandemic, CRNAs have found themselves outside of the operating room.
“Really the entire scope, not just for surgery pre-intra and postoperative care, but we’ve been called to take care of patients who are acutely and chronically ill with COVID,” said Charles Elam, clinical assistant professor at the College of Nursing. He said he and his partner were hired to manage acutely ill COVID patients in Green Valley. They installed central lines, big IVs that go into the neck or chest, and arterial lines that go into arteries. They also managed ventilators and sedated patients.
“This was above and beyond what we typically do, but because we are airway experts we were called upon and stepped up to do what we needed to do,” said Hoch.
Phillip Bullington, 31, one of the five doctoral students in the Nurse Anesthesia program who volunteered at the vaccination event, worked as a nurse before beginning his doctoral project and has experience dealing with people who are severely ill.
However, what he experienced as an SRNA in the ICU during the pandemic was beyond his expectations.
“We never really expected the way everything happened and then it just got crazy,” recalled Bullington. "Where there's people on ventilators just taking up all the ICUs. We're turning other floors into ICUs and we're running out of places for patients to go. And then they would get sick, but they were healthy enough that they would still live for a while, but they weren't getting better. So just a piling of people who would get more sick and there was nowhere for them to go.”
Jan. 11 had the highest number of adult intensive care beds occupied by COVID patients, with 1,183 ICU beds in use and 457 in use by non-COVID patients. Only 8% percent of ICU beds were available on that day. From early December to the end of January, Arizona had fewer than 10% of its ICU beds empty. Since then, ICU beds used by COVID-19 patients declined, and from about mid-March to the end of April stayed at about 10%, increasing by 1% through April into May.
While Bullington says things are better, he thinks the situation could return to how it was during the height of the pandemic.
“It could always still go back the way it was,” said Bullington. “With the new variants, I don’t think there’s any reason that it’s completely over.”
For Bullington getting vaccinated is the “safest course of action.”
“It’s not a live virus, you can’t get the virus from it. So it’s better to be safe to be vaccinated than to take the risk of getting it or giving it to your family or your grandparents or your kids.”
Bullington, who is vaccinated, has two little kids and wants to protect his wife and his wife’s parents.
For Hoch, also a member of the American Association of Nurse Anesthetists, the event not only serves the community but also honors the memory of her family members who passed away due to COVID-19.
“My father-in-law and brother-in-law both passed away due to COVID-19 at the beginning of this year. To me, playing a role in the vaccine rollout is my way of honoring their memory and ensuring others do not suffer their fate,” said Hoch. “It’s heartwarming to see my students joining the effort. As ICU practicing nurses, they’ve seen the effects of COVID from the frontlines, and share my passion for putting an end to the pandemic.”
Physical therapists also got caught in the eye of the pandemic.
Physical therapist Piper Daulton worked about 64 hours a week in packed ICU COVID units at Banner – University Medical Center Phoenix. Daulton, who works in the Trauma and Surgical ICU normally providing physical therapy to people who’ve had car accidents or received spinal surgery, volunteered for the Prone Team in April.
The Prone Team, a hodgepodge of different disciplines, including nurses, physical therapists, occupational therapists, and techs, came together to work specifically in the COVID ICU to turn patients on to their stomachs in order for them to breathe better, said Daulton. She explains how they would turn intubated patients onto their stomachs for eight hours then every two hours would turn their head and arms to prevent pressure sores.
Unlike other physical therapist colleagues, Daulton is a young, healthy 28-year-old, with no children, and no comorbidities (which would make it more likely for someone to be severely ill from COVID-19), so she felt she could volunteer to work in the COVID Unit.
“Not to say by any means, had I contracted COVID it wouldn't affect me or I wouldn't have lasting effects from it. Not at all, but it was just something, kind of a risk that I took, because I wanted to help these patients,” said Daulton.
She remembers a particular COVID patient, a “younger gentleman,” who passed away while on his stomach. His wife was able to arrive in time to say her last goodbyes, then they had to flip him onto his back when he was deceased.
“I'll never forget that. It's something that I'm happy that I was able to do, just to kind of put life into perspective, and to be with that gentleman and his last moments and for that family, but definitely, that's kind of weighed heavy on me. It's hard to talk about. it's hard to think about,” said Daulton. “No amount of schooling can prepare anybody for what us healthcare workers have gone through over the last year and a half.”
In July, in the midst of the pandemic, Daulton’s grandmother passed away from leukemia. Since then, Daulton wears a silver necklace with angel wings, a birthday gift her grandmother gave her. The necklace helped her get through the past year.
“Since July 2 I've had it on, and it just gives me some hope and peace knowing that she's proud of me,” said Daulton. “She was a woman of faith and integrity and of science. She couldn't wait to get the vaccine.”
Daulton is one of several Banner Health frontline medical workers featured in “The Things They Carry,” a visual project highlighting them and the personal items they carry to cope during the pandemic, which will launch on Sunday.
Inspired by Tim O’Brien’s book, The Things They Carried, about soldiers in the Vietnam War and the unique things they carried during combat, the project will showcase a series of portraits, video interviews and emotional stories on social media during National Hospital Week, which runs Sunday through May 15.
Others featured are ICU nurse Craig Rufener, whose silver Buddhist prayer ring etched with 82 microscopic words helped him endure grueling overnight shifts, and patient transporter Steve Stanek, who creates bracelets made from guitar strings and gives them to patients having a tough day.
Daulton hopes people will get vaccinated, and said she convinced her elderly neighbors as well.
She told them " 'I can guarantee you you will want to get this vaccine, as opposed to me having to turn you over onto your belly in the ICU,’ and that kind of resonated with them. I was like please get it. If not for me, get it for your daughter, get it for your 3-year-old grandson that you watch every week.”
Daulton hopes people will be able to put politics aside to come together and “listen to the doctors, listen to the science, get your vaccine and stay healthy.”