Thirteen patients who arrived at the emergency room at Banner University Medical Center in Phoenix last Friday had to be intubated, but there was no room for them in the ICU.
And there was one more patient than there were ventilators on hand in the post-Thanksgiving surge. The ER nurses had to keep the patient breathing by manually squeezing an AmbuBag for two hours before they were able to get a ventilator from the ICU.
“That malfunctioned,” a nurse who asked to be identified by her first name, Nicole, told The Daily Beast. “Then we got one that worked.”
There were still no ICU beds as ever more COVID-19 patients came into this Arizona emergency room.
“We are holding intensive care patients in the emergency department for more than 12 hours on a routine basis,” Nicole reported. “The people are all very sick, and we have many codes or respiratory arrests, sometimes on an hourly basis.”
On another day last week, there were six respiratory and cardiac arrests before 6 a.m. There were four more by 8:30 a.m.
“Really bad days sometimes,” Nicole said.
And at some point, the nurses ran out of body bags.
“The county brought us more immediately,” Nicole noted.
Meanwhile, the hospital’s morgue ran out of room. The dead went into a refrigerated truck trailer.
And all this came in a week that should have brought Nicole and her fellow nurses a first ray of hope in a seemingly unending horror. Maricopa County and Banner had received the first shipment of the COVID-19 vaccine. Nicole had filled out an online “pre-screening survey” on Wednesday, Dec. 16.
“Your submission has been received and you have been confirmed eligible to receive a vaccination in this phase,” the confirmation read. ”Eligible participants will be prioritized based on their exposure and risk level. Those with highest prioritized risk for exposure (i.e., healthcare workers who have direct contact with COVID-19 patients) will be the first to receive instructions [email or text message] to schedule a vaccine appointment. Emails will go out periodically as appointments become available, or order of priority. If you are not contacted right away, please be patient.”
Banner proclaimed in a Dec. 17 press release that an ICU nurse had become the first to be vaccinated and 165 other health care workers were expected to follow, with many more soon to come.
But as of that Friday, none of the nurses in the ER had been able to get an appointment.
“We were so excited, there’s a light now,” Nicole told The Daily Beast. “Then to not even get an appointment, it’s really sad. It kind of makes you feel like they don’t care about you.”
Nicole telephoned the hospital’s human resources office and the Maricopa County Health Department.
“Both said just be patient as we’re all in this together,” Nicole recalled. “I said, ‘We’re not all in this together. You’re not working with COVID patients all day every day. You’re in an office.’”
Nicole was advised by the hospital HR that she would receive the vaccine by Jan. 31. And for her that could mean weeks of working with COVID-19 patients all day, every day. She could not hope for immunity until more than three weeks after the first shot. She would in the meantime almost certainly be in a post-Christmas surge on top of the ongoing present one.
Through it all, Nicole would be in danger of becoming infected herself when a vaccine that could have protected her and her fellow nurses was on hand. She would continue having one patient after another who demonstrated how lethal the virus can be. She has had more than one patient who went to bed the night before feeling just a little tired, woke in distress, and was soon after fighting for life in the emergency room.
“It’s truly heartbreaking how fast somebody can spiral down in front of your eyes,” Nicole said. “It’s so quick.”
Even some patients who were about to be intubated clung to the same sort of denial that had people still not wearing masks and ignoring social distancing. They would continue to insist that it was just a cold.
“It’s good I have a mask sometimes, so they can’t see me dropping my jaw,” Nicole said. “The face shields we have, they probably can’t see my eyes roll, either.”
Nicole was off on Tuesday and went in person to a vaccination center. She was told that she could not get a shot unless she had an appointment. And nobody was sure when she might get one.
As she later walked her dog, Aspen, Nicole said she is well aware that various politicians have received the vaccine. She did not need to add that some of them have actively minimized the COVID-19 threat and undercut efforts to mitigate the spread. They had jumped the line ahead of frontline health-care workers after helping fill up the emergency rooms and fostering delusions that persist in some victims even as they die.
Nicole is a travel nurse based in California and was hired by Banner in anticipation of the post-Thanksgiving surge that hit big time four days after the holiday. One couple had been infected by their daughter when she came home from college. The father died and the mother is intubated with a bleak prognosis.
Now, Christmas was nigh. Nicole had the day off, but whatever joy that might bring was dimmed by the prospect of going back to work the next day, just in time for a new surge to hit.
Meanwhile, she arrived at the emergency room on Wednesday morning to learn that six nurses had called in sick.
“I hope they don’t have COVID,” she said.
Her husband got on the phone to see if he could get her a vaccine appointment. Nicole says he was told “just to be patient.”
The Daily Beast called the county health department to inquire. A spokesperson said the process was being held up by a “glitch” in a new computerized vaccine management program. She added that walk-ins were being accepted at one location and offered to arrange one for Nicole.
A short time later, Nicole contacted The Daily Beast.
“I just called [the spokesperson] and she said I could go Monday,” Nicole said.
So that light of hope will be back on for Nicole as she arrives at the holiday and continues on to the expected surge.
Call it the glitch that almost stole Christmas.