AMSTERDAM — Candice Hayes was in the thick of the first COVID-19 surge at St. Mary’s Healthcare, and now she’s in the middle of a second.
The intensive care unit nurse said neither influx of patients has been easier to manage than the other — the surge of patients in early spring came before there were good treatments for COVID, while the onslaught in late autumn brought much larger numbers of patients.
“It’s pretty chaotic, but a controlled chaos,” Hayes said during a break on the morning of Dec. 18.
There are better treatments now, but the problem is that the disease and its impact on its victims remain unpredictable. A COVID patient who has been stable all along can take a sudden turn for the worse, and a patient who has been critically ill can suddenly stabilize.
Hayes said one or the other often happens during her workday, and sometimes both.
The mission is to halt and reverse the slide of the patients who are getting worse, and to boost the recovery of patients who are getting better.
COVID-19 is known for its flulike symptoms — fever, cough, shortness of breath, fatigue — but the danger goes far beyond the respiratory tract, Hayes said.
“We’re kind of keeping a close eye on all of their body systems,” she said. “We’re finding kidneys start to shut down, liver and heart enzymes start to go up.”
A quick check of these functions can flag a likely COVID infection in a patient who hasn’t been tested or whose test results are not yet available, and they can be treated accordingly. The same check can also give warning of complications in patients known to be COVID-positive.
The lifelong Amsterdam resident is 36 years old and married with two sons, ages 7 and 12. She has been a nurse nine years, all of them at St. Mary’s.
She typically works with at least three or four other medical professionals in the ICU, with colleagues in other units available to help on short notice. During the springtime surge, a palliative care nurse practitioner, a wound-care nurse and assorted nursing supervisors repeatedly left their normal stations to work in the ICU.
“There have been days when they just stayed in there all day,” Hayes recalled.
Beyond their medical needs, COVID patients in the ICU have emotional needs that the nurses do their best to meet.
“The ones that are not intubated, most of them are very scared,” she said. (Intubated patients are sedated to unconsciousness so as not to gag on the tube down their throat that’s pumping oxygen into their lungs.)
Hayes recalls a woman barely out of her teens who was visibly frightened and frequently crying.
“Her mother couldn’t come to see her. She was hugging me,” she said.
That young woman recovered and was discharged, as were 69 other COVID patients at St. Mary’s through Dec 18.
But seven did not recover.
Hayes said the first COVID death at the hospital had a powerful emotional impact on the ICU staff, and employees of other departments came to offer comfort.
“We had literally everyone there to support us,” Hayes said. “It was amazing the teamwork we’ve had through this whole thing.”
Through all the precautions and limitations on everyday life in America circa 2020, and all the illness running rampant despite these restrictions, those who care for the sick and dying in this crisis are being labeled what they’ve always been to some degree — heroes.
In a 30-minute interview, Hayes doesn’t speak the word once. But her life since March has been dotted with the sacrifices that heroes make, nowhere more than at home.
“I try to keep distance from my children,” Hayes said, which of course is hard on all.
She wears at least a mask at all times in the hospital, and often a respirator, so she’s not overly worried about bringing COVID home.
It’s just as possible that someone close to her will get infected through community spread, like the aunt who fortunately suffered no symptoms.
Still, her husband and sons worry she’ll get sick at the hospital.
“We know that there’s that possibility,” Hayes said.
“I know my children aren’t very happy that I’m taking care of patients,” she added.
Her husband told her she could stop working and she replied that she couldn’t. “I love my job. I love my patients. I can’t just abandon it,” Hayes explained.
So she has stayed on in the ICU, through the challenges of the first wave, when there wasn’t an established treatment protocol, to the challenges of the second wave, when there are better treatments but more people to be treated.
“I always have to have hope … that eventually this will get better,” Hayes said, looking forward to widespread vaccination.
That’s when she’ll take a pause.
“I do look at Disney World a lot,” she said. “But it probably will be a while before I feel comfortable going there.”