It’s still here: That’s the main message that four nurses in the Cortez and Durango areas wanted to share with the community about COVID-19.
The arrival of the COVID-19 vaccine has helped communities shift into a new phase of the pandemic: an increasing sense of normalcy with loosening restrictions and fewer masks on the street. The virus, however, is still circulating, people are coming into hospitals with severe cases and community members still need to take care of each other, the nurses said.
“There’s still a lot of COVID in our community,” said Raiha Paewai, a nurse in the intensive care unit and emergency room at Southwest Memorial Hospital in Cortez. “I don’t know if the community realizes that.”
The daily number of new positive cases peaked in November for La Plata County residents and about a month or two later in Montezuma County, then dropped significantly. The numbers are low, but new cases are steadily appearing, according to health department data.
In total, Montezuma County has seen 2,028 cases and 14 deaths during the pandemic.
La Plata County county has had 4,124 total cases with 41 deaths among the cases during the pandemic, as of Friday.
Nurses’ days start with COVID-19 symptom screening and changing into hospital scrubs. They end with showers and decontamination procedures before seeing their loved ones.
Nurses get close to their patients. They spend their 12-hour shifts checking on patients – sometimes every hour – helping them to the bathroom, giving medications and sharing information with families.
“We may not be a family member, but we get incredibly attached to people in a short amount of time,” said Leigh Morris, a nurse on the transitional care team at Mercy Regional Medical Center. “It is always hard to watch someone suffer. When someone can not breathe, they’re terrified and they’re suffering. I wish we had less of those memories.”
Nurses, like other health care professionals, have worked at the center of a health crisis for months, in small communities where some people thought the novel coronavirus was a hoax and others wanted as many protective measures as possible.
Three of the four nurses interviewed by The Durango Herald were eager to get their vaccine when the time came. Lauren “Ren” Smith, a nurse at Southwest Memorial Hospital, had not received the vaccine because she already had COVID-19 and has some natural immunity.
Paewai estimated there were three or four patients with COVID-19 in the hospital during her shift at the end of May.
Morris said she has at least one patient with COVID-19 every week. Mark Ritchey, a nurse in Mercy’s ICU, has treated COVID-19 patients of all ages, from the 20s to the 80s.
“We’re still living the pandemic on a daily basis. I’m taking care of COVID patients today,” Ritchey said in mid-May. “It’s not like it’s ended for us. Maybe burnout’s the wrong word, but for us there’s no end in sight. That’s the frustrating part. It’s mentally fatiguing.”
Ritchey, 51, spends his shifts at Mercy in a “hot zone,” where COVID-19 patients are located. In the beginning, he said, there was a lot of fear.
“We didn’t know what PPE (personal protective equipment) was really going to protect us,” he said. “In my mind, there was a very real possibility that I could get sick and die from this.”
They rationed equipment because of shortages occurring nationwide. Gradually, more equipment became available and then COVID-19 vaccines. It was a huge relief, he said.
“I wish (the community) realized how sick people get. I’ve been a nurse for over 20 years, and this is the sickest I’ve seen people get in my life,” Ritchey said. “I’ve seen H1N1 and other bad respiratory illnesses, and there’s no comparison.”
Patients become profoundly debilitated, he said. Some people can be sedated and breathing with the help of a ventilator for a month. They’re so weak, they can’t lift their arms.
Ritchey and others on the ICU team began keeping daily journals for COVID-19 patients. The long hospitalization, delirium and confusion could lead to post-traumatic stress disorder.
Nurses would write words of encouragement or comments about their families. Others, like Ritchey, would note a timeline of clinical procedures and medical care.
For Ritchey, sitting down to write the patient journal at the end of a shift was a way to decompress.
“It was very meaningful to see with different families – how people would send giant poster boards with pictures – you could just feel the love and caring about these people,” Ritchey said. “We couldn’t have that personal interaction with a lot of them because they were so sick you couldn’t.”
For a year, Paewai, 61, lived in a garage in an attached studio. She spent time with her husband outside on their veranda, but always at a distance.
At work she felt like she was in a bubble: Hot, heavy, full-bodied personal protective equipment, like medical gowns, masks and face shields, left her feeling separated from her patients.
“To walk into that room for the first time with a patient who you knew had a deadly infection was very scary,” said Paewai, who has been a nurse for 38 years.
She remembered patients at Southwest Memorial Hospital who had COVID-19 and did well for weeks before relapsing, some seriously enough to be transferred to another hospital for more intense medical care. Or people suddenly improved, she said, recalling one person who went from being delirious for days to suddenly being fully alert.
Other patients did not want to use the care and protective measures available to them, like COVID-19 vaccines and face masks, which have been politicized during the pandemic.
“There are people that live a lifestyle that’s been researched and known to be deleterious to their health, and that’s their right,” Paewai said. The mentality is, “Alcohol and meth won’t hurt me, but the vaccine will.”
Her job, Paewai said, is to try to help community members understand their options.
“That’s all you can do,” she said. “Give them info, take care of them, show them you’re caring and compassionate. At the end of the day, you hope they go home and think, ‘maybe they’re right and I should try to do something differently.’”
Smith, 30, started her first job as a nurse amid the pandemic in 2020.
“It made me nervous. It’s already a challenging profession to start off in. The learning curve was huge,” Smith said. “Knowing this big scary thing was out there was intimidating.”
She worked in the labor and delivery unit at Southwest Memorial Hospital while picking up shifts in the medical/surgical unit to help with COVID-19 patients.
One patient denied any possible contact with COVID-19. The medical staff members, wearing personal protective equipment as a precaution, cared for her for multiple days before finding out that multiple family members were sick.
“There was this shame and guilt that goes along with being COVID-positive,” Smith said. “Some of the time, I feel like, people were afraid to own up to being symptomatic.”
She said there was a “blame game” that happened with COVID-19, part of the wider mental health impacts of the pandemic. Relationships could get awkward or tense, Smith said, particularly when political views got involved.
Her hope: That the community could return to a level of trust in each other.
“This virus can get very personal in a small community,” Smith said. “I hope we can learn to smile at each other again, without the need for masking up and being afraid of each other.”
On the transitional care team at Mercy, Morris, 53, cares for patients who are not sick enough for the ICU but are too sick for regular care.
“I’m working in the ICU today, and there’s quite a few (COVID patients) in there now, and one of them is mine. I remember days when the whole unit was full of COVID patients,” Morris said at the end of May.
For a while, the hospital was where she felt most safe. She knew everyone would be wearing protective equipment and taking the pandemic seriously – that the staff members took care of each other.
“It’s kind of like war. You don’t want to leave your buddy,” Morris said.
When people come out of the ICU, her job is to help them rehabilitate, lifting people up both physically and mentally as they recover from the debilitating illness.
“Anytime you are holding someone as they’re dying and they can’t breathe – that sticks out to you,” she said. “And to not necessarily have access to their family – that should not be anybody’s experience.”
The experience, Morris said, has taught her not to let little issues “fester.”
“One of the things that I’ve learned in this pandemic is that today is all you have,” Morris said. “It has made me more conscious of making sure everyone knows I love them.”
She dreams of a time with no overtime hours, when she will have energy left to invest in her family instead of being drained by five or six 12-hour shifts in a row.
She hopes the community will “come together and protect one another.”
“It is still here. And we are so interconnected, more so than we know,” Morris said. “Little actions of hand-washing and masks – those actions matter to people. ... Sometimes, we’ll see people on the street and think of them as a healthy person. That’s not always the case.”
smullane@durangoherald.com
