Friday was a bittersweet first anniversary for the men and women who staff Methodist Jennie Edmundson Hospital. It was a year that saw heart-warming success and gut-wrenching failures.
It was just a year ago — April 2, 2020 — that Jennie Edmundson admitted its first COVID-19 patient. April 2 added a face to the hospital’s effort to battle the worldwide pandemic that was claiming a growing number of patients, but staff had been discussing how they would deal with the pandemic for weeks before the first patient arrived. Visitation to Methodist Health System hospitals had been ended March 17.
“We really started talking about COVID at the first of the year,” said Kyle Kreger, Jennie Edmundson’s unit director for critical care. “We felt as if COVID was looming large over us.
“We knew COVID patients would take a lot of care. We saw what was happening in China and in other countries,” Kreger said. “In the U.S., we saw what was happening in New York City. Hospitals were being inundated with patients who were very sick and dying within hours of reaching the hospital.
With COVID impacting every aspect of the hospital’s operation, Dr. Sumit Mukherjee, a pulmonologist who serves as medical director of Jennie’s critical care unit, pointed to the collaboration of hospital teams during the early planning.
“We learned how we work together as teams within our hospital, how well the hospitals within the Methodist Health System can collaborate in this type of a situation and how even competing health systems could work well together,” he said.
David Burd, who came to Jennie Edmundson in May as senior vice president of operations and who will become president and CEO in July, said when COVID hit, everything changed virtually overnight.
“The amount of change was extreme,” he said. “The virus caused us to rethink policies we’d had in place for years.”
Like Mukherjee, Burd said collaboration — within the hospital, between the hospitals in the Methodist Health System and with CHI Mercy Hospital — was essential.
“We compete, but when the chips are down, we collaborate,” he said. “We work problems, we find solutions.”
“For me, it was a very anxiety-ridden time — trying to manage the ICU and prepare for the virus,” Kreger, the critical care unit director, said. “My focus was on how we were going to care for our patients if our census would double or triple. There was no early guidance on treatment.”
With considerable media focus on the shortage of ventilators and personal protective equipment during the early days of the pandemic, Kreger said the health system kept up with the need for PPE and equipment.
“There were concerns, but problems never really materialized,” he said. “There was a tremendous effort across the board to maintain supplies. Masks and face shields were donated by the community.”
While ventilator shortages did not materialize locally, Mukherjee said those treating COVID patients were learning ways to minimize the use of ventilators, machines that Kreger said further raise anxiety levels for patients.
“We’re better at utilizing results from X-rays and labs to determine when to use a ventilator,” Mukherjee said, “but there is still more to learn about when we should put a patient on a ventilator.”
“We were making changes in how we care for COVID patients every week for months,” Kreger said. “That has slowed down.”
COVID was as emotionally draining for the staff. There were more patients, the patients were sicker and their hospital stays were longer, their mortality rate was higher and they were not allowed to have loved ones or friends visit them, Burd said.
Holly Whitney, who has worked as an inpatient occupational therapist at Jennie Edmundson for the past 15 years, pointed to a necessary change that came to light as a result of the pandemic. She said if patients are on ventilators, they will be weak when they come off, but COVID is crazy because it is so patient specific. Before the COVID outbreak, using 8 liters of oxygen per minute to help a patient during therapy was considered “a lot.” Now patients are getting as much as 40 liters per minute.
Whitney said the longer hospital stays and the policy prohibiting visitors resulted in hospital workers becoming more attached to patients.
“It’s hard because you get so attached,” she said. “Just a hug or a five-minute conversation can be so rewarding to them. They are so grateful to have someone come in the room when they can’t have a visitor. It was so sad to know how lonely they felt, but they were so grateful for attention.”
Amber Bristol Mausbach, who’s worked at Jennie Edmundson for the past four years as a respiratory therapist, said the biggest challenge she faced was having to deal with the fact that so many people were passing away from COVID.
Despite the fact that we were going “from fire to fire,” patients were staying in the hospital longer and there was plenty of time to get to know people, she said.
“They would hold your hand when they were afraid,” Mausbach said.
“Being in the trenches, you learn a lot about humanity,” she said. “There was great support for patients from the staff, and patients showed a great level of trust. Most people are such fighters. Patients tried to focus on surviving.”
“Before COVID, we weren’t recognized so much for our role at the hospital,” said Terry Bertacini, Jennie Edmundson’s lead cleaning technician. That changed with the pandemic. “The unity within the entire hospital staff has increased. Everybody looks out for each other. We’ve become a more tightly knit family.”
Cleaning has become increasingly detailed in the ongoing effort to stop the spread of COVID. For the environmental services workers, the importance of their work was hammered home last October by the COVID-related death of one of their team members.
“When you clean, you try to clean as if it were one of your family members in that room or going to be the next occupant of that room,” Bertacini said.
Bertacini said that he, like other staff members, found the high mortality rate of COVID patients bothersome.
“You feel for the patients,” he said. “They have no one to talk to or see. The ones who can talk, talk to you. You become more or less their lifeline. You feel heartbroken for them. When you need your family, you need your family.”
For hospital staff members, there were moments that occurred during the last year that will stick with them forever.
“I remember a couple that came in,” Mukherjee said. “She had gotten COVID, and he got it from her. He was on a vent, and his wife couldn’t see him. It was a powerful moment when she came out of quarantine and could look at her husband through the glass in the ICU. That was a sentinel event for me.”
Mausbach recalled a woman who was on a ventilator. “Her husband called every day,” she said. “We would put the phone on her shoulder, and he would just talk to her. She could not respond because of the ventilator, but she could hear him.”
Mukherjee, Kreger and Burd all pointed to the case of 44-year-old Morris Sandoval of Denison as a turning point. He had been transferred to Jennie Edmundson with worsening respiratory difficulties after five days in the hospital in Denison. He was on a ventilator for 21 days.
“I didn’t think he was going to make it,” Mukherjee said. “We were within hours of taking him off the vent.” But after receiving a tracheostomy, a hole in his windpipe to help him breathe, his oxygen levels began to improve; and he was eventually released from the hospital on July 3.
Kreger, too, pointed to the Sandoval case as a turning point.
“We had an ICU mortality rate that was the highest it’s ever been,” he said. “Sandoval’s case was a success, and those successes were what kept us going. This case was a proud moment for the unit and for the hospital.”
“For the longest time, he was the only success story we had,” Mausbach said. “We’re seeing more and more patients in a recovery mode. Morris (Sandoval) was our beacon of light.”
“Morris Sandoval was a serious case, but he motivated and inspired the staff,” Burd said. He was the victory we needed to see.”
“I hope we’ve learned enough in the last year to lessen the impact of the various COVID mutations,” Mukherjee said. “We now have options for vaccinations, and we can see light at the end of the tunnel.”