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Monday, Dec. 14, 2020

On the E.R. Front line


Pandemic has changed emergency care

The pace in the WK Bossier Health Center emergency department on this night is as hectic as a scene out of hospital dramas “ER” or “Grey’s Anatomy.”

Exam rooms and hallways are full. Folks wait to be triaged. This means nurses identify those with the most serious problems because, in an emergency department, they get priority care. Tonight, two will code.

In the midst of this are patients whose conditions are not lifethreatening – earaches, minor lacerations, broken bones. It’s a typical emergency department scenario.

And now it is magnified by a coronavirus, the cause of a worldwide pandemic. A steady influx of patients arrives for treatment. Staff in the emergency department often feel overwhelmed. They are taxed physically and mentally. Assessing and treating patients takes more time because there is a process for nurses to protect themselves. Often, they are understaffed, susceptible not only to the dangers of the virus itself but also to shortages, abrupt changes to family schedules and more.

“It’s busy when you get here, and it’s busy when you leave. It never slows down,” says Michael Dexter, RN, about emergency medicine during COVID-19. Dexter has worked for Willis-Knighton Health System for 13 years and is now an emergency department RN at WK Bossier.

Dexter recalls hearing about COVID-19 in the media in early 2020. “We didn’t know what to expect. Our fear in the early days was we didn’t know how bad it was or how bad it was going to get,” he says. “The whole world changed. We didn’t know if we were going to have an entire department of sick patients, if we were going to exceed capacity. We saw pictures of morgue trailers being set up. There was a lot of preparation and waiting to see what was going to happen here and when.”

On March 13, the United States declared a national emergency to combat the virus.

Since that time, Dexter and other frontline workers in the health system have faced an unprecedented volume of patients critically ill with COVID and those with milder cases. “We knew this could be bad, but I don’t think any of us thought this would last as long as it has,” Dexter says.

It is a relentless virus, he says. It attacks the lungs, forcing the body’s immune system to fight back as fluid builds, preventing oxygen from getting into the fluid-filled lungs, causing organs to shut down.

“In the past, we might use high-flow oxygen occasionally, once or twice a month,” he says. “Now, we often call for more units because we use it so frequently.” When a patient’s oxygen level is low and dropping, high-flow pressurized oxygen is pumped into the lungs through tubes in the nose.

“There are still a lot of unknown factors with COVID-19,” Dexter acknowledges.

One thing is certain, though. The pandemic has changed him. He has a desire to understand disease processes better and has a more directed focus on community health and how we all have a role in the health of our community.

“In the beginning with COVID, people of all walks of life were thanking frontline workers for all they were doing, and they rallied around us,” he says. “Slowly, as people are tiring of this virus, that unity with frontline workers has changed.”

“We are still here,” Dexter says. “We are all tired of this virus, but until this is over or contained, we will continue to work hard for our patients and our community. While there are still some who feel this virus isn’t real, those of us on the frontlines have seen the very real impact it can have. We need to work together, and all do our part to protect ourselves, our families and our communities.”

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