'We Don’t Want To Do It Again': Arizona ICU Nurses Describe Exhaustion Amid 3rd COVID-19 Wave
Inside the COVID-19 intensive care unit at the Valleywise Health Medical Center in central Phoenix, the nurse’s station is surrounded by 12 rooms. Behind each sealed glass door lies a patient, sedated and covered in tubes and wires.
“When we first get them we usually chemically paralyze them for the first couple of days, and then we’ll just heavily sedate them afterwards," nurse Jeremy Neagu explains.
Critically ill COVID-19 patients are entirely dependent on medical staff and they’re often hospitalized for weeks, Neagu says. "We have the tube in to feed them, we have medications to keep their blood pressure up that’s continuously running, we have the ventilator that’s breathing for them, then we have the Foley and Flexi to collect all of their feces and urine.”
A few months ago, this unit was empty. But things changed quickly this summer. Statewide, COVID-19 ICU bed use increased 300% throughout July and August. The surge of cases and hospitalizations is similar to what Arizona experienced in the summer of 2020 and in the first months of 2021. But amid this third wave, medical staff are feeling the exhaustion of a fight that’s lasted more than a year and a half. For some COVID-19 unit nurses, the last several weeks have felt like a recurring nightmare.
“We’re tired. We don’t want to do it again," says ICU nurse manager Sara Reynolds.
Frontline medical staff say this isn’t just another round of COVID-19 cases. The more aggressive delta variant of the virus is making patients deteriorate more quickly than patients did in prior waves, says nurse Ken Neal.
“Now, within a matter of days — bam bam bam — we’re turning it up, we’re switching them to a higher level, we’re putting them on BiPap, the next day we’re intubating them,” Neal says.
Not only that, but recent patients are younger than those who were hospitalized in earlier phases of the pandemic. Neagu says in Arizona’s first waves, the patients filling the ICU tended to be in their 70s or 80s.
“This wave is like, we had a 24-year-old die today," Neagu says. "We’ve had a couple of 30-year-olds, a couple of 40-year-olds, I mean it’s just crazy."
And there's something else Neagu says stands out to him about recent patients, "they’ve all been unvaccinated.”
Nine months after the first vaccines were administered in the state, less than half of Arizonans are fully vaccinated. The state's vaccination rate lags behind the national average by five percentage points. For Reynolds, that’s frustrating.
“This wave I feel like is hard," Reynolds says, stifling tears. "It’s hard because I feel like it can be prevented."
Among unvaccinated patients arriving to the hospital are some who are still skeptical about the disease, like one man who Neal helped treat recently.
“The first thing he said was, ‘where am I and what am I doing here?’" Neal says. When nurses told the man he was in the hospital with COVID-19, Neal says the man's reply was, "Oh, COVID isn’t real.”
Neal, Neagu, and Reynolds each say they want more Arizonans to get vaccinated and to continue to take the pandemic seriously. Reynolds says with mask requirements and business restrictions long gone in much of the state, she feels like health care workers have been left to fight the virus alone this time around.
“It’s like nobody cares anymore,” Reynolds says.
Reynolds admits, it’s hard to want to come into work these days. Nursing staff vacancies at hospitals statewide reflect that kind of strain. This hospital has been short more than 20 nurses per day recently, according to Valleywise Health chief clinical officer Dr. Michael White.
"Prior to [the pandemic] we would always have some days where we were short, but never in this double-digit range," White said in a recent call with reporters. "This is new for us."
Reynolds, whose nurse manager role involves recruitment, says the hospital is looking for temporary help from out-of-state.
"We’re just not getting very many regular applicants for just our standard positions,” Reynolds says.
That leaves staff like Neagu feeling stretched thin.
“They’ve been giving us bonuses to sign on extra here," Neagu says. "You just can’t keep up with just the flow of patients coming in.”
But after 18 months, it’s not just the number of patients coming into the ICU that’s taking an emotional toll on these nurses — it’s the number of patients who never get to go home.
Neagu looks at his watch and sighs, “We’ve already had two patients we’ve lost today, and it’s 1 o’clock."
COVID-19 has killed nearly 19,000 Arizonans. A certain amount of grief might be expected when you work in a hospital. But each of these nurses say they’ve never been through anything like this.
Neal says many go into this profession because they love to be able to help people, but with a virus this deadly, that’s often not possible.
“We want to be that nurse we were two years ago," Neal says.
He pulls a folded slip of paper out of the pocket of his scrubs. It’s a list of reminders he’s carried with him throughout the pandemic.
“I tell myself every day it’s not always about me, everything is not in my control, everything is not for me to fix personally," Neal says. The final part of his list brings him to tears. "And it’s not always my fault.”
Before the pandemic, in more than 20 years in the profession, Neal says he’d only ever had one of his patients die. Now, he’s lost count.