As a respiratory therapist, I am usually there for the patient’s last breath. It’s an honor to comfort a patient at this moment, but there has been so much of it during COVID.

September 12, 2021
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As a respiratory therapist, I am usually there for the patient’s last breath. It’s an honor to comfort a patient at this moment, but there has been so much of it during COVID.

As a respiratory therapist, I am usually there for the patient’s last breath. It’s an honor to comfort a patient at this moment, but there has been so much of it during COVID.

“I didn’t realize healthcare was something I wanted to do until I Googled careers at 18 and found respiratory therapy. It called to me. I moved to Mobile nine years ago to be a respiratory therapist at Mobile Infirmary. My career is so rewarding, and I love what I do, even during COVID.

My normal routine is to treat patients with low oxygen saturations, but COVID has massively increased our volume. I now see 20 to 30 patients during my shift and even more if we’re short-staffed. After dealing with COVID for almost a year, we were starting to get a grasp on things. Our numbers went down at the beginning of summer with very few COVID cases here. We thought we found a new normal. Then Delta hit our hospital, sickening a younger demographic than ever before. Delta patients deteriorate more quickly. Our main goal is to just make sure that they are vitally stable and comfortable, but stable vitals come before comfort. I wish people could just see, with their own eyes, the suffering this disease causes and how it destroys people.

In the past, our sickest and ventilated patients would take up the majority of our time. But now, a lot of our time is spent with our COVID patients on high-flow oxygen devices. We are in constant awareness of everything around us, from their vitals to changing the settings of the machines. The BiPAP machine is a hard stage for patients because it’s incredibly uncomfortable. Patients are wide awake with these machines on their faces, and they want to pull it off. We have to make sure that they remain still and keep their mask on to keep their oxygen up. Any small movement such as eating or talking to their family on the phone can cause desaturations that send them into severe respiratory distress. It’s so hard for patients because they’re alone, isolated and aware that everything depends on their oxygen levels.

COVID is a respiratory disease that becomes severe when the immune system can’t fight the infection and it moves to the lungs. X-rays show how much air is ventilating through the lungs and a cloudy X-ray means infection. Most COVID patients’ lungs are full of infection. That means breathing is difficult, and the blood isn’t getting the oxygen it needs. Deprived of oxygen from the blood, organs and tissues begin to die. That’s why breathing therapies forcing oxygen into the lungs are so important.

Normal oxygen levels are 90-100%. In a non-COVID patient, I would be concerned at any oxygen level less than 90%. With COVID, oxygen levels plummet to critical levels. Patients with COVID do not respond to oxygen therapy as quickly or as well.

As COVID progresses and patients need more and more oxygen, they aren’t able to eat or communicate with us like they did before and may not understand what’s happening. If their oxygen levels don’t improve, we discuss putting them on a ventilator and what they want for their long-term plan. The ventilator is the last life-saving device we have, and we do everything we can to avoid using it. When we put patients on the ventilator, we keep them sedated and completely still.

It’s heartbreaking to push patients past the point of futility where their bodies are just worn out. We know they won’t have any quality of life post-COVID. It’s also complicated when the family chooses to prolong a person’s life with a ventilator. They are hoping their loved one improves and comes off the ventilator, but they aren’t able to come in the room and see what we see. We always honor the family’s wishes and continue to take care of the patient for days, weeks and months. We do everything we can until we can’t do it anymore. We’ve had some people stay in the hospital for several months and have been liberated from the ventilator and we weaned down to minimal amounts of oxygen.

Sometimes a patient will plateau for weeks and weeks. They don’t get worse, but they don’t get better. They are stuck, unable to get off oxygen. We can’t send them home because we can’t provide that amount of oxygen at their home. Patients are bored and their behinds hurt from laying down all of this time. Depression hits and they just want to get out of bed. We have about a dozen patients at that stage right now.

As a respiratory therapist, I am usually there for the patient’s last breath. It’s an honor to comfort a patient at this moment, but there has been so much of it during COVID. I have held a lot of hands as they passed away. Sometimes I am squeezing the AMBU bag and pumping their last breaths by hand. We do all we can to help them pass with dignity. It’s overwhelming to watch someone die from COVID, but this time a lot of the patients are close to my age or a little older. It hurts to see their lives end so soon.

I’m proud to be in healthcare and fighting this war against COVID. It will always be a part of my career, and it has broadened my skills and knowledge and made me a better therapist. We have improved our treatments since the beginning of the pandemic, but the limits of what we can do against this virus are humbling. I have picked up a lot of extra shifts because the hospital is struggling with staff shortages. I feel guilty when I’m at home alone and not providing support at the hospital. We are a close team in the trenches and we lean on each other.

When COVID started, we were all humans against one common enemy, and we wanted a solution to help it end. We have the solution, but society is divided about the vaccine. The majority of our patients are unvaccinated, and it’s frustrating for healthcare workers that the terrible things we see are preventable. We do everything we can for our patients, but life could have been very different for them had they made a different choice. I’ve had some patients say they regret not getting the vaccine, or they ask for it on their deathbed. I’ve also had patients on their deathbed say the Coronavirus isn’t real and that all of this is made up.

COVID is devastating and heartbreaking, but I’m thankful that God has me right here where I am making a difference in people’s lives. I get to be their friend. I try to give them peace of mind that they can trust me to do everything possible for them with their best interests at heart.”

Kayla

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