An Ever-Changing Environment: COVID-19 and Health Care

By: Erin Berge

Wearing an N95 mask, face shield, gown, gloves, and booties, Speech-Language Pathologist Emily Lindeman only had 15 minutes to see her patient.

“I need to get out of here as soon as possible, but I need to see this guy eat,” said Lindeman.

With new COVID-19 guidelines, Lindeman needed to make sure her patient could swallow after a brain injury, while also limiting her exposure time.

“I just remember that panic with COVID-19, and trying to get done as soon as I possibly can,” said Lindeman.

After a year of adapting to rules and guidelines from the Center for Disease Control (CDC), health care workers are seeing a new work environment in the health care industry. Personal protective equipment (PPE) standards have added to workloads, increasing patient numbers has created burnout, and these changes aren’t going away anytime soon.

“All aspects of my shift and my day-to-day have been affected,” said Registered Nurse Tori DePrey.

Working in a COVID-19 intensive care unit, DePrey says putting on PPE adds an extra 50 seconds of preparation. Having to put it on and take it off 40 times a day adds up.

Not only does it take time, but it can also interfere with patient care. Lindeman provides swallowing exercises and has to demonstrate sounds for her patients, which is difficult while wearing a mask.

“You do have to stop and think everyday […], and it slows you down a little bit,” said Lindeman.

PPE has become a new norm, along with limiting family visits to patients. According to Registered Nurse Christina Berge who works in a cancer unit, family member visits are emotionally important for cancer patients. Since COVID-19, only one designated family member has been allowed to visit.

“I think in the beginning it was easy to justify everything we were doing, but now people are tired and they don’t want to do it anymore,” said Berge. “Their days are limited, so for me it’s really hard to see patients get stuck in a hospital and not be able to see their loved ones.”

Emotional toll on health care workers

New rules and guidelines mean health care workers must adapt quickly, and take on more in their workload.

Nurse Practitioner for Urgent Care Lisa Berge said she would typically see 30-40 patients before COVID-19, and in the thick of the virus, saw 90-110 patients in her shift.

“It’s very fast pace, very stressful, [and] you can see the burnout in some people. They can get overwhelmed and then you’re down some staff members,” said Berge. 

With the extra case load, Berge says it’s all about time management.

“I’ll say okay, I got to manage my time here,” said Berge. “They have to stay in the room for 15 minutes to get results, that gives me 15 minutes to get a procedure done and pop my head out of there again.”

Even with time management, the burnout among health care workers is still increasing. According to Lindeman, not being able to socialize after work is causing extra stress.

“Maybe just like anyone, there is the combination of burnout at work and at home. You’re not getting that break as much to do real life stuff, [and] that combination that everyone is experiencing, that’s been hard,” said Lindeman.

With the COVID-19 guidelines, hospitals have removed simple luxuries like potlucks for nurses. According to DePrey, “nurses are big on potlucks.” And the emotional burden health care workers must take on is causing burnout, too.

“I think holding patients hands while they’re passing and then having to leave the room to tell the wife, or the son, or the husband that they passed away at this time. [Saying] this song was playing, I know you requested this music, [and] I’m very honored that I got to be a part of their passing. That has been really hard,” said DePrey.

For Christina Berge, she cannot watch the news that covers COVID-19 stories. While she was eager to volunteer to help at the beginning of the pandemic, not having a break from work has taken a toll.

“People don’t want to be obsessed with work all the time,” said Berge. “I’ve always wanted to do oncology, but we definitely never expected to sign up for this because this is not what hospitals look like, and hopefully they will never look like this again.”

Looking to the future for hospitals

Temperature checks at the door, designated visitors, and distanced procedures are changes we now see in hospitals.

According to Lisa Berge, hospitals could continue to look different in our future post-COVID-19.

“I don’t think we’re ever going to have hospitals open to people walking in. [We’ll ask] who are you coming to visit? And limit who is going to visit, limit to one parent, no other family members,” said Berge. “Urgent care is going to be similar.”

COVID-19 may have changed the precautions we take in the future when dealing with patients, but also may have changed how nurses look at their care.

“For me, [I’m] a lot more conscientious of wanting to get to know my patients of who they are outside of their ventilator,” said DePrey. “Now I really take the time to at least call my patients family members once a shift and ask them what their night-time routine looks like, [and] what they want to watch on TV. Because you are caring for them in the most intimate way, but you don’t know who they are.”

For her cancer patients, Berge calls family member’s frequently.

“I just let them know, ‘if you need me to, let me talk to [your] family. You guys can’t even be here right now, so call me as much as you need,’” said Berge.

DePrey hopes that nurses will play a more integral role in board rooms moving forward, giving a voice for patients from a bedside nurse perspective.

“The pandemic helped shine a spotlight on the role of the bedside nurse, and how much influence we have on the decisions of the patient,” said DePrey.

Along with the increased respect for health care workers during COVID-19, DePrey says she has greater respect for her coworkers as well.

“This wouldn’t have been possible without an amazing team around you. It’s really a moment where we can all look at each other and say, we got through that.”

Erin Berge has a personal relationship with each interviewee for this story.