After 12 months of grinding work on the frontlines of the COVID-19 pandemic, there was a time this year when health care workers and executives thought they had put the worst behind them.
The first of the COVID-19 vaccines had rolled out nationally at the end of 2020, and by early spring they were available to most Arkansans. The number of infections and hospitalizations began falling, and doctors and nurses were optimistic that all those long, grueling days had not been in vain.
There were tears of joy, said Birch Wright, COO of Washington Regional Medical Center in Fayetteville.
Then the vaccine resistance set in and a variant spread, and COVID roared back with a vengeance. The surge led to thousands of daily infections in the summer, and Arkansas’ death toll was more than 7,600 as September drew to an end.
“I can tell you in this region, between 90 and 95% of the folks that are in the hospital have not been vaccinated,” Wright said. “Of course, physicians and nurses are going to do no harm and are going to take care of these patients, but it is frustrating. We’ve been working 12-hour days for 18 months and we’re tired.
“We want to go home and see our families; we want to go see our parents, our grandparents. We want to take our kids to the mall. A lot of that is not happening because we have to work so much to take care of these patients who are in the hospital.”
Dr. Steppe Mette of the University of Arkansas for Medical Sciences agreed with Wright that the second wave of infections has been the toughest on health care professionals. They expected a wave of hospitalizations and death, but to have so many after the vaccines became available has been hard to take.
“There was anticipation that the vaccine would be the final nail in the coffin of the pandemic, as it were,” said Mette, the CEO of UAMS Medical Center in Little Rock. “When we saw there was a significant reluctance to get vaccinated and there was recidivism in the behavior of wearing masks and then the delta wave came, that was really demoralizing. I’ve been in health care for more than 30 years, and I have never seen the degree of disappointment by health care workers in the public.
“The politics of this was just so acrid and health care workers were just disbelieving that this had happened. They worked really hard and did everything they could to get over the first and second waves and now they had to deal with a created problem of not being interested in protecting our society. It was really demoralizing.”
Fortunately for frontline health care workers, employers had tools readily available to help them cope.
Washington Regional, UAMS and Mercy Hospital all have EAPs — employee assistance programs — available for workers to call in for counseling or other help. At Mercy Hospital Fort Smith, one of the most effective stress reducers wasn’t formal counseling but something called Tea for the Soul.
The Rev. Paul Fetsko, a priest and vice president of mission at Mercy Hospital Fort Smith, said a group of chaplains would get a cart of hot tea and coffee and make the rounds of nursing stations. Rather than just drop off snacks and drinks in a break room, the chaplains would sit and share a drink with any nurse in need of a break and some face-to-face time.
“There was something different about having the tea and the coffee that made it more homey,” Fetsko said.
Wright said WRMC set up an employee disaster fund to help staff handle any hardship associated with the pandemic. The EAP set up a COVID fatigue relief kit with a resource center with articles and training pieces on distance learning for parents with children at home, remote worker support, safe travel tips and personal coaching.
“You can call and talk with these folks,” Wright said. “You can talk about COVID-19; you can talk about anxiety or any other stressors you have. The success rate that we have measured is over 98%. The really big picture is how the self-help resources and professional-personal coaching, counseling resources are available.”
Mette said that in addition to EAP counseling services, UAMS had mindfulness seminars and monthly wellness retreats for nurses. A popular innovation was the rejuvenation room, a room at the medical center that was converted to serve as a quiet oasis for workers to get away for a break. “It is heavily used,” Mette said. “It’s amazing what a wonderful resource that is.”
‘Sense of Helplessness’
Between Washington Regional and UAMS, the hospitals have 142 ICU beds available. Washington Regional is fuller than it has ever been, and the situation is similar at UAMS.
“We are always full but we are extra full,” Mette said.
The pandemic is directly and indirectly responsible for it. Many patients delayed going to the hospital in 2020 because of the pandemic but are finding that their health has deteriorated without preventive care early.
It’s another frustration for health care workers. “There was a delay in non-urgent care that actually created a lot more urgent care needs,” Mette said.
Fetsko said the grief of not being able to prevent death was hard on health care workers.
“There is a sense of helplessness,” Fetsko said. “Then you tack on the fact that there is a vaccine, and a lot of people aren’t taking advantage of the vaccine and now they are sick. It’s a struggle for nurses because they think, ‘Well, this is preventable.’”
There are the standard workforce shortages, which existed in the nursing industry before the pandemic, but those have worsened as some health care professionals have retired, while others have found work as contract or traveling nurses more lucrative.
“We sort of force people to take time off,” Mette said. “There are employees here in all jobs who will just never take a day off because they are so dedicated to their work. They don’t know how to take care of themselves and we have to remind them.”
Those who remain soldier on, Wright said. “We are still fighting it and we have a ways to go,” Wright said. “We see a light at the end of the tunnel. We don’t know what the next variant may bring. We really need everyone vaccinated. That is the way out.”