Public health officials are nervous about the rapid rise in coronavirus cases in LA County over the last few months.Preventative measures are back in place, such as closing beauty salons, gyms, movie theaters, and indoor dining at restaurants.
But hospitals are still struggling to deal with the onslaught of patients suffering from COVID-19. In some places, every bed is full, and every ventilator is taken. Doctors, nurses, and custodial staff are working around the clock to ensure the welfare of patients.
KCRW talks with two nurses who have worked on the medical frontlines since the COVID-19 pandemic began. Erin McIntosh is a rapid response nurse at Riverside Community Hospital and a local union steward of SEIU 121. Roni Kosmal worked as a nurse at Pacifica Hospital. Her time there ended this week.
As a rapid response nurse, McIntosh says she works with some of the toughest COVID-19 cases.
“They are unexpected. They crash rather quickly. One minute they're talking, and the next minute, they're on life support. It's unlike anything that I've seen in my career. “
She says that despite the virus’ presence in California since January, the appropriate preparations were not in place. “Because of the lack of support, our nurses are just exhausted. And with this exhaustion comes bad outcomes. And that's where I come in. I'm the nurse that sees the worst of the worst.”
Her biggest concern is patient safety, and right now, there aren’t enough staff to care for patients.
“Nobody wants to feel like they're [not doing] a good job. And at the end of the day, all of us nurses are left feeling like we're not enough. It's causing burnout.”
McIntosh remembers one instance where she had four patients and had to “cluster their care.” That meant she had to bathe, feed, and provide medical care to each one. She also had to sit with each patient for at least an hour per shift.
“When you're in one patient's room for an hour, you're neglecting your other patients. If we had more support to check on those patients, then maybe they will find those subtle clues that nurses are well trained to pick up on that could prevent something like a patient not being able to breathe appropriately.”
In late June, McIntosh joined hundreds of nurses who striked for 10 days over staffing and unsafe working conditions. She protested because she thought her hospital would be a source of support as the pandemic worsened and would provide extra resources. She says nurses have gone 12 hours without breaks.
In response, Riverside Community Hospital issued a statement that says the institution has worked to avoid layoffs and has provided appropriate pay, even when some employees aren’t working. McIntosh says many of those benefits don’t impact the nursing staff, who are some of the workers hardest hit by the pandemic and low staffing numbers.
For Kosmal, who worked at Pacifica Hospital, the last few months have been a scramble. Before the pandemic, she worked for 15 years as an operating room nurse in plastic surgery, and was part of the first health care providers in her hospital’s COVID-19 ward.
She’s seen lots of coronavirus patients in March and April. Then a lull came when stay-at-home orders were enacted. The hospital was able to close a COVID unit and a COVID tent. But Kosmal says that’s changed.
“The past two weeks have been the worst I've ever seen it. I mean, we are at capacity plus. We are taking critical care patients into non-critical care units.”
Now as coronavirus cases rise, she’s frustrated with the greater community.
“The public isn't supporting us. … We're putting our lives on the line. We're exhausted. We're fighting every day to keep these patients alive, to get them out of the hospital. And meanwhile, people don't believe in wearing masks and they don't believe in staying home.”
Kosmal says the ICU at her hospital has turned into its own COVID-19 unit, as well as other spaces that aren’t meant to act as ICUs.
McIntosh worries about what will happen as the pandemic wanes on.
“I worry that maybe I'll be so exhausted, I'll take a wrong step, and it costs somebody's life. It's not like we're on a manufacturing line and we're putting together car parts. We're dealing with human life.”
She says community members who don’t follow public health orders are disrespecting the health care workers and patients fighting COVID-19.
“It's such a slap in the face to all of us health care workers that are already exhausted. … I've held human people's lives when they're passing, and there's nothing quite like it. These patients are dying, and they're dying alone. And nobody should have to go through that,” says McIntosh.