As an infectious disease specialist for Cottage Health, Dr. Lynn Fitzgibbons is no stranger to witnessing suffering and death. But nothing, she said, could have prepared her for what she saw during the darkest days of the COVID-19 pandemic.
“I don’t think you ever get used to seeing your patients suffering,” Fitzgibbons told the Sun. “What happened during the last year and a half has taken that to a very different magnitude, a very different level of intensity.”
In Santa Barbara County, Fitzgibbons quickly became a prominent voice in communicating what was happening with the virus. The Public Health Department frequently invited her to speak at press conferences to share what the medical community was learning about this new disease.
But what Fitzgibbons doesn’t speak about as frequently is her personal experience of treating patients during the winter surge, when she became the attending physician for a team of doctors who were caring for the sudden overflow of COVID-19 patients. She worked seven days a week for more than three months straight.
“This last winter was by far the most difficult thing I’ve ever been through professionally,” she said. “I think that maintaining balance during those darkest days was very, very difficult.”
As the world began to reopen in the spring, bringing some normalcy back to average people’s lives, health care workers everywhere were still stuck processing the horrors they endured and the trauma they now live with. And as the number of hospitalized patients is ticking back up, Central Coast health care workers are preparing to do it all over again. Nurses and doctors say getting through it requires leaning on mental health resources—and each other.
Unprecedented isolation
Something that distinguished caring for patients during the pandemic from the past was hospital visitation being largely curtailed. Health care workers not only treated their patients, but also offered company in the absence of family and friends.
“There was a period of time where family members weren’t allowed in,” said Melissa deBacker, MSN, Lompoc Valley Medical Center chief of quality improvement, risk management, and infection prevention. “So the nurses and our case managers as well had to do what they could to be that liaison, to keep family members informed, and it was really difficult. It was very difficult on our physicians.”
In the thick of the winter surge, Fitzgibbons said her team of internal medicine residents devoted time to sitting with patients, holding their hands.
“In place of their vacation and their elective time, [they] were spending just those extra few minutes sitting down with patients and being their company,” she said.
French Hospital in San Luis Obispo telemetry nurse Tamara Astorga said it was hard to see her patients be so secluded.
“In order to support people, you have to put them on so much oxygen. It’s hard to breathe, you can hardly talk,” she said. “And the other thing is that we have to isolate those people. They’re just alone in a room. There was a striking loneliness to the isolation of it.”
Also striking was the length of COVID-19 patients’ stays.
“The more difficult ones were the cases where a patient perhaps didn’t very quickly deteriorate, but rather worsened over a small number of weeks, and ultimately didn’t leave the hospital,” Fitzgibbons said. “Those cases, I think, I will never forget.”
Brittany Martinez, an ICU nurse at French Hospital, said “relentless” is the word that best sums up her experience.
“Typically I think that we are able to get through traumatic experiences in the ICU because there’s usually an ebb and flow,” she said. “We have periods that are hard, but then periods that have a lot more success stories and people do better. … But I think throughout the course of the year it sort of slowly built up.”
The winter surge months were the hardest for Martinez.
“A lot of COVID patients, when they get sick, they are with us for months at a time,” she said. “But when you’re critically ill like that, the issues sort of compound, they pile on top of each other, until eventually the person you’re looking at is sort of a shell of who they once were. … It was very defeating, and I felt very helpless.”
For Dr. Alicia Gonzalez, medical director of Marian Regional Medical Center’s Emergency Department, one of the hardest parts of COVID-19 is not being able to escape work outside of the hospital.
“It was so much more than just seeing sick people,” she said. “It was arguments about masking or vaccination or ‘is this even real?’ And I think for our staff, the reality of having to see what we saw at work, and then leave the building into communities where maybe people questioned that it was real, or if we were telling the truth—that took a way bigger emotional toll on all of us.”
Prioritizing mental health
From June to September 2020, Mental Health America hosted a survey of health care workers to see how COVID-19 was affecting them.
“Ninety three percent of health care workers were experiencing stress, 86 percent reported experiencing anxiety, 77 percent reported frustration, 76 percent reported exhaustion and burnout, and 75 percent said they were overwhelmed,” the results said.
The majority of workers also reported feeling emotionally exhausted, having trouble sleeping, physical exhaustion, and work-related dread.
Because of the nature of health care workers’ jobs, hospitals already had a slew of mental health resources available to employees pre-pandemic. Lompoc Valley Medical Center, Cottage Health, and Dignity Health all have an employee assistance program and counseling options for staff. But what health care workers were experiencing with COVID-19 required more.
DeBacker leads the Lompoc Valley Medical Center Healing the Healers initiative, which stemmed from the hospital’s COVID-19 task force. The hospital invited a local licensed therapist who was available to talk with any employee who needed to. It was completely confidential and free to all staff.
DeBacker said, from her observations, health care workers leaned on these services more after the worst surge had ended, rather than in the thick of it.
“You don’t realize in the moment: Your adrenaline’s going, you’re doing what you need to do,” she said. “Later on, some of our staff started struggling with being able to sleep; started having scenarios repeating that upset them. It was later that people began understanding, ‘I might need to talk to somebody.’ That’s absolutely normal.”
It’s still here
As cases start to flare up again and hospitalizations increase, a lot of the trauma from the past year and a half is coming back to the surface for health care workers.
“You become burnt out, and it takes time to mentally and emotionally recover from that,” French Hospital ICU nurse Martinez said. “So I think now that cases are surging again, it’s definitely scary, but it’s also just disheartening. It’s hard not to just continue to feel like the burnout hasn’t really gone away.”
And with the vaccine widely available, nurses and doctors said it adds a new layer of frustration that people are still ending up in the ICU and dying when these outcomes are now largely preventable.
“It’s such a difficult debate because most of these people just want more information, but how long are you going to wait?” French hospital nurse Astorga said. “It’s an interesting stretch in compassion that we hadn’t really had to deal with prior to COVID either.”
But at the end of the day, Astorga continued, being a health care worker is about staying neutral and doing everything you can to care for the human in front of you.
Dr. Fitzgibbons said this mindset is crucial to getting through it all, day after day.
“A sick patient is a sick patient, and we’re tasked to provide care,” she said. “The job is caring for the person in front of us, while in parallel, making sure that we do whatever we can to prevent that next sick patient from coming in next week. … At the end of the day, no one deserves to have this disease.”
Reach Staff Writer Malea Martin at mmartin@santamariasun.com.
This article appears in Aug 26 – Sep 2, 2021.