'Every Week Our Numbers Are Doubling': An Arizona ICU Nurse On Treating COVID-19

Published: Monday, July 6, 2020 - 1:10pm
Updated: Tuesday, July 7, 2020 - 8:47am
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LAUREN GILGER: Arizona has passed another bleak milestone in the coronavirus pandemic today, surpassing 100,000 confirmed cases of COVID-19 in our state.

STEVE GOLDSTEIN: The state Department of Health Services reports another 3,352 new cases of COVID-19 today, bringing the number of in-state cases to 101,441. And to date, 1,810 Arizonans have died of COVID-related illness.

GILGER: And as those numbers rise, so does the number of those patients who end up in the intensive care unit (ICU). As of Sunday, 89% of ICU beds in the state were in use. So now let's turn to our co-host Mark Brodie and his conversation with Neva Farmer, an ICU nurse at a Valley hospital who works in the COVID ICU.

NENA FARMER: I would say that the biggest thing that we're seeing at work right now is that it's always changing, and we're seeing a very large increase in the number of patients. We've been dealing with this COVID since March. And in the beginning, we were really prepared for it to be a lot of patients, and it wasn't as many patients as we had initially thought. But now, in the last two weeks, I would say that our hospital is becoming completely — full capacity. I mean, every week our numbers are doubling.

MARK BRODIE: How is your hospital handling this? I mean, do you have space for all these people?

FARMER: We have space, but we are literally making new spaces every week.

BRODIE: And what about staffing? I mean, it's great to have extra beds, but you also need doctors and nurses to care for those patients. Is your staffing level OK?

FARMER: We're OK right now, but we have increased some of our patient ratios. And initially some of our patients, we were all considered one-to-ones for our ICU patients. And now we're two-to-one and one-to-one, depending on the severity of the case. But our patient load is increasing because our staff has not increased because everyone is having the same issues statewide for staffing.

BRODIE: Do you and your colleagues have the PPE that you need? Do you have the other supplies that you need right now?

FARMER: Yeah — I'm very thankful the hospital that I work for has been very supportive, and I would say kind of at the forefront of providing adequate PPE for us. So I'm very thankful in that I feel completely secure with the amount of PPE that we have. We are seeing somewhat of a shortage of supplies in general just because there are so many patients statewide.

BRODIE: What kind of condition are some of these COVID patients in when you get to them?

FARMER: Oh, wow. It depends. Some of them are extremely, extremely ill. Meaning as soon as they get to the ICU, we are starting numerous medications, life-saving medications, and they may or may not already be on a ventilator. And then if they're not on a ventilator, we're getting them on one very quickly. And then we see other COVID patients that are coming in with hardly any symptoms, but those — sometimes we have seen with COVID and depending on their additional comorbidities, we can see it progress pretty quickly. I would say the hardest part about COVID is that it's a very long recovery process, whether they come in extremely sick or not. Most of our patients are in the units for quite some time — a week, two weeks. Some of our ICU patients have been there four, five, six weeks.

BRODIE: Wow. That seems like a particularly long time.

FARMER: It is a very long time.

BRODIE: What is it like for you going to work knowing that this is what you're going to be doing and these are the kinds of patients you're going to be seeing? And it seems like the numbers aren't really stopping, that it's just more and more and more every single day.

FARMER: It's difficult. I love what I do. I take pride in what I do. But as a single parent, every time I go to work, I am concerned about bringing COVID home. Is my family going to be infected? I would say that every time I go to work, I do kind of expect it to be a tough shift as far as COVID goes, because we are the patient's only advocate. Their families aren't there. They aren't allowed to visit them. They can call. We can update them. But as far as providing their care and making sure they're getting everything they need, we are their person. And so sometimes that can be really taxing, emotionally and physically, just because of the high demand of that patient.

BRODIE: So I would imagine being an ICU nurse is never an easy job. You mentioned that you expect your shifts to be tough now. Are they tougher now? Like, is this more difficult to do both physically and emotionally than if such a thing as a standard day as an ICU nurse exists?

FARMER: Yeah, it's definitely more difficult than what we had before because the patients are very sick. But on top of them being very sick, we have a virus that we are battling that there's no cure for. Normally in the ICU, we have patients that come with cardiac arrest. They come with hypertension, they come with strokes. All those things. But we have medication that we know can reverse those disease processes, things that we do. With COVID, we don't have a cure yet. So we are giving them everything that we possibly can. And every patient is very different, depending on the comorbidities that they have — if they have diabetes, if they have heart disease, if they have kidney issues. We have to treat them very, very specifically, and a lot of them have multiple issues underlying the COVID.

BRODIE: When you think about the immediate future, knowing that the number of cases is not likely to start dropping, you know, in the next couple of weeks, what do you think about that? How does, like, what goes through your mind when you think about stuff like that?

FARMER: It's tough. It's hard to imagine. And it's worrisome for me as a nurse because I know that we are doing everything that we possibly can. And as nurses, my coworkers and I really are taking a lot of preventative measures, not only at work, but also at home, because we are seeing this first and forehand. So, you know, we all wear our masks everywhere we go, but we know that there are a lot of people that aren't doing that. We've seen a really large increase in patients in the 30 to 40 age group, which we had not seen that in the beginning. Most of the time in the beginning, it was a lot of the elderly population, but we're actually seeing that number decrease, and we're seeing younger individuals struggling with COVID now. So it's harder.

BRODIE: All right. That is Neva Farmer. She is an ICU nurse at a Valley hospital. Neva, nice to talk to you. Thank you for your work, and stay safe.

FARMER: Thank you. You too.

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