When she woke up in the ICU a couple years ago, Ashley Joffrion remembers being surrounded by her coworkers.
Joffrion is a respiratory therapist at Baton Rouge General. Her job is to care for patients having trouble breathing. Some of the sickest ones end up on ventilators.
But that day, Joffrion was the one on the ventilator. She had a severe episode of angioedema, which caused swelling in her airways and put her into respiratory distress.
She doesn’t remember much from her short time on the ventilator. Just bits and pieces. The feeling of the breathing tube in her throat. The faces of her fellow respiratory therapists and nurses, hovering over her before they removed the tube. The discomfort. The fear.
But those memories came flooding back this spring, when Joffrion’s patient load surged during the COVID-19 outbreak. It’s a story she now shares with her own patients, trying to comfort them before they’re placed on ventilators. I’ve been in your shoes before, she tells them.
“I was definitely not as sick as these patients are. But I can relate to them. I know what they’re going through when it is time to have to go on the ventilator,” she says. “I don’t want to tell them it’s just going to be OK. I want them to know the truth that it is not a comfortable feeling, but we’re going to get through it.”
Joffrion’s story is unique, but her fellow health care workers have been seeing similarly distressed patients the last couple of months. We interviewed staff at Baton Rouge General, Our Lady of the Lake, Ochsner Medical Center – Baton Rouge, and Woman’s Hospital about what they’ve seen as coronavirus cases reached their units.
They describe scared patients who don’t always understand what’s happening to them. When they do get better, coming off a ventilator is like waking up in a fog. At first, some might not even realize they were sick during a pandemic.
For medical workers, life is foggier, too. Their entire reality has changed, at work and at home.
Hospitals were restructured to create COVID-only units. ICU bed capacity was doubled, then tripled. Nurses who did not have ICU experience partnered with those who did, prepping for a new normal. Respiratory therapists tested new tactics to streamline care for patients on ventilators. Nurses and physician assistants developed clever ways to minimize exposure, such as keeping patients in one bed for the entirety of their visit and even stretching long IV wires outside the doors.
For most people in Baton Rouge, the coronavirus has felt like an invisible disease. Many of those who are infected are asymptomatic or only present mild symptoms.
But every day, hospital workers are seeing this virus at its absolute worst. Patients’ ages range from their 20s to 80s. Some have underlying conditions. Some don’t. Most take weeks to get better—if they get better. There have been sick parents in their 30s, whose young children have been unable to come say goodbye.
Rules restricting hospital visitors are constantly changing, but workers describe halls that felt like ghost towns in the beginning of the outbreak. Even as patient load rapidly increased, the hospitals got quieter. Waiting rooms were empty. Family members were only able to visit with loved ones through iPad screens. No more happy celebrations as babies were born, no families in the hallways to cheer when the sickest patients were discharged.
Every conversation has been happening through heavy layers of PPE. Coworkers have learned to communicate with their eyes, or even through shared feelings. And because they’re now giving care while wearing a mix of face shields, goggles, boot covers, impermeable gowns, gloves and masks, they can no longer just run into a room to help a patient.
“It looks like we’re just wearing some extra stuff in the pictures, but the process of putting on and taking it off adds so much time to the care,” says Nicole Allen, an Ochsner ICU nurse practitioner. “If there’s a major change, and we need to get into the room, you’re looking at two to three minutes. Which doesn’t seem that long, but in the ICU world, it really is.”
Pregnant moms are even wearing N95 masks for hours during labor, mirroring their PPE-clad nurses and doctors. It’s unbearably hot, but it’s necessary to protect every person in the room.
To safeguard their families, some hospital employees have been sleeping in hotels or isolated parts of their homes. They shower constantly. When those with young children finally see their kids, they describe a painful inner battle: “Is today a day I can do without a hug?”
But for a time of such high stress, hospital workers also describe an experience that’s been deeply rewarding. Every employee we interviewed emphasizes how impressed they have been with their hospital’s response. They talk about how proud they are to work there, and how they and their coworkers are working so, so hard for their patients. They all say they’re being provided with plenty of PPE, and their hospitals are doing everything possible to keep them safe. The hospitals, they say, were ready for this.
They’re grateful to the community for the outpouring of support, the flyovers and all the donated restaurant meals—lifesavers on days they can’t leave the COVID units to enter the regular cafeteria.
Finally, they all stress that even though they work with this virus daily, they don’t fully understand it. It’s a brand-new disease scientists and medical workers alike are still learning about.
Most say they feel more comfortable walking into their hospitals now than they did at the outbreak’s beginning. But they still never know what the new day will bring.
In the following pages, these workers share—in their own words— what the coronavirus has looked like in Baton Rouge hospitals. They tell stories of grief and triumph, and of managing the unexpected.
While we spoke with them collectively for hours, their interviews have been edited for clarity and brevity, representing just a small slice of what’s been happening during this pandemic.
And even as you read their words, stories like these continue to unfold every day in Baton Rouge—right this very minute—behind closed hospital doors.
This article was part of the June 2020 cover story of 225 Magazine.