Woeful in Wise: ICU nurse -‘You’re the last person sometimes that patient has spoken to’

Local Coronavirus Coverage

Editor’s note: This is the fourth in a series of stories on COVID-19’s current impact in Southwest Virginia. The delta variant has produced case rates double those in the state as a whole, with even more disproportionate death rates. News Channel spent a day in Wise County. We spoke to half a dozen people — from an ICU nurse to a small business owner, an elected attorney to a respiratory therapist. We gained a firsthand look at life in an area where, as one local business owner whose mother died of COVID last year, put it, “a lot of people … will wear a gun in Walmart to protect you from a robber but they won’t get a vaccine to protect the community from the virus.”

NORTON, Va. (WJHL) – Lori Looney feels like she’s working in a war zone sometimes — and when the ICU nurse leaves that zone for ‘civilian life,’ she has to listen to some of her own community members deny there’s even a war on.

Looney’s seeing death and suffering mount at Norton Community Hospital, where Ballad Health established a COVID-19 unit this spring, a few months before the delta variant surge took hold.

“Our COVID beds are staying full our ICU COVID beds, especially,” Looney told News Channel 11 during a brief break outside the hospital.

RN Lori Looney oversees Norton Community Hospital’s ICU.

“And right now, most of the patients we have are on ventilators that have COVID. And we’re not having great outcomes.”

A registered nurse and director of patient care services at Norton’s ICU, Looney said she’s grateful not to have experienced firsthand treating patients in the winter surge. Ballad’s Wise County COVID units were at Lonesome Pine Hospital in nearby Big Stone Gap back then.

That changed this spring for Looney and her team. She said they’re seeing COVID patients who are “sicker than ever” and whose status can fluctuate dramatically in a short period.

“These patients will come in on room air on no oxygen and (then) be on the vent requiring 100% sometimes in minutes, it changes,” Looney said.

“So we’re constantly in these rooms, adjusting, transferring from med-surg to ICU and vice versa, so it has been a very stressful time.”

Among Virginia’s 95 counties, Wise County has one of the 10 highest COVID death rates per 100,000 population over the course of the pandemic. Its rate of 321 is more than double Virginia’s rate of 153 and more than 50% above the national rate of 212 deaths per 100,000.

“My ICU nurses have had such a hard time and my med-surg nurses — everybody’s experiencing it, even the ER,” Looney said.

Southwest Virginia’s population-adjusted COVID-19 death rate has been nearly quadruple Virginia’s over the past week — and triple the rate since Sept. 1.

“But it’s very hard, being especially that we’re limiting visitors and … you’re the last person sometimes that that patient has spoken to. So it’s very hard and then having to deliver the news to the family. It’s been really awful for lack of a better way to put it.”

Frustration in the checkout line, fatigue on the floor

Now that she’s seeing it firsthand, Looney said some attitudes she encounters in the community are about more than she can take.

“There’s definitely a frustration a lot of times,” she said. “Even at Walmart you hear people say that it’s a hoax or it’s not truly as bad as it is and I can tell you it’s worse, from being in it.”

Meanwhile, in 12-hour shift after 12-hour shift, the nurses’ tress comes on two fronts. One is sheer workload.

“My ICU nurses at one time have two to three patients depending and we’re truly just going from room to room,” Looney said. “It’s almost like a war zone with the limited resources that we have and doing our best for these patients.”

Their best often doesn’t avail, Looney said.

“This is the first time that we’ve had to do this but I can say from experience and talking to people that have had these patients before that this … new wave is the sickest we’ve seen.

These patients will come in on room air on no oxygen and be on the vent requiring 100%, sometimes in minutes, it changes. So we’re constantly in these rooms, adjusting, transferring from med-surg to ICU and vice versa so it has been a very stressful time.

“We have all the resources, we’re doing all the treatments that anybody else, that any other facility would do, and it’s just, it’s not working.”

She said the poor outcomes are very difficult from a professional standpoint.

“That’s hard as a nurse because you want to help people and you go to school to be a nurse to help people — and we’re doing everything we can, but … the prognosis is so poor.”

The emotional strain makes it worse, as the staff work in a locked down environment with strict limits on patient-family interaction.

“The multiple layers of PPE and trying to talk on the phone — we have really nice windows in our ICU, so a lot of the patients will direct … their family members to the window and you can kind of see that way,” Looney said. “But even then it’s, the touch is missing.”

The outside of a window at Norton Community Hospital’s ICU — which is often the only place people can see loved ones who are in the COVID ICU.

And while those families wait, hope and pray from afar, Looney and her colleagues fill emotional roles even as they’re carrying out clinical ones.

“Like I said these patients just so quickly their status can change, and we’re having to make phone calls and tell the family that,” she said. “And they don’t understand why, just a few minutes ago their mother or father was talking to them, and now they’re not able to.”

She said staff can’t help but get attached to the patients.

“They’re here three weeks or four weeks at the worst of the illness, so it’s very hard emotionally just because you spend so much time with these patients and you build relationships with their families. So that’s very difficult when you lose a patient or when you see a patient not progressing like you would like for them to.”

All she and her colleagues can do, Looney said, is bear up, relying on each other and the emotional assistance program Ballad offers.

“It’s been very tough. We had a 49-year-old (die) on Friday and it was tough for the whole team, because that’s just way too young.

“We have the resources and stuff for our staff and we talk to one another and vent about it, but it’s just really difficult. There’s nothing that you can really do to prepare yourself for that.”

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