“I remember asking myself, ‘Is this what the frontline is going to be like?’” said Paul, an RN who works in our Emergency Department (ED). “I remember thinking that if there was more where this was coming from, it was going to be really bad on the frontline.”
While the term “frontline” has now become a staple in our pandemic vernacular, the word was reintroduced to the public vocabulary around the time when Paul and others in our ED encountered their first COVID-19 patient, Steve Soeffker. Read a letter from Steve to our President and CEO, Patty Henderson, MBA, BSN, where Steve reflects on the care he received at GRH during his difficult journey with COVID-19.
Steve was one of the first patients in McLeod County to be diagnosed with COVID-19, and this first experience treating and caring for a severely ill COVID patient was impactful for our staff.
“The biggest thing I think of, when I think about Steve, is how eerie it was – the way he was acting for his condition,” said Paul.
Although Steve’s oxygen levels were critically low, he was up and able to have a conversation with our team while in our ED, something a patient should not be able to do while deprived of so much oxygen. This alertness despite oxygen deprivation is now referred to as “happy hypoxia,” and is somewhat common in COVID-19 patients.
“Normally, if someone has severe respiratory problems or their oxygen levels drop, they become very restless, anxious, and panicky. They get this wide-eyed look,” said Paul. “That wasn’t the case with Steve.”
When your brain receives a signal that your oxygen levels are low, it sends your body into a fight-or-flight mode, in an attempt to get those levels back up.
“It’s like being held underwater,” said Paul. “If you were held underwater until your oxygen levels were in the 60s, which is blackout oxygen level, can you imagine how hard you’d be fighting to reach the surface? And here’s Steve, just chatting it up with me. Asking me where I’m from, and if I live in Glencoe.”
At first, staff attempted to re-check his oxygen levels, wanting to confirm that the equipment was not malfunctioning.
“We were swapping his fingers in the equipment to check his oxygen, and I remember looking at Dr. Palmer and saying, ‘I think those numbers are real,’” said Paul.
There is a chemical receptor in the aorta that senses the oxygen levels in the bloodstream. Because COVID-19 affects the nervous system, it can cause a short-circuit in the oxygen sensor – meaning a patient’s oxygen levels can be very low without them being aware of it.
“It was eerie,” Paul said. “Very eerie. We were all shell-shocked after Steve left. We were stunned.”
Our ED team did all that they could to improve Steve’s oxygenation – however, even intubation did not make much of an improvement for him, and chest x-rays confirmed that his condition was severe. The decision was then made to transport him to Abbott Northwestern Hospital. After leaving GRH, Steve spent 40 days in an ICU.
“Before we transported him, we were running nebulizers and intubated him – the whole works – so I felt like I was just covered in virus afterward,” said Paul.
After Steve was transported, Paul headed to the locker rooms to shower and change. Nurse anesthesiologist Logan Becker, DNP, APRN, CRNA, had also been caring for Steve, and was also headed to the locker rooms after Steve was transported.
“We just looked at each other and said, ‘That was bad, wasn’t it? That was really bad.’ We both thought there was no way Steve was going to make it,” said Paul. “I remember clearly remarking several times: ‘I think we just saw the future.’”
After hearing for weeks about COVID’s devastation in Italy and New York, the virus was finally at our doorstep.
“I remember thinking about that on the drive home, and thinking about it on my way back for that very next shift in the ED: ‘What’s it going to be like on the frontline today? Is this the start of the wave?’” said Paul.
Steve was discharged after his 40 days in the ICU, and shortly afterward, he was hospitalized at GRH with a pulmonary embolism, or blood clots in his lungs. These are a common side effect of COVID-19, even after the other respiratory effects have cleared up.
One morning while Steve was hospitalized with us, Paul was assisting our team on our hospital floor.
“I heard that Steve was here, and I really wanted to talk with him, but I wanted to be respectful of his space, so I was just at the ready if he ever hit his call light,” said Paul. “When he did, I made a beeline to help him out.”
After assisting Steve, Paul reintroduced himself as one of the nurses who had taken care of Steve during his initial visit to our ED. The two got to talking while Paul helped Steve with his medications for the morning.
“It was great to visit with him – it was a really special moment,” said Paul. “He had a lot of questions. There was this big blank spot in his memory, so he had a lot he wanted to ask me about. I could tell that filling in those gaps was really meaningful for him.”
Not only was the conversation meaningful for Steve, but it was meaningful for Paul.
“There are a lot of hard days in the ER, but that was one of those days where I drove home after my shift and thought, ‘It is so amazing that I get to do this job,’” said Paul. “Not every day through the pandemic has been like that, but experiences like getting to see Steve again offsets the difficult days. An experience like that makes it all worthwhile. Seeing Steve again was one of those special moments that doesn’t come along all the time.”
Steve has battled a difficult journey with COVID-19, but has retained a positive attitude, and is surrounded by support from our team.
