I have written four other stories about how COVID-19 has changed the American way of life, most likely forever. I am aware of the toll the virus is taking on health care workers, doctors, and nurses all over America, but the focus has been on how hospitals and nurses have been overwhelmed in the big cities. What about small towns such as ours with much smaller hospitals? I met with three nurses at our Muleshoe Area Medical Center who graciously shared their time and thoughts with me on this subject.
Kristen Benavidez is the Chief Nursing Officer at the hospital and has been a nurse for fourteen years. Lyndi Austin is an RN with three and a half years of experience. Blanca Cordero has been a medical assistant for seven years. Kristen led the group, but as I asked questions, the answers, concerns, and comments tumbled out of all three of them faster than I could write down their thoughts. I quit trying to keep up at times and found myself just listening to the situations they have to deal with on a daily basis, things those of us outside the hospital with no medical training or background don’t have a clue about, have never even considered.
I started with the obvious question, I guess: how has the pandemic affected them physically and mentally? Some days are worse than others, they told me, and yes, they get physically tired. But it’s the mental/emotional drain that is the worst and makes it hard to look forward to coming to work. They feel like they always have to be on guard about everything and don’t always have the answers. People get upset when they aren’t allowed to visit their sick family members; problems arise when needing to transfer patients; problems occur with how to handle the overload in this small hospital. They always have to deal with careless comments from people who don’t take the situation seriously or don’t really understand the severity of the problem. Nurses get yelled at a lot. Of course they want to help people; that’s why they went into nursing. Seeing people die hurts, and death happens right now more often than they want it to. All this tends to make them feel mentally defeated when they come to work. Something else that is mentally depressing is the effect all this has on their families and realizing the unanticipated long-term residual effects of the virus their patients have to contend with.
Kristen went on to say that of course big city hospitals have more cases and are overwhelmed by the sheer number of patients that Muleshoe doesn’t have, but Muleshoe doesn’t have the resources they have, and therein lies much of the problem. For example, big hospitals have several departments that patients can be transferred to when specific treatments are needed; MAMC does not and has to take care of patients where they are. It is simply a fact of life that smaller hospitals are not as well-equipped as larger hospitals that have more resources and money. Big hospitals tend to have more modern, state-of-the-art equipment that smaller facilities can afford, so they have to make do with what they have, which the staff has done here. Kristen said they have to MacGyver stuff all the time. (Google MacGyver if this is a foreign concept to you.) COVID patients tend to need ICU care one-on-one; here that is sometimes hard to do. MAMC has twelve COVID beds available and some days they are all full, so that puts a strain on nurses making the rounds as well.
The hospital building itself, being old, creates some problems. One example is that the building has no negative pressure rooms, a room with a recirculating air system that keeps air that might be infected with germs from circulating in the whole hospital-one of those issues that had to be MacGyvered-and the temperature settings are sometimes a problem as there are no individual thermostats to set. The hospital is either all cold or all warm. Kristen likened it to a married couple dealing with their home thermostats, which I could relate to!
When the staff goes home after their shift, the first thing they do is hit the shower and put that day’s clothes in the washing machine before they ever get to greet and interact with their family. Shoes are left in the garage. Fifty percent of the nursing staff has contracted the virus and had to quarantine. Originally if the staff had been exposed at home or elsewhere, they had to quarantine and couldn’t come to work. That has changed, and now after testing, if they are symptom-free and don’t test positive, staff can come back to work, continue to help their patients, and earn a salary to help support that family.
The general public wants solid answers; there are none. People use their own limited experience with the virus and draw their own conclusions without realizing everyone responds differently to treatments and don’t take into consideration the myriad inconsistencies of this disease which no one can predict.
I asked if they had lost nurses who just couldn’t deal with the crisis, and while the majority of MAMC’s nursing staff has remained steadfast, they are aware of nurses from other facilities who, because of the lack of resources and the stress brought on by the pandemic, chose an early retirement. MAMC does have emergency management agencies that send in nurses from other towns and state which helps fill the gaps, but they are temporary.
What about the controversy over wearing the masks? We all were wearing masks during this interview, so I couldn’t see their faces, but I suspect a wan smile appeared when I asked. They all agreed that masks are not a cure-all, but masks, along with the extra handwashing and social distancing do help. They don’t like wearing the masks, either, and of course are required to wear them, but they feel like it is something worth doing. Kristen said the theory is that if she wears a mask, it helps to protect me from getting the germs from her in the event that she is a carrier without realizing it. And that in turn helps stop the spread of the disease in general. They appreciate that the community is beginning to understand and abide by these guidelines.
I want to make something perfectly clear here: all of the comparisons to larger hospitals does not make MAMC an inferior hospital; it is a typical smaller hospital with fewer resources which makes it more difficult for the staff to achieve positive results. And they do save lives here. If anything, this crisis should remind the community how important a local hospital is. In 1984 the hospital was being badly run by a California chain which was run out of town, the hospital closed, and Bailey County went without a hospital for several years. That is a story in itself, but the short version is that by 1988 the hospital eventually reopened with the community responding to the need by showing up to paint, clean, rebuilt, provide financial aid, whatever it took to reopen the facility. Since Muleshoe is the only incorporated city in Bailey County that can even maintain a hospital, people all over the county and surrounding counties depend on it being here, whether they need to be treated here or provided with the option to be transferred to another hospital in a larger city for treatment. And that critical care makes all the difference in the outcome for the patient. These nurses were disappointed when the recent hospital district bond issue failed because it would have provided the financial resources to better equip the hospital to deal with the needs of the pandemic and medical care in general. Yes, the building is old, but no one is suggesting leveling it and starting over from scratch. In fact, when the required inspections are made, the hospital and staff get high marks and compliments for how they have handled the problems. Dedicated staff along with close interaction with Dr. Bruce Purdy across the street and all that MacGyvering make a huge difference.
Since April, the staff sits in on Zoom meetings, which have become the new normal, to learn about new drugs, treatments and issues that develop. Crying on the way to work has calmed down a bit, and day dreams about a Hawaiian vacation still crop up from time to time, but the nurses and staff continue and persevere. Staffs in small hospitals become a family and they support and take care of each other. They will continue to make do with what they have available. And they will help us get through this.
In the event you cross paths with these nurses, or any nurses, in lieu of giving them a hug, a kind word would speak volumes.
Thanks to Kristen Benavides, Lyndi Austin, and Blanca Cordero for their input for this story.
The other stories I wrote about the effects of the virus can also be found in this blog if you would like to read them. Type the title of the story in the Search line, click on Search, and the stories will come up. Then click on the story title.
A Coronavirus Story: Malina’s Masks, April 7, 2020
An Informal Coronavirus Survey, April 13, 2020
Coronavirus and Education, April 16, 2020
COVID Care Packages, August 7, 2020