Nurses inside the Northern Light Eastern Maine Medical Center Credit: Courtesy of Northern Light Eastern Maine Medical Center
By Wanda Curtis

When Maine healthcare workers across the state began battling Covid-19 last year, the most difficult thing for many was working with the unknown. No one knew exactly how the virus would progress or which treatments would work. There was no FDA-approved drug available to treat the killer virus.

Northern Light Mercy Hospital nurse Jordynne Copp said it was unsettling to work with those unknowns. Copp is a registered nurse who works in the intensive care unit at the Portland hospital where many  Covid patients were treated during the past year. Cumberland county has reported some of the highest  Covid numbers throughout the pandemic.

“The Covid patients that we get in the intensive care unit are those who are experiencing respiratory distress/failure, which is a patient condition that we commonly treat in our unit,” said Copp. “The difference with the Covid patients in the beginning was the uncertainty of how their condition could change and what treatment would be beneficial for them. It was an unsettling feeling to have a condition in which we were unsure of what medication would be the most beneficial.”

According to Copp, when the pandemic first began, they saw many Covid patients who were extremely ill. She said it seemed like they always had at least one or two patients in their unit who required mechanical ventilation because the virus had affected their lungs. She said that after the initial rush, things slowed down some.

“In the ICU the most common care that we provide for our Covid patients is respiratory support,” said Copp. “These patients require high amounts of oxygen via a special type of nasal cannula or mechanical ventilation. There were multiple patients that developed acute respiratory distress syndrome (ARDS)… In addition to respiratory treatment, these patients required interventions to combat the consequences of the virus such as organ dysfunction related to sepsis, or simply deconditioning from being in a hospital bed for so long.”

Dealing with the unknown was difficult not only for the staff caring for Covid patients but also for patients and their families, said Copp. Patients were fearful because they had no idea how the disease would progress. She said that fear extended to their family members who were left wondering what was going to happen as well.

“When Covid patients come into the ICU, I am sure that they are terrified,” said Copp. “During the first hour of being admitted to the ICU you are bombarded with people trying to stabilize you and get you attached to all the monitoring equipment. Once you’re settled in ICU, the rest of your time is centered around the ICU team treating your illness and supporting your body as it fights the virus. The patient’s fear stems from the uncertainty of how their recovery will progress and for those requiring high amounts of oxygen, the horrible feeling of not being able to breathe. This overall fear is extended to the patient’s family members and is heightened by the fact that they are unable to visit their loved one in the hospital.”

Unlike some healthcare workers in the U.S., Copp said she always had adequate protective equipment (PPE) to do her job. She said having the recommended PPE made her more comfortable performing her job. She said everyone in her unit has been very diligent about adhering to guidelines set in place by the CDC and the hospital.

“At work I follow all the specified precautions for our Covid patients in regards to PPE,” said Copp. “This includes gowns, gloves, N95 and goggles each time that we go into a patient’s room.”

Besides dealing with the unknown, Copp said it was very difficult when they battled long and hard but were unable to save the lives of some patients. She said that was very stressful.

“There were definitely times during the past year when I felt burned out,” said Copp. “We had patients that we fought tirelessly for day after day that sadly did not make it, despite doing every possible thing that we could do. That’s an incredibly defeating feeling that never gets easier.”

The decision not to allow families to visit was also very difficult for both patients and staff, said Copp. Staff members did their best to update families and set up Zoom calls. However, the staff knew that wasn’t the same as family members being able to sit by a loved one’s bedside holding their hand.

“Nothing can replace holding the hand of a loved one,” Copp said.

In regards to the general atmosphere in the ICU, Copp said that it progressed and changed along with the course of the pandemic. She said the initial anxiety and fear of the virus has been replaced with determination to help their patients recover and return home to their families. She said there was a feeling of hope when the number of cases began to decline. 

“During this past year, I have learned how quickly things can change and how important it is to be able to adapt to those changes that we are presented with on a daily basis,” said Copp. “I feel very grateful to have such an amazing team in the ICU. We truly relied on each other during this past year which helped combat the stress of working at a hospital during a pandemic. I believe one of the most frustrating parts of the pandemic for those working on the frontlines was hearing people say that this virus isn’t that bad or that it doesn’t even exist, because we are seeing it first-hand. This frustration still lingers. However it’s offset by seeing how much has changed and improved during these past few months.”

Northern Light Eastern Maine Medical Center nurse Melissa Brautigam was responsible for supervising about 30 emergency room nurses this past year. In addition to her nurse manager responsibilities in the ER, she also floated to the intensive care unit. She said that another challenge nurses have faced during the pandemic is the inability to communicate face-to-face with patients and their families due to the need for masking. She said it’s also been difficult for patients, especially those who are hard of hearing, not to see someone’s face when trying to communicate. 

According to Brautigam, some patients who came to the emergency room with Covid were very ill and others were not that sick. She said that two of her responsibilities were to provide them with the information needed to make an informed decision and to offer comfort. 

“A lot of people just needed to hear that it’s okay,” Brautigam said. “Not everyone with Covid gets really sick.”

In addition to offering support to Covid patients, she tried to be supportive of staff. She said they weren’t just dealing with stress related to caring for patients but were also dealing with stress in their own personal lives caused by the pandemic. That sometimes included scaling down long-anticipated weddings and missing group birthday celebrations. She said they’ve focused a lot on self-care and coping skills for nurses.

“Some people go outdoors and other people read books or listen to music,” she said. “For others, making a phone call and hearing a familiar voice makes the difference.”

Throughout the pandemic, Brautigam said she’s been very impressed by the resilience of people. She said that she’s always been impressed with the resilience of children but now she realizes how resilient adults can be as well, finding creative ways to stay in contact with other people. 

“We are a social people,” she said. “We need to show compassion for each other.”

Another EMMC nurse manager, Mikele Neal, is responsible for overseeing staff and patient care in the neonatal intensive care unit, pediatrics and pediatric sedation section. She’s also involved in supporting family in those areas. She said the past year has been the most challenging but also the most rewarding year of her nursing career.

“This year has been extremely challenging for all of us, personally and professionally,” said Neal. “In my role, it has been very busy staying ahead of policy and guideline changes, and making sure staff are always aware of updates. More than ever before, our enhanced protocols ensure that the patient care environment is as safe as possible, and staff and patients have everything they need. As well, it has been an interesting year, shifting away from in-person meetings and more online.”

In regards to addressing the needs of her staff, Neal said that she’s learned how critical it is for staff to have the right information, at the right time, to perform their jobs effectively. She’s another nurse manager who’s also learned how important it is to provide emotional support for staff dealing with stress caused by the pandemic, both at work and in their own personal lives and families.

“Helping people personally as they have had to navigate this virus both at work and at home, at the same time dealing with our own fears for ourselves and our loved ones,” Neal said. “It’s been the hardest year of my professional life but the most fulfilling.”

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