Intubating respiratory therapists
The WSWS recently spoke to a respiratory therapist at Elmhurst Hospital in Queens, New York City, about her experience with the coronavirus pandemic. For two months, in March and April, Elmhurst Hospital was considered the "real epicenter" of the pandemic in the United States. Most of the people who frequent the hospital come from a residential area of immigrants and workers.
Respiratory therapists are trained to treat patients with severe respiratory diseases. You use respiratory and other breathing apparatus. They are therefore indispensable for the treatment of seriously ill Covid 19 patients. We changed the employee's first name to Patricia to protect her identity.
Patricia has worked with intubated patients for 22 years. During the interview she was overwhelmed by emotions several times when she recalled the deeply traumatic experiences of the past months.
"We started admitting patients in late February, but we didn't realize they were Covid-positive until March. It went so quickly that we weren't prepared at all. We tried, but the number of patients who were with Covid-19 appeared was higher than we expected. "
Both the Trump administration and the Democratic Cuomo administration criminally delayed all social distancing measures and coronavirus mass tests, despite the fact that the first Covid-19 case was registered in the US back in January.
New York, the state hardest hit by the pandemic in the spring, did not introduce lockdown until March 22nd. Later scientific models showed that around 10,000 people in New York must have been infected with the virus by early March. In fact, March was like Patricia WSWS reported "the toughest month" at Elmhurst.
“We had practically no staff and we were unable to treat everyone. There were multiple cardiac arrests, critical reactions, and intubations at the same time. Although doctors and nurses were present at these events, we could barely keep pace with ventilators for intubation and BIPAP -Bringing devices [for non-invasive ventilation] to the wards. We had to choose who to help. Many wards were calling us at the same time. It was physically and emotionally overwhelming. "
She said they had to "beg" the administration for more staff. When she suggested that the hospital hire agency respiratory therapists for $ 4,500 to $ 7,000 a week, the answer she received was, "I'm not paying."
In late March, an emergency room doctor at Elmhurst Hospital, Colleen Smith, published in the New York Timesa video with a desperate cry for help, in which she described the conditions in the hospital as "apocalyptic". At this point, refrigerated trucks and makeshift morgues appeared outside the major hospitals in New York City.
In early April, Nurses at Elmhurst were finally notified that they would receive help. On April 9, Patricia said, the first respiratory therapists came from outside the state. The air force and the army also sent personnel. A total of about 25 respiratory therapists were added, she said. The last ones should leave on June 30th.
"Before we got help, it was pure hell. Ten to 20 patients died every day. Most of the time, a single person was responsible for two to three floors and / or several intensive care units. You were assigned around 20 to 30 ventilators, and more you had to react to cardiac arrests, provide immediate aid, manage the transport of ventilator-dependent patients to departments or operations, and administer medication. And at the same time we tried to help our colleagues. "
She continued: "Originally we had five respiratory therapists for the day shift and four for the night shift, but that declined in the course of March because people got sick and left us. Two older employees quit because they were overwhelmed. because he got sick and was burned out. Another employee got really sick and was intubated. He's no longer intubated today, but it will be a long time before he recovered. He's not the same. "She guessed that at Elmhurst five or more hospital workers have died of Covid-19.
The lack of personal protective equipment (PPE), especially masks, was particularly acute in her department. While there were limited PPE supplies to other departments, Patricia said her department received no supplies at all. "It was very humiliating to have to beg the nurses on the wards and floors for PPE, even though we help with intubations, extubations, cardiac arrests, transporting artificially ventilated patients and more. To send ourselves to the floors without proper PPE and appropriate personnel, it's like sending soldiers to war without helmets, bulletproof vests and rifles. I felt like we were dying. We were so exhausted and scared to death. "
In addition to the government's criminally negligent response to the pandemic, healthcare austerity has played an important role in increasing the death toll from the pandemic for decades. As part of the Health + Hospitals public hospital system and located in one of the poorest neighborhoods in New York City, Elmhurst Hospital is particularly hard hit by these cuts. In an analysis published on July 1, the New York Times found that patients in hospitals in poor communities, such as Elmhurst, die up to three times more often than in facilities in Manhattan's richest neighborhoods due to understaffing and lack of facilities.
Even when the pandemic was at its peak, New York State was pushing for $ 400 million Medicaid cuts. State hospitals such as Elmhurst Hospital, which also treat uninsured patients, are particularly affected.
Patricia emphasized that the shortage of personnel among respiratory therapists had been great even before the pandemic, and that she and her employees had repeatedly warned against it.
"When I started at Elmhurst eight years ago there were 30 to 35 respiratory therapists. Now there are only nineteen. There have been no layoffs, but almost every time someone retires they have not been replaced. hire more staff, but apparently if treatment just fails here and there over time. Bad treatment and corruption have made people come and gone. We all love what we do and try to do our best. But it is very difficult if you don't have enough staff and support from your line manager and administration.
Almost everywhere in the country there are an average of four to eight ventilator patients on a ward. In Elmhurst, a ward could have anywhere from 10 to 20 patients in the past 10 years. It is very unsafe; it makes it very difficult to get good respiratory care. ”Becker's Hospital Review found in late April that New York, New Jersey, and Connecticut are the three states with the greatest shortages of respiratory therapists. New York would have needed an additional 7,400 respiratory therapists to adequately treat Covid-19, more than twice as many as the 4,490 respiratory therapists the state was employing at the time.
Patricia stressed that adequate staffing and PPE could have prevented deaths. "So many patients wouldn't have died in March if we had more staff and better equipment to work with. We wouldn't have been so stressed either."
Patricia warned that Elmhurst Hospital was unable to adequately cope with a new influx of patients in a second wave. The number of coronavirus cases has skyrocketed across the country and is rapidly approaching the 3 million mark. While New York State is at an advanced stage of reopening, New York City continues to see hundreds of new infections every day. At Elmhurst Hospital, Patricia said, cases are picking up again. "It's very scary because it's not even flu season yet."
Although the hospital is still treating Covid-19 patients, the already low standards for PSA have been lowered again. "We used to be allowed to wear protective clothing, but now it is no longer allowed to wear PPE outside of the designated Covid units. There are goggles, gloves and gowns, but it is very difficult to get masks." Patients with and without Covid-19 are still mistakenly pooled, which has happened repeatedly throughout the pandemic and which has further increased the infection.
Stressing that the administration had failed at her hospital, Patricia concluded: "If they stop getting [breath] therapists, we will again be ill-prepared in case a second wave breaks out. We really need adequate staffing, to achieve a better security situation. "
Governments across Europe are not doing enough to contain the pandemic. Therefore, students and young workers must take responsibility for their own health and the lives of their loved ones.
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