COVID: Fighting The Fight

Yankton native Abbey (Stotz) Salmon dons the protective gear she wears as a nurse on a COVID-19 unit in Grand Island, Nebraska, which has emerged as a hotspot for the virus.

GRAND ISLAND, Neb. — Abbey (Stotz) Salmon didn’t speak the same language as her patient in the COVID-19 unit, but the registered nurse could sense his fear.

The Yankton native is fighting on the front lines against the pandemic, which has hit her Grand Island, Nebraska, hospital hard. With this particular patient, the man spoke little or no English and was welling up with tears.

“I sat with him. I had all my (protective gear) on and I held his hand,” she said. “I said, ‘I can see you’re crying and you’re scared. But I’m scared, too, and I cry a lot. I want you to know it’s OK to cry, and we’ll fight this.’

“He squeezed my hand, and it really touched me (emotionally). His eyes weren’t open, but he knew we (hospital employees) were there and would help him through this.”

Salmon, who graduated from the University of South Dakota, worked for a time at Avera Sacred Heart Hospital in Yankton. She and her husband then moved to Aurora, Nebraska, about 20 miles outside Grand Island.

Salmon works as a registered nurse at CHI Health St. Francis in Grand Island, a city of about 50,000 residents that has become a hot spot in the coronavirus pandemic.

Hall County includes Grand Island and was listed Wednesday with 1,441 coronavirus cases and 39 deaths. While many restrictions will be loosened June 1 for most of Nebraska, the Grand Island area will remain under them.

“It really hurts me that this community is going through this (pandemic) and to have this many people affected by it,” Salmon said. “I would say this is different than anything I have ever dealt with, how quickly the virus spreads and how it is making people sick. I’ve never seen (a disease) progress so rapidly.”

CHANGING ROLES

Salmon has worked as a registered nurse for four years, the last 1½ years in Grand Island. She has been thrust onto the front line of COVID, sharing her story with the Press & Dakotan and also with a Facebook video.

“It’s real and it’s raw,” she said of the pandemic. “It’s our life these days.”

When she joined the St. Francis staff, Salmon started as a Progressive Care Unit (PCU) nurse. She was cross-trained as an Intensive Care Unit (ICU) nurse, which has played a key role in her current assignment.

“I started out as a float nurse, basically serving different units throughout the day shift. As ICU began to see more patients, I began working more in that unit,” she said.

“For some people with COVID, they’re recovering nicely. But the patients I’m seeing are getting hit much harder. I have been working on a PCU 33-bed unit that is now a total COVID-19 unit.”

The coronavirus cases have put more demand on staff, as the ICU patients require more care, Salmon said. “But the hospital still needs to continue doing its other work, like delivering babies and taking care of broken bones, that sort of thing,” she said.

For staff members, the conversion to a COVID-19 unit has become obvious from its appearance, Salmon said.

“My environment has changed since two months ago. Our hallway used to be spotless. There were no signs on the doors. Now, there are signs on every floor just to remind us of the precautions we take when we enter a room,” she said.

“When you go down the hallway, you see an isolation cart outside each room. We have our PPE (personal protective equipment) hanging from a hook on the wall next to the room. That way, we can grab our masks and face shields and get into a room quickly.”

Treating COVID-19 requires extensive preparation before and after caring for each patient, Salmon said. The workers wear N95 masks, gowns, gloves, surgical caps and face shields. Rooms and equipment are wiped down with disinfectant in an effort to kill the virus.

The entire process takes more time but is necessary, particularly in the COVID-19 unit with patients on ventilators, Salmon added.

“Before, getting gowned up to get into the rooms was a two-minute process,” she said. “Now, we need to put on all of the protective gear and then change when we leave a room so we don’t spread to the virus to the rest of the staff. It definitely makes things a lot more difficult.”

Besides the care itself, the bedside manner provides the only human contact for the COVID-19 patients.

“I’ve been asked what it’s like to take care of these patients, especially since they can’t have any family in the room or visiting them,” she said. “It has taken a toll on many of them emotionally as well as physically.”

In addition, Grand Island contains a culturally diverse population, Salmon said. A number of residents speak little or no English, making it difficult to hold a simple conversation, let alone make complex medical explanations.

Salmon described the hospital scene this spring as patient numbers climbed at Grand Island.

“Over Easter, we had a full patient load of COVID patients, and each and every one of them was on oxygen. There was a lot of anxiety, and patients were scared. They asked me, ‘Am I going to be OK? What is going to come next?’” she said.

“It’s hard as a nurse because you know where they’re headed and what could happen. But you have to reassure them that you’re doing absolutely everything you can for them.”

She has sought to comfort patients even under the most difficult of circumstances.

“You hold their hand and advocate for what they need,” she said. “They’re very vulnerable, and they trust you to make them better. It’s a scary time for our patients but also for us nurses.”

MAKING A DIFFERENCE

Salmon works four 12-hour shifts a week. She usually leaves for the hospital around 5:30 a.m. and may arrive back home around 7:30-8 p.m.

“When I walk through the doors of St. Francis, it’s so unpredictable,” she said. “I don’t know what’s going to happen that day.”

When Salmon isn’t at work, she thinks “100%” about how COVID-19 can affect her family. Her husband works for a utility company, and his work takes him into homes where he becomes vulnerable to contracting the virus.

“We talk about what if one of us comes down with COVID-19 and the whole family needed to be quarantined,” she said.

The 29-year-old Salmon and her husband have three sons, ages 14, 13 and 5 years old.

“We have patients ranging in age from their mid-30s to their 80s. It really puts things into perspective that it’s not just impacting older persons,” she said. “It’s hard for me, knowing and working directly with patients about my age. These (younger) people have families, jobs and so much life ahead of them.”

The hospital has done a good job of maintaining the proper staffing and personal protective equipment, Salmon said. In addition, staff members continually show their willingness to step outside their usual roles to help co-workers in any way possible, she said.

While she would like to see more people following social distancing and other precautions, Salmon noted the community has shown strong backing for the health care workers’ efforts.

“We’re super appreciative of all the (things) the community is doing for us,” she said. “They’re supporting us with kind words, prayers and thoughts.”

The pandemic has shone a spotlight on the important role of nurses and other health care workers, Salmon said. That level of commitment has always been part of the profession and will continue, she added.

“I didn’t sign up for a pandemic, nobody did. But it demands that I care for the people who need me, so here I am,” she said.

“What keeps me going are the patients’ improvement and that their families know others are helping their loved one.”

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