A tale of two nurses: ‘It’s as bad as they say it is’

SALT LAKE CITY — Two Utah nurses weren’t prepared for what they’ve seen in New York hospitals.

Like most of the 100 Utah nurses sent by Intermountain Healthcare to help in two New York hospitals, Nathan Barney had read and seen news reports about how COVID-19 had brought the city that never sleeps to its knees. But seeing the ravages of the virus in person brought him to tears.

“For those who are back home, it is as bad as they say it is,” Barney said in a video he posted to Facebook on his third day working in New York Presbyterian Milstein Hospital. “That’s as simply as I can put it. It’s getting better, but it’s as bad as they say about it.”

He wiped away tears.

“Think about it,” he told family and friends. “If you pray, pray about it. Pray for the nurses and the caregivers here in NY. They’re exhausted. And you can see it. I’m grateful for the opportunity to be here, and to help out, even though it’s for a short period of time.”

Barney was one of hundreds of Utah nurses who volunteered to work in New York hospitals for several weeks. Intermountain Healthcare sent two teams of 50 nurses to offer support to New York health care workers who have been working around the clock caring for patients in the epicenter of the U.S. coronavirus outbreak.

Barney, who came to nursing late in life, has posted a video each day where he discusses his experiences and what he’s learning. In an interview with the Deseret News, he said he’s normally a “positive person” who doesn’t get emotional. But upon arriving for his first shift at Milstein, he said it was “just an overwhelming feeling of shock.”

When John Killpack, a certified nurse anesthetist from St. George, arrived at Bellevue Hospital in New York City, he was put to work right away.

“The medical conditions in New York are even worse than portrayed on TV,” he posted on Facebook last week. “I spent 10 years training for a mass casualty situation, including 3 1/2 years in a dedicated trauma facility, and I was still blown away.”

Eight people, he said, “coded” in less than four hours on his first day.

“I’m an old man and haven’t worked this hard since my training,” said Killpack, 55, adding that he runs 7 to 10 miles a day up and down the hospital halls and stairways to do what little he can for an overwhelming number of very sick patients.

“It’s hard to walk away at the end of the day,” he said. “You have to look at it kind of like a war ... peacetime rules don’t apply.”

He works 60 to 70 hours a week at the hospital, giving everything that he can, and then he goes home, showers, and wipes everything down with Clorox wipes and “just hope that I’m OK.”

Killpack has been assisting patients on ventilators and has seen many of them — he estimates about 80% — not make it.

When a patient does make it, he said, Journey’s “Don’t Stop Believin’” plays over the sound system at Bellevue. “When you hear that, you know, it’s a sign, that, yes, we are making progress,” Killpack said. “They’ve made it through that super critical phase to recovery.”

Patients with COVID-19 occupy units spanning eight or nine floors at the 20-story Bellevue Hospital.

Milstein typically has 110 ICU beds, which are pretty consistently near capacity. Because of the ongoing COVID-19 outbreak, the hospital has opened what Barney called “a field hospital in a bubble on a field” which is staffed by military personnel. They’ve also expanded their indoor capacity to 253 beds by converting operating rooms to patient rooms.

Bellevue has done pretty much the same, knocking out windows and installing vents to create units with negative pressure and utilizing areas previously used for other types of patients and procedures.

Killpack said, “They’ve gone through PPE like nobody’s business.”

“This is a good example of what happens when the system gets overwhelmed,” he said. “We did a great job with what we had, but it was the best we could do. This is so far beyond anything I imagined.”

John Killpack

During training, Barney and his colleagues learned how to care for the most critically ill patients, some of whom have been on ventilators for up to 15 days.

“Each suite has three patients,” he said. “They’re intubated, sedated and very, very sick. It’s not an ideal situation. They’re short on supplies ... and due to the nature of the virus, there is minimal time spent within the patient room. These patients are tenuous, and what nurses would consider normal care kind of goes out the window. ... You can see it in the faces of the nurses who have been there that they are exhausted. It’s hard not to sympathize with that. You can just see how tired they are. ... They’ve been here for six weeks dealing with the worst of this.”

The contagious nature of the novel coronavirus makes him worry about his own health in ways he never has since he began working at Primary Children’s Hospital 2 1/2 years ago.

“Even when you leave the room, you feel dirty,” Barney said. “Psychologically, it weighs on you; there’s concern about, ‘Am I going to get sick? Am I going to give it to somebody else?’ And so, you clean everything multiple times, all day long.”

He said the biggest difference is the mental aspect of worrying about being exposed or exposing someone else to the virus. The safety precautions are nothing new, but Barney said they are much more diligent about adhering to them now.

“I can’t even tell you how many times I washed my hands last night,” he said in a telephone interview. “Maybe 100 times? We’re constantly on guard. ... Ultimately, I can’t control whether or not I’m going to get it.”

In one of his videos, Barney said that he’d heard statements on social media and elsewhere that health care workers “knew this is what they signed up for when they became health care workers.”

“Nobody knows this is what you signed up for,” he said. “This is unlike anything I’ve ever seen. I could probably safely say that about everyone I’m here with. This is a very unique situation.”

He said too many people believe Utah is so different from New York that the state could never experience the same level of illness.

“It’s easy to believe that we’ll never have that same fate,” he said, referring not just to the millions of people who live in New York City, but to how they live in densely populated areas. He pointed out that Los Angeles is even more densely populated and hasn’t been as hard hit.

“(The virus) doesn’t discriminate, but what it does do is it kills. And it is not a pleasant way to die.”

Barney said intubation is extremely difficult on a patient, but one of the more “unfair” aspects of COVID-19 is that patients can’t have the human contact from health care workers or family that they’d normally have in critical situations.

He believes scientists and doctors are learning important lessons every day.

Killpack said things are slowing down — if slowing down means fewer patients bunking in the same rooms. There’s been fewer admissions.

“We’re still very busy, but no longer insane,” he said. “Codes are down to two a day instead of two an hour.”

Part of that, he said, is thanks to increased staffing, as more help has arrived from all over the country.

“The real heroes were here without the help,” Killpack said. “We have 10 to 12 people doing the job that three of them were doing before we got here. And, several of them have had no contact with their families, they’re staying in hotels to avoid the risk of spreading anything to their loved ones.”

In all, he’ll likely spend three weeks in New York City, which is longer than he anticipated. He said he misses his wife, his dogs and a young granddaughter with whom he communicates via cell phone. He feels more strongly for all of them after what he’s been through.

Courtesy Intermountain Healthcare

“I trust science,” Barney said. “I trust medicine, that we’ll get things figured out. But it’s going to be a long road. ... I urge everybody to be cautious, to be a little bit empathetic, and to be willing to sacrifice for people that you don’t know, or for people that you’ll never know.”

Each day he’s offered more upbeat and more hopeful messages, even as he details how meticulous nurses have been in trying not to spread the disease as they come and go from the hospital.

“Good things are happening,” he said. “For the caregivers who’ve been dealing with this for the last two months, a small victory, like extubating one patient, is huge in terms of it’s mental impact, on mental well-being ... so, that’s a big deal.”

Courtesy Intermountain Healthcare

Both nurses expressed gratitude for the opportunity to help their colleagues in New York.

Killpack said he hopes in the future to look back and “remember the good and the bad will be faded.”

And, he hopes Utah doesn’t suffer the same fate, as medical professionals are learning more and more every day about how to treat this pervasive virus.

“It’s been an incredible experience to be here and to be part of it,” Barney said. “To be a witness to their perseverance. It’s remarkable.”

Then Barney adds, “I’m glad I’m here. I’ve gotten a lot of messages, texts ... ‘What’s it like?’ I can say, it’s as bad as they said it was. This is a city in crisis.”