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Angry & fearful patients, heartbreaking decisions: St. Johnsbury hospital staff are 'exhausted emotionally'

A photo showing six fists held together in a circle.
NVRH, Courtesy
Northeastern Vermont Regional Hospital staff pose for a "NVRH Strong" photo.

Until this summer, COVID numbers in the Northeast Kingdom remained low. Since the summer and the onset of the delta variant, those numbers have risen, and in the weeks after Halloween, there's been a surge of COVID patients at small regional hospitals.

Every day this week, VPR is airing stories from frontline healthcare workers at Northeastern Vermont Regional Hospital in St. Johnsbury. Today independent producer Erica Heilman talks with hospital staff members about how they’re holding up.

Here’s ER physician assistant Betsy Piburn.

Betsy Piburn: “I watch them go through the stages of grief. They have this denial, ‘No, I can’t.’ And then we talk about why they might have COVID and how I know they have COVID. And then it’s this real, kind of this acceptance and this realization, and it is fear, not only for themselves, but for who they’ve exposed. And then a fear for, what does this mean long-term, because so much is still not known about this disease.”

Erica: “Is it also, I mean, in the emergency room, are you ever getting responses? Angry responses?”

Betsy Piburn: “Oh, angry responses in the ER right now are daily. It's amazing how mean people are to health care providers. We put our heart and our soul into this job, and it's devastating when we have people that can be so mean and blame really all of this on us.

“And I often try to remind people, ‘You know, I didn't make you sick. My job is to help you.’ But a lot of times there still seems to be this blame. And I don't know if it's a ‘us versus them.’ You know, ‘the vaccinated versus the unvaccinated.’ I'm not sure if that's what the root of it is. But yeah, it's amazing how — you know we went from being heroes to being worse than the scum on people's shoes, some days.”

More from VPR: Short on staff, equipment, two NEK respiratory therapists on getting through the day (and night) amid COVID

This is clinical educator and ICU nurse, Callie Phelps.

Callie Phelps: “Coming back into the summer, we had prepared for a surge, but we had not gotten a surge per se. We had had patients trickle in, and in the last month, month and a half, patients started pouring in. So we filled up the ICU, which was all four beds. It sounds very small to people like, ‘Oh, there's only four beds,’ but the problem is here, we have 25 beds total, but we only have four ICU beds.

“And so when those four beds are full, you have to start making phone calls. And the problem is, all of the other larger hospitals have already been taking on for months all the COVID patients that we've sent and the different hospitals have sent, that have gotten a lot sicker, so they will not take anymore. So there have been cases of calling, you know, into New York and into other states just to try and get patients somewhere.

“And that pressure of feeling, ‘What do you do when you can't get this person somewhere?’ makes feeling full, significant. And when we maxed out the patients that we just had in the last few months, we ran out right to the end of equipment. So we were taking it from one patient because they were just good enough for the last hour or two to give it to another patient.

“The news doesn't always show, or they don't always feel that emotional side at the bedside. It's the reality of, ‘This person doesn't have a machine. Now what?’ And that could be your mother, that could be someone else that you know, that doesn't have the equipment that they need. And so there's just such an emotional reality to it. It's very wearing. That piece, the toll on the actual hospital and nursing staff, is what I feel people most don't understand.”

"[T]hat could be your mother, that could be someone else that you know, that doesn't have the equipment that they need. And so there's just such an emotional reality to it. It's very wearing."
Callie Phelps, clinical educator and ICU nurse at Northeastern Vermont Regional Hospital

Betsy Piburn: “So right now, with the demand of COVID on our health care system, especially locally with the surge we're having … and then on top of it, nursing shortages and health care shortages, I've had to send people to Connecticut from our small hospital. And it's really, it’s heartbreaking, because we're such a tight-knit community, that taking people out of that community can really be devastating for the patient and for their families and for us. You know, the last thing I want to do is put somebody who's sick in an ambulance for four hours, five hours, however long it takes. And that's generally what we have to do, is transfer people by ambulance.

“And then I'm also asking our EMS providers, the people that are the first to respond when there's an emergency, to sit in an enclosed space for several hours with somebody who has COVID. But that's, you know, we're in the business of saving people's lives and treating people's illnesses, and that's what we have to do.”

Here's pulmonologist Brittany Duchene.

Brittany Duchene: “There was an extremely difficult case recently that affected all of us, because she was here for so long, and was a very sweet lady and did everything right. She had other medical issues that made her get so sick from COVID and to go in and see her day after day, and see her getting worse and worse … and then to the point where I'm telling her, ‘We're at the point where we're going to make you comfortable because we can't … you're dying.’ And her being alone in the room, and I'm petting her head with gloves and in a gown and a face shield and a mask, and she can't hear me. I mean, I'm still early in my career, but I left and I cried.

More from VPR: Two St. Johnsbury night nurses on mourning loss here, and abroad, from COVID-19

“And normally those cases … they happen. You know, pre-pandemic these cases happened, and I cried over patient cases before, and I was extremely touched and affected by them. But now they're happening so often. I mean, if this puts things into perspective, when I was a fellow at UVM and we were a referral center, so we were taking in the sickest people in the state. I'm still having those conversations to the same frequency as I was then, and this is with a small, 25-bed hospital and only four ICU beds.

“Every week, a couple times a week, there's a challenging conversation. It's contributing to the burnout. It's contributing to people feeling exhausted. And the fact that it feels like there's not an end in sight for this is so disturbing. I'm early in my career and I feel exhausted emotionally from that. It's hard.”

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