Nurse Discusses the Strain on LA Healthcare Workers

NOW, TURNING TO THE SURGING CORONAVIRUS PANDEMIC, HERE IN LONDON, ONE IN 30 HAVE THAT VIRUS.

AND ACROSS THE OCEAN, IN LOS ANGELES COUNTY, A PERSON IS DYING OF THE VIRUS EVERY 10 MINUTES.

THIS IS ACCORDING TO THE PUBLIC HEALTH CHIEF THERE.

THE TOTAL NUMBER OF CASES HAS DOUBLED IN JUST OVER A MONTH, AND AMBULANCES ARE BEING TOLD NOT TO TRANSPORT PATIENTS WITH LITTLE CHANCE OF SURVIVAL.

ON THE FRONT LINES IS NURSE NERISSA BLACK.

SHE IS FROM HENRY MAYO NEWHALL HOSPITAL, AND HE SAYS SHE'S NOT SEEN ANYTHING LIKE IT IN HER 10-YEAR CAREER.

AND HERE SHE IS TALKING TO OUR HARI SREENIVASAN.

Sreenivasan: CHRISTIANE, THANKS.

THANKS FOR JOINING US.

FIRST, I THINK PEOPLE HAVE HEARD DIFFERENT STORIES ABOUT PARTS OF THE COUNTRY WHERE HOSPITALS ARE OVERWHELMED.

WHAT IS IT LIKE RIGHT NOW TO WALK INTO YOUR SHIFT?

DESCRIBE THE SCENE FOR ME.

RIGHT NOW, WALKING INTO MY SHIFT, I'M DREADING STARTING MY SHIFT, BECAUSE I KNOW THAT I HAVE MORE PATIENTS TO TAKE CARE OF THAN USUAL.

AT THE BEGINNING OF THE PANDEMIC, AND EVEN BEFORE DECEMBER 11, WE WERE GIVEN A MAXIMUM OF FOUR PATIENTS TO TAKE CARE OF, WHICH ON A GOOD DAY IS JUST ENOUGH TIME TO TAKE CARE OF THOSE PATIENTS PROPERLY, LIKE A HUMAN BEING.

BUT THESE DAYS, WE HAVE UP TO SIX PATIENTS, WHICH MEANS THAT INSTEAD OF SPENDING 15 MINUTES EVERY HOUR WITH EACH PATIENT, NOW I ONLY HAVE 10 MINUTES FOR EACH HOUR TO SPEND ON EACH PATIENT.

THOSE 10 MINUTES ARE NOT JUST WITH THE PATIENT IN THE ROOM.

THE 10 MINUTES INCLUDE PUTTING ON P.P.E., REVIEWING LAB WORK, IMAGINING RESULTS AND REPORTING ABNORMALITIES TO PHYSICIANS.

IT INCLUDES COORDINATING CARE WITH THE PHYSICAL THERAPIST, THE CASE MANAGER, THE SOCIAL WORKER.

THE 10 MINUTES INCLUDES CALLING FAMILY MEMBERS.

IT'S NOT JUST US BEING IN THE ROOM GIVING MEDICATIONS TO THE PATIENTS, TURNING THEM.

IT'S A LOT OF BACKGROUND WORK THAT WE DO, ALSO.

Sreenivasan: SO THAT'S HAPPENING OVER AND OVER AGAIN.

YOU'RE PUTTING YOUR P.P.E. ON AND TAKING IT OFF IN BETWEEN EVERY PATIENT SO YOU DON'T GET ONE PERSON INFECTED WITH SOMETHING ANOTHER PERSON HAS?

CORRECT.

WE PUT ON OUR-- A NEW SET OF P.P.E. IN BETWEEN EACH PATIENT TO PROTECT OUR ALREADY-VULNERABLE PATIENTS FROM GETTING AN INFECTION THAT THEY DON'T CURRENTLY HAVE BECAUSE OUR PATIENTS THESE DAYS ARE NOT JUST COVID PATIENTS.

I MEAN, EVEN THROUGHOUT THE WHOLE PANDEMIC, OUR PATIENTS DON'T JUST HAVE CORONAVIRUS.

OUR PATIENTS ARE SICK WITH A HEART ATTACK, AND THEY HAPPEN TO HAVE COVID.

THEY HAVE A STROKE, AND THEY HAPPEN TO HAVE COVID.

THEY FELL OFF A LADDER PUTTING UP THE CHRISTMAS LIGHTS, AND THEY HAPPEN TO HAVE COVID.

SO THEY HAVE AN INJURY OR AN ILLNESS ALREADY, AND ON TOP OF THAT, NOW THEY HAVE COVID AS WELL.

IT JUST ADDS ANOTHER LAYER OF COMPLICATION TO THEIR CARE.

Sreenivasan: AND FOR PEOPLE OUTSIDE WHO MIGHT LOOK AT YOUR WORKLOAD AND SAY, 'YOU KNOW WHAT?

SHE'S JUST TALKING ABOUT GOING FROM FOUR PATIENTS TO SIX PATIENTS.

WHY IS THAT SUCH A BIG DEAL?'

IT DOESN'T SEEM LIKE A LOT MORE, BUT GOING FROM FOUR PATIENTS TO SIX PATIENTS MEANS 50% MORE CARE, THE MORE PEOPLE THAT WE NEED TO TAKE CARE OF, AND EXTRA 50% ON THE WORKLOAD PUTS A LOT OF STRAIN NOT JUST ON US, BUT ULTIMATELY, IT PUTS A STRAIN ON OUR PATIENTS BECAUSE OUR PATIENTS NEED HELP, AND WE HAVE TO DECIDE IF WE ARE ONLY GOING TO BE ABLE TO SPEND SO MUCH TIME WITH EACH PATIENT, WE HAVE TO FIGURE OUT WHO WILL GET THE CARE FIRST.

Sreenivasan: WHEN YOU ARE DESCRIBING THIS SCENARIO TO ME, EVEN WHAT YOU'RE DOING AND THE 50% EXTRA WORK THAT YOU'VE BEEN DOING, DO YOU THINK THAT THIS IS DECREASING THE QUALITY OF CARE THAT A PATIENT IS GETTING, AS HARD AS YOU'RE TRYING?

YES.

WELL, EVER SINCE WE CHANGED OUR RATIO-- CHANGE THE NUMBER OF PATIENTS THAT WE ARE GIVEN TO TAKE CARE OF, IT HAS DEFINITELY DECREASED THE QUALITY OF CARE.

I PERSONALLY BELIEVE THAT WE ARE ABLE TO GIVE OUR PATIENTS.

AT THE END OF THE DAY, I GO HOME AND I FEEL LIKE I COULD HAVE DONE MORE FOR OUR PATIENTS TO MAKE SURE THAT THEY ARE COMFORTABLE, TO MAKE SURE THAT THEIR NEEDS ARE MET.

BECAUSE I FEEL LIKE I-- MY PATIENTS, I TREAT THEM LIKE MY FAMILY MEMBER.

THEY'RE HUMAN BEINGS.

THEY'RE SOMEBODY'S MOTHER.

THEY'RE SOMEBODY'S DAUGHTER.

THEY'RE SOMEBODY'S SON.

THEY'RE SOMEBODY'S GRANDFATHER.

AND AT THE END OF THE DAY, IT'S HARD TO THINK ABOUT WHEN I GO HOME THAT I DIDN'T-- I FEEL LIKE I DIDN'T GET TO DO ENOUGH FOR THEM LIKE I NORMALLY WOULD.

THE STANDARD OF CARE THAT I'VE GIVEN IS NOT THE SAME AS BEFORE OUR RATIO CHANGED.

Sreenivasan: DO YOU THINK PEOPLE AREN'T TAKING LONGER TO COME TO THE EMERGENCY ROOM AND THEY'RE MORE SICK NOW?

OF COURSE.

A LOT OF OUR PATIENTS ARE COMING IN MORE AND MORE SICK THESE DAYS.

A LOT OF PEOPLE ARE WAITING TO GET THEIR ILLNESS OR INJURY TAKEN CARE OF.

THEY'RE WAITING-- THEY'RE HOPING IT WILL GO AWAY, UNTIL IT BECOMES UNBEARABLE.

I HAD A PARTICULAR PATIENT COME IN WITH ABDOMINAL PAIN THAT SHE HAS HAD FOR SEVERAL DAYS, AND IT TURNS OUT HER APPENDIX HAD BURST BY THE TIME SHE CAME IN TO GET HELP FOR HER ABDOMINAL PAIN.

BEFORE THE PANDEMIC, SHE WOULD HAVE PROBABLY COME IN AFTER A DAY OR TWO OF THAT ABDOMINAL PAIN NOT GOING AWAY, AND WE COULD HAVE TREATED THAT MORE QUICKLY, AND THE OUTCOME WOULD BE BETTER.

BUT IN HER CASE, SEE, SHE HAD WAITED SO LONG, AND HER APPENDIX CAN BURST, SHE BECAME SEPTIC.

AND THIS IS A RELATIVELY YOUNG WOMAN.

AND PEOPLE ARE JUST GETTING MORE AND MORE SICK BECAUSE THEY'RE WAITING LONGER AND LONGER TO GO TO THE HOSPITAL TO BE TREATED.

Sreenivasan: NOW, AT THE SAME TIME, THEY ARE HEARING ON THE NEWS AND THEY'RE HEARING FROM E.M.S., 'DON'T CALL 911 UNLESS YOU'RE IN A LIFE-THREATENING SITUATION.'

YEAH, OUR EMERGENCY MEDICAL SYSTEM HAS BEEN DIRECTED TO NOT TRANSPORT PATIENTS TO HOSPITALS IF THEY DON'T GET WHAT'S CALLED A RETURN OF SPONTANEOUS CIRCULATION.

IF A PATIENT'S HEART STOPS OR THEY STOP BREATHING, AND THE PARAMEDICS CAN'T GET THEM BACK IN THE FIELD, LIKE, THEY CAN'T RESUSCITATE THAT PERSON IN THE FIELD, THEY ARE NOT-- THEY'RE DIRECTED TO NOT TRANSPORT THAT PERSON TO THE HOSPITAL.

ESSENTIALLY, THEY PASS IN THE FIELD WITH NO HELP ANYMORE.

Sreenivasan: I'VE ALSO HEARD STORIES ABOUT AMBULANCES BASICALLY BECOMING HOSPITAL BEDS, THAT THEY'RE WAITING OUTSIDE HOSPITALS BECAUSE THE HOSPITAL IS SO FULL THAT THE I.C.U.s HAVE NO CAPACITY, THAT THE E.R.s ARE BACKED UP.

IS THIS TRUE?

IT'S TRUE.

WE HAVE AMBULANCES WAITING IN THE AMBULANCE BAYS IN THE EMERGENCY ROOM, NOT JUST MY HOSPITAL BUT OTHER HOSPITALS.

BECAUSE MANY OF MY COLLEAGUES WORK IN OTHER HOSPITALS AS WELL.

THEY WORK IN THE E.R., AND THEY HAVE MULTIPLE AMBULANCES WAITING FOR-- TO EVEN JUST GET INTO THE E.R.

Sreenivasan: NOW, HAVE YOU BEEN THE LAST PERSON THAT A PATIENT'S FAMILY MEMBER SPEAKS TO?

I-- I HAVE BEEN ONE OF THE PEOPLE THAT A PATIENT HAS SPOKEN TO.

Sreenivasan: WHAT WAS THAT LIKE?

CAN YOU DESCRIBE THAT FOR ME?

RECENTLY, I-- I HAD A PATIENT WHO WAS PLACED ON COMFORT CARE, AND FOR THIS PARTICULAR PATIENT, SHE WAS DECLINING RATHER QUICKLY, AND THE SON-- MY PATIENT'S SON HAD CALLED ASKING, 'IS THERE ANY WAY I CAN VISIT MY MOM?'

BECAUSE THE PATIENT WAS IN THE COVID UNIT AND IN ORDER TO PREVENT FURTHER SPREAD OF INFECTION, OUR HOSPITAL HAS THE RULE OF ABSOLUTELY NO VISITORS ALLOWED IN THE COVID UNITS.

AND THE BEST-- THE NEXT BEST THING WE COULD DO FOR OUR PATIENT IS TO, YOU KNOW... TO INITIATE A PHONE CALL WITH THE PATIENT AND THE PATIENT'S SON.

THE PATIENT'S SON WANTED TO SAY GOOD-BYE TO HIS MOTHER ON THE PHONE.

AND I WAS THE ONLY REALLY ONE AVAILABLE TO BE THE MIDDLE MAN.

FOR THIS PARTICULAR PATIENT, SHE WAS ALREADY VERY... SHE WAS NOT WEAK ANYMORE.

HER BREATHING WAS VERY SHALLOW.

THE SON HAD ASKED ME TO REPEAT HIS WORDS TO HIS MOTHER ON THE PHONE BECAUSE HE WAS WORRIED THAT SHE WAS HARD AND HEARING AND SHE WON'T BE ABLE TO HEAR HIS WORDS.

SO I HAD TO REPEAT-- I WENT INTO THE ROOM WITH THE PHONE ON SPEAKER MODE, AND I LAID THE PHONE NEXT TO THE PATIENT'S EAR ON HER PILLOW.

AND I REPEATED HIS WORDS TO HER.

AND HE SAID, 'MOM, I LOVE YOU VERY MUCH.

I WANT YOU TO KNOW THAT WE'RE GOING TO BE OKAY.

I WANT YOU TO TAKE CARE OF YOU.'

HE-- HE HAD SOME CHILDREN, AND HE SAID THAT, YOU KNOW, 'YOUR GRANDCHILDREN LOVE YOU VERY MUCH.

THEY WILL MISS YOU.

BUT THEY WILL BE OKAY WITH US.

MAKE SURE THAT YOU TAKE CARE OF YOU.

WE LOVE YOU VERY MUCH.

YOU'LL BE OKAY.

AND IT'S OKAY TO GO.'

AND IT WAS VERY EMOTIONAL AND HEARTBREAKING FOR ME TO BE THE MIDDLE MAN DURING THAT CONVERSATION.

Sreenivasan: YEAH.

WELL, THANK YOU FOR BEING THERE FOR HIM AND FOR THE OTHER PEOPLE.

YOU KNOW, WHAT'S SO STRANGE ABOUT THIS IS WHILE YOU'RE DESCRIBING WHAT'S HAPPENING INSIDE OF A HOSPITAL, THERE ARE STILL PEOPLE ON NEW YEAR'S IN LOS ANGELES GOING TO RAVE PARTIES, YOU KNOW.

AND PEOPLE THAT ACTUALLY DON'T BELIEVE THAT THIS IS REAL.

WHAT DO YOU SAY TO THOSE PEOPLE?

I WOULD TELL THEM, YOU KNOW, PLEASE STOP GATHERING.

IT'S-- IT'S A VERY SIMPLE WAY TO SPREAD THIS-- TO PREVENT THE SPREAD OF THIS ILLNESS.

IT'S NOT ONLY AFFECTING THE ELDERLY.

IT'S AFFECTING MANY PEOPLE, ESPECIALLY OUR HEALTHCARE WORKERS, WHICH A LOT OF PEOPLE SAY WE'RE THE FRONT LINE, BUT I THINK WE ARE THE LAST LINE OF DEFENSE AGAINST THIS VIRUS.

THE PEOPLE, THE POPULATION ARE THE FIRST LINE.

THEY'RE THE ONES WHO CAN PREVENT THE SPREAD OF THIS DISEASE.

AND I FEEL... THAT THEY SHOULD KNOW THAT THE PEOPLE WHO KEEP GATHERING SHOULD KNOW THAT WE ARE STRAINED.

WE'VE HAD-- I'VE HAD A PATIENT'S-- ANOTHER PATIENT'S SON CALL BECAUSE HIS MOM WAS HOSPITALIZED, AND HE SAID, 'I JUST SAW HER LAST WEEK, AND SHE'S VERY ELDERLY, AND HE WAS VERY, VERY WORRIED THAT HE WILL NOT SEE HER AGAIN.

AND HE WAS CRYING ON THE PHONE.

AND I HAVE TO CALM HIM DOWN, EVEN THOUGH MY HEART WAS BREAKING, TOO, BECAUSE I COULD HEAR HIM.

I COULD HEAR HIS HEARTBREAK OVER THE PHONE ASKING ME, 'WILL I EVER GET TO SEE MY MOTHER AGAIN?

BECAUSE I JUST SAW HER LAST WEEK AND I WAS JUST TALKING TO HER, AND THAT MIGHT HAVE BEEN THE LAST TIME I SAW MY MOTHER.'

Sreenivasan: WE KNOW NOW IN LOS ANGELES, ALMOST ONE IN FIVE PEOPLE ARE TESTING POSITIVE FOR THIS.

WHAT YOU'RE LIVING THROUGH ISN'T GOING TO END TOMORROW OR NEXT WEEK.

HOW DO YOU GO IN DAY AFTER DAY KNOWING THAT IT'S GOING TO BE JUST AS HARD, AND YOU'RE GOING TO HAVE TO HAVE THESE CONVERSATIONS?

I'M-- I'M-- I'M HOPEFUL THAT WE WILL HAVE-- THAT THE SITUATION WE'RE IN WILL END.

WE RECENTLY HAVE THE VACCINE.

I RECEIVED MY FIRST DOSE TWO AND A HALF WEEKS AGO, AND I'M ACTUALLY SCHEDULED TO GET MY SECOND DOSE A LITTLE BIT LATER TODAY.

SO I'M HOPEFUL THAT BY THE END OF THIS YEAR, THAT WE WILL BE ABLE TO BE BACK TO OUR NORMAL LIVES.

I'M HOPEFUL.

I'M ALWAYS HOPEFUL THAT WE WILL GET BACK TO WHAT WE NEED TO GET BACK TO, WHICH IS, YOU KNOW, GETTING TOGETHER OUR FAMILY AND FRIENDS.

BUT WE NEED TO DO IT SAFELY.

WE NEED TO DO IT SO THAT WE DON'T SPREAD INFECTIONS TO OTHER PEOPLE, ESPECIALLY THE MOST VULNERABLE IN OUR POPULATION.

Sreenivasan: WHAT IS THE TOLL THAT THIS TAKES ON YOU WHEN YOU GO HOME-- I'M SURE THERE ARE A LOT OF THINGS THAT YOU SEE THAT YOU DON'T SHARE WITH YOUR FAMILY.

BUT HOW DO YOU-- HOW DO YOU GET THROUGH THIS?

FOR ME PERSONALLY, MY HUSBAND IS VERY, VERY SUPPORTIVE.

HE LISTENS TO ME AND TO MY STORIES, THAT THAT DAY WHEN I HAD TO PUT MY VERY FIRST PATIENT INTO A BODY BAG, A HUMAN BEING, SOMEBODY'S MOTHER, IT WAS VERY DIFFICULT FOR ME BECAUSE I'M GOOD AT WHAT I DO.

I FEEL LIKE I'M REALLY GOOD AT WHAT I DO.

AND I WAS TELLING MY HUSBAND WHAT HAD HAPPENED THAT DAY, AND I GOT HOME, AND I WAS REALLY HUNGRY BECAUSE I HADN'T EATEN MY LUNCH YET.

I TOOK-- I GOT SHOWERED AND I LOOKED IN THE FRIDGE, AND I JUST STARED, YOU KNOW, AT THE TUBS OF ICE CREAM WE HAVE IN OUR FREEZER, AND I SAID, 'SHOULD I PUT THIS IN A CUP OR A CONE?'

AND I SAID, YOU KNOW WHAT, I'M JUST GOING TO EAT THIS OUT OF THE TUB SM.

AND AS I'M EATING IT OUT OF THE TUB I'M SOBBING TO MY HUSBAND TELLING HIM THIS STORY ABOUT HOW MY PATIENT'S SON HAD CALLED AND ASKED ME TO SAY GOOD-BYE TO HIS MOTHER FOR HIM.

AND THEN LATER ON THAT SHIFT, I HAD TO CLEAN HER UP AND GET HER READY TO GO INTO A BODY BAG TO GO TO THE MORTUARY, AND IT WAS A VERY, VERY HARD SHIFT FOR ME.

I TRY MY VERY, VERY BEST TO NOT HAVE TO DO THAT WITH A PATIENT.

BUT FOR THIS PARTICULAR ONE, THE PATIENT WAS PLACED ON COMFORT CARE, AND I WAS SUPPOSED TO LET HER GO SO THAT SHE CAN BE AT PEACE.

BUT IT WAS STILL VERY DIFFICULT FOR ME TO THINK ABOUT DOING THAT, YOU KNOW.

SHE'S A HUMAN BEING.

SHE COULD HAVE BEEN MY MOTHER, WHICH THE WAY I THINK OF MY PATIENTS, WHICH MADE IT EVEN MORE DIFFICULT FOR ME.

Sreenivasan: NERISSA BLACK, THANKS SO MUCH FOR JOINING US.

THANK YOU SO MUCH FOR HEARING OUR VOICES.