Battling the pandemic 'ultramarathon,' through a nurse's eyes

Even a short time wearing mask 'could save somebody's life,' Centennial ER nurse says

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Even though he had followed all the guidelines — social distancing, wearing a mask, spending most of his time at home, washing his hands — a senior still arrived at Centennial Medical Plaza, feeling tired but thinking the sensation would go away.

Without a smartphone or tablet, the man was communicating with family on the landline in the emergency room.

Emergency-room nurse Michelle Schroder knew, after observing the man's condition, that her staff would need to transfer him to another medical campus. And she knew that, at the time, visitors were not allowed. The man had come to Schroder's building with his wife and daughter.

“I just had a sinking feeling that that was going to be the last time he was going to see his family,” said Schroder, 48. She added: “It's kind of a feeling that's really hard to shake.”

Working in the ER, Schroder sees patients leave and usually doesn't find out what happens to them next. She never found out what happened to the senior.

“They go home or they get admitted (to a hospital) and it's not often that we know the outcomes of the patients,” Schroder said. “We're in their lives for just a brief moment, and that's it.”

It's one of the challenges that Schroder, who lives in southeast Aurora, has faced during 10 months of working a job that puts her face-to-face with the pandemic and the array of emotions that it entails. She remembers the stress as COVID-19 patients first began to surge into local health-care facilities as the pandemic mounted in Colorado.

“I remember the very first shift when we realized, 'Hey, it's here, this is a problem,' and just feeling as if something really bad was just going to come through the doors,” Schroder said.

Working in emergency medicine, the scene can feel like all-or-nothing: Nurses go through hours of shifts with smaller matters, such as lacerations or sore throats, and then someone arrives with a more acute emergency — having a heart attack or a stroke, Schroder said.

“But you never really worry too much about what's going to come through the door,” Schroder said. As a nurse, “you know you can handle it,” she added.

With treating COVID-19, though, “it almost felt like because we didn't know what it was, it felt a lot scarier,” Schroder said.

As she watched Colorado's public health restrictions in March slowly build up into a stay-at-home order, she had no idea how long it would be before things started to return to normal and people could safely socialize again.

“In the very beginning I just took it in a day-by-day basis,” Schroder said. “And I think that's what a lot of other folks did as well. That feeling of, 'March and April lasted two years.' It was the feeling of being fully in the day, minute by minute, waiting and watching. I knew it wouldn't last forever — I figured it would be less than two years. But had no idea.”

'A mom of schoolkids'

A day after receiving her first shot of a COVID-19 vaccine in mid-December, despite all the trials of fielding patients in a pandemic, Schroder still smiled when talking about her experience living through COVID-19's spread in Colorado.

“In the beginning, people would say, 'Gosh, this must be such a change for you,'” Schroder said. “And (already) having to work nights and sleep in the day, having kids in school, having a husband, not a whole lot changed for me in terms of my routine. I'm a mom of schoolkids, so you need to do the same things: You need to make dinner, help with schoolwork, make sure the house is in some kind of order.”

With her husband working from home and her two kids taking classes online after Cherry Creek School District went remote in March, getting adequate sleep between her shifts was difficult at first, but the family learned to adjust. The isolation from friends and “the heaviness of the situation” weighed on her kids and husband, but Schroder says her own mental health wasn't impacted.

She found her experience partly summed up when watching a TED Talk, a popular type of thought-provoking speech posted online.

“It was an ER doctor who was talking about, 'How do you manage stress during the time of the pandemic?'” Schroder said. “She said it's the constant triage we do. It's reprioritizing the information, the stressors that are coming in to us. We can't treat every stressor as if it's a 'red.'”

In the system of “triage” — the priority of which patients to treat first — health-care workers assign the levels red, yellow and green based on the urgency of the problem, said Schroder, a clinical nurse coordinator who has worked in health care “at bedside" for 22 years. She started as a certified nursing assistant, worked as an emergency medical technician for 10 years and has worked as a nurse for 10 1/2 years.

“For me, having done this for such a long time, I think I had the advantage of treating my stressors as: OK, is this immediately life-threatening? Requires my attention but can wait? Or is it somewhere in the middle?” Schroder said. She added: “I think in my personal life and as far as my mental health, that's helped me out a lot.”

'We weren't planning on a marathon'

Because Centennial Medical Plaza doesn't have inpatient beds, Schroder hasn't had to confront COVID-19 deaths but has responded to severe illness. She and her staff care for patients in the short term until they are transferred to inpatient care — the plaza can't keep patients overnight.

That will change when the plaza completes an expansion to become the newly named Centennial Hospital, a shift expected in the upcoming months of 2021.

By that time, the landscape of the pandemic in Colorado could be markedly different. The highest-risk health care workers and individuals — and then Coloradans aged 70 and up, moderate-risk health care workers, first responders and “frontline” essential workers — are expected to have access to the vaccine this winter, according to Colorado's COVID-19 website. Up next are other high-risk individuals and other essential workers in spring, and then comes the general public in the summer.

The vaccine rollout's timeline could change based on logistical factors involving the federal government and health-care providers, according to the governor's office.

As Schroder watched Colorado's public health restrictions take hold of daily life, she thought of the timeline of the 1918 flu pandemic, hoping the public could avoid some of the pitfalls society faced back then.

The world has more advanced technology and better health care now, “but really what it came down to was prevention, and that holds true for any medical condition that can be acquired,” Schroder said.

She felt prepared to handle the coronavirus pandemic in the short term, but she thinks what's wearing on health professionals now is how long the pandemic has endured at severe levels.

“We weren't planning on this being a marathon, and I think it's more turned into an ultramarathon,” Schroder said.

Reading fiction books — stories that have “absolutely nothing to do with medicine,” she said with a smile — has helped her move forward through the slog of working through the pandemic month after month. So has watching TV shows as a family, which came as a new aspect of life in her home amid the pandemic, along with doing puzzles together and taking the dog on walks more often.

Some activities she and her husband miss the most are attending concerts at small venues where friends of theirs would perform, Schroder said.

As public activities hopefully become safer, Schroder is looking forward to skiing again now that resorts have opened up.

“I still have my pass in hand and ready to go,” she smiled.

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