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Patient Care COVID-19

Caring for the Sickest COVID-19 Patients Brings Challenges, Sacrifices, Big Rewards

'The majority of the patients that are on life-support systems are going to live, and they are going to do well'

Author Debra Melani | Publish Date May 21, 2020

Editor’s note: “Our COVID-19 Fighters” is an occasional series highlighting the ways the CU Anschutz Medical Campus community is helping patients and the wider community in the fight against the pandemic. We welcome your story ideas; please share them here.

Since COVID-19 took over his world, Marc Moss, MD, lingers in his patients’ rooms a little longer.

The critical care pulmonologist works even harder at earning his patient families’ trust and answering every question they have about their loved ones’ care. And when the stress becomes too much, he takes a walk, re-energizing through the slew of yard signs thanking front-line workers for their sacrifices.

His coworker, Charge Nurse Traci Priebe, RN, BSN, uses her voice and eyes to show scared patients staring up at her masked face in the COVID-19 Intensive Care Unit (ICU) that she genuinely cares. As she holds their hands and strokes their hair, letting them know they are not alone, she tries not to think of the irony of her personal struggle: She cannot be with her own father, who is facing late-stage cancer.

The two healthcare providers shared their challenges working with the pandemic’s patients at UCHealth University of Colorado Hospital during a May 18 talk: “COVID-19: On the Front Lines.” The virtual event was presented by the Colorado School of Public Health, the Denver Museum of Nature & Science and the Institute for Science and Policy.

‘Appreciative of us for the care we give’

Forming bonds and building trust with his patient families has always been an important part of his job, said Moss, head of the Division of Pulmonary Sciences and Critical Care Medicine in the University of Colorado School of Medicine. Doing that over a computer screen with a mask covering his face, talking with someone worried about losing a quarantined loved one, makes his job tougher, Moss said.

The highly contagious novel coronavirus also targets multiple family members at once, Moss said, another unusual circumstance families and critical caregivers now face. “There are times when we have a husband in one room and a wife in another room. And that’s a horrendous experience for that family.”

"Trust that we care so deeply and so very much, and we are doing our best in trying to show that to your loved ones." – Traci, Priebe, COVID-19 ICU charge nurse

 

Fear of being a vector of the virus with their own family and friends, as with Priebe and her immunocompromised father undergoing cancer treatment, also weighs on their minds, Moss said. “I’ve never in the past worried about my own health caring for patients,” he said.

Yet drive and compassion outweigh those fears for him and his colleagues. “I think I’m actually spending more time in patients’ rooms than I have in the past, because there are no family members in the room,” Moss said.

Reminding that losses are relatively rare, Moss said watching only one family member allowed in the hospital room when a loved one is passing away, bearing the brunt all alone, is excruciating to see. But doctors and nurses sit with that family member, often holding an iPad and allowing other family members to say goodbye.

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Dr. Marc Moss, professor in the CU Anschutz School of Medicine, speaks at a governor's press conference on COVID-19.

“People are very appreciative of us for the care we give,” Moss said.

Although it’s impossible to put themselves in their patient families’ situation, Priebe said her biggest advice to those families is: “Trust us. Trust that we care so deeply and so very much, and we are doing our best in trying to show that to your loved ones. We are there to care for them more than just physically. We are there to care for them psychologically, spiritually, emotionally. We are doing everything we can to support them and to make sure they don’t feel alone.”

Nurses comfort patients and doctors explain everything, even with patients who are highly sedated or in medically induced comas, the two said. And despite mixed messages in the media, Moss said: “The majority of the patients that are on life support systems are going to live, and they are going to do well. That’s the rewarding side.”

‘This is unprecedented in medical history’

Learning from doctors in countries who faced COVID-19 before the United States helped prepare him and his colleagues, allowing for better patient care, Moss said. “The world has gotten very small,” he said of technology’s impact both in talking to faraway doctors and to worried patient family members.

“I really do think this is unprecedented in medical history – that people are communicating and learning in real time to better take care of patients.”

Technology reigns in direct patient care as well, Moss said, showing pictures of the life-support systems the hospital on the University of Colorado Anschutz Medical Campus has available for its critical patients with the oxygen-stealing COVID-19.

Mechanical ventilators breathe for the patients whose lungs can withstand it. ECMO (extracorporeal membrane oxygenation) machines help when lungs are not strong enough, taking the blood from the patient, re-oxygenating it to normal levels, and pumping it back in their oxygen-deprived bodies. Dialysis machines work for failing kidneys, and intravenous drips of potent medications keep blood pressures from dropping too low.

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Critical care nurse Traci Priebe poses with her father, who cannot see his daughter while undergoing late-stage cancer treatment because of the risk of viral transmission.

Moss said society needs to prepare for an onslaught of exhaustion and burnout in providers, one of his primary research areas. The system must tend to those needs of healthcare workers moving forward, a movement he hopes can help de-stigmatize mental healthcare for society.

“There’s nothing wrong with the healthcare professional. We just have difficult jobs and have seen difficult things and need help to recover from that.”

The camaraderie in the profession and the unity felt in the community are two big positives he also hopes will persevere, Moss said, referring to the signs of support in people’s yards. “Everyone needs a little external validation now and then. When I’ve had a particularly bad day, I take the dog for a walk, and see those signs, and it kind of cheers me up.”

Find this and other video recordings of the series here.