What’s life like in French Hospital ICU during COVID? ‘Nobody has ever once backed down’

Michele Constable misses smiling at people at work.

As a nurse in the Intensive Care Unit of French Hospital Medical Center in San Luis Obispo, Constable said things often get a little, well, intense.

But a smile has always been the key to conveying a message to her patients and their families: “I’m here to help. Everything will be alright. Trust us.”

For the past year, that sympathetic gesture has been obscured by the simple paper masks required of all staff in the ICU thanks to coronavirus.

“I think it’s important,” Constable said of mask-wearing, “but it’s also changed nursing for me personally. I feel like losing the ability to smile at a patient, encourage them — something so small, it’s changed nursing quite a bit, I think.”

For the staff working in French’s ICU, the past year of pandemic has been a roller coaster of change, unmatched by even their previous experiences in potentially the most high stakes unit of the hospital.

Since March 2020, the members of the ICU have pivoted daily, at times hourly, to meet the needs of the hospital’s critically ill patients, all while managing the stressors of living through a pandemic themselves.

In the ICU, they’ve witnessed brilliant recoveries and the joyful postcards months later from patients, thankful for the care they received.

But they’ve also witnessed death, and the sadness that comes from loved ones unable to be at the bedside because of coronavirus restrictions.

It’s hard work, but somebody has to do it.

“It’s scary to get hit with a pandemic,” Rose Bray, senior director of nursing and the ICU, told The Tribune during an interview March 9. “That seems silly to say but, you know, it’s every day going into these rooms, and having face-to-face interactions with patients and their families at probably one of the most vulnerable times of their lives.”

“And it’s a privilege,” she added. “I know that sounds odd, but it is a privilege to be part of that.”

‘No fear, no hesitation.’ Administrator describes how they prepared for pandemic

Looking around the ICU unit on the first floor of French Hospital, physical evidence of the pandemic is littered throughout.

Orange bags labeled with nurses’ names hang from metallic poles, pushed aside to various corners of the room somewhat haphazardly.

Inside those bags are staff’s individual PAPR (powered air purifying respirators) and personal protective gear they wear when working with COVID-19 patients.

Hand-sanitizing pumps stand next to doors, and are frequently used by the staff as they move between rooms.

In Bray’s office at the front of the unit, a quarter of one shelf is lined with binders labeled “COVID-19 Preparedness.”

That’s actually what much of Bray’s job over the past year has been: preparing for coronavirus.

“For an open-heart patient, we know the pathology, we know the protocols. It’s very set. It’s very choreographed,” Bray said. “If somebody comes in with sepsis, we know our protocols, we know our medicine, we know everything about how to treat that patient.”

“This was different, she said. “We didn’t know.”

So what did they do? They practiced.

Immediately, the ICU team launched into learning mode, Bray said. How do you deal with a virus you’ve never seen before?

“We knew it was a novel virus, so we took what we had based on dealing with similar viruses and applied it,” Bray said. “And then every day, we’d learn new things, adjust, learn new things, adjust. So there was a lot of change.”

They started implementing morning and afternoon huddles to stay up-to-date and to keep staff informed. They updated one of the wings of the hospital into a secondary ICU in case of a surge.

They began running drills: What do you do if a COVID patient goes into cardiac arrest? They began training the nurses to do the jobs of other people in the ICU, like how to draw blood and how to use the wireless EKGs, to reduce the risk of contaminant spread and save limited PPE resources.

“We did it on night shift, we did it on day shift,” Bray said. “So we trained.”

All that preparation didn’t really come into play until late in 2020, when local coronavirus cases began to surge. But by that time, they were ready, Bray said.

“No, no fear, no hesitation,” she said. “Just people willing to get in there.”

Physical therapist urges people to take COVID-19 seriously

Wade Tillotson is one of those people whose job requires him to just “get in there” with the patients.

As a physical therapist, Tillotson’s said his work with coronavirus patients in the ICU is really about trying to “reactivate them as people.”

“Usually what happens when we have patients who’ve had COVID, sometimes they’ve been on a ventilator, sometimes they’ve been just deconditioned because they’ve been in bed for so long,” he said. “What ends up happening is, their lungs — nothing’s working very well anymore. Everything starts to kind of slow down because they’ve been on a ventilator or in bed for a long time. So because of that, just even getting them up and getting their tolerance for standing and sitting is sometimes a big job of itself.”

Another big task has been the focus on safety and reducing the chance of cross-contamination between patients, Tillotson said.

“It’s kind of been eye-opening because we have to be so cautious,” he said. “It’s really put a spotlight on safety.”

Tillotson said the hardest task however, has been watching patients struggle with the contagious virus, with almost no rhyme or reason to who is hit hardest.

“Having someone who is younger than me, and they struggle, trying to make sure that she can get up, sitting on the edge of the bed, reliant on oxygen ... it’s been hard,” he said with a weary sigh. “We see a lot of very sad cases come through here, very difficult cases.”

One key example is a father and son duo who were roommates in the ICU, Tillotson said.

Both had COVID-19. The son in his 30s pulled through — not without complications — but the father died.

“You never know who it’s gonna hit hardest, but it can. There’s the potential for it to hit very, very hard,” Tillotson said. “So people should take care of themselves, wear masks, keep distancing going because if you don’t do it for yourself and aren’t doing it for somebody else, care about your fellow people in the area. Care about your neighbors, and just do the things you’re supposed to do keep everybody safe.”

Nurses, ICU staff come together to fight coronavirus

Watching their cool efficiency as another (non-COVID) patient is wheeled in, it’s easy to forget that the people working in French Hospital’s ICU are just that: people.

They had to deal with the personal uncertainty of the times just like the rest of us — What am I supposed to do with my kids when schools are closed? When will I get to see friends and family again? Why is the toilet paper always gone now?

But come time for their next shift, they still suited up in personal protective equipment for long, grueling and emotionally draining stints on the pandemic’s front lines.

Bray said soon after the pandemic really got rolling, and it began taking a toll on the staff, French Hospital made efforts to relieve some of the stress on its workers.

They turned an unused room into a serenity room with a massage chair and yoga mat so staff can stop by to relax during a difficult day.

They also began having virtual “debriefing” session after a patient dies. The meeting is held on Zoom and all staff in the unit are invited to attend, though not required.

“Whether they choose to come or not, it is an opportunity for the whole team to get together and just kind of have a confidential venue for them to talk about what happened,” she said.

In all, Bray said she has been “extremely proud” of her team and how bravely they’ve faced being on the front lines of the pandemic.

“The nursing, the physicians, the care coordinators, physical therapists, respiratory therapists — the entire team has come together, and they don’t shy away from anything,” she said. “I mean, they run into it and embrace this. And nobody has ever once backed down.”

Though the last year has been filled with challenges, they’ve weathered the storm as a family, she said.

“I would be proud for any one of them to take care of me or my family members,” Bray said. “I trust them implicitly.”

Kaytlyn Leslie

The Tribune

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Kaytlyn Leslie writes about business and development for The San Luis Obispo Tribune. Hailing from Nipomo, she also covers city governments and happenings in San Luis Obispo. She joined The Tribune in 2013 after graduating from Cal Poly with her journalism degree.