'This is worse than ever': Shands doctors, nurses deal with stress of latest COVID surge

There’s the community outside of UF Health Shands Hospital, where mask-wearing has declined from the early days of the pandemic, businesses are open and tens of thousands of mask-less fans attended a UF football game last Saturday.

To some, it could seem like life is getting back to normal.

But then, there’s the world inside the COVID unit of the hospital, where doctors and nurses say they have been seeing the tragic results of foolish decisions, particularly a reluctance by so many patients they see to get vaccinated.

They repeatedly use terms like “demoralized,” and “frustrated” when describing the emotional toll this latest surge has taken on them and their families.

"Demoralizing is a great word for that,” said nurse Christina Tretter. “It’s been very frustrating because it seems that many people still don’t take it seriously."

Patients seem to be sicker with this latest delta strain, she said.

"This is worse than ever," Tretter said. "I feel like we are swimming up-stream."

Tretter, who has worked in the COVID unit of the hospital for the duration of the pandemic, said the stress on health-care workers is worse than ever.

“At the beginning it was kind of an adrenaline-fueled, ‘Wow, what kind of craziness is this?’ It was exciting — in a bad way," she said. "It was new. It was unknown. Nobody really had answers yet. But now we have the answers. The patients are becoming more sick. Many people are almost defiant about the knowledge we have about the disease.”

She said it’s disappointing that most of the patients they are seeing in the COVID ward are unvaccinated.

“And many admit to not wearing masks at all — going to parties, going to different activities and events with no masks,” she said. “It’s frustrating when they still don’t think it’s a thing. They’ll say, ‘Vaccinations don’t help anyway. Masks don’t help anyway.’"

Considering other careers

Tretter said many health care workers have left the hospital to take less stressful jobs.

“I know a lot of nurses who are considering other careers altogether,” she said. “Nurses have the weight of people’s lives on their shoulders, but they are not paid that way. Unfortunately, we’re asking people to come into a career field that wears you down emotionally, mentally. You are on your toes for 12 hours. We’re wearing all this equipment for 12 hours.

She points to her paper mask.

“This has been pressing against my sinuses all day,” she said. “And that’s just paper. We’ve got all this other stuff. We are sweating in our gowns.”

And she said potentially having COVID patients' lives in your hands all day adds to the tension.

“We are having to predict what is going to happen with each and every case at any given time," she said. “We are having to solve problems as they come up. We’re having to save lives. We are having to make sure we give the correct treatment and we don’t kill the patient. There is a lot of stress on us."

Tretter, who has adult children and two grandchildren, said the worry doesn’t leave when the shift is done. 

"When you cough you think, ‘Did I give them COVID? Did I bring that home with me?’” she said.

Her four, weekly 12-hour shifts usually end up being 13 hours or more, as treating COVID patients is time-consuming. Talking with family of those hospitalized is part of the job.

“They are anxious and they are frustrated,” she said. “And sometimes they are downright angry that they can’t see their family members. Most of them are understanding, but some of them are very upset, so we try and do our best.”

For more than 18 months, doctors and nurses have been treating COVID patients. And a few months ago, they said, they thought they had it licked, with only a handful of COVID patients at Shands being treated.

Then, the highly contagious delta variant came along just when society had let its guard down and many people stopped wearing masks  — even the unvaccinated.

'I cannot tell them that this wouldn't have happened if they had taken the vaccine'

Dr. Kiran Lukose, who works in the COVID ward, said he sometimes has to bite his tongue when he sees sick patients, knowing they likely would not even be there if they had been vaccinated.

“I’m not frustrated about taking care of these patients because that’s our duty,” he said. “Looking at the patients I take care of, the way they are suffering, I cannot tell them that this wouldn’t have happened if they had taken the vaccine.”

But he said he can't help but think that to himself.

“I know that, and it’s really hard (to watch),” he said. “We have had 12 months of data and we’ve had all this time, and this could have been prevented. Several deaths could have been prevented. It hurts. But there is no point telling them at that time because they are suffering, so we have to give all the support we can to them.”

The influx of new COVID cases has strained hospital resources and staffs throughout the country. Shands has brought in contract nurses to help out, but the staffing struggle is ongoing, hospital officials have said. The hospital is also taking in many patients from the region, as other area hospitals in outlying counties with lower vaccination rates than Alachua County are at capacity.

With this latest surge, Lukose said he hardly ever gets to spend time with his young children when it's his week to work. Due to the time-consuming nature of handling COVID cases, his seven-day, 12-hour shifts from 7 a.m. to 7 p.m. usually end up being longer, he said. His wife, a pharmacist, is able to spend more time than him with their 6-year-old and 9-year-old children, he said.

“By the time I get home, they are all asleep and I don’t want to go hug them (out of caution)," he said. "I go straight in the shower, take off all the clothes and then try to avoid too much contact."

Adding to his tension is the fact that this variant is hitting more young people and he doesn’t want his kids to be one of them, he said.

“We don’t know how bad that is going to be,” he said.

Lukose, who has been a physician at Shands since 2012, said the intermediate care area where there are sicker COVID patients is "literally a war zone.”

“One minute I see that everything is fine, and 10 minutes later, they are crashing,” he said.

'Most people cannot understand the seriousness of this'

Rocio Rosario, another nurse who works the COVID unit, said much of the public is unaware of how serious this surge has become.

“We spend 12 hours with these patients (on a shift),” she said. “Most people cannot understand the seriousness of this. It's been just very emotionally taxing.”

Adrienne Williams, a nurse manager, said health care workers are also having to deal with psychological trauma of what they are seeing in the COVID ward.

“When you have young patients that are coding, and the teams are having to do CPR on them, seeing that, and seeing your team of nurses deal with this day in and day out, continuing the cycle —  it’s tough and challenging,” she said. 

Nurse Brenan Bading, who has two young kids and another one on the way as his wife is pregnant, said this latest surge has “been a roller coaster ride."

Bading admits he has pondered getting another job.

“I’m just weighing my decisions if I stay here or not,” he said. “(Leaving) has crossed my mind a lot of times, especially when you are tired. It’s like, ‘What am I doing here?’ But then again, we are here to help people.”