Jen Howard worked hard to help her COVID patients breathe easier.
Seeing patients recover was wonderful.
But it was tough when patients didn’t survive.
Today, Howard credits co-workers, the support of her family and prayer for helping her through times that she — and so many others like her — never would have imagined.
Howard, who works at Methodist Fremont Health, has been a respiratory therapist since 2017.
Although not as well recognized by the public for their work, respiratory therapists like Howard have played a crucial, front-line role in the battle against the deadly virus, which has claimed the lives of more than 537,000 Americans.
Before COVID, Howard saw patients with Chronic Obstructive Pulmonary Disease, asthma or pneumonia.
She’d provide breathing treatments, inhalers and different therapies to help with lung expansion.
Howard occasionally worked with a ventilator or a non-invasive ventilator, called a BPAP, for a week or two on a patient after surgery or one who had severe pneumonia.
Typically if patients were going to be on ventilators long term, they were sent to a skilled rehab facility.
That changed after the coronavirus pandemic broke out across the country.
“During COVID, we had lots of ventilators running,” Howard said. “We had about six at one time, which is typically unheard of for us here at Fremont, and patients were on the vents for two weeks to a month or more.”
Her days were spent making ventilator changes, drawing arterial blood gases from patients’ wrists or from arterial lines.
Medical professionals learned early in the pandemic that having COVID patients lie on their stomachs helped open the air sacks in their lungs so they could breathe better.
“We spent a lot of time putting patients on their stomachs,” Howard said.
It takes four to five people to roll one patient over. A respiratory therapist stands near the patient’s head and keeps the breathing tube in place while nurses turn over the patient and monitor IVs.
The goal was to have patients remain on their stomachs for 12 to 16 hours a day.
Every two hours, the patient’s head would need to be moved so they wouldn’t get stiff or develop sores on one cheek or the other, Howard said.
Patients who were on ventilators were sedated. While patients were still on a ventilator, medical professionals conducted wakening trials, taking them off some of the medication to let them wake up a little.
When that happened, patients wanted to see their families or asked for food.
It was difficult for Howard and other health care workers to tell patients they couldn’t have food or a family visit at that point. Nurses could help patients talk to family members via an iPad.
Howard recalls some of those times.
There were prayers. She heard lots of “get better” wishes from families.
Some patients asked for their cell phone once they came off the ventilator.
“You go to hand it to them and their thumbs are so deconditioned that they can’t even hold things like that,” she said.
Howard remembers patients who weren’t so sick that they needed a ventilator but were on high levels of oxygen.
She’d talk to them for their entire hospital stay.
“You really got to know them and got to know their story, and you thought they were doing better and the next day they went downhill and that was it and their families couldn’t make it fast enough to see them before they passed away,” she said. “It was very hard.”
Health care professionals weren’t immune from the heartache caused by what’s been called, “an unpredictable virus.”
“The hardest part was seeing the patients so sick for so long,” Howard said. “Our patients are normally on the vent for such a short time and having the same patient for a month at a time and then they didn’t make it or were trying to Face-time with their family so they could say their final goodbyes, that was so hard.”
Howard recalls what helped her through those times.
“Something we did in our department to kind (of) help with all the stress was we started praying before our reports in the morning to kind of ease everyone’s minds a little bit before the day started,” she said.
She’s appreciates the Rev. Scott Jensen, the hospital chaplain.
“It was always nice to have Pastor Scott there most of the time when the patients were kind of at the end stage to be able to pray with the families, whether that was via Face-time, pray with the staff, pray with the patient,” she said.
It was gratifying to see patients improve and be able to leave the hospital. Staff would clap and cheer as a patient was rolled out in a wheelchair.
She remembers a man who’d been at the hospital for more than a month. His wife was able to be there daily.
“You got to know her and him and then he was able to go to rehab, so that was amazing to see him roll out of here and talking a little bit and able to do things again,” Howard said.
Looking back, Howard recalls the teamwork and the long hours.
“We were working overtime like crazy in our department as well as other departments in the hospital,” Howard said. “There were some weeks I was doing 60 to 72 hours, and I normally work 36.”
How did she adapt?
“Lots of coffee,” she said.
Although she’s been a respiratory therapist for a while now, Howard never expected to see something like COVID-19.
“It’s not something you can prepare for at all,” she said.
She appreciates her co-workers and family — and something else:
“The community coming together to provide snacks or the cafeteria providing snacks when you don’t get time for lunch was super nice,” she said.
Howard believes her skills as a respiratory therapist were sharpened during the pandemic. She finds hope in the fact that numbers of COVID patients are declining.
“I’m hoping we’re on the downhill slope of this,” she said.
And that could help everyone breathe a little easier.