Intermountain doctors and nurses return from New York with lessons for Utah during the coronavirus pandemic

(Leah Hogsten | The Salt Lake Tribune) l-r Dr. Dixie Harris, Dr. RJ Bunnell, Dr. Paul Krakovitz and Dr. Harland Hayes, all members of Intermountain Healthcare Team that recently returned from New York City after assisting with ongoing COVID-19 care, shared their experiences at a press briefing, May 6, 2020 at the Intermountain Transformation Center.

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Whitney Hilton said working in a New York intensive care unit during the coronavirus pandemic was like trying to use ice cubes to put out an inferno.

The Utah nurse, who volunteered to respond to the crisis there, would race around hundreds of beds and turn patients onto their stomachs and insert breathing tubes and administer medications and check on heart rates. But there were so many sick people. And what she could do to help them was limited.

“In the end, you could only focus on what was the most important: keeping the patient alive as best as possible,” she said Wednesday.

Hilton was one of a team of 100 doctors and nurses from across Intermountain Healthcare who went to New York to lend a hand to health care workers in one of the worst-hit areas in the country. After 14 days of duty, the group returned to Utah this week. It’s been a somber homecoming.

Like Hilton, many have been reflecting on the hardships they saw and have struggled to describe just how bad it was. They’ll now be tasked with taking what they learned from the experience — one of the reasons for going — and using that to help guide efforts in Utah, where the hope is to stop the pandemic before it spreads as widely but also to be ready if it does.

“I know that Intermountain is going to be prepared now,” said RJ Bunnell, one of the physicians who went on the trip, during a news conference Wednesday. “There is so much we learned in New York.”

As of Wednesday, there were more than 5,500 cases in Utah and 58 deaths. Those who returned from New York said that could quickly change; the devastation there includes more than 20,000 deaths. Some of the hospitals where they worked, too, were in suburban areas that looked like Utah. Physician Dixie Harris said where she was stationed in Long Island reminded her of Millcreek.

“It really drove home how horrific this disease is and how cruel it can be,” Harris added.

Four staffers took turns describing their encounters. All warned people to stay home and maintain social distancing as much as possible — even as Utah relaxes some restrictions — to avoid a similar tragedy. Emergency physician Harland Hayes suggested that if any state reopens too soon, there will be dire situations comparable to what they dealt with in New York.

The Utah caregivers recalled seeing patients line the hallways. Ventilators whirred loudly trying to keep them breathing and alive. Hilton said she heard the “code blue” buzzer go off about 20 to 30 times a day over the intercom in the ICU. It meant another person had died from the virus.

“It would beep and beep and beep,” she said. “I was just overwhelmed by the number of times.”

The staffers said that both the losses and the triumphs will inform their care here. For Hilton, the biggest lesson was making sure that staffers remember the humanity of the patients even as they’re inundated with cases.

She recalls on her first day in the New York ICU going into a man’s room where there were photos of him and his family plastered on the walls. In one, he was holding his grandson. In another, he hugged his wife. It reminded her that he was human — not just another sick person to check off a list.

“There were people in those pictures who wanted him back,” she said.

In New York, she also held the hands of dying patients who couldn’t have family there because of how contagious the disease was. And she tried to learn their names or learn something about them, such as what shoes they prefer to wear. Hilton plans to incorporate some of that in her care in Utah.

(Leah Hogsten | The Salt Lake Tribune) Dr. RJ Bunnell and nurse Whitney Hilton, both members of Intermountain Healthcare Team that recently returned from New York City after assisting with ongoing COVID-19 care, shared their experiences at a press briefing along with Dr. Dixie Harris, right, May 6, 2020 at the Intermountain Transformation Center.

Harris said the experience reminded her why health care systems are set up as they are, such as requiring nurses to double-check a medication before administering it. Even if cases soar here, she added, hospital staff should maintain those safety basics and “not take any short cuts."

That includes breaking up tasks by teams, as the staff in New York did, so that nothing crucial is forgotten. There’s so much going on, she said, but simple things keep patients alive. And she warned that no one should be relying on unproven or unstudied treatments.

The physician also learned how to recognize cases of the coronavirus that are unusual or symptoms that might indicate someone is worsening quickly. And she realized anyone — no matter their age — can be impacted. Before going to New York, she said, she knew that was the case, but she wasn’t prepared to see it. She didn’t realize how shocking it would be.

“Every one of us saw someone who was very sick and in their 20s,” Harris said.

She recalled one of the nurses she worked with there who had a relative catch the virus; the individual was being treated in the same hospital where the woman also worked. Each time an alert went off for a patient on the sixth floor, the nurse held her breath, hoping it wasn’t her loved one.

Harris cried. She has been worried about her own mom becoming infected. “I know now that this disease can spread like wildfire,” she added. “And we need to respect it.”

Upon returning to Utah, all of the Intermountain staff who volunteered have been tested for the coronavirus. So far, all of those tests have come back negative.

With their return, each of the caregivers also described how entire floors of the hospitals in New York were converted into ICUs — something they never expected to see — and how patients were put two in a room and in every open spot in the hallways. At the hospital where Bunnell volunteered, they normally treat up to 200 in the ICU. They had 590 patients.

Intermountain will study those plans, too, and try to prepare to convert its own facilities, if needed.

Bunnell said he took away from the experience just how drastically different the coronavirus is from the flu and how they shouldn’t be treated the same. In five weeks in New York, more patients have died from COVID-19 than in five years of dealing with the seasonal flu.

They had to adapt minute by minute to help people, he said. Where Hilton described it as an inferno, Bunnell said it was like a giant, constantly changing puzzle.

Either way, Hayes, the physician who warned against opening states too soon, said he learned the only way doctors can get through the chaos is to cling to the happy moments — like when he delivered a baby in the middle of the bustling New York ER.

He was placing a breathing tube into a coronavirus patient when he heard a nurse scream from down the hall. “Hurry! Help!” she yelled. “There’s going to be a delivery.”

Hayes said he ran through the ER to the ambulance bay, where there was a young woman in labor. She didn’t have the coronavirus, but there wasn’t time to get her to a separate maternity ward, so the staff made her a private space where they could help her.

And in a place where there had been so much death, the woman gave birth to a healthy baby boy.

“The stress and tension gave room to smiles and laughter and joy,” Hayes said. “It reminded me there’s happiness during difficult times.”

To him, it was like a really big ice cube.

(Photo Courtesy of Intermountain Healthcare) Intermountain medical staff flew to New York to help fight the coronavirus there.