6 Spirit Summer 2020 Edition
ON THE FRONT LINES continued from page 4 She’d give a patient a mask if he or she didn’t have one, “put them at ease as much as possible” and stick her swab deep into the nasal cavity. “It’s over very quickly,” but “it’s unpleasant and uncomfortable,” she said. Gochenour and his fellow respiratory therapists had to get used to wearing more protective equipment — N95 masks, goggles and face shields — than had been typical during an ordinary 12-hour shift. Only when preparing to enter a confirmed COVID-19 patient’s room did they put on protective yellow gowns, two pairs of gloves and PAPR hoods, said Gochenour, a former Douglas County corrections officer who had to change careers due to on-the-job injuries at the Omaha jail. In those first weeks, he said, they had few options for treating patients other than inhalers much like those used by asthma sufferers. “It’s more palliative,” he said. “Our big thing is just trying to ease their work of breathing.” The Callaway and Dawson County patients filled up the initial 16 beds GPH had isolated for COVID-19 patients. The hospital had plans for handling many more but didn’t have to go there, Gochenour said in June. Staffers at the Callaway nursing home had enough success in caring for them that none of their COVID-19 patients required ventilators, he said. By contrast, the Dawson County patients, including Orellana, were mostly “already intubated when they arrived,” he said. Tensions were high among COVID-19 ward caregivers early on, Gochenour said, as they coped with their personal fears and national and world health treatment guidelines that “seemed to change every six hours.” But staffers gradually learned how to reduce their own stresses while also seeing some of their on-the-fly treatment strategies pay off, he said. One vital technique revived from the 1918-19 Spanish flu pandemic — many of whose victims subsequently died from pneumonia — involved turning patients onto their stomachs. That keeps the heart from pressing down atop the lungs and making it even harder to breathe, Gochenour said. The “awake pronation” helped improve their long-term breathing capability. Therapists would have patients hold one arm up and the other one down. “I refer to it as the ‘Superman’ position,” Gochenour said.
GPH also enjoyed limited success with albuterol, a drug that dilates the airways, Gochenour said. Regardless, weaning patients off ventilators was tough for all involved. Because ventilated patients often had to be sedated, he said, “they were unable to do the simplest things like picking up a spoon.” Physical and occupational therapists had to help them relearn. Like other GPH workers during the height of the pandemic, Gochenour and Jacobson were isolated from the public during the day and faced much the same situation after shifts. They had to bring extra clothing to work to change into before going home. They’d bag up their “regular” clothes in plastic bags, put them immediately in the washer once home and go straight into the shower. For Gochenour, whose 14- and 12-year-old sons live with their mother in Fullerton, that meant an empty home in Kearney. He’d order his groceries and toiletries from Walmart’s drive-up service, which put them in his car. “Before this started, I sported a big, full beard I had to get rid of,” he said in April. “That was hard to do. I’d had it for 15 years.” As the lockdowns continued, Gochenour gave up his 200-mile round-trip commute and moved to North Platte. Because he had stayed self-isolated at home, he didn’t have to miss work at GPH after his move, he said. He talked to his sons a lot on the phone and via FaceTime. With COVID-19 restrictions finally relaxing in May and June, he planned to finally see them in person on Father’s Day weekend. “It’s easy to stay in touch, but it’s not the same as having them there with you,” Gochenour said. Jacobson and her husband, whose three children are grown, at least had each other. By taking “every precaution possible when I’m at work,” she didn’t have to self-isolate at home, she said. Even with the recent easing of some COVID-19 restrictions on public gatherings, Gochenour said, it’ll likely take six to 18 months before the virus recedes and proven, safe vaccines are ready. “The prevalence of COVID-19 here has remained relatively low because, No. 1, we’re already relatively socially distanced because we’re a fairly rural community,” he said. “What we fear is a second or third wave that could be worse than the first.” Nonetheless, he and Jacobson said, Nebraskans should be proud that they’ve thus far avoided the nightmare scenarios so widely feared in March. For now, “I think we have to maintain a diligence and maintain the safety level we already have,” Jacobson said.
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