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The pandemic is not over and healthcare workers are not OK.

COVID-19 has profoundly impacted the world. We learned new terms and behaviors like pandemic, super spreader, herd immunity, self-isolate, social distancing and quarantine. Masks, at first awkward and in short supply, are now considered an accessory and come in colors and fabrics that coordinate with our wardrobes. Americans no longer wonder when things will return to normal and are resigned to the fact  we are living a new normal.

COVID’s impact on healthcare – employees, systems, processes – is unprecedented. In the space of a single day, doctors and nurses face many life and death struggles. Those on the frontlines of acute care have seen a higher incidence of sickness and death than what one might experience in an entire career. Industry crippling nursing shortages require current staff to work additional shifts and longer hours to meet the needs of patient care. Nurses and nursing leadership are pulled from different departments to  cover gaps in schedules. As we are well into the pandemic’s second year, the extra challenges and work demands are taking a physical, emotional, and mental toll on healthcare providers.

“COVID has tremendously impacted our front-line staff, especially our newer nurses. They have seen things in a short time that many providers only see  over a lifetime. People are weary of this pandemic and fatigued from the emotional, physical, and mental wave of the events. It has left many struggling with mental health issues like post-traumatic stress disorder, that may require therapy, medication, and support to help them cope,” said Karen Zimmerman, chief nursing officer and vice president of patient care.

In the Trenches
Elin Busta completed her Bachelor of Science in nursing (BSN) in 2018 from South Dakota State University in Brookings. She chose nursing because she felt it provided her an opportunity to support patients during good or difficult times. “My passion has always been to connect with patients and  support them emotionally when they are most vulnerable. In hindsight, I didn’t realize the gravity of my desire,” Busta said. She came to Trinity Health soon after graduation and worked in the Medical Unit. Prior to COVID-19, Busta said a stressful day might include many patients moving in and out of the unit, which would require a lot of follow up administrative duties. “Stress back then was ‘comfort care’ stress, or ‘busy’ stress. We had a lot to get done, but we didn’t carry it home after work,” she said.

When COVID surfaced in Minot, the Medical Unit was designated as the COVID floor, and stress took on an entirely new meaning. “In the beginning, it was scary for everyone,” Busta said. “We had little knowledge about COVID, patients were scared, and supplies were hard to find. As a nurse, my job was to  be compassionate, but it is hard to watch someone suffocate to death and not be affected. I’ve seen people as young as 21 die; I had a 56-year-old man beg me to help him breathe – most of these patients are unvaccinated. These are things I carry home from work and that keep me up at night.”

It’s a daily battle that shows no sign of slowing down. Since March 2020, the Medical Unit has experienced only one 24-hour period where staff did not have a COVID patient to care for.

Busta attended therapy sessions offered by Trinity Health but felt that was not enough. She became serious about mental health options for providers when she realized one of her colleagues was severely depressed. Motivated to  influence change, she spoke to her superiors, led discussions on mental health issues, and soon found her passion shifting from patient advocacy to provider advocacy. This month, Busta will begin a new chapter in her nursing career as a nurse manager of the RehabCare Unit in Trinity Health St. Joseph’s Hospital.

Kate Zimmerman has felt similar pains and finds solace in belonging to a great team of professionals. Growing up, Kate Zimmerman watched her mom advance throughout her career, which influenced Kate to pursue nursing as well. “My mom worked in the ER, and as a floor nurse. She always had such  amazing relationships with coworkers and patients. I remember being at the mall, she’d run into a former patient and they’d remember her. I thought that was so cool.”

Kate Zimmerman earned her BSN from Minot State University in July 2020. Her internship and practicum had been in the Medical Unit, and she’d really enjoyed her coworkers, so when offered a job, she asked to return to the Medical Unit.

Being a new nurse during the height of COVID was not easy. “How you care for the needs of a medical patient, versus the acute needs of a COVID patient is very different,” she said. “It was a steep learning curve. My coworkers created a “cheat sheet” for assessing a COVID patient, but after a while, you figure it out.

In nursing school, I remember reading about “Code Blue” or “Rapid Response” protocol and thought that might be a rare occurrence. But that’s not the case; during one shift, I had three rapid responses on one patient. Advocating for patients and talking to families can be so emotionally draining; it’s stressful for a new nurse, but you learn how to decompress. We rely on each other a lot.”

Staff attrition due to burnout is a large problem in hospitals everywhere and Karen Zimmerman knew it was critical to support employees’ overall well-being through different strategies. She’d read about Resiliency Rooms and decided to establish one in Trinity Hospital, which would require renovating a  room to create a space of calm. Trinity’s resiliency room is painted a soothing tan, has soft flooring, ambient lighting and peaceful artwork. Inside, two full-body massage chairs, separated by a curtain, provide therapeutic support for tired muscles and minds. The Trinity Health Foundation assisted with costs and donated electronic tablets that provide meditation apps, and a small refrigerator contains water and ice packs for use. It is open to all employees.

Scientific data suggests that a well-developed serenity area for healthcare providers decreases stress and increases feelings of well-being and renewal.

“As we looked at ways to help employees, it was apparent that there was not a place to go to truly regroup or take a restful break,” said Karen Zimmerman. “Our breakrooms are often busy with several people in them; our lunch room is busy; and the chapel maybe used by visitors and is not always the first choice. We wanted to create a serene space where people can go to refuel and refresh – even if only for 5 minutes.”

The resiliency room was made possible by a generous Trinity Health Foundation donor and former nurse, Joanne Quale. The room is dedicated to Ruth Rexine, a Trinity Health nurse for over 50 years, and all nurses who tirelessly and compassionately care for their patients. The furnishings can be  utilized in the current hospital and will be moved to the new campus when it opens.

If you are interested in donating to the resiliency room project please contact Jamie Swenson at Trinity Health Foundation 701-857-2870 or [email protected].