The night before the wedding, Newfoundland nurse practitioner Jennifer Richard told her husband that she was going to Alberta.
“I’m not surprised,” he said, and they proceeded directly to book a post-honeymoon flight to Fort McMurray.
Thus ended a blissful three-week hiatus, his first chunk of grim time since the start of the COVID-19 pandemic. The past 18 months were a frantic stretch of ICU work at St. John’s, broken in April by only one attempt to help with third-wave care at Toronto General Hospital.
Last Monday, she said goodbye to her new husband, boarded a plane and flew to Fort McMurray, arriving late that night, to help with her hospital’s newly expanded intensive-care unit.
On Tuesday morning, he started the first of four straight 12-hour shifts.
“It’s really just eating, sleeping, and working,” Richard says.
“On these visits, it’s about relief for the physicians, relief for the nurses, providing them with some support and backup. … So, we just put our heads down and get to work as soon as we get here. “
Richard is one of the faces of the unrelenting fight against the coronavirus taking place across the country, a conflict so unevenly distributed that an overwhelmed and entrenched health care system in one part of the country has been forced to take a call in other areas. are – in this case Newfoundland – for reinforcements.
She is part of a seven-member crew of health care workers – four registered nurses, a nurse practitioner and two physicians – who traveled from Newfoundland to help out at Fort McMurray, the hospital shouldering the extra burden as that province battles. Running side by side. The fourth wave of the pandemic.
As of Friday, even with that fourth wave in an apparent decline, Alberta still reported 12,978 active COVID-19 cases — the highest caseload in the country by a wide margin, and the third highest rate of active cases per capita, in the Northwest Territories and Saskatchewan. behind .
Newfoundland, by contrast, has one of the lowest per capita COVID-19 cases in the country, second only to PEI, which prompted Newfoundland Premier Andrew Fury to extend his offer of health care support to his Alberta counterpart, Jason Kenney. inspired to do. Much as he did with Ontario during the third wave.
What would it take for a nurse to volunteer – not once, but twice – to travel from one of the safest places in the country, pandemic-wise, to work in the two most dangerous?
Even Richard says she’s not entirely sure, but a partial answer extends to the circumstances of what she does, where she comes from, and how she grew up.
“I feel like, as a health care professional and a Newfoundlander, this inside of us just wants to help,” Richard says.
The desire to sacrifice has its roots in the tree of its descent. His father was a firefighter, both his grandfathers were firefighters, his brother served in the military and his mother was in public service.
“My mother always used to say that growing up I was always the one who ran for new adventures. And I was the first to raise my hand to volunteer for something. And I feel like it just came into my adult life. “
Richard’s interest in volunteering now traces him to the Northern Lights Regional Health Care Center in downtown Alberta with a long history with Newfoundlanders, many of whom moved west to work at Oilpatch there.
That connection is so close, in fact, that the Northern Alberta hospital had little problem finding the Newfoundland flag—its blue-and-white color scheme harmonizing well with the hospital’s blue front—to raise in front of its emergency room entrance. For the arrival of the forward squad.
Inside, to deal with the onslaught of COVID-19 cases, the hospital has converted one of its recovery rooms into an ICU unit, nearly doubling its ICU capacity to 10 beds.
Those beds are almost always full, Richard says. When a patient is well enough to leave the ICU, or when the patient’s condition becomes too severe for the facilities there, they are briefly evacuated, after which they are transferred to Edmonton or Calgary. is done. But there is inevitably another patient who quickly takes that place, usually transfer to the ICU from another northern region.
“It’s a revolving door,” Richard says. “It’s not just this hospital. The entire province is cycling through patients, and each system is overwhelmed in its own way. “
The unit was stocked for the original ICU with six beds. Nearly doubling that number to meet regional needs inevitably puts a new level of pressure on the local health care team. And though they may not be showing much of it outwardly, local nurses and doctors are undoubtedly weary and grateful for the new faces, Richard says.
“The morale is really good. The nurses are still very excited and enthusiastic. Of course they were happy to see us. This is their fourth wave and they really have no breaks in between waves. And every wave has been tiring for them .
“We get to say ‘thank you’ about a hundred times a day, and we applaud him for inviting him to the unit. … It’s really been such a positive experience already.”
Richard’s previous health care respite trip to Toronto in mid-April, which she describes as a highlight of her career, was a posting where she learned things she could bring home not only to St. Could take it anywhere. McMurray on the way.
That stint was in the ICU at Toronto General Hospital, called tertiary care hospitals – those capable of specialized health care; Generally, they are also the ones who have the most advanced resources.
These are the hospitals where the sickest people go. At the Toronto General, Richard says, every single patient in the ICU was receiving extracorporeal membrane oxygenation (ECMO), a procedure in which A machine pumps blood through the patient’s body, oxygenates it mechanically, then replaces it. Doctors use it when standard ventilation by intubation is not sufficient.
She says, “We were very much a hospital that provided the last line of defense for these COVID patients, the kind of last line treatment that these patients could get to help them survive the disease, ” she says.
One thing that may not be known to people outside hospitals, says nurse Megan Bradbury, is how sick these patients are with COVID-19, and the measures doctors and nurses are taking to keep them alive.
Bradbury is one of the Newfoundlanders who have traveled to Fort McMurray to help. Like Richard, she volunteered to move to Toronto during the third wave, working with him at the Toronto General.
For example, the ECMO machine requires one large tube to take blood out of the body, and another to return it, which seems pretty neat. But on top of that, Bradbury says, patients will also have peripheral IV lines for fluids and medications, and central lines and arterial lines for vital monitoring — heart rate, blood pressure, respiratory rate and blood oxygen level.
In most cases in Toronto, those patients will also have running dialysis machines, each with its own maze of tubes and monitoring lines.
In addition, she says, at times, patients need to be sedated — sometimes even paralyzed — to allow treatment.
“These are the most important patients you could ever imagine,” she says.
At Fort McMurray, those most serious patients are transferred to Edmonton or Calgary. But the condition of the patients in that hospital is still very bad.
“They still require intubation, ventilation, paralytic sedation, pronation, and very high amounts of oxygen,” Bradbury says. “These are very serious patients.”
Little wonder, then, that some patients have a level of frustration for the health care workers they are seeing. As of Thursday, the ICU at Fort McMurray Hospital was full, with every COVID-19 patient there completely unvaccinated.
And the resources and manpower needed to keep those patients alive far outweigh health care workers.
Bradbury learned, talking to locals at the hospital, that staff there were constantly working overtime on their vacation days, that they were often working 16-hour shifts to help even with newbies to Newfoundland. .
“A lot of sacrifices are being made to keep things going the way they are here and to take care of the public,” she says.
That’s something she totally understands. Like Richard, his family was shocked when he raised his hand to travel to Fort McMurray.
“It warms my heart to know that I have done the best I can to care for the patients here and help provide better quality care,” she says. “That’s what’s in it for me — just knowing that we can care for as many patients as possible and get through it together.”
That attitude surrounded the crew from Newfoundland with a warm welcome from local hospital staff, which could have lasting consequences, beginning with the Newfoundland flag in front. – Visitors saw the first time they arrived.
“They’re so tired to the point that having us there … I think it uplifted the staff,” she says. “We hear constantly that they are very happy to have us there. And they said it would be very difficult to take down that flag after we left.
“It might have to stay.”