Wearing blue scrubs, a mask and a floral print surgical cap, Tanya Shaw blends in with the other nurses in the COVID-19 isolation unit of St. Cloud Hospital’s intensive care unit.
But Shaw is a major in the U.S. Air Force, and she's a long way from home. She's originally from New Mexico, and is usually stationed at Keesler Air Force Base in Biloxi, Miss.
Shaw arrived in St. Cloud, Minn., a little more than a week ago as part of a 23-member medical response team sent by the U.S. Department of Defense, at the request of the Federal Emergency Management Agency and Gov. Tim Walz.
Since arriving, Shaw has been working side by side with CentraCare staff, caring for patients critically ill with COVID-19 in the hospital’s ICU.
“The staff have been very welcoming and very supportive of us, especially when we only had a minimal amount of orientation to the floor,” she said. "For the ICU nurses that are deployed here, we all take care of one another. And we take care of the patients.”
St. Cloud is one of two Minnesota hospitals — along with Hennepin HealthCare’s HCMC in Minneapolis — where federal military teams are providing direct support. The teams include nurses, doctors, respiratory therapists and support staff.
Shaw said the workload is demanding — checking patients every two hours, monitoring their vital signs, and, if possible, turning them to help them breathe.
"I can certainly understand how the nurses here are exhausted,” she said. “Being here just for a week, it definitely takes a toll on your body, having to gown up, having to wear a mask all day long. It's been very tiring."
Federal teams like Shaw’s, known as Joint Task Force Civil Support, have provided direct support at hospitals in 13 states since last August. There are currently teams in five states.
St. Cloud Hospital was chosen because it's a hub for a number of central Minnesota counties, where a rising number of COVID-19 cases are straining resources and staff.
Lt. Col. Joseph Huseman, officer in charge of the St. Cloud emergency response team, said caring for complex COVID-19 cases day in day out is draining for staff.
"They've sustained under these withering conditions for 1 1/2 to 2 years,” Huseman said. “There's an incredible amount to be said for the fortitude and professionalism of their staff."
On Wednesday morning, there were 111 patients with COVID-19 in St. Cloud Hospital. Twenty-six — the sickest of the sick — were in the ICU.
In room after room, glimpsed through glass doors, patients lay in beds, most sedated and connected to ventilators that provided oxygen they needed to survive. Some lay prone on their stomachs to help their breathing.
"We are full,” said Dr. Jacob Lyons, a critical care physician. “In fact, we are so full, we are turning down patients from smaller hospitals that ordinarily would be transferred to us for life support."
Most COVID-19 patients will be in the ICU far longer than the typical stay of a few days, Lyons said.
"These are folks that are with us for two, three, four weeks at a time on the ventilator in the hopes that with enough time their lungs can begin to heal and they can recover,” he said.
Lyons paused to check on a patient who had been intubated earlier that day, after efforts to maintain his oxygen levels through less invasive means failed.
"Despite having what amounts to a leaf blower in each nostril, he wasn't able to keep the saturations up enough,” Lyons said. “So he ended up going on the ventilator just a few hours ago."
Caring for critically ill COVID-19 patients is stressful, Lyons said. Burnout and compassion fatigue among staff are real problems.
"Some days half of our COVID patients will pass,” he said, adding, “no one is built to withstand that week after week after week."
Staff are working long days and extra shifts, spending a lot of time away from their families, Lyons said.
"Two years is a really long time to sprint,” he said. “We are seeing folks leave the profession, folks cut back on their hours for their sanity’s sake. I'm seeing folks leave for mental health breaks, folks that have been told they must leave by mental health practitioners."
In central Minnesota, vaccination rates continue to lag behind the statewide rate. The vast majority of COVID-19 patients in St. Cloud’s ICU are unvaccinated.
"Everyone talks about how sick these patients are. You don't really see it until you're here on a unit, working with them every day,” said Shaw, the major in the U.S. Air Force. “You wonder, if they were vaccinated, would they be this bad off?"
Lyons said he wishes more people would get the vaccine. But by the time they get here, it's too late to change their decision.
"Then I'm left with a person who may or may not wish they'd made a different choice,” he said. “Now they're here in front of me and very sick, and they need our help. And so we take care of everybody, vaccinated or not."
The military response team is scheduled to be in St. Cloud for 30 days. That could be extended, depending on what happens with the pandemic and the new omicron variant.
Shaw said she expects to spend the holidays in St. Cloud.
“I honestly don't know how long I'll be here for,” she said.
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