Mary Jane Poloncarz and Cindy Harris are career nurses, both working at Buffalo General Medical Center and each with critical care experience measured in decades. They can honestly say they thought they had seen everything, witnessing and dealing with pain and trauma on a scale difficult to quantify.
But their lives and their experience have been no match for the enormity of the tragedy they have seen in the past few weeks, as they have come face to face with the victims of Covid-19.
“I’ve seen nothing like it at all,” said Poloncarz.
“We cry a lot in the back room,” Harris said. “Last Monday, I had four deaths. It breaks your heart, because they’re people.”
The health care system has never dealt with a pandemic of the size and scope of Covid-19, and nurses are often the first line of defense. Because Covid-19 – at its worst – can attack the respiratory system frighteningly fast, their shifts can be like this: A person who was previously healthy is brought to a hospital. In one moment, that patient could be talking, describing symptoms, conscious. But soon, that same patient could soon be intubated, fighting for oxygen.
Or like this: A patient in intensive care is on a ventilator for weeks — and because of the infectious nature of Covid-19, no family can visit.
“Can you imagine that?” Poloncarz on a recent afternoon at Buffalo General. “You drop your family member off. You think they’re just going to go get a test and come home, and they are not. And then they may never come home again.”
This isn’t the story of most people who become sick with Covid-19. Most recover fully at home and are never hospitalized.
But critical care nurses and other medical professionals in hospitals don’t deal with the common stories. They work on the toughest cases — and in this pandemic, the difficulty of doing that is unprecedented.
'The sickest of the sick'
Timothy J. Kline walks past an intensive care room at Erie County Medical Center. The lights are bright. The bed is empty. A pair of workers dressed in full protective equipment are scrubbing every surface.
That bed won’t be empty for long. This medical intensive care unit – MICU, in hospital parlance – is treating patients who are in the most harrowing fights. The coronavirus that causes the disease spreads easily and, once inside a person, can move with alarming speed. The disease attacks a person’s respiratory system. When that fails, it can affect the heart and the kidneys.
That speed has medical professionals like Kline on alert, which we saw last week when The News visited the Covid-19 floors at three Buffalo hospitals: ECMC, Buffalo General and Catholic Health System’s Covid-19 Treatment Facility.
Nurses discuss a patient in the emergency department ICU at the Covid-19 Treatment Facility at St. Joseph Campus. (Sharon Cantillon/Buffalo News)
“Patients go from awake to a state where they need to be intubated faster,” said Christie Leas, who, like Kline, is a registered nurse and ECMC critical care unit manager. “It’s lasting longer than anything we’ve seen. Ventilator days are usually less than a week. Now it’s a couple – or a few – weeks on a ventilator.”
As Kline walked us around the ICU, he stopped outside the room of an older man who was fully sedated, with a breathing tube the size of a garden hose near his neck. The top of his hospital gown was rolled down, revealing his bare chest. He was a thick, broad-shouldered man, who looked like he had been strong and sturdy in his life before he was hospitalized. Kline called him "the sickest of the sick.” He pointed to a machine that was oxygenating the man’s blood outside the body.
Few patients who contract Covid-19 reach a condition this critical. Most are like two nurses we met at ECMC who were diagnosed a month ago, early in the pandemic, after treating a patient who had tested positive. They experienced mild symptoms that lasted only a few days.
“I thought it was almost allergies, but then it escalated from there,” said Emily Stelmach, 27.
“You start to feel that lower backache, your head really hurts, you attribute it to being stressed out, you’re busy,” said Jessica Simone, 26. “You’re doing this physical, demanding job. Then all of a sudden you lose your taste and smell and you’re like, ‘This is so weird.’ Then that prompted both of us to call and get tested.”
They were quarantined for two and a half weeks and then cleared and back to work. As we spoke about their experience with Covid-19, the two women were lighthearted – slightly – at moments, which is something several medical professionals pointed out during our visits: You have to find small ways to smile and even laugh during this pandemic. Otherwise, the weight of it can be crushing.
When I asked Simone how she spent her quarantining time, she said, “With some ‘Jersey Shore.’ ”
Stelmach, who is studying for her master’s degree, said, “Schoolwork.”
They laughed — but then turned serious.
Both made clear how fortunate they felt to have had relatively light symptoms, likely because they are healthy and young.
“This is proof,” Simone said, motioning behind herself to the ICU rooms. “If anything, the takeaway would be: Please stay home. Please take it seriously. We don’t have enough nurses for more patients. We just don’t.”
'It's scary. It's unknown.'
A focus on treating patients above all else was apparent at each hospital. It’s a pervasive attitude that superseded whatever fears the medical professionals have about getting sick themselves.
“I feel safer here than I would some other places,” said John LaForge, a nurse manager at Catholic Health’s Covid-19 Treatment Facility.
Rigorous safety procedures have helped them feel at least some comfort that they can focus on the work. But that work is harder than ever.
“It’s scary. It’s unknown,” said Harris. “I’ve never been like this in all my years of coming to the ICU.”
Harris, who is in her 34th year as a nurse, was standing in the critical care unit next to Poloncarz, who has worked in this MICU for 35 years. (She is related, by marriage, to Erie County Executive Mark Poloncarz.)
“It is scary,” Poloncarz agreed. “It is something we have never seen before, and I hope we never, ever have to see again.”
One of the things that still shakes them is the idea that the families of their patients cannot come to see them.
“The patients are all by themselves,” Harris said. “It breaks your heart.”
Registered nurse Kim Conley peeks out of her patient's room to tell fellow registered nurse Melissa Kozlowski, who is assisting, to adjust a patient's pain medication at ECMC. (Sharon Cantillon/Buffalo News)
“Can you imagine being a patient and not being able to have anyone visit you, and you’re so sick?” said Poloncarz, who can project her own experience into this. Her daughter, Keri Hendrix, works as registered nurse at Mercy Hospital of Buffalo, where Jim Poloncarz — Mary Jane's husband and Keri's father — is a charge nurse in the emergency department. Keri, who is married with four children, was diagnosed with Covid-19 and spent 15 days isolated at home. She’s now recovered.
“It was the scariest time of my entire life,” Mary Jane Poloncarz said. "It was awful. And Cindy knows, because she saw me crying. A lot.”
Several nurses at Buffalo General have a group chat they used to keep in touch and support each other. “We’re not used to this type of nursing,” Harris said. “You know what I’m saying? This is not regular nursing.”
The intensity of their focus on the job can come at a stressful cost, and when they finally do have downtime on days off, something as simple as a cough or a headache can have them wondering if there’s something more. “We have to take care of ourselves,” Harris said.
And they take care of each other, too, so that they can ultimately take care of their patients.
“You have to be strong,” Poloncarz said, “because they depend on you.”
“It’ll get better,” Harris added. “It will. We’ve been through everything.”
This is true. In critical care, you do see it all – from sorrowful tragedy to seemingly miraculous recovery with medical realities of all sorts.
“But,” Harris added, “never a pandemic.”
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