© 2021 KLCC

KLCC
136 W 8th Ave
Eugene OR 97401
541-463-6000
klcc@klcc.org

Contact Us

FCC Applications
Oregon's Willamette Valley seen from Eugene
NPR for Oregonians
Play Live Radio
Next Up:
0:00
0:00
Available On Air Stations

Inside OHSU’s fight to save the region’s sickest COVID-19 patients

In glass-walled rooms at Oregon Health & Science University Hospital’s medical intensive care unit, patients are sedated and on life support.

They are all here suffering from respiratory failure or other life-threatening complications of COVID-19. They are much younger than the people sickened by the coronavirus’ earlier waves — middle aged, or people still in their twenties or thirties.

Among the youngest in the unit is an unvaccinated dark-haired woman in her 20s. She is on a form of life support known as extracorporeal membrane oxygenation, or ECMO.

Her lungs are too damaged to be inflated by a ventilator. Instead, she’s on something that’s like dialysis for the lungs. The ECMO machine pumps blood out through one large tube, infuses it with oxygen, and then returns the blood through a second tube for her heart to pump back into her body. Two stuffed animals are propped up on the window next to her bed.

“We have had people in their twenties die in this unit. We have had mothers lose their babies in this unit,” Erin Bonai, the charge nurse on duty, said on Thursday.

“People always think it can’t be them because they are fully functioning in their lives and that’s just not true. And the real truth is that we don’t know who is going to be impacted,” Bonai said. “We can’t look at five people on the street and say, oh that’s the one who would get critically ill. That’s just not how it works.”

About one of every three intensive care unit hospital patients has COVID-19 in Oregon. That’s 232 people statewide.

Many of the sickest have been transferred to OHSU, which invited OPB to see how the strain is affecting its hospital.

OHSU has four intensive care units, including a 16-bed medical ICU that has been converted into a unit dedicated to COVID-19 patients. All four ICUs are completely full, so some patients who need intensive care been moved to other areas of the hospital.

Julie Kleese, one of the nurses, said OHSU is short on both staff and physical places to put the sickest patients.

The highly trained doctors and nurses working in this unit support smaller hospitals across the state, providing advice and accepting transfers from hospitals that can’t handle more complex patients.

Now there are no beds left — but the phone calls asking for help keep coming from rural Oregon hospitals.

“This patient is 26 and dying. This patient is 21 and dying. This patient is a father of four and dying. You know, can you help us? Our rural partners are struggling. They’re at the limit of their capabilities and that’s when they turn to us — and the inn is full,” Kleese said.

Many of the nurses and doctors who remain feel like they never had time to recover emotionally from the COVID-19 surge in the winter. And now it’s happening all over again.

Even before the COVID-19 pandemic, Oregon and the U.S. were facing a nursing shortage. With the additional stress of the pandemic, more nurses are burning out and leaving the profession altogether.

The doctors and nurses who remain on staff at OHSU use all the tools at their disposal to try to save each life — a demanding effort that often requires one nurse per patient.

Some simple but powerful interventions that can help a person’s lungs recover do not require costly equipment. Rolling patients onto their stomachs, a practice known as proning, can help the back of the lungs open up more, for example.

It sounds simple. But it can take four people working with a sling and a mechanical lift to do it, because it’s risky to move a patient who is on a breathing tube and ventilator.

At many smaller hospitals, interventions like these aren’t an option. They just don’t have enough staff. So COVID-19 patients may be more likely to die because no one is available to move them onto their stomachs.

And health care workers expect it to get worse. OHSU is preparing to accept more COVID-19 patients next week. The hospital is taking steps toward what’s known as “crisis standards of care.” Nurses may be assigned more patients to care for, or people may be put in parts of the hospital that aren’t normally used for ICU patients.

All but one of the patients in OHSU’s COVID-19 intensive care unit last week were unvaccinated.

For the medical professionals trying to save their lives, that can be one of the hardest parts of working through this crisis: caring for people suffering and dying of a syndrome that has no cure, but that’s preventable with a vaccine.

Kleese said she primarily feels grief that her patients and their families are suffering unnecessarily.

“I think there can be misplaced anger for people who simply don’t have the right information,” she said.

“Sometimes they will say, ‘I was wrong, when can I get the vaccine?’ Sometimes they’ll deny it to their dying breath, and sometimes they don’t get to ever know what their outcome is because they die too soon.”

Their work is exhausting. Frustrating. Sad. Overwhelming. And endless.

Each nurse said camaraderie and a sense of supporting each other is what keeps them showing up day after day.

But that won’t stop the pandemic or keep people from dying of COVID-19 in their ICU. More people getting vaccinated and wearing masks is the only way out.

“Ten years down the road, I think I’ll be really proud of the nurse I was these couple of years,” said Kristen Roach, who picked up an extra shift to help her colleagues this week. “I think we need to think about our future selves and how we would look back on this moment. And to feel like you did everything you could to limit the transmission of delta would be something that you could feel really proud of.”

Kristyna Wentz-Graff contributed to this story.

Nurses work together to turn a patient over. Patients must be turned and repositioned a minimum of every two hours.
Kristyna Wentz-Graff /
Nurses work together to turn a patient over. Patients must be turned and repositioned a minimum of every two hours.
Statewide there are over 230 patients with COVID-19 in intensive care--the highest number since the pandemic began.
Kristyna Wentz-Graff /
Statewide there are over 230 patients with COVID-19 in intensive care--the highest number since the pandemic began.
Emily Williams, a registered nurse, disinfects her face shield after being in a patient room.
Kristyna Wentz-Graff /
Emily Williams, a registered nurse, disinfects her face shield after being in a patient room.
OHSU staff members grab a quick hug in the hallway of the ICU. They say that camaraderie and a sense of public service is what keeps them going.
Kristyna Wentz-Graff /
OHSU staff members grab a quick hug in the hallway of the ICU. They say that camaraderie and a sense of public service is what keeps them going.
COVID-19 patients require a lot of intensive care and monitoring. Patients must be turned and repositioned a minimum of every two hours.
Kristyna Wentz-Graff /
COVID-19 patients require a lot of intensive care and monitoring. Patients must be turned and repositioned a minimum of every two hours.
The most critical patients are placed on extracorporeal membrane oxygenation, or ECMO, which removes blood from the patient, infuses it with oxygen, right, and the oxygen rich blood is recirculated to the patient’s body. Every bed on this intensive care unit at Oregon Health and Science University is critically ill with COVID-19 in Portland, Ore., Aug. 19, 2021.
Kristyna Wentz-Graff /
The most critical patients are placed on extracorporeal membrane oxygenation, or ECMO, which removes blood from the patient, infuses it with oxygen, right, and the oxygen-rich blood is recirculated to the patient’s body.
There is no cure for COVID-19. Health care workers work to keep patients alive long enough for the infection to subside and their body can begin to recover.
Kristyna Wentz-Graff /
There is no cure for COVID-19. Health care workers work to keep patients alive long enough for the infection to subside and their body can begin to recover.
Staff prepare to perform a surgical procedure in the ICU.
Kristyna Wentz-Graff /
Staff prepare to perform a surgical procedure in the ICU.
“It’s devastating, and really heartbreaking knowing people are fighting for their lives and it could have been prevented,” says Erin Boni, a charge nurse, center.
Kristyna Wentz-Graff /
“It’s devastating, and really heartbreaking knowing people are fighting for their lives and it could have been prevented,” says Erin Boni, a charge nurse, center.
About one of every three intensive care unit hospital patients has COVID-19 in Oregon. That’s 232 people statewide.
Kristyna Wentz-Graff /
About one of every three intensive care unit hospital patients has COVID-19 in Oregon. That’s 232 people statewide.
A nurse dons PPE before she enters the room of a COVID-19 patient. Most of the patients in this ICU unit are between 20-50 years old, with a single patient in their seventies.
Kristyna Wentz-Graff /
A nurse dons PPE before she enters the room of a COVID-19 patient. Most of the patients in this ICU unit are between 20-50 years old, with a single patient in their seventies.
A medical team reviews a patient's X-rays. All but one of the patients in the ICU was unvaccinated.
Kristyna Wentz-Graff /
A medical team reviews a patient's X-rays. All but one of the patients in the ICU was unvaccinated.
Staff prepare to perform a surgical procedure on the ICU.
Kristyna Wentz-Graff /
Staff prepare to perform a surgical procedure on the ICU.
There is effectively one nurse per patient as this type of care is very intensive.
Kristyna Wentz-Graff /
There is effectively one nurse per patient as this type of care is very intensive.
Doctors and nurses use all the tools at their disposal to try to save each life — a demanding effort that often requires one nurse per patient.
Kristyna Wentz-Graff /
Doctors and nurses use all the tools at their disposal to try to save each life — a demanding effort that often requires one nurse per patient.
Staff prepare to perform a surgical procedure in the ICU.
Kristyna Wentz-Graff /
Staff prepare to perform a surgical procedure in the ICU.
A patient is rolled onto their stomach, which helps the back of the lungs open up more. And pretty early on, there’s evidence that COVID-19 patients are less likely to die if they’re put on their stomachs periodically.
Kristyna Wentz-Graff /
A patient is rolled onto their stomach, which helps the back of the lungs open up more. And pretty early on, there’s evidence that COVID-19 patients are less likely to die if they’re put on their stomachs periodically.
The reality of the ICU is that a lot of these patients don’t make it, and a big part of being an ICU nurse is facing those deaths sometimes when no one else can be there.
Kristyna Wentz-Graff /
The reality of the ICU is that a lot of these patients don’t make it, and a big part of being an ICU nurse is facing those deaths sometimes when no one else can be there.
Every bed on this intensive care unit at Oregon Health and Science University is critically ill with COVID-19.
Kristyna Wentz-Graff /
Every bed on this intensive care unit at Oregon Health and Science University is critically ill with COVID-19.
"No one ever thinks they're going to end up in the ICU," says Sarah “Mo” Mohkami, a registered nurse at OHSU.
Hanin Najjar /
"No one ever thinks they're going to end up in the ICU," says Sarah “Mo” Mohkami, a registered nurse at OHSU.
Nurses and medical staff say that one of the hardest parts of this whole experience for them is caring for people suffering and dying of a disease that is preventable with a vaccine.
Kristyna Wentz-Graff /
Nurses and medical staff say that one of the hardest parts of this whole experience for them is caring for people suffering and dying of a disease that is preventable with a vaccine.
OHSU is preparing to accept more COVID-19 cases next week. Nurses may be assigned more patients to care for, or people may be put in parts of the hospital that aren’t normally used for ICU patients.
Kristyna Wentz-Graff /
OHSU is preparing to accept more COVID-19 cases next week. Nurses may be assigned more patients to care for, or people may be put in parts of the hospital that aren’t normally used for ICU patients.
Julie Kleese cries after sharing her experiences as an ICU nurse at OHSU Hospital in Portland on Aug. 18, 2021.
Hanin Najjar /
Julie Kleese cries after sharing her experiences as an ICU nurse at OHSU Hospital in Portland on Aug. 18, 2021.
Julie Kleese, a registered nurse, walks out of the doors of the ICU at OHSU Hospital in Portland on Aug. 18, 2021.
Hanin Najjar /
Julie Kleese, a registered nurse, walks out of the doors of the ICU at OHSU Hospital in Portland on Aug. 18, 2021.
"We just need more people to get vaccinated," says Kristen Roach, a registered nurse. She says it feels like they never had time to recover emotionally from the surge in the winter. And now it’s happening all over again.
Hanin Najjar /
"We just need more people to get vaccinated," says Kristen Roach, a registered nurse. She says it feels like they never had time to recover emotionally from the surge in the winter. And now it’s happening all over again.
Amanda Bryant, a registered nurse, tends to a patient.
Kristyna Wentz-Graff /
Amanda Bryant, a registered nurse, tends to a patient.
The most critical patients at OHSU are connected to an extracorporeal membrane oxygenation device, or ECMO, which removes blood from the patient, routed through an  oxygenator unit, right. Then oxygen-rich blood is recirculated to the patient’s body.
Kristyna Wentz-Graff /
The most critical patients at OHSU are connected to an extracorporeal membrane oxygenation device, or ECMO, which removes blood from the patient, routed through an oxygenator unit, right. Then oxygen-rich blood is recirculated to the patient’s body.
Julie Kleese, RN, cries after sharing her experiences as an ICU nurse at OHSU Hospital in Portland, Ore., Aug. 18, 2021.
Hanin Najjar /
Julie Kleese, RN, cries after sharing her experiences as an ICU nurse at OHSU Hospital in Portland, Ore., Aug. 18, 2021.
A patient is rolled onto their stomach. It helps the back of the lungs open up more. And pretty early on, there’s evidence that COVID-19 patients are less likely to die if they’re put on their stomachs periodically.
Kristyna Wentz-Graff /
A patient is rolled onto their stomach. It helps the back of the lungs open up more. And pretty early on, there’s evidence that COVID-19 patients are less likely to die if they’re put on their stomachs periodically.
During rounds, medical teams at OHSU work together to strategize individual patient care on Aug. 19, 2021. At a time when hospital crews are stretched thin by efforts to respond to COVID-19, nurses say camaraderie keeps them going.
Kristyna Wentz-Graff /
During rounds, medical teams at OHSU work together to strategize individual patient care on Aug. 19, 2021. At a time when hospital crews are stretched thin by efforts to respond to COVID-19, nurses say camaraderie keeps them going.

Copyright 2021 Oregon Public Broadcasting

Related Content