In the early 1990s, Moses Kitakule was a young resident, doing his training in New York City. A pulmonologist, he was intimately involved in patients being brought into the intensive care unit at a time when that city’s hospitals were filling up.
“I did my training as a young resident at the peak of the AIDS epidemic in New York City,” Kitakule said. “There were a lot of patients dying in the intensive care unit with lung problems. The ICU was full of patients with AIDS-centered complications.”
Now a pulmonologist at Iberia Medical Center, Kitakule was able to draw on that experience as the hospital continues to work through the COVID-19 outbreak. But even with that experience that he could share, there were additional challenges with the new pestilence that the AIDS epidemic did not prepare him for.
“That experience, of course, had tense moments,” Kitakule said. “We had an ICU full of patients. But this was totally different. This was very rapid. It came up much more quickly. The timeline was much more compressed.”
Preparing for the unknown
Dr. Robert Lahasky, who was part of the team helping to care for patients who were admitted to IMC with COVID-19, said that Kitakule’s prior experience was invaluable in preparing for the COVID-19 onslaught.
“Dr. Kitakule was able to explain how we would establish a room for patients,” Lahsky said. “He told us how to set up a negative pressure room and the special needs that we would face in setting up rooms to care for these patients.”
The hospital began preparing for the influx of COVID-19 patients months ago, while most Teche Area residents were still celebrating Christmas. Chief Executive Officer Dionne Viator said the hospital was already stockpiling the supplies — masks, gowns, ventilators and other equipment — that would be essential intreating a highly contagious pathogen.
“It started at Christmas, when we started understanding the severity of it,” Viator said. “We started understanding that some of the supplies that were needed were already becoming rationed, so we were ordering at our maximum capacity. We really have not had any issues. Our materials management team, headed by Tanya LeBlanc, had a lot of sleepless nights.”
The hospital was able to establish a ward on the fourth floor specifically for COVID-19 patients, equipped with negative-pressure rooms that would prevent any germs from the patients from being carried through the ventilation system into other areas of the hospital. The hospital also received two ventilators from the national stockpile, as well as two each from Lafayette General and Our Lady of Lourdes, to buttress its supply of equipment on hand.
Managing a pandemic
Even with the knowledge and experience in house to face the new health threat, the last few months have taxed the front line staff at the hospital.
Registered nurse Kerrill James had just moved into a new position as the med-surg manager for IMC, but the coronavirus epidemic made her experience at her previous job as an ICU nurse invaluable.
“I was trying to learn a new job, but while all of this was going on,” James said. “It made it a challenge.”
For Kelley Perez, who has been an RN in the ICU for 18 months, the experience was a challenge as well, but more because of the load of patients.
“We usually only had one patient on a ventilator,” Perez said. “To have eight, with each nurse caring for two, was a lot. We had to don and change PPE (personal protective equipment) each time we went in and out of a room, so it was a huge learning curve. Our staff in the ICU are well seasoned and we have a lot of protocols in place so that made it easier.”
Lahasky said that Kitakule’s experience was a boon in the area of protecting the staff as well.
“I’m going to point back to Dr. Kitakule giving us the guidance and showing us some of the things we had to do on the preventative side,” Lahasky said.
Viator said the staff was able to minimize any danger through their careful hygiene and PPE protocols.
“We have had few employees test positive for COVID-19,” she said. “We had about .7 percent of our employees test positive. It says a lot about their diligence and attention to detail.”
Surviving the wave
The most stressful part of that time for Perez was having one of her patients who had been on a ventilator recover and move to the ward, only to return.
“I had this special bond with one patient, we took them off the vent and sent them out of ICU,” she said. “I came back for my shift and they were back on the ventilator. They came off it again, and were able to return to their facility.”
James said the physical challenge of donning and doffing gear to care for the large number of ventilated patients was something she would remember.
“We had to prone our patients,” she said. “This is literally putting our patients from their back to their belly. These are patients who are sedated, with tubes and wires to keep track of, and we were in full PPE. We have never had to do that for so many patients. It’s a team effort, the collaboration and the work we had to put into that is something I will remember.”
She also had to face the personal challenge of not being able to touch or hug her mother during the pandemic.
“Not being able to be there or being around,” she said. “Not being able to embrace her or to kiss her, that was a big difference for me personally. In my 31 years, I have never had to do that, just seeing her from the front porch.”
For Perez, whose parents also have some comorbidities that make them more susceptible to the disease, it meant a drop in social contact across the board.
“I’m not the most popular person when I get home,” she laughed.
For the nursing staff, it was also a challenge not being able to allow family to see their loved ones while they were still in recovery.
“It’s hard not being able to be that advocate for the patient,” Perez said.
“It’s compassion in general,” James said. “It was a touch of the hand, to let them know that someone was there. Even when they are sedated, there is no way of knowing what they can perceive or not. But it is a matter of being there, of letting the family know their loved ones are not alone.”
In the first round of the epidemic, IMC admitted more than 60 COVID-19 patients. Of those, Viator said that just shy of 75 percent recovered.
“That’s a testament to our doctors and nurses and the care they were able to offer,” she said.
James said that when the next wave comes, she feels that the hospital and the staff is ready.
“We know what the symptoms are,” she said. “We know what the signs are. We know how to treat them, or how to get the protocols in place so they can go home and quarantine.”