Fr. Joseph Echeme, a hospital chaplain, and Rev. Micki Varner, PeaceHealth Oregon’s director of Mission Services, are pictured at the blessing of the new chapel at PeaceHealth Sacred Heart Medical Center, University District in May 2021. (Courtesy PeaceHealth)
Fr. Joseph Echeme, a hospital chaplain, and Rev. Micki Varner, PeaceHealth Oregon’s director of Mission Services, are pictured at the blessing of the new chapel at PeaceHealth Sacred Heart Medical Center, University District in May 2021. (Courtesy PeaceHealth)

It was Aug. 25 when Bob Ferguson, vacationing in Idaho, suffered a serious stroke.

Instead of immediately admitting him to the nearest intensive care unit, the staff of an Idaho hospital began searching elsewhere for a bed for the 88-year-old philanthropist from Eastern Washington. Idaho ICU beds were filled with COVID-19 patients, most of whom were not vaccinated. The Tri-City Herald reported that after two days waiting in the emergency room for a bed, Ferguson was put in a room meant for one patient but held two.

Colleen Ferguson Lowry, Ferguson’s daughter, works for Providence Heart Clinic at The Oregon Clinic Gateway in Portland. She and her sister, who lives in Chicago, were at last able to arrange a private airplane Sept. 6 to fly their father halfway across the country to a hospital in Chicago.

Idaho has since activated crisis standards of care, allowing hospitals to ration care, mostly based on who is most likely to survive.

It’s not just Idaho.

Alaska’s largest hospital, Providence Alaska Medical Center in Anchorage, was forced to implement crisis standards of care, as was Montana’s largest hospital, St. Peter’s Health in Billings.

Oregon too teetered on the brink. In August, COVID-19 cases in Jackson County were growing faster than anywhere else in the country.

“We’re on the edge of what we can manage right now,” Patrick Allen, director of the Oregon Health Authority told the New York Times.

While the news accounts of this surge are frightening — “‘If you get sick, we may not have a bed’: Covid surge pushes Oregon hospitals to the brink” was the headline in a British newspaper — caregivers in Oregon’s Catholic hospitals tell a quieter, more complicated story, with strands of resilience and hope alongside the alarm and desperation.

“I was surprised by how significant resistance to the vaccines was,” said Jana Bitton, executive director of the Oregon Center for Nursing, a nonprofit that crunches data about nursing. “We’ve divided into ‘yes, I’ll get vaccinated’ and ‘no, I’ll never be vaccinated.’ It’s sad, especially knowing history — like how the campaign to eradicate polio was successful. That said, I still have hope for the future. This may be an opportunity to move toward supporting each other’s physical and mental health.”

Rev. Micki Varner, director of Mission Services for the Springfield/Eugene-based PeaceHealth Oregon network, remembers a recent “Blessing of hands” that chaplains led in the ICUs. As nurses and other professionals felt water pour over their hands, the chaplains blessed them:

“May your gifts of healing be offered in love for those you touch.

And may your body, mind and spirit be blessed as you care for each other, your family, and the community.”

“It was beautiful,” said Rev. Varner.

Father Joseph Echeme is a key member of the six-person chaplain staff. “Daily Mass in the hospitals is very much one of the ways we provide support for our caregivers,” Rev. Varner said.

The blessing came about because the nurse manager of the ICUs asked the chaplains to provide grief ministry for the caregivers at the change of shifts.

During the past weeks caregivers have lost and mourned many patients.

Rev. Varner thinks caregivers go into health care wanting to help others and believing that they’re strong enough to handle the inevitable deaths of some patients. She worries that the number of deaths they’re seeing now may be shaking some caregivers’ belief in their own abilities and resilience.

Some nurses have left their jobs. For the most part,“they’re leaving because they’re overwhelmed and overworked, because of losing so many patients,” said Bitton. “This is not normal.”

Bitton said health care providers work from “the tender parts of their hearts.” The past weeks, however, have “tapped out their resources. There’s a lot of despair and frustration.”

Most of the people hospitalized with COVID-19 are not vaccinated. “Nurses are seeing the damage from that firsthand,” Bitton said. “But for all the frustration they convey, they follow up with, ‘Well, we’re going to take care of them anyway,’ and they do.”

Nicole Hudson, who works in a Portland-area Providence emergency room and is a member of the Oregon Nurses Association, said she understands why people are hesitant to get a COVID-19 vaccine. “But seeing younger people get so sick, hearing them say, ‘Why didn’t I [get the vaccine]?’ is heartbreaking. I can’t tell you how many patients have asked me, ‘Can I get the vaccine?’”

Hudson advises those who are hesitant to research credible sources and talk with their physicians.

The fallout for nurses has been crushing. “It used to be, when you shared with a co-worker, you might say, ‘Hey, I had this really bad case yesterday,’” Hudson said. “Those hard cases really stood out. Now it’s every other case.”

She also described “triggering” moments, when a patient reminds a nurse of “the last one you lost to COVID.”

Staff who never have had to do so before are reaching out for counseling. “It’s hard to see coworkers leave in tears,” Hudson said.

She’s grateful for the chaplains. “They’re a great group and it’s reassuring and heartwarming when they come in to check in on us,” she said. “That’s huge, to be a buffer to process the emotions that are inevitable with this.”

Hudson praised the National Guard troops in the hospitals, who are helping patients with meals, stocking carts, sitting with confused patients and cleaning rooms. “They have great attitudes,” she said.

But she and Kevin Mealy, communications manager for the state nurses association, agreed that the hospitals aren’t doing enough to retain experienced nurses. “It’s hard to see them invest in traveling nurses when their own staff is leaving,” Hudson said.

She noted that four nurses in her emergency room have left to work in less stressful positions. “We love the travelers,” she said. “But it feels like the systems are waiting it out, not investing in the regular staff and when it’s time they’ll let the travelers go. None of us wants to leave our jobs, but it’s hard to sustain hard work when you see you could leave, have less stress and make more money.”

Hudson believes there need to be more nurses on each shift — something this latest COVID-19 surge has made brutally clear.

“COVID-positive patients in the ICU are the most complicated patients there are,” she said.

And yet ICU nurses are taking care of several patients at a time — assuming those patients can get into the ICU. “We’re boarding people in the ER on a regular basis,” Hudson said.

Mealy said every hospital in the state is having this kind of staffing crisis.

“In 11 years, I’ve never seen anything like this,” said Hudson. “It’s not what we went into nursing to do — I’ve seen it called ‘moral injury.’”

Rev. Varner points to another element of what she called “moral distress.” “It’s knowing that this was preventable, had our neighbors chosen to be vaccinated. That hurts,” she said.

That gets to the core of what communities can do to support nurses and other caregivers.

“Banging pans at 6 p.m. won’t help,” said Bitton. “You can help by wearing a mask in public and getting vaccinated. And if you’re already doing that, remember the nurses who are taking care of the sickest.”

“Absolutely hold the community of the hospital in your prayers,” said Rev. Varner.

Most recently, people in Lane County responded when the hospital sent out word that the traveling nurses needed housing in a tight market. Community members reached out, saying they had a space for an RV or a room in their home.

For Rev. Varner, it’s all part of what she calls “the compassionate heart of Jesus” that calls us to respond to the person in front of us.

“That’s truly our mission,” she said.

Housing for nurses

PeaceHealth’s new housing resource supports caregivers in need of housing. Call 541-222-8111 to add to this list if you have housing in Lane County.

Catholic health care ethics

Although this COVID-19 surge has probably peaked nationally, Oregon Health and Science University statisticians expect Oregon hospitals to remain full until the end of October or the middle of November, meaning that rationing for other health care needs — like surgeries and cancer care — will remain in place for now.

In 2020, during the first surge, Catholic ethicists warned hospital groups to steer clear of utilitarian models of determining which patients should get personnel, beds, ventilators and medicines. The idea of using “quality of life” in the metrics is especially discouraged.