On the Front Lines: Intensive Care During a Pandemic

Alexa Bette Lehtinen ’94 is a registered nurse in the ICU at Yale New Haven Hospital, where she’s currently working around the clock on the front lines of the fight against coronavirus. Lehtinen, who graduated with a B.S.N. from Fairfield University in 2008 and has been a registered nurse for 12 years, was kind enough to take the time to answer several questions about her experiences of late.

What has it been like in the ICU? 

The medical ICU at Yale New Haven Hospital usually takes up two floors within the Smilow Cancer building. Back in early March, Yale moved most of the oncology patients out and reconfigured two more floors to care for critically ill, COVID positive patients. All four floors were soon filled, and we faced staff, supply, and PPE (personal protective equipment) shortages. We had to pull nurses and doctors from all other parts of the hospital to assist. The atmosphere was chaotic and tense at first. We didn’t know when the curve would flatten, and the hospital had to adjust daily to rising numbers.

How has your job changed since COVID-19? Are you working much longer hours?

I usually work three 12-hour shifts per week. Luckily, I have not been mandated to work longer hours. Care for critically ill COVID-19 patients is a whole new area of medicine. There is no one proven treatment yet for the virus, so we are seeing various drug and convalescent plasma trials. Many of our patients end up intubated and in ARDS (Acute Respiratory Distress Syndrome). We often “prone” these patients, which involves using a team of six to eight people to turn them onto their stomachs. This position opens up the lungs and improves oxygenation.

What has been the hardest part of your job in recent weeks/months? 

Strict visitor restrictions went into place in early March. Family members are not allowed to come into the hospital unless a patient is actively dying. Talking to family members and hearing their anguish at not being able to hold a loved one’s hand while they are so ill has been heart wrenching. Additionally, the suffocating feeling of having to wear a mask for each entire 12-hour shift has been incredibly challenging.

What has been the most gratifying?

Connecting family members with their loved ones via Zoom and FaceTime, and seeing their faces light up as they talk to the patients is often the highlight of our shifts. Also, we have had a few extremely ill patients pull through after many weeks in intensive care, so we line the hallways and clap as they roll out of the ICU.

Are there any COVID-related statistics you feel comfortable sharing?

As of late May 26, 2,778 COVID-19 patients have been cared for and discharged home by Yale New Haven Hospital. As of May 28—according to the state website—Connecticut has 41,288 confirmed cases and 3,803 deaths.

How are you feeling about the future? Do you feel that things are improving/that the curve is flattening? As someone on the front lines, what are your projections?

We have seen the number of patients in the ICU go down slightly, but we still have all four ICU floors open. We are worried about people recklessly defying social distancing guidelines. We are exhausted and feeling apprehensive about second and third waves. There is a huge disconnect between what we are witnessing in health care (the horrible ways in which this virus ravages the human body) and those within the community that feel this isn’t something to be taken seriously.

Any other thoughts you’d like to share?

When we first started caring for COVID patients, I moved out and lived separately from my family for a while, worried I would bring the virus home. However, at a certain point it became apparent that we would be caring for COVID patients for a very long time. A “new normal” set in for everyone on our health care team. I am living at home again, trusting in the fact that we have effective PPE and taking every precaution possible to protect my family.

—Carola Lovering Crane ’07