Faces of the Fight from Dixie Kiefer, rural RN: I worry there will be nowhere for you to go

By Dixie Kiefer, Registered Nurse at Humboldt District Hospital

Do you want to know what I worry about first when they say Saskatchewan’s ICU beds are full? It’s not necessarily that I’m worried about me or my family will need the bed. I worry about YOU, my next patient who needs one.

I’m scared you are going to come into my rural ER when you are sick. Very sick, COVID, or not COVID, we are going to treat you and care for you and give you everything our fantastic team can muster up for you. Like we always do. But let’s say you deteriorate anyway. And we have to call for a transfer.

And there will be nowhere to go.

Let me say that again.

There will be nowhere for you to go.

No open ICU bed anywhere. No specialized nurse or respiratory technician or critical care doctor to watch over you.

So we will make do. We’re rural health care; that’s what we do.

We figure things out and make do and accommodate.

But you still decline. And we will intubate you. And medicate you. And I will bag* you to breathe for you, but this time, instead of doing this short term in prep for a higher level of care, I have to do it for an hour… for two hours… for three… and my hands will cramp. And my arms will be sore. And my fingers will be raw. And you will continue to deteriorate. My only job will be to breathe for you.

And while I do that, I will watch the doctors consult specialists about your care and try more medications for you. And I will cry for you. Because you need to be in critical care, with a respiratory therapist and critical care nurses. And I needed to have stabilized and shipped you out hours and hours ago.

But there is. Nowhere. To. Go.

And at the end of the work day, which will likely be hours after my shift ended, you won’t make it.

I won’t be breathing a sigh of relief like I would be after successfully sending you via our fantastic EMS team to a larger centre.

No. I will be weeping on the floor, knowing I didn’t have enough to give. It’s not my fault, or yours. But I will live with this forever. And so will your family.

That we couldn’t save you.

That we weren’t supposed to save you.

They were.

And they can’t.

They’re full.

Overfull.

It’s scary. For all of us. Please do what you can so that you don’t end up being my next patient needing critical care. Take care of yourself. And get vaccinated for COVID-19 if you haven’t already.

* Support a patient’s respirations with a face mask and a manually compressible source of air or oxygen.