Coronavirus: Calm before the surge for nurses at IU Health Arnett’s converted COVID unit in Lafayette

LAFAYETTE – There’s a certain calm about Pam Landrum, coming off a 12-hour overnight shift on the second floor at IU Health Arnett, a 42-bed space the Lafayette hospital three weeks ago converted into what it calls the COVID unit.

Then again, the intensive care unit nurse says, she doesn’t get rattled often.

“I’ve always been the calm one, even when I was a kid,” said Landrum, a nurse since 2003 and one of about 115 nurses and others – not including physicians, maintenance and cleaning crews – working on a floor once dedicated to progressive care and intensive care patients.

“People are more tense than normal,” Landrum said. “And emotions are higher. It’s intensive care, so it’s always intense. But it’s a little extra intense when there’s a pandemic going on. For me, I feel it’s part of my job to be calm – that it doesn’t help anyone to panic.”

Other hospital staff have opted to isolate themselves between shifts by staying hotel rooms. But she’s opted for home, like most of her colleagues, taking extra care around her two sons, ages 4 and 6.

She said she’s spending a little more time with her daily devotionals. She’s returned a lot lately to Psalm 91, a passage her husband gave her years ago, one about God’s protection and comforting those who lean on him. (From Psalm 91: 5-6: “You will not fear the terror of night, nor the arrow that flies by day, nor the pestilence that stalks in the darkness, nor the plague that destroys at midday.”)

Landrum isn’t particularly following the news about coronavirus, whether from Gov. Eric Holcomb’s daily afternoon briefings for the state or the political battles about the pandemic response outside the hospital walls. Essential bits and pieces – “Schools are closed, that sort of thing, I know, of course” – she gets from her husband filling her in.

“But I already know what’s really going on,” Landrum said. “It’s right in front of us here. … Is it scary? Yes, it’s a little bit scarier than what we normally do. But there’s work to do, so we do it.”

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The COVID unit is off-limits to visitors, with some patients waiting to be ruled in or out as confirmed cases of the contagious viral disease and others surviving on ventilators. Rhonda Jones, an IU Health Arnett spokeswoman, didn’t give specific patient stats, but she said the converted, 44-bed unit “wasn’t stressed, yet.”

That assessment seemed consistent with conversations over the weekend Landrum and two others working in the COVID unit.

“I think we have a lot of things in place to be prepared for a surge (in cases), which I think is coming,” said Rachel Hendrix, a registered nurse who was assigned from IU Health Arnett’s progressive care unit to the COVID Unit.

“How to have more COVID beds. How to have more nurses taking care of ventilated patients in the ICU,” Hendrix, who has been a nurse for 19 years, said. “They’ve been thinking this through. It’s not like we’re out there, ‘I hope they have a plan.’ They’ve been sharing it with us.”

Was there trepidation about taking the assignment?

Elizabeth Dabbs, a patient care assistant working the day shift on the progressive care unit before moving to the COVID unit, said management and floor educators talked early on that the progressive care unit would be the first stop for coronavirus rule-outs, positives or negatives, before patients went home or to other floors.

“So, we had a little bit of a warning, I think,” Dabbs said. “Me, personally, I didn’t anticipate it growing from where I had one rule-out a week to suddenly I had six or seven – or a whole hall. It just kind of erupted into, this is all people are coming in for. This is our new normal.”

Hendrix said nurses were given ways to opt out, if they fit certain criteria based on age or medical history. She said she didn’t meet any of those.

“But I was happy to be working with the COVID patients,” Hendrix said. “I mean, initially, it was just part of the PCU rule-outs, which transitioned into COVID. But I was kind of interested in it. I don’t know, it’s a historic thing. And I want to serve and help. I don’t know if this is the right way to put it, but I wanted to be where the action was. I wanted to be part of it.”

On the second floor, care adjusted to limit exposure. Medical masks are worn all the time. Instead of going on shift in uniforms they once wore from home, nurses are changing into clothes kept and laundered at the hospital. Rounds mean consolidating individual tasks into groups of tasks, forcing the staff to be more efficient and spend less time overall in each room. Trips into a room mean full personal protective gear – including gowns and face shields.

“We feel like we have what we need in supplies, right now,” Hendrix said. “That doesn’t mean we haven’t had to conserve.”

Landrum said the changes mean fewer hands-on opportunities with patients, who can be seen through windows where consultations happen via the phone first.

“It works, but it’s not the best,” Landrum said. “People tend to get better quicker when family is around. And that’s not going to happen at this point.”

Hendrix said it’s been hard to miss the support from the community, whether on her personal Facebook feed or the reception the medical staff gets as they head to their cars after a shift.

“We’re part of a big team,” Hendrix said. “The doctors. The chaplains have been a big presence lately on the floor. The people who deliver the food. The people with environmental services are huge right now, because they are in the rooms, too, cleaning. There’s so many steps to planning this out, day by day, making this happen.”

“Everybody needs to know,” Dabbs said, “this isn’t a joke, anymore.”

Landrum said she was a bit mystified early on with the tents going up outside the hospital for makeshift testing areas and triage space and so much attention when there were no cases close to home.

“I thought maybe we were overreacting, thinking, ‘Why do we need to be doing all of this? Is this really coming?’” Landrum said. “Now, I’m glad we overreacted. … Every week, it gets a little bit worse. All the graphs do have this trend: Oh, there’s not very many, then there’s a ton. I’m just waiting. It’s probably coming.”

She paused.

“Not probably,” Landrum said. “It’s coming. You’ll start knowing people. We all will.”

Landrum was perfectly calm as she said it.

Reach Dave Bangert at 765-420-5258 or at dbangert@jconline.com. Follow on Twitter: @davebangert.