NM avoided rationing of care through worst of surge - Albuquerque Journal

NM avoided rationing of care through worst of surge

Registered nurses Mandy Cordova, left, and Mikayla Salazar, right, help Dr. James Gonzales put a breathing tube for a respirator into a COVID-19 patient at Guadalupe County Hospital in Santa Rosa on Dec. 11. The patient, an inmate at Guadalupe County Corrections, was later transferred to a hospital in Albuquerque. (Eddie Moore/Albuquerque Journal)

The deadliest seven-day stretch of the pandemic in New Mexico started 2½ weeks before Christmas.

As many New Mexicans turned to online gift buying and planned scaled-down holiday celebrations, hospitals in the state were bursting at the seams — and dealing with the horrific realities of the pandemic.

A staggering 297 New Mexicans succumbed to the virus from Dec. 7 to Dec. 13, among them Jerry Hernandez, a 68-year-old retired truck driver from Albuquerque who died at Presbyterian Rust Medical Center a week after testing positive.

“None of us were able to be by his side at all,” said Cindy Hernandez, one of his daughters. “… The doctor held my dad’s hand as he was passing. So my dad wasn’t alone.”

State officials were so concerned about the surge of patients during this period that the Health Department instituted crisis care standards on Dec. 10, a move aimed at helping overwhelmed hospitals decide how to ration scarce medical resources should the need arise. Those crisis standards of care were in place until Jan. 4.

Dr. David Scrase, the state’s Cabinet secretary for human services, described that time as “literally our darkest hour.”

Officials said the statewide health system bent but didn’t break despite the extraordinary pressures wrought by the pandemic.

“No care rationing was needed, but we came very close,” said Jodi McGinnis Porter, a spokeswoman for the Human Services Department.

McGinnis Porter said the biggest shortage the state faced was a lack of health care professionals. Equipment, such as ventilators, never ran out.

“New Mexico had as good of an outcome as possible,” said Dr. Michael Richards, the vice chancellor of clinical affairs for the University of New Mexico Health System.

ICU nurse Lang Kirchheimer, left, and his wife, Richelle Suttle, an occupational therapist, work in the COVID ICU at the University of New Mexico Hospital. They’ve been on the front lines since the pandemic reached New Mexico. (Roberto E. Rosales/Albuquerque Journal)

Saying goodbye

One of the health care workers on the front lines from the beginning has been University of New Mexico Hospital ICU nurse Lang Kirchheimer. He’s been with several COVID-19 patients as they drew their last breath and has even developed a system for shepherding families through the process of saying goodbye to loved ones over a computer screen.

“I pull the sheet over (their head) because it’s hard for the families on the other end to discern their loved one has actually passed,” he said. “And I think people are searching for those cues. We’re in this incredibly unfamiliar space.”

Kirchheimer, 36, and his wife, Richelle Suttle, 34, both work in the COVID ICU at the University of New Mexico Hospital, the state’s only Level 1 Trauma Center. Suttle is an occupational therapist.

Because they don’t have children or relatives in the area and because Kirchheimer was already going to be exposed to COVID patients, Suttle volunteered to work primarily in the ICU as well.

For the past year she’s helped New Mexico’s sickest COVID patients do simple tasks like sitting up in bed or using the bathroom.

“We were the ones who felt like our life situation could be a little more flexible and to allow (working with COVID patients) to happen without endangering family,” Suttle said.

Kirchheimer said he didn’t shy away from working with COVID patients when the virus first arrived in the state.

“I very much felt a sense of duty. I happen to be an ICU nurse in the only Level 1 ICU unit that the state’s got during a global pandemic,” he said. “I felt like this was my moment.”

‘Not quite as terrifying’

The decision by state officials to institute crisis care standards allowed hospitals to shift from focusing on individuals to instead taking into consideration limited resources and making decisions that would lead to the best outcomes for the population as a whole. Essentially, it meant that health care workers could devote their efforts to patients most likely to survive. But in the end, hospitals didn’t have to ration care.

Kirchheimer said he doesn’t think patient care at his hospital was affected when the state went into crisis mode.

“That first wave (in the summer), it gave the hospital time to figure out a plan, where we could expand. They seemed to have a plan on what to do and how to keep operations running smoothly.

“It wasn’t ideal but it was absolutely safe.”

By the time crisis standards of care were put in place, Kirchheimer and Suttle had already learned to deal with the load.

“By the time December and January hit it almost felt like the new normal. Things were definitely worse, there were more patients, it was really intense,” Suttle said. “But because it was the second go around, it almost felt not quite as terrifying as the first time when we really just felt we were doing everything in the dark.”

Suttle’s experience as a behavioral therapist working with COVID patients gave her a unique perspective on the virus. She spent weeks with many of them. Some recovered. Others did not.

Her goal was to teach patients how the virus had affected their bodies. She tried to teach them how to live knowing that the disease was going to make a walk to the bathroom a struggle, in some cases leaving them gasping for air.

“They are so sick and they need so much care and so much hands-on (treatment) throughout the day for weeks and weeks on end,” Suttle said. “So you would develop relationships with them.”

Kirchheimer said he shared the final moments with more than a half dozen COVID patients, often holding a tablet up so their family could say their goodbyes.

“It’s just you, in the equivalent of a space suit, just holding a person’s hand while their family watches, often in horror,” Kirchheimer said. “It’s a really bizarre ordeal, and it’s very tragic, and I really feel for the families affected by this.”

And how has the last year affected the front-line workers who shared those gut-wrenching moments?

“I think everyone’s still figuring that out,” Kirchheimer said. “It’s helpful to … know that we’re in it together. Richelle and I have the advantage that we both work in health care and see the same things. That’s tremendous in helping to process that.”

Online Memorial: Those We’ve Lost

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