To fight our invisible enemy, the COVID-19 pandemic, the majority of people have a simple role: stay at home in order to prevent spreading the virus; however, hospital workers risk their lives to diagnose and treat the infected. Amongst them is Stephanie Busselberg, an X-ray and CT tech at IU Health Saxony, a branch of IU Health in Fishers, Indiana. As an essential healthcare worker, her days have drastically changed as she plays a critical role in fighting the pandemic.
“It is what I do. I help people,” she explains. Stephanie still goes to work at the same place, at the same time, and with the same people; however, little else is the same.
In the beginning, few people realized the scary potential of the new coronavirus, which was first introduced on January 7, 2020 in China; however, concern grew as America watched in horror as the Chinese government imposed a strict lockdown in Wuhan on January 23rd. The entire city was quarantined: any attempt to leave the city was forbidden. Videos from Wuhanese citizens surfaced online describing the mass panic and chaos in the city. Quarantine has been used as a measure of controlling the spread of disease since 1377; however, it has never been attempted on this large of a scale. The entire situation incited concern for United States citizens, especially considering that, two days earlier, the first positive case of the 2019-nCoV infection was confirmed on the homeland. The patient was a 35-year-old man from Washington who had returned home a week earlier from Wuhan after visiting his family. Stephanie, well versed in the history of disease and pandemics, knew that conditions in the United States were likely to worsen, but no one could have predicted how quickly and harshly the situation escalated.
A month later, the first case of suspected local transmission was reported in California. Three days later, the first coronavirus death in the country was reported in Washington. On March 6th, Governor Eric Holcomb declared a public health emergency in Indiana after an adult male who had traveled to Boston tested positive in Indianapolis. Stephanie’s home county, Hamilton, announced the first positive case of COVID-19 a little more than a week later, on March 15. It was at this point when things started to turn at IU Health Saxony Hospital, a branch of Indiana University Health, the largest and most comprehensive healthcare system in Indiana. Saxony is one of 16 other hospitals under its IU Health brand and is located within the residential and commercial development known as Saxony, in the growing community of Hamilton county in Fishers. This state-of-the-art facility has 44 beds, six operating rooms, a full emergency department, a helipad for medical transport, and a medical office complex.
On March 16th, Gov. Holcomb banned non-essential surgeries in an executive order meant to allow hospitals like Saxony to focus on potential coronavirus patient backup while simultaneously freeing up bed space and critical personal protective equipment, or PPE, such as gloves and masks. With nonessential patients absent, life at IU Health Saxony has dramatically slowed down. Despite the low traffic at the hospital, Stephanie assures that there is still plenty to do as an X-ray and CT technologist.
In fact, chest x-rays and CT scans have emerged at the frontline diagnostic imaging tests for coronavirus, marking Stephanie’s job extremely essential in the fight. At IU Health Saxony Hospital, Stephanie spends her days diagnosing coronavirus patients. When a patient proves to be in critical condition, she transfers them to a partner hospital such as IU Health North Hospital or one of the downtown locations, where IU Saxony has lent out their ventilators.
“It is amazing how much we have had to change,” Stephanie explains. Before the pandemic, she worked alone examining patients; however, it is now critical that she works with a partner in order to decrease her personal health risk. The process of performing X-rays and CTs is now a two-man job, which they often switch off roles. There is what they call a “clean tech” and a “dirty tech”. The clean tech positions the portable machine in the room, swings the tower toward the dirty tech, and exposes the image while the dirty tech works closely with the patient. “I do not always work with the same partner,” Stephanie says. “It depends who else from the X-ray department is there that day.”
While she is performing less X-rays and CTs than she would on a typical day before the outbreak of the virus, Stephanie does not find herself with any extra free time because the process is now much more complex. This is accredited to the extra time she spends before, during, and after an examination in order to ensure the safety of herself, her partner, and the patient. Every time she sees a new patient, whether they show coronavirus symptoms or not, she performs an extensive process of dressing and undressing in her personal protective equipment, called “donning” and “doffing.” Donning is performed before patient contact and is a potentially lifesaving process. She begins by sanitizing her hands and then securing her gown at the neck and waist. Then, she carefully fits her surgery mask, cap, and protective eyewear. Again, she sanitizes her hands before applying her gloves. Every part of her body is then covered and protected from the virus. The donning process takes about a minute and a half. Doffing is performed after contact with the patient and includes a process of undressing very slowly and with care to avoid coming into contact with any contamination lurking on the PPE. This meticulous process takes longer than donning; however, Stephanie describes how she and other healthcare workers have safely sped up the process. Practicing several times every day, “we are getting really good at it.”
Despite working directly with patients who have potentially lethal infections, Stephanie never fears that her own health is compromised. “I feel completely safe working with coronavirus patients. It is my job. It is what I do,” she says; however, when coronavirus cases first started appearing at Saxony, a standard of safety was not yet established. Stephanie recalls one particular instance earlier in the year when a man came in for a fall and needed an X-ray done. Since he had not come in for coronavirus symptoms, no precautions were taken, and no one was wearing a mask. “When the scans came back, his lungs looked scarily similar to the lungs of someone infected with the virus. It was scary and we felt naive for not taking precautions.” She was lucky to not have contracted the virus, but things changed at IU Health Saxony after this scare.
With this transgression, IU Health Saxony implemented life-saving regulations throughout the hospital. Before the pandemic, patients could walk directly to the front desk and explain their reason for coming in, but now patients partake in strict coronavirus screenings before they are cleared to enter the hospital. The screener asks each patient their reason for coming in. If they display COVID symptoms, such as shortness of breath, fever, and/or cough, they receive a checkmark on their screening badge. In addition, every person in the hospital, whether they are a patient or a healthcare worker, must wear a mask at all times.
Some COVID patients exhibit feelings of guilt about coming in and potentially infecting healthcare workers, despite all of the precautions that Saxony has set in place to protect them. “I remember one lady in particular who was overcome with guilt,” Stephanie explains. “It broke my heart. I had tears streaming down my face because that is what we do, and that is what we are here for. We are here to help people. I do not ever want a patient to think I am scared to go into a room with them.”
However, not all members of the community have acted so selflessly. On Saturday, April 18, more than 300 Hoosiers arrived at Gov. Holcomb’s residence protesting the stay-at-home order. Stephanie, like many other healthcare workers across the state, was disappointed to see Hoosiers protesting an order which has saved countless citizens from contracting the virus. “It needs to be a medical thing, not a political thing,” she explains. “We need to stop worrying about the politics and make it about people’s health.” While Stephanie sees the good that has come with the stay-at-home order, she also understands the views of the protesters. “I have mixed feelings. I worry about the economy, but I also worry about the depression, the anxiety, the alcoholics, the kids in abusive homes, and the intercity kids that rely on school for two meals a day. There are kids that need to get out of their houses.”
The goal of Gov. Holcomb’s order was to allow the hospitals to catch up with the virus, and, according to Stephanie, Saxony has caught up. “Some days we have zero coronavirus patients and then the next day we will have more than four. Every day is different,” Stephanie explains. “But we definitely have not declined. It has been pretty steady.”
Despite the small number of people that have fought the stay-at-home order, most have been extremely supportive. “My community is showing me and Saxony support every single day. Children enhance our sidewalks with chalk drawings. Local businesses cater food all the time. One day the police rang their sirens and played ‘Eye of the Tiger’ in our front lot!” Stephanie adds to the growing list all of the sweet and supportive letters they have received. “One act of kindness has topped them all,” she explains. “My neighbor’s son and his baseball team made us signs that read ‘Heroes work here’. It made my heart happy and reminded me of why I love working in healthcare: I like to help people.” •