Exclusive access: Inside Froedtert’s Medical ICU with sickest COVID-19 patients

WAUWATOSA, Wis. — It’s a quieter than usual afternoon on the floor.  Of the 26 beds in the Medical Intensive Care Unit at Froedtert Hospital in Wauwatosa, six are occupied by COVID-19 patients.

Continuing Coverage: COVID-19 in Wisconsin, “It is a big relief,” said registered nurse Katie Dillon.  A sense of relief considering where they were two weeks earlier when the hospital said the majority of patients in the MICU — 15 to 18 — were there because of COVID-19.

“I hope we’re on the downswing, but we’ve been in this position before,” Dillon said. “We have had zero patients and we thought, ‘This is the end. This is great.’ But, you know, numbers shoot back up, we surge again, so cautiously optimistic I would say.”

Dillon and her colleagues have become all too familiar with how cruel the virus can be.  They have been on the front line of the pandemic for the past two years.  “People outside who haven’t been here, they just see maybe like a common cold or flu-like symptoms. Oh, loss of taste or smell, but we see, what we’ve been seeing is just death. For two years straight,” Dillon said.

The sickest COVID-19 patients at Froedtert end up in the MICU.  “When they’re here in the Medical Intensive Care Unit it’s because they’re too sick to be on the general medical floor,” said Dr. Mark Barash, who specializes in pulmonary and critical care. “Virtually all the folks that we’re seeing coming in now are unvaccinated, unfortunately.”  Of those patients who are vaccinated, Barash said, “These are the folks who have some reason for why the vaccine was less than effective. People who have had organ transplants. People who have malignancies. People who are on a variety of medications that impact the way that the body responds to infection or is able to mount a response to the vaccine itself.

“Since March 2020, Froedtert said its hospitals and emergency departments have cared for more than 8,600 people with COVID-19, with 905 COVID-19 patients admitted to the MICU in 2020 and 2021.  Dillon said it’s been hard to witness the suffering of patients.  “We do everything we can to prevent them from going on a ventilator,” Dillon said. “They lay on their stomachs for 24 hours at a time. We have them maxed out on all oxygen. They know that once they go on a ventilator that the chances of coming off are low.”

That particular day, every COVID-19 patient in the unit was on a ventilator.  “I had a patient the other day, who, she was a COVID patient,” Dillon said. “She was in respiratory distress. Maxed out on all therapies and she knew she needed a breathing tube. She was so scared. She told me she wasn’t ready to die. And how do you tell them it’s going to be OK when you don’t know if they’re ever gonna come off a ventilator?”  Dillon said the patient was still on a ventilator.

The MICU is not just for COVID-19 patients.  Those who are in the unit because of the virus have their sliding glass doors shut.

The medication pumps and drips are kept in the hallway, in part to limit exposure and the process of dressing in full personal protective equipment or PPE.  Every time someone enters a COVID-19 patient’s room, they put on fresh PPE, including gowns and gloves.

When they’re done, the PPE stays in the room.  “Wash your hands in the room, come out, sanitize again and go on to the next patient,” said respiratory therapist Doug Murray.  Among his responsibilities, Murray helps run the ventilators, assists with intubations of patients who can’t breathe on their own and gives treatments such as oxygen.

“In order to help prevent our patients from getting pneumonia, we do oral care every four hours with our patients,” Murray said. “Clearing out their mouths, making sure there’s no secretions. Making sure that they’re not going to get pneumonia and get sicker and have any other issues on top of their COVID.”

He’s been in the MICU throughout the pandemic.  When asked what it’s been like the last two years, he described it as “very busy.”

“We’ve been working very hard,” he said. “It’s very stressful. Every day is a new experience with the COVID patients because you’re fighting a new battle every day.”  Murray had just left a room where a man in his 40s has “been intubated for probably about 10 days now,” he said.  The patient was sedated and “not aware of what’s going on around him at all,” he said.  As the pandemic continues, he and his colleagues are noticing a trend in the patient profile.