As coronavirus cases multiply across Louisiana, health care workers have been sharing their stories about managing patient influxes, rationing supplies and trying to keep themselves healthy with reporters from The Times-Picayune | The Advocate. The newspaper has interviewed many Louisiana health care workers on the front lines of the COVID-19 pandemic. The newspaper is withholding the workers’ names at their requests, as most hospitals prohibit staffers from speaking directly to the media. Are you a health care worker with a story to share with us? Fill out our confidential form here.

ICU nurse, Ochsner

An Ochsner nurse says she has spent years working in the ICU, but nothing prepared her for the waves of coronavirus patients she’s been seeing. In less than a week, her unit went from having a handful to having only coronavirus patients.

“The first night I worked where the entire unit was COVID patients, I got into my car and started bawling,” she said. “When I tell you it's like a war zone up there, that's kind of putting it easy.”

There are so many patients and so few nurses that the recommended ratio of one nurse for every patient on a paralytic drug has already fallen by the wayside, she said. The hospital network is putting scores more nurses without ICU experience on a crash course to learn how to treat coronavirus.

Nurses try to minimize their contact with their desperately ill patients, because the hospital is already experiencing a shortage of protective gear, especially masks.

The ICU nurse said goes home every day exhausted. But she sequesters herself on a couch, watching Netflix and scrolling through social media, rather than go anywhere near her loved ones.

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“We're superheroes when we’re in our yellow gowns, and the second we get home, we just crumble to pieces,” she said. “I've never seen such heartache, and it kills me.”

It’s been disturbing for her to watch people she knows post pictures of house parties on Instagram. It feels like she’s living in a different reality.

“I want to shake them,” she said. “Come step one day in my shoes, and I bet you next weekend you're not going to have that pool party.”

Ochsner said that while doctors and nurses are being asked to conserve masks and gowns, they are issued new ones when the protective gear becomes wet or soiled. The hospital chain also said that protective gear isn’t used across units containing “cohorted” coronavirus patients and the general hospital population.

ICU nurse, New Orleans area

French Market streets empty during the coronavirus pandemic in New Orleans, Monday, March 23, 2020. Governor John Bel Edwards announced a statewide stay-at-home mandate starting at 5pm on Monday. STAFF PHOTO BY SOPHIA GERMER ▲

Another New Orleans ICU nurse has been battling her own case of COVID-19 while bracing to return to work to help handle the outbreak. She believes she acquired her infection outside the hospital.

And while she has what experts might deem a “mild” coronavirus case, one that doesn’t require hospitalization, she said it still drained her.

“I cannot express how severe the headache and bone and joint pain was. Severe and terrible,” she said. “Now I am dreading going back to work. If we’re down to reusing masks today, in a week are we going to have any left at all?”

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Her hospital’s protocol quickly switched from one mask per patient to one mask per nurse. The hospital is also reusing protective goggles by scrubbing them down with disinfectants, she said.

“The same things that you would have been in a lot of trouble just a few weeks ago if you did are now OK,” she said. “They are backing down from what should be done to what can be done.”

Amid the coronavirus outbreak, photos of spring breakers enjoying Florida beaches infuriated her.

“I don’t think people have been taking this seriously nearly fast enough. That whole spring break thing? That’s crazy,” she said. “You go to spring break, and you bring that home to your 52-year-old dad who doesn’t realize he has an underlying lung condition, you’re going to feel really great when he’s on a ventilator.”

Those ventilators are the only hope for keeping some COVID-19 patients alive. But the ventilators are nothing to look forward to. She remembered a short experience on one when she wasn’t sedated.

“It was the worst 90 seconds of my entire life. You ever get choked on a grain of bread or a piece of chip goes the wrong way?” she said. “Sometimes you can’t hardly sedate people enough. It’s uncomfortable. It’s like breathing through a straw.”

Patient care tech, Touro Infirmary

Touro Infirmary on Prytania Street in New Orleans on Tuesday, March 10, 2020. STAFF PHOTO BY CHRIS GRANGER ▲

It’s been over a week since a patient care tech at Touro Infirmary in New Orleans has changed her N95 face mask or her gown, even though she said she should be changing them each time she works with a new patient in the hospital’s quarantine units.

Health care workers at Touro can only receive new masks if the ones they’ve been wearing are broken or soiled from patients, though the masks aren’t meant to be used for more than eight hours. The tech works 12-hour shifts, meaning her mask was potentially ineffective by the end of her first day. She’s now been wearing it for five days.

She said the hospital is also short on gowns, with workers being told to preserve them unless they rip, get wet or soiled. Short on supplies and feeling unprotected from the spread of COVID, she said her job has become increasingly stressful.

“They’re short of everything,” she said. ”Everybody is scared to be in the [patient] rooms for a long period of time. It seems like we’re not caring for the patient, and that adds stress.”

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She described three quarantine units in the hospital, one where the worst-off patients are mostly on ventilators. And she said there’s increased pressure to discharge patients quickly because beds at Touro are filling up rapidly.

She worried, though, that people who are potentially positive for coronavirus — but who get discharged after 24 hours without a fever — could still be spreading it once they leave the hospital.

Asked to respond to this story, a spokeswoman for LCMC did not answer reporters’ questions Tuesday about the shortages workers described. A statement from Dr. John Heaton, president for clinical and system operations for LCMC, said patients are given proper guidance for self-quarantining when they are well enough to be released, and that LCMC was adding resources to manage employees’ stress.

Nurse practitioner and primary care provider, St. Bernard Parish

One primary care nurse practitioner in St. Bernard Parish keeps all of her work shoes outside of her home so that she does not potentially carry coronavirus inside. She rotates between three pairs, and sprays them down with disinfectant once she arrives home. PROVIDED PHOTO ▲

One of the best parts of the day for a nurse practitioner in St. Bernard Parish is when she gets to take off her N95 mask at lunchtime. After wearing the mask so much — with a second mask over it — she finally has mastered how to make it fit right on her face with her ponytail, but it still hurts her ears so much that they feel like they might fall off.

She described elaborate attempts to find more masks, having friends slip envelopes with sets of masks into her mailbox as she promises to send them money through the app Venmo.

“It’s scary, it’s really scary, it’s miserable,” she said. “You go to work every day playing Russian roulette.”

Suddenly, patients she’s known for years are asking for malaria medicine after President Donald Trump touted it on TV. And while she’s treating people for routine health problems, she’s constantly trying to monitor whether they’re also exhibiting coronavirus symptoms, taking temperatures and handing out masks. Of the 11 patients she saw Monday morning, five had a cough.

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It was shortly after Mardi Gras, when people were returning from trips to Disney World and cruises, that she kept seeing patients who seemed sick but tested negative for the flu. She thought there was something wrong with the swabs, but now believes she was exposed to coronavirus back then, as she treated those patients without wearing the extra protective gear that she’s wearing now.

She hasn’t exhibited symptoms so far, and takes many precautions to keep it that way: three pairs of shoes that she rotates and leaves outside of her door before she goes home, and showering immediately after work before she socializes with her family.

Physician assistant, major Baton Rouge hospital

Overall congestion and foot is less than normal-- but that might not be such a bad thing-- at Baton Rouge's downtown Red Stick Farmer's Market, Saturday, March 21, 2020. Buildings part of St. Joseph Cathedral are top, background. Copper Alvarez, executive director of Big River Economic and Agricultural Development Alliance (BREADA), which organizes the market and a similar one Thursdays near Pennington Biomedical Research Center, said that novel coronavirus COVID-19 public health precautions the market is using to keeps both farmers and customers safe include a 'Shop-N-Go' strategy where customers are asked to get their goods and keep moving, half-moon 'On Deck' circles drawn in chalk on the pavement at booths, prompting customers to keep their social distance until it is there turn to be served. STAFF PHOTO BY TRAVIS SPRADLING ▲

A physician assistant at a major Baton Rouge hospital is increasingly worried about the number of people who are relatively healthy but show up in the emergency room just to get “checked out.” It takes time and resources away from others who are far sicker, he said.

He suggested Baton Rouge implement a better system for people to get screened over the phone and to be able to get tested for COVID at a non-Er location, as Lafayette is doing with Cajundome screenings for people who have called a COVID hotline. In Baton Rouge, drive-thru testing is still only available for people with a physician’s order. He also wished his hospital would devote more resources to telemedicine, which he said could keep unnecessary patients out of the ER.

Meanwhile, his hospital is low on testing supplies, trying to preserve them for the sickest patients who are being admitted. And it’s also running low on personal protective equipment.

“In Baton Rouge, we don’t have any N95s (masks) available unless you are the one intubating the patient or doing a swab in the back of the throat,” he said. “At least to have one per shift would be fantastic.”

Nurse, New Orleans-area hospital

A cyclist rides down S. Peters during the coronavirus pandemic in New Orleans, Monday, March 23, 2020. Governor John Bel Edwards announced a statewide stay-at-home mandate starting at 5pm on Monday. STAFF PHOTO BY SOPHIA GERMER ▲

When one New Orleans-area nurse looks at patients on ventilators lying in their hospital beds, her anxiety ratchets up that she — or her spouse — could have the next severe case of COVID-19. Being young and healthy is of little solace, as some of her hospital’s severe cases have affected people with no underlying conditions.

“I think really the thing could go after anybody,” she said. “Really, anybody should be scared they could be in that 20% that has a severe case.”

She doesn’t blame her hospital for supply shortages, but rather poor political leadership in planning for the pandemic. She has tried to manage her anxiety by accepting the idea that she will — at some point — become sick, and praying she can easily kick it off when she does. She also tries to spend time walking her dog in the park and avoids visiting even grocery stores.

She said her nursing team is used to working with infectious diseases — even tuberculosis — but that the coronavirus presents too many unknowns, whereas others have a known course of treatment.

“When I signed up to become a nurse, this virus didn’t even exist,” she said.

Doctor, New Orleans hospital

Viewed from the 310 Bridge, The city of New Orleans along with the entire state is mandated to stay-at-home during the coronavirus pandemic in New Orleans, Monday, March 23, 2020. (Photo by David Grunfeld, NOLA.com, The Times-Picayune | The New Orleans Advocate) STAFF PHOTO BY DAVID GRUNFELD ▲

One New Orleans ER doctor said her hospital’s staff has burned through several months’ worth of masks and gloves in one week. Those precious supplies — personal protective equipment, or PPE — are now under lock and key at her hospital because patients and employees were stealing them.

“There’s just not enough hours in the day to think about fear,” she said. “I’m too tired to really think about it.”

It’s taking four or five days for some tests to return, she said. That means if a patient is admitted, staff must use PPE when interacting with them — even if they aren’t sure the person is positive. If the tests came back sooner, they’d be able to preserve the scarce PPE.

She said coronavirus has not discriminated based on the age of patients coming to the hospital: “They’re young, they’re old, they’re middle-aged.”

Nurse, UMC and Ochsner

The emergency drop-off area at UMC during the coronavirus pandemic in New Orleans, Tuesday, March 24, 2020. (Photo by David Grunfeld, NOLA.com, The Times-Picayune | The New Orleans Advocate) STAFF PHOTO BY DAVID GRUNFELD ▲

It’s not older people who are filling up ICUs in hospitals, said another nurse. “The people on vents are 40 and 50 years old,” she said. “It’s not the elderly. It’s scary.”

Like others, she said being asked to reuse protective gear that’s normally seen as disposable makes her worry for the family she goes home to every night.

“We didn’t sign up to be soldiers,” she said. “We didn’t sign up to die, have our families die, so we should be taken care of. If we’re told we don’t have any (protection), a lot of nurses are not going to be working.”

Provider, the VA hospital in New Orleans

Officials celebrate the grand opening, ribbon cutting and tour of the new Veterans Medical Center in New Orleans Friday, November 18, 2016. Along with New Orleans Mayor Mitch Landrieu and Governor John Bel Edwards, US Senator Bill Casidy, Dr. David Sulking and VA Secretary Robert McDonald spoke during the ceremonies. (Photo by Ted Jackson, NOLA.com | The Times-Picayune) ORG XMIT: NOLA2015061614435814(Ted Jackson) ▲

Guidelines for the proper use of protective gear from the U.S. Centers for Disease Control and Prevention have been loosening as supplies run low, one provider said. Without protective equipment, the fear is that health care workers will get sick, leading to a shortage of providers and exposing patients.

“At this rate, we won’t have enough doctors, let alone vents and masks,” the employee said. “They have not provided testing for employees who have symptoms. They told us if you get sick, you have to take your own leave or don’t get paid. Doctors are being asked to risk their lives.”

Asked to respond to this story, a VA hospital spokesman denied any supply shortages, said the hospital has been screening both patients and employees for coronavirus and that the VA has added counseling and other resources for employees to manage their stress related to COVID-19.