As head of the emergency department at University Hospital, Dr. Ralph Riviello has seen a lot these past nine months.

Working both on the front lines in the emergency room and as an overseer of ER nurses and doctors, Riviello said some of the hardest moments for him have been seeing his burned-out staff put on brave faces and keep working, having to deliver bad news to family members over the phone rather than in person. 

As the end of the year approaches, health care professionals have reflected on what they have seen during months of unprecedented challenges, both at work and personally. They tell stories of long hours, comforting frightened patients, and a strong commitment to being there for the sickest people in their final hours. As many of those treating COVID-19 patients have just recently begun receiving vaccines, they also feel a sense of hope amid their exhaustion.

One registered nurse who’s worked for more than 30 years in health care in San Antonio tearfully described colleagues who have never looked more tired.

“Even though they’re tired, they’re coming to work,” said the nurse, who asked not to be identified for fear of jeopardizing their job. “They’re coming and doing their jobs. We just are very committed to not letting people [die] by themselves. They put on their PPE and go in there.” 

A different kind of pandemic fatigue

Another San Antonio registered nurse who asked that her name not be used said she and her fellow health care workers are exhausted and overworked; many feel abandoned by the hospital administrations that employ them. There is still an insufficient amount of PPE to go around, and there’s still a shortage of health care workers in general, she said.

While talk of “pandemic fatigue” is widespread, the nurse offered her perspective on the importance of abiding by precautions such as staying home and wearing masks.

“I have my days, too. But you know what’s worse than wearing a mask [in public]? Dying alone in a generic hospital bed with no family or friends around,” she said. “The last thing you’ll see in this world is the eyes of a stranger hidden behind a mask and face shield.”

Nurse Practitioner Olga De Luna-Demenev won’t easily forget comforting the terrified man who had just learned out his mother tested positive for the coronavirus.

Having brought his two young daughters into the pediatric urgent care clinic where De Luna-Demenev works to get tested, the man broke down. He confessed to her he was scared for his mother’s life.

“He said to me, ‘I mean, she’s old, she’s got underlying conditions, and I don’t want her to die – and I don’t want her to die alone,’ and it was heartbreaking to see that,” De Luna-Demenev recalled. “That was right after Thanksgiving.”

Amid a pandemic that has killed more than 1,400 people locally, De Luna-Demenev’s message to San Antonio residents this holiday season is similar to that of most health care workers: “Just hang in there for a little bit longer.” 

“I did not think that we were going to see the vaccine come until early next year, so my first thought was ‘This is it, this is the light at the end of the tunnel. It’s here,’ and it just felt like I could finally take a deep breath, that there was hope again.”

With the vaccine bringing hope back into the weary hearts of San Antonio health care workers, De Luna-Demenev said she still wants everyone to remember to follow anti-COVID-19 health practices. 

“We’re almost there,” she said.

A long haul to hope

Kristen Knott, an intensive care unit nurse, saw the worst of the pandemic, in its early days when medical professionals were just learning about how COVID-19 sickened patients and how to treat the most severely ill. In April, the San Antonio resident volunteered to go to New Jersey to help deal with the influx of patients, spending eight weeks there. 

Leaving the hospital each night, she said, was like leaving a bad dream, just to wake up to it all over again in the morning. 

After returning to San Antonio in early June, Knott thought she’d get to rest a bit, but local coronavirus cases began spiking and hospitalizations rose sharply. Knott said she worked every day of July – 31 days straight – in a COVID ICU. 

“[I was] caring for the sickest patients I’ve ever had to care for in my entire career with a huge workload, and my drives home were the worst,” she said. Knott was recently featured on “Good Morning America,” where she shared more about her experiences.  

With cases again on the rise, health care workers are asking everyone to continue social distancing, wearing a mask, and washing their hands, she said.

“Knowing that the vaccine is here during the holidays, it gives us hope,” Knott said.

Lindsey Carnett

Lindsey Carnett is the Science & Utilities reporter for the San Antonio Report.