Medical staff are liaisons to the sick and dying for relatives not allowed at bedsides. The emotional toil at one Montana hospital is a case study of what caregivers are grappling with across the U.S.



One of the most devastating effects of the coronavirus is how friends and relatives are kept away from the bedsides of the sick and the dying. Nurses and doctors shuttle messages between patients and their loved ones. The task is hard and often heartbreaking. Nick Mott of Montana Public Radio shares compelling and emotional accounts from one small town hospital.

NICK MOTT, BYLINE: Livingston HealthCare is a 25-bed hospital that looks more like an upscale ski chalet than a medical facility.

UNIDENTIFIED PERSON: So we'll just take your temperature.


It's framed by the rugged Absaroka Mountains, not far from Yellowstone National Park, but it could be anywhere. There are more than a thousand hospitals about this size in the U.S. Today, three beds here are occupied by COVID patients.

JENN SCHMID: Nice to meet you. Welcome.

MOTT: Jenn Schmid is the assistant director of nursing. She stands outside large windows that offer a view inside the hospital's two ICU rooms. The beds are empty, neatly made. But a few weeks ago, this hospital was in the midst of the biggest surge in cases they'd seen so far.

SCHMID: My job consisted of 24/7 begging people to try to come in to get help, coming in to try to staff it myself just because we didn't have enough nurses.

MOTT: The CDC recommends that hospitals limit visitation, especially during times of community spread. That requires balancing safety with the emotion and trauma faced by patients and their families. Here, the hospital banned most visitors, but when patients near the end of their lives, their closest relatives are allowed to say their goodbyes through those windows that look into the ICU. Schmid sat outside the room with families. She says that glass barrier between patients and their loved ones made farewells an even more emotionally devastating experience.

SCHMID: We see patients die all the time (crying) but their family's with them. And having to sit out here with the family and try to be their support and give them that affection or that caring when you yourself have to try to stay 6 feet away and they can't see their dad or their husband for the last time and you have to watch that, it's gut wrenching. And I don't think I'll ever get used to that (crying). I've seen a lot of death, and I've held multiple people's hands while they're dying, but I've never had anything that has affected me like that. It's so foreign, and it's tragic.

MOTT: Doctors and nurses experience that isolation very differently than do patients and families themselves who maintain connection with each other only through screens and glass. Last month, Lori Schmidt's husband, Jerry, was in one of those ICU rooms.

LORI SCHMIDT: If I had known, I mean, that, I would never get to hold his hand or anything again (crying) oh, my gosh, I would have done things so differently. But I guess, naively, I really didn't think Jerry was going to die from this.

MOTT: I met Schmidt at her home on the edge of Livingston.

SCHMIDT: Come on in from the blizzard.

MOTT: She's 59, a retired banker and calls herself a glass-half-full kind of person. Her husband was in his mid-70s.

SCHMIDT: He was an amazing man. He could build, fix, wire. He was electrician. He could do anything. He could rebuild a Mustang from start to finish.

MOTT: One night in early November, her husband fell down in their house. He had a fever and was throwing up. She called the paramedics, who took him to the hospital. It was the last time she saw him face to face. Schmidt says, at Livingston HealthCare, nurses would call her from her husband's cellphone on FaceTime.

SCHMIDT: When Jerry pops up on my phone, there's a big daisy. And when I would see that, no matter how bad I felt, I felt renewed. It was like Jerry's calling. I'm so excited.

MOTT: It was the closest she could get to human contact. When it became clear it was the end, the hospital brought the family into the ICU where they could see Jerry through the window. She remembers the nurses at his side...

SCHMIDT: Listening, you know, saying, OK, they're telling you, you know, how much we love you and it's OK to go. And, you know, and my son-in-law and my son were - and Mom - Dad, don't worry. You know, we're going to take care of Mom and, you know, she's already got a honey-do list for us and, you know, just trying to make him feel like he didn't have to hang on anymore because he was so tired.

MOTT: Schmidt says Jerry passed peacefully after 12 days in the hospital. As we talk, it's been one month to the minute since his death. She's thankful for the health care workers who made sure her husband felt less isolated. Screens, windows and all the small efforts of health care workers are a saving grace for Schmidt and people like her.

SCHMIDT: I mean, that made all the difference in the world.

MOTT: Medical floor nurse Kristy Blaine does the hard emotional work at the bedside patients need to feel connected.

KRISTY BLAINE: It makes me sick to my stomach thinking about the fact that, like, so many people are dying alone and their nurse that has maybe known them for a couple of days is the last person they see.

MOTT: Nurses layer up in masks, protective glasses and other gear to stave off the spread of the disease. Instead of smiles and facial expressions, only eyes can show emotion and establish connection.

BLAINE: You also, you know, feel bad for your patients because these martians are coming in looking so different. You literally look like an alien, and you're trying to care for your patients, and they just feel like lepers.

MOTT: She does what she can to make the hospital feel less sterile for her patients, less like a, well, hospital. Blaine keeps a squishy pink-haired unicorn dangling from a keychain on her ID badge. When you squeeze it, she shows me, a little brown bubble forms on its backside.

BLAINE: It poops.

MOTT: (Laughter).

BLAINE: I like to joke around and I like to have fun. And I feel like we only get one trip on this Earth, and it might as well be part of a good old laugh. You know, nurses always ask about poop. (Laughter) sorry.

MOTT: Blaine says that, for nurses, adaptability is part of the job description. With only eyes peering out behind a mask, that pooping unicorn is one way of bringing joy into a world of isolation. Hospitals across the country are unlikely to reduce visitation limits much until the spring or summer when vaccines are widely available. Until then, health care workers will continue to adapt, to innovate and to find reasons to smile. For NPR News, I'm Nick Mott in Livingston, Mont. Transcript provided by NPR, Copyright NPR.