‘It’s just ingrained in us to want to help’

Health-care workers in Newfoundland step up to aid other provinces

The night before they got married, Newfoundland nurse practitioner Jennifer Richard told her husband-to-be she was going to Alberta.

“I’m not surprised,” he said, and they proceeded to book her a post-honeymoon flight directly to Fort McMurray.

Thus ended a blissful threeweek hiatus, her first chunk of serious time off since the beginning of the COVID-19 pandemic.

The past 18 months had been a frenetic stretch of ICU work in St. John’s, broken only by a foray into Toronto General Hospital in April to help out with third-wave care there.

This past Monday, she said goodbye to her brand-new husband, got on a plane and flew to Fort McMurray, arriving late that night, there to help out in its hospital’s newly expanded intensive-care unit.

On Tuesday morning, she began the first of four straight 12hour shifts.

“It’s really just eat, sleep and work,” Richard says.

“On these trips, it’s about reprieve for the physicians, reprieve for the nurses, providing them with some support and backup … So, we just put our heads down and get to work as soon as we get here.”

Richard is one of the faces of the unbalanced battle against the coronavirus taking place across the country, a struggle so unevenly distributed that overwhelmed and embattled health-care systems in one part of the country are forced to call up on other regions — in this case Newfoundland — for reinforcements.

She is part of a seven-member crew of health-care workers — four registered nurses, a nurse practitioner and two physicians — who travelled from Newfoundland to help out in Fort McMurray with the extra load the hospital is shouldering as that province battles the fourth wave of the pandemic.

As of Friday, with that fourth wave in apparent decline, Alberta still reported 12,978 active COVID-19 cases — by a wide margin the highest caseload in the country, and the third highest rate of active cases per capita, behind the Northwest Territories and Saskatchewan.

Newfoundland, by contrast, has one of the lowest per-capita COVID-19 case rates in the country, second only to P.E.I. That prompted Newfoundland Premier Andrew Furey to extend an offer of health-care aid to his counterpart in Alberta, Jason Kenney, much as he did to Ontario during the third wave.

What would possess a nurse to volunteer — not once, but twice — to travel from one of the safest places in the country, pandemic-wise, to work in two of the most hazardous?

Even Richard says she is not entirely sure, but the partial answer spans the circumstances of what she does, where she comes from and how she grew up.

“I feel like, as a health-care professional and a Newfoundlander, it’s just ingrained in us to want to help,” Richard says.

That willingness to sacrifice has its roots in her family tree. Her father was a firefighter, both her grandfathers were firefighters, her brother served in the military and her mother was in public service.

“My mom always said growing up that I was always the one who ran toward the new adventure. And I was the first to put up my hand to volunteer for something. And I feel like that’s just carried through into my adult life.”

Richard’s penchant for volunteering now finds her in the Northern Lights Regional Health Care Centre in an Alberta city with a long-standing history with Newfoundlanders, many of whom migrated west to work in the oilpatch there.

So close is that connection, in fact, that the northern Alberta hospital had little problem finding a Newfoundland flag — its blue-and-white colour scheme meshing nicely with the blue facade of the hospital — to raise in front of its emergency room entrance ahead of the contingent’s arrival.

Inside, to cope with the onslaught of COVID-19 cases, the hospital has converted one of its recovery rooms into an ICU unit, nearly doubling its ICU capacity to 10 beds.

Those beds are nearly always full, Richard says. They empty briefly when a patient recovers enough to leave ICU, or when a patient’s condition becomes too serious for the facilities there, whereupon they are transferred to Edmonton or Calgary. But there is inevitably another patient to quickly take that place, usually a transfer into the ICU from another northern region.

“It’s a revolving door,” Richard says. “It’s not just this hospital. The whole province is cycling through patients, and each system is overwhelmed in its own way.”

The unit had been staffed for the original ICU, with six beds. Nearly doubling that number to meet the regional need has inevitably put a whole new level of strain on the local healthcare team. And though they aren’t outwardly showing it much, the local nurses and doctors are undoubtedly tired and palpably grateful for the new faces, Richard says.

“Morale is really good. The nurses are still very upbeat and enthusiastic. They certainly were happy to see us. This is their fourth wave and they’ve really had no break in between waves. And each wave has been exhausting for them.

“We’re told ‘thank you’ about a hundred times a day, and we’re just as appreciative of them inviting us into the unit … It’s really been such a positive experience already.”

Richard’s previous healthcare relief trip, to Toronto in mid-April, is one she describes as a highlight of her career, a posting where she learned things she could not only bring home to St. John’s, but also to places such as Fort McMurray along the way.

That stint was in the ICU at Toronto General Hospital, what’s called a tertiary care hospital — those that are capable of specialized health care; generally, they’re also those that have the most advanced resources.

These are the hospitals where the sickest of the sick go. At Toronto General, says Richard, every single patient in the ICU was receiving extracorporeal membrane oxygenation (ECMO), a process in which a machine pumps blood out of a patient’s body, oxygenates it mechanically, then replaces it. It’s what doctors use when the standard ventilation by intubation is not enough.

One thing that perhaps people outside of hospitals don’t realize, says nurse Megan Bradbury, is how sick these patients get from COVID-19, and what extreme measures doctors and nurses are taking to keep them alive.

Bradbury is another of the Newfoundlanders who has travelled to Fort McMurray to help out. Like Richard, she volunteered to go to Toronto during the third wave, working alongside her at Toronto General.

The ECMO machine, for example, requires one large tube to take the blood from the body, and another to return it, which sounds very tidy. But on top of that, says Bradbury, patients will also have peripheral IV lines for fluids and drugs, and central lines and arterial lines for monitoring vitals — heart rate, blood pressure, respiratory rates and blood oxygenation levels.

In most cases in Toronto, those patients will have dialysis machines running as well, each with its own maze of tubes and monitoring lines.

Adding to that, she says, oftentimes, patients need to be kept sedated — sometimes even paralyzed — to allow the treatment to take place.

“These are the most critical patients you could ever imagine,” she says.

In Fort McMurray, those most critical patients are transferred to Edmonton or Calgary. But the patients in that hospital are still in very dire straits.

Small wonder, then, that there’s a level of frustration for health-care workers in some of the patients they’re seeing. As of Thursday, with the ICU at the Fort McMurray hospital filled, every COVID-19 patient there was completely unvaccinated.

And the resources and the manpower required to keep those patients alive takes its toll on health-care workers.

Bradbury learned, speaking to the hospital locals, that staff there are constantly doing overtime on their days off, that they’re frequently working 16hour shifts to keep up, even with the newcomers from Newfoundland there to help out.

“There are a lot of sacrifices being made to keep things going the way they are and take care of the public here,” she says.

That’s something she fully understands. Like Richard, her family was unsurprised when she raised her hand to make the trip to Fort McMurray.

“It warms my heart to know that I’ve done the best that I can possibly do to take care of the patients here and help provide better quality care,” she says. “That’s what’s in it for me.”

That attitude has earned the crew from Newfoundland a warm welcome from the besieged local hospital staff, one that may have lasting consequences.

“They’re just so exhausted at this point that having us come in there … I think it kind of uplifted the staff,” she says. “They said it’s going to be very difficult to take that flag down once we leave.

“It may have to stay.”

As of Thursday, with the Fort McMurray hospital ICU filled, every COVID-19 patient there was completely unvaccinated