Andrea Krautkremer is a nurse in the intensive care unit in Koblenz. Since the beginning of the pandemic, the workload there has been extremely heavy. Patients suffer not only from Kovid-19. SG spent a day with her in the hospital, writes “Deutsche says“.
At 4:00, Andrea Krautkremer’s alarm clock rings. At 5:45 he is already at work. The 54-year-old German has worked as a nurse in one of the intensive care units at the Marienhof Hospital in Koblenz for more than three decades. In the meantime, only half a working day.
Against the background of great physical and mental strain since the beginning of the pandemic, she does not want to work full time. But he does not stop emphasizing how much he loves his profession.
Enormous physical and mental strain
From the corridor you can see the patients separated from each other by high glass partitions. Currently, 11 of the 12 beds for extremely severe cases are occupied. Three of them – from patients with Kovid-19.
“Around Christmas, the workload was incomparable,” recalls Andrea Krautkremer, adding that she and her colleagues were only able to provide basic medical care. “If I always had to work like that, I wouldn’t be here today,” says Andrea Krautkremer.
“In March 2021, there are fewer patients with Kovid-19. The beds are filled with patients with heart attacks and strokes, as well as people for planned operations, which Marienhof Hospital is performing again,” explains Kurt Simon, who heads two intensive care units. offices. He is pleased that at the moment there is someone to carry out the shifts despite the shortage of staff.
The work of nurses and caregivers does not seem to be valued enough by society, says Simon, stressing: “Good care costs money.” Much more recognition is needed for these cadres, he said.
At the beginning of the working day, Andrea Krautkremer is in a meeting with her colleagues. At it, the nurses and caregivers from the overlapping shift receive information about the patients, discuss their condition and decide who will receive what tasks. On this day on bed number 1 and 2 there are patients with Kovid-19 who are on respiration.
The patient from bed number 4 is in “maximum serious condition”. And the patient from bed number 8 in a state of delirium tore the system from his hand and bit one of the tubes. The ambulance also brought a man suspected of having coronavirus.
He is accommodated in one of the isolation rooms. After the meeting it became clear: today Andrea takes over the leadership of the shift, two of the patients, as well as the accompaniment of a new intern.
“Breathe well through your nose”
Before meeting the first patient of the day, Andrea Krautkremer had a quick test for coronavirus. It is tested once a week. Most of her colleagues have been vaccinated, but she was quarantined during the immunizations.
At 7:30 a.m., before entering Martin Faber’s room (name changed), Andrea put on protective clothing, two pairs of gloves, and a helmet over the FFP2 mask.
Today she would visit him four times, each time wearing protective clothing, taking it off again very carefully, and throwing it away.
Mr. Faber is just over 50 years old, has leukemia and has been in the ward for three days. His mother died of Kovid-19 in January, a bed away from his. When the room door closes, the sound of the breathing machine is heard.
“Good morning, Mr. Faber, how was your night?” Andrea greeted with a smile. “Okay,” he replies under the mask. “It’s good that you lasted so long on your stomach.” The patient lies on his stomach from the previous day to achieve better breathing of the lungs.
The device to which it is connected is called “Eliza”. It monitors heart rate, blood pressure and oxygen saturation. This is one of the many machines used by the nurses at Marienhof. In case of renal insufficiency, a dialysis machine is also used. And in extreme cases, ECMO, in which the blood is enriched with oxygen outside the body.
Andrea checks the monitors, cleans Mr. Faber’s body carefully with pre-warmed disposable towels, and makes his bed. He then controls the infusions, gives medicines, arranges the many tubes. They discuss how he finally wants to marry his partner, preferably immediately, and talk about his cats, who love to lie on his stomach at home.
To have breakfast, Andrea Krautkremer lifts the ventilation mask from Martin Faber’s face. He sighs with relief, “Oh, that’s nice!” The nurse immediately inserted the thin tube with which another machine injected oxygen into his nose: “Breathe well through your nose.” The patient eats breakfast and talks on the phone, the nurse tidies up the room.
Shortly after Andrea put the mask back on, the patient’s partner called to find out what his condition was. “She can call at any time,” Andrea explains, adding, “Talking to loved ones is very important.” They bought tablets from the hospital to facilitate contact during the visit ban imposed because of the pandemic.
The staff in the intensive care units must document everything they do – for the safety of the patients and the payments of the health insurance funds. And all this against the background of constant noise emitted by the monitoring devices and the computers on which the indicators of the patients are reported.
It’s a miracle how caregivers manage not to miss an important signal. In case of any emergency indication, someone reacts immediately. “It’s very stressful here,” says Andrea Krautkermer, “but thanks to the great team, it’s sustainable.”
The work of nurses is far from being limited to the care of accommodated patients. The phone rings often, ambulances drive new patients, and large boxes of drugs arrive that need to be sorted. In addition, in the event that a device breaks down, nurses and caregivers must notify the technicians immediately. There are daily conversations with the kitchen – from there they ask what food patients can eat. And the bed plan needs to be constantly updated.
“Death is a part of life”
At 9:20 Andrea Krautkremer turns on the mourning lamp at the reception. “Unfortunately, patient on bed 4 dies,” she says. The treatment was stopped, two relatives are with him. Visits to relatives are only allowed for dying patients. The warm light emitted by the lamp is a signal “for a little more silence”, explains the shift supervisor.
“You can’t work in an intensive care unit if you don’t accept that death is a part of life.”
But Andrea has no more time to think about life and death. She was told that the patient in bed 1, who had coronavirus, was getting worse. A gastric tube should be inserted through the abdominal wall. An incision is also made in the trachea, as the patient must receive a tracheostomy cannula for ventilation.
Despite all efforts, the patient loses the battle with the virus: two days later he dies. “You do everything you can – but it’s not enough” – this is how Andrea commented on this situation, in which she found herself more than once.
A few days later we talked to her on the phone. Another patient died. Many of her colleagues are already on the brink – fatigue, seriously ill patients and the fear of infection have their say.
“Yes” and last goodbye
Andrea also talks about Martin Faber. The doctors advised him not to wait long for the wedding. The priest of the hospital called the registry office, from where they sent an employee. The priest bought red roses, the nurses brought sparkling wine.
And Andrea decorated the patient’s room with hearts and holiday ribbons. The two newlyweds swore eternal fidelity. Tears streamed down the faces of those present.
Andrea tells us that in the following days Mr. Faber’s condition improved, but shortly after that the indicators deteriorated seriously. Dialysis and intubation were required. A week after the wedding, Martin Faber died. He will now be buried with his mother – her funeral was postponed until his discharge.
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