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Unvaccinated ER nurse barely survives COVID-19

Julie Stevens is a registered nurse in the emergency department at UnityPoint Health – Marshalltown, and she found herself in familiar surroundings in August.

However, now she was a patient.

Stevens chose not to receive COVID-19 vaccination and had contracted the virus. Because she was a healthy 39-year-old with no underlying health concerns, she tried to manage things at home. Soon, though, a trip to the ER in Marshalltown was necessary and a hospital admission came next.

Through the next two weeks, Stevens’ situation grew grim, and she fought for survival. When she needed intensive care, she was transferred to Ames, where she was intubated and placed on a ventilator. Meanwhile, her care team stayed in contact with UnityPoint Health in Des Moines in case she required dire action, such as extracorporeal membrane oxygenation (ECMO) treatments.

In between fighting for breaths of air, Stevens found time to think.

“I was lying there thinking, ‘Why didn’t I get the vaccine?'” Stevens said. “Of course, at that point, it’s too late, and I’m getting ready to be put on a vent. Number two was this — I have two teenage daughters. I wondered who’s going to care for my kids? I’m not going to be there for their weddings, for their graduations, you know, those things.”

Fortunately, Stevens finally took a turn for the better. After 15 days of hospitalization, she was discharged to home on oxygen and is weaning herself from it. Still, she emerged from the battle convicted about the decision she made not to get vaccinated.

That’s because her husband, Taveis, also contracted COVID-19 but had chosen to be vaccinated. His symptoms were limited to a low-grade fever and some body aches.

“My big thing is to try and take the politics out of the vaccination,” Stevens said. “Having a career in health means we believe in the science. It’s been proven that people with the vaccine are way less likely to end up in a situation like mine.”

Stevens’ battle began with a fever and severe pain. “Pain like I’d never felt before,” she said. “My skin even hurt.”

After being admitted to UnityPoint Health – Marshalltown, she was placed on regular oxygen, however, that wasn’t sufficient, and she was transferred to an ICU.

Once there, her oxygen levels plummeted into the 60 percent range. Typically, anyone below 92 percent or demonstrating significant respiratory labor such as rapid respirations is cause for hospitalization. Her heart went into V-tach, or ventricular tachycardia, a heart rhythm disorder. Typically, patients in V-tach have their hearts shocked back into rhythm.

Medication helped get Stevens’ heart in rhythm, but she was on high-flow nasal cannula oxygenation receiving 15 liters of oxygen per minute, which is the highest a patient can get. And, still, her oxygen levels were only in the 70s.

The ICU pulled in the hospitalist and the critical care, pulmonology and infectious disease departments. They decided to intubate Stevens and planned for potential ECMO treatments, which is when a machine is used to bypass lungs in order to enhance blood oxygenation. When people go on ECMO, it’s typically for weeks.

The intubation and the ventilator helped stabilize Stevens. She was discharged at the end of August and is expected to make a full recovery. She remains off work and, should her recovery plateau, a pulmonologist will need to explore whether she suffered long-term lung damage.

“Really, my thing is if I can just make one person realize how important the vaccine is, then I feel like I’ve done my job,” Stevens said. “I think people have a misconception, like I did. Number one, I was like, ‘I don’t want to get (a vaccination) because I’m going to feel sick for a couple days.’ Well, I would have taken a couple days of the body aches and fever as opposed to two weeks in the hospital with intubation. I mean, I was a healthy, 39-year-old.

“And number two, the vaccination doesn’t mean you’re not going to get COVID. You can still get COVID, but it should keep you out of the hospital.”

Stevens is grateful for the care she received in both locations, including from hospitalist Karrie Lisboa and her team in Marshalltown. And her fellow caregivers reached out daily with messages of support, while delivering meals when she returned home.

Perhaps the most impactful touchpoint was a reassuring comment from one of the human resources contacts, who told Stevens her job would be waiting for her and to concentrate on getting better.

Stevens had her reasons for not getting vaccinated, and she hopes she can spare others the dangers associated with making the same decision.

“A lot of it was I just didn’t want to,” she said. “And then as soon as (UnityPoint Health) came out and said, ‘You have to’ … then you kind of dig your heels in and say, ‘Well, if you say I have to, then I’m not going to.’

“Hindsight is 20/20, but I’ve realized that UnityPoint and everybody else are doing it for their staff and patients,” Stevens said. “I mean, if we’re out ill, we can’t take care of patients. So, it’s really not political to me anymore. They’re trying to do what’s best for staff.”

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