“God, just keep us resilient. Let’s not get discouraged. There are so many things we can do and are doing well, and we have to keep looking for those bright spots.”
Janice Murphy, president and CEO of St. Vincent Medical Charity Center, was asked by The Plain Dealer for a personal account of leading during the pandemic. The Plain Dealer and Cleveland.com are celebrating health care heroes who helped through the coronavirus pandemic and are honoring them with a collection of first- and third-person stories about their work. See all the profiles here.
This essay is written by Murphy as told to George Rodrigue, editor at large of Advance Local. The text of her essay is below or available here.
The pandemic really came to a head here on St. Patrick’s Day of 2020. I’m Irish, so that’s a higher holy day to me than Christmas. And that was the day the governor stopped surgeries. We had to go up to the operating rooms and tell our staff that all surgeries, especially elective procedures, would stop immediately. It was 7 a.m. and there were probably close to 100 people in there, all in scrubs, ready to go. And everything stopped.
We didn’t know what would come next, but we are a Catholic hospital and we put our faith in God.
Our founders, the Sisters of Charity of St. Augustine, were here in this building caring for patients during the 1918 pandemic. To go back and read their notes, it was the same things we were hearing now in 2020. No gatherings. Stay home. No church. No funerals. It was uncanny to see the similarities. They wrote about what hard times they had, but also that they came together in ways that were unimaginable.
And I think that’s our story, too. The collaboration of our doctors and nurses, our technicians and our support staff and our pharmacists, it was just beyond anything I’ve ever seen.
They came in every day, before we had a vaccine, when we didn’t even know yet how people got COVID-19. That takes a certain amount of courage and humility. You’ve got to keep going every day, and put your faith in God. I asked every morning that we prayed. Psalm 91.
Because you have made the LORD, who is my refuge,
Even the Most High, your dwelling place,
No evil shall befall you,
Nor shall any plague come near your dwelling;
For He shall give His angels charge over you,
To keep you in all your ways.
I think that was our spiritual antidote to COVID. It gave us inner strength.
We had two COVID care areas, and the nurses there were some of the biggest heroes I could imagine. They came in every day and took care of their patients. They were scared. I think we all were. But they never complained.
One thing that overwhelmed me to see is that because of our restrictions on visitors, our caregivers treated patients like family. Holding their hands, letting them know they would stay with them if they were being intubated or coming off the ventilator. That’s very scary for a patient. The nuns and our pastoral care team still visited with patients and would bring an iPad, so they could FaceTime with family. Our nurses also facilitated a lot of that. This is what we mean when we at St. Vincent say we provide Care Beyond Medicine.
At first, there was no playbook on how to care for COVID patients. It was as much an art as a science. Our people watched, and talked to their colleagues, not just here but across the country, and we learned and we adjusted.
For example our pharmacists; the drugs they had to prepare were so complicated. Early on, we weren’t sure what would work. We had to try all these different dosages and drugs and learn as they went. One day I was rounding in the pharmacy. The pharmacist had been working so hard to help a patient, and she started to cry. She said, “I don’t think he’s going to make it.” When I think about that, it still makes me cry.
Our pulmonologists and respiratory therapists, the doctors and staff who managed patients on ventilators, they saved countless lives. They learned different things related to positioning and drug doses and managing airflow. We saved more lives as we learned how best to set the ventilators. Steroids were an incredible treatment tool.
Our infection control doctors and nurses were the best. Learning every day, from the CDC, from their colleagues here and across the country and around the world. They were really the glue that kept everyone together. They are who people went to with questions, fears and treatment insight. Because of their guidance and research we converted our COVID units and rooms in the emergency department into negative-pressure rooms, venting air to the outside. CDC didn’t require that, but we did it. I think that’s one reason why so few on our staff got COVID.
For me, the biggest challenge was exhaustion. You’re fighting so many battles on so many fronts, managing information that was sometimes contradictory, fighting an invisible enemy and living in it every day. So you pray every day, “God, just keep us resilient. Let’s not get discouraged. There are so many things we can do and are doing well, and we have to keep looking for those bright spots.”
A great example of that is the masks. When the pandemic hit, the fear was that we wouldn’t have enough protective equipment for the clinical staff and at that time the CDC was saying we did not need masks. I was coming to the hospital and people were begging me, “Give me a mask” and we couldn’t because the supply wasn’t there and the experts were saying the mask wouldn’t help. I said, “This is ridiculous. We have to give out masks, if only so people just feel safe even if they don’t help.”
We had a group of Hispanic women from Esperanza Threads, and they started making cloth masks that everyone could wear. They made St. Vincent Charity more than 2,000 masks. And then, of course, the CDC mandated masks and cloth masks were not to be worn in clinical areas so we had to adjust again!
In addition to the daily challenges of providing patient care and trying to keep our staff safe, financially, for the hospital, it’s been devastating. We were required to stop all surgeries on March 17 of 2020, and surgery is how St. Vincent Charity gets the bulk of the revenue to support our other programs that are not self-sustaining. We do a lot of addiction treatment services which are critical for our community and reimbursement for these services does not come close to covering their cost. One month without surgeries costs us about $3 million per month. Annually that would cost us $36 million.
Even after elective surgeries became possible again, volumes never returned to 2019 levels. People were afraid to come to the hospital for fear of catching COVID. That’s understandable. And then once we got the vaccine, people decided to delay surgery until they were vaccinated. That’s understandable, too. But I read that by the end of this year, about 50 percent of American hospitals will be in negative cash flow. So there will be even more hardship in the future as we work to dig ourselves out of this.
But we’re still serving our community and celebrating what I call “miracle moments.”
When we had to close the hospital to visitors people from the community couldn’t come to our cafeteria any more for food. That’s a hardship because the hospital is one of the only places in the neighborhood for a warm, home style affordable meal. The average per capita income in our part of Cleveland is $9,000 a year. So our chefs created a concept called Mission Kitchen. Caregivers can order food online and proceeds go toward hot meals delivered to people in the neighborhood. Since February 21, 2021 our chefs have provided more than 350 hot meals to the community.
We also created a fund so that our employees, some of whom we had to furlough, could get help with rent and food. Many of our own staff have donated to the fund for their fellow caregivers. Some even gave their stimulus checks to the fund. The fund for our employees facing hardship has reached almost $60,000.
In the beginning of the pandemic when fear was at an all-time high and people were scared to possibly bring COVID home to their families, the two Sisters who still live in the hospital’s convent opened their doors to staff as a place to stay. Many of our medical residents who were doing rotations in the COVID unit stayed in the convent for short periods of time.
We’re working hard to ensure that our community is vaccinated. We have given more than 10,000 doses of the vaccine.
And we didn’t lose any staff members to this disease, and most of our patients fared well. We were blessed in that way.
It is a very scary disease. It was unbelievable, the strain that it put on our entire staff. But the beautiful sense of strength and camaraderies that we created here, that was something to behold. And I will always be grateful that I was able to be here, and to lead through it. The people who lived through this are never going to forget it, or the people they worked with.
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