The trauma of the pandemic has affected many: health care workers, first responders, even grocery store clerks. Hospice workers - who deal with death every day - were heavily affected.The isolation of the coronavirus pandemic turned hospice care on its head. While the death rate from COVID-19 has dropped, some hospice workers worry about the next surge and the personal toll the past year has taken.
Hospice care focuses on the quality of life, comfort and emotional well-being of people near the end of their lives. The work is typically slow and calm.
CarrieRae Shamel is a medical social worker for BAYADA, a not-for-profit home health care company. 鈥淚 absolutely love my job,鈥� she said of hospice work.
Heather McAllister agrees.
鈥淚t fills my cup and gives me gratitude,鈥� she said.
McAllister works for BAYADA as a hospice nurse. Both women work in and around Chittenden County.
鈥淧re-pandemic, people would say to me, 'Your work must be so depressing,'鈥� Shamel said.
鈥淎nd that is, like, the opposite [of what it is],鈥� she went on. 鈥淎 lot of the time, I鈥檓 in disbelief that I鈥檓 paid to listen to people鈥檚 stories and have these intimate moments with individuals and their families.鈥�
Death is social and spiritual, both women say. It鈥檚 raw and powerful and ideally, families go through it together with lots of tears, laughter and touching.
But this past year, because of COVID-19, Shamel says she was often the only person in the room with patients. And there were times when it was hard to keep up.
鈥淸I was] going from room to room, trying to hold these hands of people who were dying, trying to schedule these Zooms and it was so chaotic and so sad,鈥� she said.
Shamel provided hospice care at Birchwood Terrace, the Burlington nursing home that had the deadliest coronavirus outbreak in the state. Twenty-one residents died there.
McAllister, meanwhile, was caring for COVID-19 patients at Burlington Health and Rehab.
鈥淚 remember at 4 a.m., I got a call from the facility saying we had seven patients crashing at the same time ... [There were] nurses running around, crazy. We鈥檙e in full gear, head to toe, and [with] N95 masks and the shield.鈥�
In November and December, Shamel worked at Elderwood, a Burlington long-term care facility ravaged by COVID-19.
鈥淚 never understood the term 'dropping like flies' until I went to these facilities,鈥� she said.
People would test positive and have no symptoms, she went on, 鈥淎nd I鈥檇 think, 'Shouldn鈥檛 we re-test these people? They鈥檙e not coughing, they don鈥檛 have a loss of smell and [they] seem to be doing OK.' And the next day I鈥檇 go in and they were actively dying. They would turn in a second.鈥�
Heather McAllister worked at St. Albans Health and Rehab around the same time and says it still haunts her.
鈥淭hat was probably the worst that I had,鈥� McAllister said. 鈥淚 became basically a triage nurse and started having to [do] what we call 'black tagging' people. In nursing, if you鈥檙e going to die in a couple hours, that鈥檚 a black tag. It was absolutely a war zone.鈥�
McAllister said she鈥檚 lost track of how many people she had to pronounce dead.
鈥淚 can鈥檛 tell you how many bags of belongings sat outside doors because families weren鈥檛 able to pick [them] up. I can鈥檛 tell you the sheer amount of exhaustion and stress and frustration of having to call a family member and say, 鈥業 know you haven鈥檛 seen them, but here鈥檚 what鈥檚 going on. They鈥檙e dying and you still can鈥檛 see them.鈥欌€�
McAllister pauses then continues, 鈥淗ospice work has always filled my cup, but COVID just hit us all so hard. The PTSD (post traumatic stress disorder) from COVID, you鈥檙e doing to see for years and years to come.鈥�
The women talk about balancing iPhones over patients, their arms aching at the end of a long day.
CarrieRae Shamel remembers a Facetime goodbye she set up between a dying husband and his wife of 55 years.
鈥淚 mean, I know I have PTSD,鈥� she said. 鈥淎s one nurse at a facility said, 鈥楨very time I put on an N95 mask, I have a trauma response.鈥欌€�
Shamel and McAlllister both describe the red marks etched into their faces from those N95 masks -- masks McAllister admits she sometimes forgets to take off. 鈥淚 will walk into my house wearing a mask and my kids will just laugh at me,鈥� she said.
CarrieRae Shamel said working with the elderly, she鈥檚 always hated the ageism she sees in society. But during the pandemic, in the midst of all this trauma, she said it felt especially cruel.
鈥淔or example, just in my neighborhood, I ran into my mother-in-law, who was talking to another neighbor I didn鈥檛 know. And I overheard this neighbor saying, 鈥極h, it鈥檚 just people in long-term care facilities that are dying. You know, it鈥檚 already people who are sick.'鈥�
She says she was too exhausted to confront the woman, but said comments like that infuriate her.
The good news is that she hasn鈥檛 had a COVID-19 patient die in her care since January.
But both she and Heather McAllister say that in their minds, they know the pandemic is not over.
Amy Gray is director of area growth and experience for BAYADA Hospice. She says the company employs approximately 400 people in Vermont; from nurses and social workers to physicians, chaplains and home health aids.
During the height of the pandemic, she says BAYADA facilitated a daily prayer line for staff of all disciplines. They also held daily calls with leadership and field staff, expanded medical director office hours, created a COVID-19 response line and weekly Friday afternoon check-ins for any staff in Vermont and New Hampshire.
While many feel encouraged by the vaccination efforts underway, Gray admits there鈥檚 still a lot of unease about the coming months.
Even before COVID-19, a published by the National Library of Medicine found nearly 40% of hospice workers experience burnout.
鈥淭he pandemic created staffing shortfalls and it鈥檚 gone on so long,鈥� Gray said.
鈥淪o when I start to hear about new strains of COVID, I鈥檓 like, 'Let鈥檚 get ready.' There鈥檚 just so much we don鈥檛 know and that鈥檚 what鈥檚 hard. And I鈥檝e got to be honest, as a clinician, that鈥檚 what鈥檚 exhausting.鈥�
Carrie Rae Shamel and Heather McAllister say they鈥檙e trying to take care of themselves. Both are in therapy, which they say is helpful. And both say they spend as much time as possible outside.
Last July, Shamel climbed Camel's Hump 16 times.
The women each consider hospice work their calling and they have no plans to find different jobs.
But Shamel said she was struck last month by the warmer weather and longer days. Normally she celebrates the change of season. But this year, she said it triggered memories of last March, when all the dying started.
鈥淸It was] to the degree that when I went to let my dog out the back door, I smelled the spring air and I thought 'Hmm, it smells like COVID to me,'鈥� Shamel said.
鈥淚t鈥檚 making me think of all the lives I鈥檝e seen lost to the disease.鈥�
Correction 4:55 p.m. 04/20/2021 An earlier version of this story did not list BAYADA as a not-for-profit company.
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