Ask Renee Fesperman what it looks like to work in Cox’s coronavirus intensive care unit, she’ll offer a few words:

Loud, stressful, sad.

Her fellow nurse, Lois Miller, said the room in Cox South's west tower looks like an “airplane hangar” lined with beds and “big, blue walls.”

Inside, machines and monitors beep and screech. Phones ring.

Patients, delirious and confused, cry out and attempt to pull oxygen tubes from their noses or crawl out of bed.

Care providers shuffle through the aisles, covered head to toe in protective equipment. They wheel equipment around on carts, practically yelling to be heard behind their face coverings.

“It would, to an observer, seem chaotic,” Fesperman said.

But in that apparent chaos are nurses like Fesperman and Miller, working as hard as they can during their 12-hour shifts to save patients and help them recover.

There are people like Dalton Swindle, a respiratory therapist who has taken on more duties than normal to help account for perpetual staffing shortages.

And in each of the beds, there are patients, fighting for their lives.

Many of them won't make it.

“I’ve been a nurse for almost 25 years, and this is the worst continuous situation I’ve ever been in," Fesperman said. “We’re working our asses off, and patients are dying left and right."

'That could be me'

On Thursday, a record high 155 COVID-19 patients were being cared for at Cox and Mercy in Springfield — 29 were in intensive care.

In the first 10 days of October alone, Greene County reported 35 coronavirus-related deaths — about a third of the 112 total fatalities since the pandemic began.

Those numbers are especially real to hospital staff.

Coronavirus patients are particularly labor-intensive. Many people in the later stages of the disease require help breathing; some take medication or have treatments that require close monitoring.

They’re all different ages, which 25-year-old Swindle said was especially jarring.

“Seeing people in my age group being sick and critically ill, that really tears me up,” said the respiratory therapist. “Because that could be me on a ventilator. That could be me on a bi-pap (machine) fighting for my life.”

But even the older people, who have accounted for most of the deaths, have many years of life left, Swindle said.

Those patients tell hospital staff about their children or grandchildren. The nurses may even get to know those loved ones while updating them on the patient’s condition, Miller said.

“These are people that we’ve known. We ask them about their families, I’ve talked to their families every day on the phone, updated them on their care, worked as hard as I can to save them,” she said, “and you watch them get weaker and deteriorate and it’s really hard.”

'We did absolutely everything for him'

Due to the highly contagious nature of the virus, family and friends aren’t allowed to visit their loved ones while they fight it.

That often leaves nurse Lacey Gates' patients in Mercy’s ICU isolated in their own rooms for hours on end.

It takes a toll on their mental health.

“The hardest part is trying to keep our patients mentally happy and try to keep working and pushing forward,” she said. “It’s almost like sometimes they just give up. Just imagine being secluded to yourself for 21 days and not being able to see a family member.”

To help, Gates said she and her colleagues become a sort of family.

They ask about the patient’s loved ones. They provide support. And when the patient needs help, they take the time to listen.

“Sometimes, the biggest thing you can do is just sit in their room and hold their hand and just pray with them,” she said. “Just be there.”

But that closeness also makes it especially difficult when the patients take a turn for the worse.

Gates said she cared for a man who was in the hospital for several weeks. During that time, she got to know him well. He was fighting and could talk to her until very his last day, she said.

“We did absolutely everything for him,” she said. “And I’ve seen this multiple times, not only with this patient, but we sit there and … we’re holding their hands and they know nothing else can be done for them. It’s just very sad.”

'This is a real problem'

Swindle said sometimes at the end of the person’s life, the family may be able to come to Cox, suit up in layers of protective gear, and say goodbye.

Those loved ones can sometimes be confused and angry, Fesperman said, lashing out at the staff physically or with words.

“Families are upset with us, they’re mad, they don’t understand,” she said. “I just want to say, ‘We’re doing the best we can, and it’s not our fault.’”

Fesperman said the denial and anger over the virus have also impacted the people she cares for.

She said she’s met people in the hospital who say the virus isn’t real. She even cared for a patient who didn’t believe COVID-19 was the reason they were sick.

“If you’d walk our path every day, you’d know it’s not made up,” she said. “This is a real problem and a real virus that is killing people.”

And for Gates, the fear of losing loved ones is something she experienced firsthand. 

For nine days, the Mercy nurse was home-bound, experiencing heavy fatigue after being infected with COVID-19. She temporarily moved out of her grandparents’ house because she was “terrified” about passing it on to them.

Luckily, she didn’t, but she said she wanted to spread the message so that others would care for their own loved ones and community, too.

“I hope people can find how (serious) this disease is and how important it is to wear a mask and try to wash their hands and social distance,” she said. “People are dying daily in our ICUs … and it’s one of the saddest ways to die I’ve ever seen.”

'It's not even close to over'

On a recent day, Swindle stepped out of the unit after losing one patient and seeing another become critically ill.

He said he looked out the window of the break room, saw the highway, and thought about what people in the cars were seeing as they looked up at Cox South’s tower.

“Everything looks normal outside,” he said. “Everything looks like it’s going about its day, and there are so many people that are not really in touch with what’s going on in this health care setting with this disease process.”

Miller said there have been several times when she has been sitting with friends or family after work, thinking about everything she saw during her shift.

“You’re here, and you’re in this extreme environment and you’re seeing these things, and then you go home and you see friends and family out in the community and it’s so difficult to convey what your day was like,” she said. “I don’t even know how to translate it if I could.”

And there seems to be a disconnection, she said, in how people perceive the virus. It’s spreading quickly and killing people locally, but people seem to have lost interest.

“It’s not even close to over,” she said. “Until you actually walk into the tower, see the patients, see the staff taking care of them, you can’t imagine it.”

But there is a sense of community and support among the people who are dealing with it.

Gates said she felt like the virus had brought the community and she and her colleagues at Mercy closer together.

And at Cox, the nurses said there’s a teamwork approach that has pulled people together as well.

That doesn’t mean the care is easy, though.

“It’s physically and mentally draining … it’s hard every day,” Fesperman said. “Impossible? No. Difficult? Yes.”