(Trent Nelson | Salt Lake City Tribune) ICU nurse Kristen Thun in Sandy on Tuesday, October 19, 2021. Health care workers report that patients who are upset about COVID-19 have increased aggression and hostility, especially when these people are affected by misinformation and conspiracy.

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The man sitting in front of the nurse practitioner Cara Wolf asked for ivermectin. When she refused him, she saw his eyebrows frown and his chest puffed up with anger.

The patient who came to the Urgent Care Clinic in Utah didn't really want to be tested for coronavirus at first, even though he was the perfect candidate: unvaccinated, sick and coughing.

When he turned to ask for ivermectin, her heart fell. Ivermectin is an antiparasitic drug touted by right-wingers as a potential COVID-19 treatment. Wolf’s dogs take this medication once a month to prevent heartworms, but it is rarely prescribed for humans, and the U.S. Food and Drug Administration warns against using it to treat the coronavirus. She told the man that she might lose her license for prescribing these drugs and refused to do so.

She said that the man was furious. Most verbal abuse is vague to her, but Wolfe said that she did remember the words he called her vulgar.

"This is the first time in my career that I am truly afraid of patients," said Wolfe, speaking as an individual, not as a representative of an employer.

Wolf was more than 5 feet tall and paled in front of this burly man. What if he has weapons? What if he comes after her after get off work?

That night, she made sure that the security personnel were there to send her to her car.

Wolf and other medical staff interviewed by the Salt Lake City Tribune said that this hostility will only intensify as the pandemic spreads. They said that at the beginning of the public health crisis, it was generally felt that everyone was on the same team. Many people now walk into the hospital door with COVID-19 conspiracy theories and misinformation-these people often see caregivers as enemies.

Health care workers in Utah say that patients insist on receiving unproven and potentially harmful treatments, walk out of the hospital or tear off their intravenous fluids despite medical advice, because they are afraid that someone will slip unwanted drugs or government monitoring equipment into the tube. middle.

Over the weekend, a group of Utahans affected by the misinformation gathered outside the Mountain Medical Center to "protest" the medical staff. Some patients or family members have verbally or even physically assaulted the person entrusted with them.

At the urging of hospitals across the state, a Utah lawmaker is seeking to strengthen the punishment for assaults on medical staff, hoping to curb such violence. State Rep. Robert Spendlove said at a recent hearing that he heard that a patient assaulted another patient and medical staff, banging a security guard on the head 13 times, then bit a hospital employee hard to draw blood.

It is not clear in Spendlove's description what caused this particular conflict. But Dr. Yong Sheng, the medical director of Park City Hospital, described the increasingly tense relationship between medical staff and their patients during the pandemic.

He said that health care workers are familiar with the abuse of patients suffering from mental crises or mental state-changing medical conditions, and they are used to "turn around."

However, due to distrust of the medical system and misinformation about the coronavirus, the aggression suffered by medical staff is different now. The province said that although hospital staff are committed to caring for patients, regardless of their beliefs, these conflicts really make them frustrated.

"If you use the analogy of our cup being filled every time we have a positive impact on someone’s life, it will only reduce the amount of replenishment of that cup when someone is not necessarily grateful or they abuse you verbally or physically. It makes us feel complete at work," he said. "But we continue to do so."

Wolf said that at the beginning of the pandemic, the COVID-19 floor felt like a "war zone." Nurses work 12 hours in shifts, sweating in personal protective equipment that protects them from new, little-known viruses floating in the surrounding air.

Some nurses have headaches or nosebleeds from wearing air purifying masks, and many nurses worry that they will spread the disease to their spouses or children. They had to watch the patient die without anyone holding hands, and family members stood outside the windows on the first floor of the hospital so they could hold up signs for their loved ones.

A respiratory therapist estimated that she had intubated approximately 150 COVID-19 patients during the pandemic. Among them, only three recovered enough to allow her to remove the breathing tube-one was a COVID-19 denier who still did not admit that she had the disease after waking up.

"He didn't even realize that he was a miracle," said the Taylorsville respiratory therapist, who was anonymous by the Tribune because she was worried that her job might be threatened.

Wolf said that these difficult days survived with the friendship of colleagues and the support of the grateful community.

At the beginning of last year, representatives of the Utah House of Representatives raised funds to buy lunch for medical staff. Local firefighters and police held a parade of lights and sirens to honor pizza and chocolate bars donated by hospital employees and businesses.

But she said that even at this time of uniting to deal with emerging crises, some people are still cautious about medical staff. She said that there was a shocking encounter last spring when the wife of a patient slammed the nurses and doctors because their husband's condition deteriorated rapidly due to COVID-19 and they rushed to the intensive care unit.

They tried to steal his organs and she screamed in the hallway. They killed her husband on purpose. She heard that hospital staff across the country are doing this.

"Obviously, my first reaction was to defend. It was like, wow, we would never do that," said the Salt Lake City medical staff. "And you are trying to calm this person down, but they are very sure that this is what is happening. How do you convince others not to do this?"

Health care workers say that with the pandemic, the problem will only get worse. As a nurse on the COVID hotline, Becca Thomas heard more and more anger from people as the pandemic subsided.

In the beginning, many callers will express their gratitude. She will answer questions about whether they should be tested for COVID-19, how long should they be quarantined, and whether masks can protect them, and they will tell her that she is doing well.

"I like to take care of people, and I like to make their lives better," said Thomas of Bluffdale. "And I like to comfort people who are scared and let them know that everything will be alright."

But thanks now are rare. Instead, Thomas heard the shouts of many people who angrily believed that their surgery had to be postponed due to the surge in COVID-19, or was angry because she encouraged them to get vaccinated.

"I was yelled and told that I was part of a conspiracy theory because I was promoting vaccines from my large pharmaceutical company. How do I enjoy these salaries?" she said. "I think, I'm shopping at WinCo, what are you talking about?"

Thomas said her plan has always been to continue working as a nurse "until I am 90 years old." However, at this point, she said she was about to give up. She is tired of a divided life. One of them is a nurse immersed in people's anger and fear, and the other is in a world that seems indifferent to the pandemic.

"I don't know if I can do it," she said. "And I'm tired of being scolded. Being scolded is really tiring."

David Gessel, executive vice president of the Utah Hospital Association, said that last year, in hopes of a vaccine that would end the pandemic, medical staff absorbed the initial wave of COVID-19.

He said that now—between the return of unvaccinated diseases, the confrontation and exhaustion of certain groups of people—hospitals across the state have been laying off staff.

Krishna Shove, a registered nurse at Payson, said these departures represent a huge loss of institutional knowledge and professional experience.

She said: “When you or your family crash and are dying, there is a big difference between having an experienced nurse and having a brand new nurse who has been out of school for a month.”

Due to the stress caused by the pandemic and the hostility of people affected by COVID-19 misinformation, many veterans who stayed "have suffered from post-traumatic stress disorder, depression, anxiety, and overall terrible mental health."

The Taylorsville respiratory therapist interviewed by the "Tribune" said that the medical staff at her hospital joked that she would leave the stressful medical job and be hired as Ross clothing together.

"Some people want to work in the fitting room, some want to be a doorman, some want to be a cashier," she said.

A patient demanding ivermectin threatened to take legal action against her, while others were very angry and tried to record everything the respiratory therapist did with their mobile phones.

Spendlove's proposal will expand the criminal penalties for assaulting medical staff, but it will not solve all these situations. But Gesell said he hopes this will deter the wave of violence against frontline employees.

"I don't want to over-promote it as it happens every day in every hospital.... But this is an increase. I have been doing this for 26 years," he said. "We have never seen this before."

Spendlove, R-Sandy submitted his legislation to other legislators on Wednesday. Hospital representatives, the Utah Medical Association, and the Utah Family Physician College also joined. Their executive directors stated that they saw “significant acts of aggression against us. It’s increasing and it’s disturbing. Medical staff."

The college’s executive director, Maryann Martindale, said a doctor recently told her that a patient threw a stapler at the nurse, but the nurse could hardly avoid it. A representative of St. George’s Regional Hospital said that patients would beat providers on the head and face, push them and spit at them.

"I hope we can act with a sense of urgency," said Mitchell Cloward of St. George's Hospital. "Show our caregivers that we have their support."

Because two state senators voted against it, the Legislative Council’s Interim Committee on Health and Human Services refused to collectively support the drafted bill. As a personal legislator, Spendlove can still advance legislation.

Respiratory therapist Jenelle Waite estimates that during the pandemic, she has intubated about 50 people as a last resort because the oxygen level is no longer sufficient to sustain the patient's life.

A person treating respiratory distress with COVID-19 feels like watching a "slow moving train crash" because the decline of this person begins to feel that it is moving with inevitable force.

She said this is more challenging because she and her colleagues sometimes have difficulty getting some patients to cooperate with basic care. She adds that some people even refuse to lie on their stomachs to help maximize the oxygen levels in the blood.

"It seems to be a very simple matter, but the patient is very hesitant about it," said a resident of Woods Cross.

Even more extreme are those patients who refuse to accept the coronavirus altogether, or those who ask to leave the hospital even if they rely on oxygen. Waite must tell them that it is not safe to send them home-and they may not be far from the front door of the hospital.

Patients or family members swear to Waite to resist health precautions and visitation rules, and even "marginal abuse" her and her colleagues.

Shove said that in one case, a patient who denied COVID and his spouse even barred hospital caregivers from entering their room because they were uncomfortable with the medical treatment they received. She said that health care workers could not access any drops or BiPAP ventilator, "until it is too late, we have to code the patient."

That man died, Shove said.

She added that hordes of patients have arrived to request "Facebook treatment." She said that some people asked for ivermectin, some wanted to inhale atomized hydrogen peroxide, and one patient asked for intravenous bleach.

"For obvious reasons," she said, "These are very insecure and not a good idea."

Each of these so-called coronavirus therapies has flourished on the Internet and social media, despite warnings from medical experts that they are dangerous and have not proven effective against COVID-19. But health care workers say that people are often too ingrained to hear sound medical advice.

Wing of Park City Hospital said: "Usually this makes patients feel very upset, they feel that because we rejected the drug, we are trying to kill them." "We even have patients because we refused to give them this drug. They violated the medical advice and left the hospital, then they went home and died."

He said that COVID-19 patients have also pushed away life-sustaining oxygen and pulled out IV infusion sets from their arms because they did not trust their medical providers.

Christine Toone, a nurse in the intensive care unit, said that the hostility and suspicion towards medical staff made her feel "like a betrayal."

Year after year, opinion polls show that nursing is one of the most trusted professions. Somehow, she had no reason to understand, and all her trust seemed to vanish. Now, patients behave as if a few hours of Internet research or in-depth understanding of conspiracy theories on Facebook is more important than years of medical education and training.

At this point, Toone—a Sandy resident who left her job in a Utah hospital during the pandemic and is now a traveling nurse—was exhausted.

"The despair when patients realize that they are led to believe in untrue'facts' is devastating," she said.

Nonetheless, Wolfe took comfort from the fact that being in a hospital means that a person still has a trace of trust in health care. She said that the people she worries most are those she has never met.

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