UNC Hospitals were preparing for a COVID-19 sprint. Now it looks like a marathon.

The hospitals of UNC Health are preparing to live “in two worlds” where they continue to care for COVID-19 patients and admit more patients whose surgeries were delayed when coronavirus infections first began to spread.

When the pandemic started, hospitals braced for a rush of COVID-19 patients. That sharp rise in admissions did not materialize but COVID-19 hospitalizations are rising slowly. The state is averaging about 100 more COVID-19 hospital admissions than it was two weeks ago, but still has available hospital beds, The News & Observer reported.

North Carolina is loosening some stay-at-home restrictions. Gov. Roy Cooper announced Tuesday that Phase 1 of the reopen plan would start Friday, The News & Observer reported.

“Early on, we thought we were really going to be in a very quick sprint,” said Cathy Madigan, chief nursing officer at UNC Hospitals in Chapel Hill. UNC was grateful that it did not see a giant wave, she said, but now it looks like hospitals are going to be seeing COVID-19 patients for a long time.

“Now it’s the dichotomy of how do we continue to take care of COVID patients as we also start to do surgeries and some other things that we put off for a while,” she said Wednesday during a video briefing for reporters.

Madigan said the hospital is “watching very cautiously” for any effect the eased stay-at-home order may have on COVID-19 admissions.

Nurses in the medical ICU at UNC Medical Center in Chapel Hill have changed the way they work, said Cecily Landis, a clinical nurse on the unit.

Before the pandemic, each nurse worked with two patients each shift. Now, nurses work in pairs, with one nurse in full personal protective equipment working directly with two patients in the high risk zone, with the other team member in the low risk zone gets needed medicine and supplies that the other nurse can retrieve from a cart. After two hours, they switch.

Sometimes, one patient will have three to four nurses, she said.

“We kind of always joked before that nursing was a team sport,” she said. “It’s not really a joke anymore that nursing is a team sport. I think it’s showing at its finest, that we all have to be there to make this work.”

ICU nurses are used to trauma, Landis said, but in the past, families were allowed in the hospital to provide staff with information and support their loved ones.

With the pandemic, hospitals imposed strict limits on visitors to contain the spread of coronavirus infections.

“With our families not being there, I think that is the most challenging part for us as ICU nurses,” she said. Nurses are in rooms with iPads so families can be with patients “as they spend their last moments.”

The nurses know that time is important for families, she said, so they’re sure “we make time to where we can stay in the room as long as the families want to.”

Though UNC Rex Hospital has nothing like the crush of patients in hard-hit areas like New York City, the atmosphere has changed, said Joel Ray, chief nursing officer and vice president of patient care services at UNC Rex Healthcare in Raleigh. Patients and the small number of visitors allowed are screened as they come in. Everyone walking the halls wears a mask.

“There is no doubt it feels different,” he said. “It raises the level of awareness that our world has changed.”

This story was originally published May 7, 2020 at 9:00 AM with the headline "UNC Hospitals were preparing for a COVID-19 sprint. Now it looks like a marathon.."