“I wonder if this is how it started in NYC?” ER nurse Bohmfalk back from New York, alarmed by what she’s seeing now in SA

Stefani Bohmfalk is a 1997 Devine graduate who volunteered on the front lines of the COVID fight in NYC. A Clinical Manager of a local ER and Registered Nurse, Stefani Bohmfalk, recently returned home to Medina County after volunteering many weeks in New York hospitals that were totally overwhelmed with COVID patients. New York saw hundreds of deaths PER DAY for a period of time. After weeks of isolation, she is now back home working in San Antonio Emergency Rooms, and broke down in tears last Friday as rising number of COVID patients here struck a chord with vivid memories of what took place on the frontlines of New York.

“Last week our ER saw a spike in our patient volume along with patients testing positive for COVID. Our waiting room was experiencing 4 hour wait times which are not the norm. We have seen a steady rise in the number of beds being used for positive COVID-19 patients. The momentum is here and all we can do is our best to maintain it,” Bohmfalk said.
“Our ER’s in San Antonio are overflowing with people. We have a high level concern. The other night, we had 14 COVID positive patients waiting for beds, and nowhere to put them…. I mean, we have beds upstairs, but COVID patients need to be isolated in separate areas or wings of course, and so that is something we are working on. Our COVID units were full so we are at the point where we had to work on designating another wing for COVID patients. It is surreal to see the waiting rooms full at the hospital where I work here in SA. It scares me to death, and I leave there wondering ‘Is this how it started in New York?'”
“I am begging my nurses to work and stay longer. So many have stepped up, but I don’t know how long we can take it without help. When is it going to be too much? I worked 40 hours within 3 days last week, and then 2 additional days. My feet are just burning at the end of every day. And these patients are very ill, they require constant care, and the PPE we wear is another challenge. It is HOT in that PPE. I have a feeling that hospitals in SA are going to be knocking on the door of staffing companies like the agency that I worked with to bring relief to hospitals here like they did in New York.”
“I have been to New York, and I’m telling you, we need to be worried, we need to be making room for these COVID patients right now. We also need to think twice about doing any elective surgeries. I had a patient come in recently who was in a lot of pain, but our surgeon wasn’t willing to do a surgery right now. It was hard to tell him no, but it’s just too risky right now.”
“When I look at that photo of the acute area of the ER in the NYC hospital, it’s an eerie feeling. The acute area was an 11-bed unit, but we had 44 critical patients crammed into that room, up underneath the counters in every direction. We would normally have maybe 2 people in that acute area.”
We have 6 beds in our acute area here in SA, and I see that our acute areas here are reaching capacity on a regular basis too. We always have to try to hold one bed open for patients coming in by ambulance because we cannot turn them away. I find that we are constantly having to think about ‘Okay who can I pull out if we have a cardiac arrest come in? Who is the most stable right now?’ and that is never a good sign. That acute area is for resuscitation, for people who are dying who we have to try to resuscitate. It is worrisome that we are constantly having to start thinking about making those decisions about who we can move, and where we can move the, when we are in that acute area.”
“We have PODS in our ER, different areas for somebody with ankle pain versus somebody who is short of breath for example, but earlier this week it got to a level where we couldn’t control it. There were too many people in the ER. It is a horrible feeling coming back from where I’ve been, and seeing this happen here, because this is home.”
“The numbers are bad,” Bohmfalk said. “You might not know somebody whose fighting COVID today or tomorrow, but mark my words, by the end of this you will. We had 538 new cases in one day in Bexar County, and that is huge compared to two weeks ago. We are definitely seeing a lot more patients coming in by ambulance.”

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” I had a conversation with a physician today, who worked every day last week, and they said ‘Every day there are more patients coming in, and every day they seem to be sicker. They try to send them home to isolate, but we are seeing more and more patients that we cannot send home. The percentage of patients who need to be admitted is growing. We are also noticing a lot more patients showing gastrointestinal symptoms like diarrhea rather than the typical shortness of breath.”
“When I arrived in New York, I was skeptical, but I almost lost my mind during the first shift. It was so heartbreaking. It was an eye opener because I saw very quickly that COVID can happen to anyone. One of my greatest concerns here in SA is that we have a large population of diabetics, and I have treated many patients in NYC who were diabetics and they had a long fight.”
“One patient that really sticks out to me was a 40-year old lady (close to my age) who came in breathing 40 breaths per minute. She had to take her mask on between taking a bites of food. She had no other conditions, only diabetes. I held her hand and I made promises to her, because I thought we could save her life. But we couldn’t. It was really hard.”
“If you have diabetes, and you get infected with COVID, you are going to be fighting for your life. It doesn’t matter how old you are or how healthy you are otherwise. I am not sure what the connection is, but I saw it over and over in New York.”
“Another one of my first patients was a 40 year old man, with No medical history…he comes in and he has to be intubated within hours. COVID does not discriminate. It can affect anyone, and you just never know who it is going to be.
“I remember a patient who is a bartender. When he could talk, he told me he always wore a mask. Of course he told me his customers don’t. He said ‘I had to provide for my family.’ It’s was so sad. These people are hospitalized and their families cannot be with them, and so many people like this don’t make it. You can protect yourself all you want–but if other people aren’t wearing a mask–they can still infect you. That is one of the saddest things about it.”
“Another thing to think about is, when I arrived in NYC, half of the staff in their ER was out sick with COVID. Those are things healthcare workers need to think about. Don’t take it lightly. Don’t walk in a room without proper PPE.”
After an extra hard day in an area SA hospital this past Friday, she explained how hard it is to see rising cases at home, after seeing the devastation in New York first-hand, which she previously described as a ‘medical warzone.’
“As I sit in my car in the parking garage before I head home, I think to myself, like I have all week…..I wonder if this is how it started in New York,” Bohmfalk said.
“I helped out on a COVID unit here in SA for a few hours after one of my shifts. My first patient told me he was scared and asked if he was going to die. Immediately, I was hit with a wave of emotions I have yet to process while I was in NYC. Every patient that was able to talk, told me they were scared and asked if they were going to die in NY. I cried the whole way home,” she adds.
“Our Emergency Department faced many levels of uncertainty this week….We now have to step out of our comfort zone and take more than our normal patient ratio. We always seem to ‘figure it out’… we don’t have a choice.”
“The point of this is that if you think this isn’t real and it’s okay to be sloppy and out in public without a mask, it’s NOT OKAY. It CAN happen to you and/or a family member. It’s happening NOW. Be smart. Wear a mask.”
In some closing thoughts, she adds, “When I was in New York, our ER here in San Antonio was very slow due to people not wanting to leave their homes. Illnesses patients deemed an emergency prior to COVID-19, seemed to no longer be viewed as emergencies, so our waiting rooms in SA sat empty.”
“I pray every day that I don’t see what I saw there, happen here.”

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