There is a bulletin board on a wall in the hospital where Sarah Burnette finds time to feel at ease.

A moment when she can turn off her thoughts for a second and appreciate something simple in life.

Filling the space are pictures with encouraging words from children, offering a contrast to her days behind a hot, form-fitting mask that has made her face break out.

“Tugged on our heartstrings a little,” she said.

She was guided by life experiences to become a nurse and help others. Her family lived with her grandfather, who suffered a stroke when she was growing up.

“I felt like I kind of was a nurse from the start,” she said.

But there was a moment when her world changed — one that now has Burnette putting her scrubs in a garbage bag each night and leaving her shoes at Fort HealthCare, where she has worked for the past dozen years.

She is one of the many nurses on the frontlines in the fight against COVID-19 who have shared their experiences only with co-workers who understand what the last few months have been like — both physically and emotionally.

But many have had one question on their minds through all this: What is the right thing to do?

For Melanie Kutz, she found that helping a patient see their family on Facebook was the right thing to do.

For Allie Ulrich, taking a week off work to relieve stress, even though she never calls in sick, was the right thing.

And for Burnette, taking time to look at a bulletin board with encouraging letters was something that felt good, and right.

A pandemic is not supposed to come to a rural hospital like Fort Memorial Hospital. That’s something one hears about or sees on TV.

But a few months ago, the nurses here left their normal days at various locations to become part of a COVID-19 triage team, undertaking duties ranging from swabbing people who drive up for tests to caring for sick patients in the ICU.

“We needed all hands on deck. I let my nurses know their world would change,” said Lisa Jensen, who has led the team. “We needed them here and anywhere else we needed them.”

They questioned themselves on what was right. They were scared. They were brave. They found an absolution in the fact that they were all well trained and ready.

As the patients came, the nurses relied on each other, becoming steady and confident. There were difficult days that brought them closer together to talk about how they were feeling. And there were the best days when everything went right.

But one question remains. Will there be another wave of cases that washes over the state, and how deep will those waters be?

The test

Walking into the room of a patient was an uneasy feeling.

Dressed in a gown and tight-fitting facemask, Sarah Burnette secured her shield before entering.

“I never thought it would happen,” she said of pandemic coming to this rural hospital.

You want to be the person who rises to the occasion, a team player who is positive and supportive, she said.

But there was an uneasy feeling of what exactly this virus was and how easy it spreads. Questions abound, and still do.

Only days before, Burnette had a patient who came in for non-COVID symptoms and suddenly had shortness of breath and a sore throat.

“And we had to test them,” she said. “And that was a lot of anxiety.”

In the days after Gov. Tony Evers’ “Safer-at-Home” order in March, hospitals started to see more COVID patients here in Wisconsin. They were preparing for a surge, but they were short on supplies like personal protective equipment (PPE). Testing for the virus also still was in its infancy as hospitals worked to stock supplies like swabs and find labs that could turn around test results quickly.

Having worked at Fort HealthCare and grown up in the area, Burnette worked on the inpatient floor, in pediatrics and in the ICU before the pandemic. Back then, staff would wear their full gear only in certain scenarios.

By late February, Burnette started to notice more cases of COVID-19 in America inching closer to Wisconsin.

“It loomed over you,” she said. “I remember buying my care package — my at-home COVID care package. I remember talking, discussing how we were going to start screening people that came.”

The next time the nurses and staff met, the question of “if” COVID would arrive no longer was asked.

And when the NBA canceled its season on March 11, the next few days went into fast-forward, as if someone had hit a remote-control button.

“We spent a lot of time preparing for a surge in patients. And also, how to take care of those positive patients,” Burnette said. “We wanted to know how to take care of them properly.”

There was more education, especially with those patients who would need to be put on a ventilator.

The first time she entered the room of a patient with COVID-19, another feeling hit.

“It’s a very uneasy feeling. You feel alone with that patient,” Burnette said.

That is a feeling she dealt with by relying on her training and being the optimistic person she is.

“I want to go through this and be the nurse I want to work with. I try to set aside my own emotional side. I say 'that’s scary for them,'” she said. “I don’t want to complain. I’m not the sick person.”

A not-so-simple plan

Lisa Jensen was teaching a nursing class at Madison College when a student mentioned that the NBA had canceled its season due to the coronavirus.

“You’re kidding me,” she said.

Jensen had little idea what was about to come next, but did have a bad feeling.

“The moment that changed my world,” she said. “Taught my last class on March 12 and all hell broke loose.”

A native of La Crosse, Jensen has spent 29 years in nursing working in ICU and inpatient areas, and a job she loves in community school nursing.

In a matter of days, schools were closed statewide and she got a call from the hospital. They needed a person to lead their infection-control team, something she had years of experience doing.

“I felt certain, that this would be the thing that would hit us. I knew we truly had to prepare,” she said of the pandemic.

Jensen looked at the background of the nursing staff and made a plan.

“We developed this COVID triage line and ran that ever since,” she said. “Yes, everybody’s job changed.”

Management and staff quickly had to look at who was walking into the facility and how they would be screened.

The next thing Jensen took on were PPE supplies that have been synonymous with this virus for their shortage around the globe.

“How do we keep everybody safe?” she questioned.

Jensen put together an inventory list, pulling out things like gowns and N95 masks.

“If we burn through as much as we did in first two weeks, we will be out,” she said of the decisions that came next. “That was the worry — that we will not have enough to keep our staff safe. We didn’t have testing supplies.”

They had to teach everyone again how to properly put on PPE for a patient with COVID. She had been through preparations like this with the Ebola virus and had learned from that.

“We prepared for three months for that and it never came here,” she said of Ebola.

The preparation, Jensen said, didn’t come without worry and tears. Worry that she couldn’t get answers fast enough for her staff. Worry that the words “we are working on it” might not be fast enough to get what they needed.

There is that fear for them, she said. For for all of them. Worry for families, worry to come to work.

The stress built, and so did the sleepless nights for Jensen.

Supplies were trickling in slowly, but thanks to some donations like those from the University of Wisconsin-Whitewater, there was help.

“Incredible teamwork,” Jensen said of the staff. “Not one thing we had done here was not without transparency and teamwork.

“I believe we are surrounded by …,” she added, choking up. “It’s hard not to get emotional about it.”

Jensen spoke of the staff, their dedication and her concerns for their health and self-care.

And what got her through the vast changes in only days was her experience.

“I believe me knowing I was doing everything I could possible (helped me). It wasn’t without some tears,” she said. “I allowed myself to feel sad.

“I had to go deep and take care of others and myself.”

Most days

Early on in the outbreak, Melanie Kutz had a headache most days when she left the hospital. She felt emotionally drained.

“I am not good leaving work at work. In the beginning, it was really hard. I was so stressed,” she said.

Kutz has been a nurse for 14 years, all at Fort HealthCare, but she didn’t always want to be a nurse. That was something she came across in college.

“This is such a cliché answer. I like helping people and I like to be there and care for people. I like to be there when there is a lot going on,” she said.

Kutz and her husband own a dairy farm in Jefferson and have four children.

Before the outbreak, she said, there never were two days the same at the hospital. But they always were busy.

She is a charge nurse, who helps throughout a floor caring for patients.

Those days, she said, have never been the same since COVID-19.

“The more we heard about it, things changed. Everyone became really scared,” she said. “I haven’t thought back about that. What those feelings were like.”

Everyone had to check email daily, as changes were happening so fast.

Their administration and the VP of nursing did a phenomenal job, she said.

On a day when she had a patient about to be transferred to Madison, she spoke with the daughter who wanted to see her parent. But with hospital regulations across the country not allowing visitors for safety precautions, that was not allowed.

Kutz told her to “friend” her on Facebook.

“I took the phone in there (the parent's hospital room). That was really emotional,” she said.

“That’s the hard part. Where do you draw the line? What’s going to be the right thing to do?” she added.

When patients are moved to Madison, there is no telling the outcome. Unless a family member reports to staff later.

Kutz said she saw on Facebook a good outcome of a patient who had been a “very scary situation.”

“(The case) lasted so long and (we) didn’t know if they were going to make it,” she said. “And it was a younger person.

“This virus not only affects those with (high-risk conditions) and are older; it doesn’t care.”

The best day

On most days, Allie Ulrich would glance at windows filled with messages of support.

Driving to Lake Mills, where she worked at a Fort HealthCare clinic, she was set in her routine taking care of patients each day.

Ulrich knew at a young age that she had a caring side. Her cousin was in an accident in the eighth grade and spent three weeks in a hospital. And that’s when she saw nurses helping and knew that’s what she wanted to do.

At the clinic, she worked a standard dayshift. Ulrich said she wasn’t paying too much attention to the news as the virus was spreading across the world.

Then one day, a patient who was in South Korea called. They soon were on the phone with infectious control.

“Then a snowball from there,” she said.

Ulrich was asked to be part of the hospital’s COVID team to prepare to triage sick patients during a surge.

“That Thursday meeting was all day,” she recalled. “And I haven’t been back to Lake Mills since.”

Ulrich became part of the drive-up testing the hospital began in April. She also works the triage floor.

There is an uneasy feeling not knowing who has the virus when swabbing people. They can sneeze or cough on you. And wearing the PPE is the only protection.

“I became more anxious. I am going to push through this. I am going to be back in Lake Mills in a week,” she thought to herself.

She said some of the hardest points were all the changes so rapidly. Ulrich was trying to be a leader at a new workplace and felt the pressure.

“I felt that pressure and people relying on me and my knowledge," she said.

“A little more stressful for myself. I am a person who is so tied in my routine. Same groups in Lake Mills. My same routine. My same everything.”

With a child at home and parents and a grandmother who she did not want to put at risk, Ulrich found herself, like others, turning to co-workers to talk about what she was feeling.

To keep in touch, she set up her grandmother with Facetime, so they could talk.

“I can’t go see my mom and my stepdad,” she said of the precautions. “You don’t have anybody. That is what really hit me, and I don’t have anywhere to turn. I can’t put my family members at risk.”

In the last 10 weeks, the most difficult time, she said, was when she had to admit that she needed a few days away from work.

“The hardest day was the day I really felt all this change and stress.”

And then admitted she need a break.

“I don’t do that,” she said. “I’m always there for people. I never call into work.

“And have to go to my manger and say 'I’m not OK, and I need to take care of me.'”

In those few days off, Ulrich went for walks, spent time with her child and binged Netflix.

She turned off the news, didn’t check social media. She needed to just do her.

Her best day, she said, came a week ago when things were so busy and chaotic, but everyone handled things beautifully.

“Pure chaos, but I couldn’t have had a better team and crew,” she said.

A bond

She turned off the TV and took her two little dogs for a walk, and that night she tried to get some sleep without much success.

Jensen tried to practice what she preached to the COVID-triage team: Take care of yourself so you can take care of others.

She also soon had to learn how to communicate differently with staff, using the social distancing a computer provides for meetings.

“My first true meeting on Zoom was a total bomb,” she said with a laugh.

Jensen has children in Chicago and Phoenix and was worried for them living in large cities where outbreaks are more common.

In the months leading up to the shutdown in Wisconsin, Larson knew the pandemic was coming here.

“We will never be the same as the world was on March 12,” she said.

For the first time since then, Larson said, there has been a little feeling of comfort. But that soon went away when the “Stay-at-Home” order was overruled by the state Supreme Court. There also have been protests around the country without participants undertaking social distancing.

And the sleepless nights returned.

For those on the COVID triage team, they all turned to each other for comfort when things got hard, and then even harder.

“I remember telling them I was scared, too scared to take care of COVID patients. I was afraid. I was scared I would watch people die and we couldn’t do anything,” Kutz said.

Her faith, Kutz said, got her through tough times.

“Unless you were in the hospital seeing it, you didn’t understand,” she said. “Some days, I came in so mad. You are so mad because you are scared for so many reasons. I talked with co-workers and calmed down. If I didn’t have co-workers or leadership, I think this would be different.”

Walking into the nursing station during the first days of the outbreak, Kutz always was anxiety-ridden. What if they couldn’t send patients to Madison because their beds were full? What if the surge hit here?

“We get a few sick patients, positive patients, and we handled it and handled it well. I think that helped encourage us,” Burnette said.

“We did a lot more family time stuff,” she added.

The stress also came in the form of having to ask her parents babysit her children, and they agreed.

"That put pressure on me, and worry,” she said. “I could bring something home to my kids.

“But honestly, talking about it, to my co-workers, about what they are feeling and I’m feeling (helps).

Ulrich said she tried to turn everything off the best she could and was grateful for the support of a “super-strong team.”

“I need to take care of me or I can’t take care of others,” she said.

Ulrich said she always tries to send the message of thanks to the team, because at the end of the day, everyone needs to hear that.

“It’s OK to talk about what you feel and admit you are overwhelmed,” she said. “It takes a team. No one person will lead us to success.”

Throughout this pandemic, Jensen said, there have been a lot of positive changes on how things are done at the hospital.

When she heard that the first case of COVID was at the hospital, she knew the staff was ready.

“It was like riding a bicycle. You become steady and confident in your ability and do what you’re taught,” Jensen said.

And keeping one thing always in mind when it comes to the patient.

“There is a person there,” she said.

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