The Slatest

What Nurses Are Seeing and Hearing in South Dakota

A nurse in scrubs wearing a face shield and mask tugs on her gloves, on a background of coronavirus particles
Photo illustration by Slate. Photo by Boyloso/iStock/Getty Images Plus.

The coronavirus pandemic is surging throughout the U.S., but in no place is it worse than the Dakotas. The states lead the country in cases and deaths per capita while also having some of the lowest rates of mask use. North Dakota recently implemented an order requiring masks indoors in businesses and public spaces. But in South Dakota—a state that held its annual state fair and the massive Sturgis motorcycle rally—there is still no mask mandate, and Gov. Kristi Noem has consistently downplayed the threat of the virus and cast doubt on the science.

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On Monday, a tweet from a South Dakota emergency room nurse—and her subsequent interview on CNN—went viral and brought extra attention to the challenges for health care workers in conservative areas where politically motivated misinformation finds a more receptive audience. The nurse, Jodi Doering, said that patients were denying the existence of COVID until their final breaths. “Their last dying words are ‘This can’t be happening. It’s not real,’ ” she said. “And when they should be … FaceTiming their families, they’re filled with anger and hatred.”

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To get a better sense of whether Doering’s experience was widespread among health care workers in the state, Slate spoke with Ashley Kingdon-Reese, a health care worker in Huron, South Dakota. Kingdon-Reese owns a company that provides in-home care and other health care services. She was also recently elected the Government Relations Committee chair for the South Dakota Nurses Association and has served on her county’s COVID-19 task force since June. Our interview has been condensed and edited for clarity.

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Slate: There’s been a lot of attention paid to Doering’s comments. How have the local health care workers you’ve known reacted to the news cycle?

Ashley Kingdon-Reese: I’ve known Jodi for years. I understand. I think her frustration is high. Certainly the amount of frustration she was voicing is not felt universally here, and there are many who aren’t seeing the same things. Some of the backlash has been about her generalizations. But the one message I did love is when she said that when you come in for emergency care, we don’t care if you’re Republican or Democrat. I don’t want her comment about political views not weighing on health care to get lost.

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She said in her interview that patients in her community are angrily rejecting their diagnosis and even screaming at the nurses when they’re nearing death. Is this something many other health care workers have seen?

It may be they’re shocked initially when they find out they have it. But their last words being them in denial—intubating someone while they’re screaming isn’t a practice. You’d sedate them first.

But I think it’s right that when a family member turns quickly, families are emotional and upset. I don’t think it’s necessarily at the nurse; it’s at the situation. You know, “How could this be? They were just healthy.” Most of them are a little bit shaken up.

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I just don’t feel like there is animosity towards nurses. Maybe there’s the belief [among the public] that we are overreacting, but not so much denial. Because by the time we’re in a position where we’re putting them on a ventilator, we’re past the point where you question it.

What about earlier in the process of being diagnosed and treated, before it gets that serious?

I don’t think it’s accurate to say that people are getting screamed out, that [patients are] in denial. Earlier in the pandemic, that might have been true. But you’d be hard-pressed to find someone in our community of 13,000 who hasn’t been affected by COVID.

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What are nurses seeing from family members once someone has died from COVID-19?

I’ve had people who lost family members, and it was almost like shame. They didn’t want “COVID” on the death certificate. It’s “They had this complication,” or “It had to be this other thing.” It was almost like shame.

How do you not get frustrated when you encounter this kind of difficult reaction?

I do get frustrated. But you take an oath. I’ve had patients that are pedophiles, that are racist, sexist, ageist. You don’t get to pick and choose who you help and save.

But when an elected official isn’t protecting us, it’s easy to put it on the blame there. You have to put the messenger to account. Start from top—the White House—and go on down. Because it’s not an individual issue. It’s an entire mindset, where our whole state equates freedom with [rejecting] mask-wearing. And that’s where it’s really affecting us.

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Our governor is out there saying the data on masks are mixed. It’s not. We have to start with the facts: If PPE didn’t work, I would have COVID already. It’s been a battle for us to contend with the comments and opinions. She’s flying all over without a mask. And that’s very frustrating.

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Have community leaders been as hands-off as state and national leadership?

[The City Commission] passed a resolution last night requiring masks in public. Where that leads, I don’t know. But I feel we were negligent for so long. We do have clients who are in denial that it exists, or [in denial of] the ramifications or the impact that something as simple as a mask can do. But I know with business owners, what I’ve heard is they were hoping for something from the government so they weren’t the bad guys. My friend, when she had a “mask required” sign on the door, people would come in and say, “Never mind, I’ll go down the street.” She lost business trying to protect her employees.

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So I think the frustration that Jodi has is just people in disbelief [nationwide]. From both sides, but predominantly from the right side, where they think they’re not going to be touched by it. I have to find hope, because there are good people trying to do their best under the circumstances.

We have to correct the thought that if you mandate a mask you’re suppressing freedom. For those who participate: You’re protecting our freedom to keep businesses open and keep schools open. By exercising that, you’re securing our freedom. So it’s important that people stop thinking that they’re aligned politically by what’s put on their face.

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