'God, please keep us safe': Amid Covid, an Oklahoma nursing home faces impossible decisions
January 7, 2021
ALVA - It's 4:45 a.m. when the first chimes of Dayna Jordan's phone alarm vibrate softly from her nightstand.
The volume, and Jordan's anxiety, grows with each ring until the once peaceful room is overwhelmed.
As she lies in the dark under a heavy comforter, Jordan is consumed with questions about the day. The answers could mean the difference between life and death for nursing home residents and staff in her care.
Are there enough workers to cover three shifts?
How many will have symptoms?
Are there enough tests?
In November, there were not. Jordan was rationing Covid-19 tests as supplies ran low. A decision that she hoped would save a life ended up costing four.
The 51-year-old director of nursing is responsible for 150 staff and residents at Beadles Nursing Home in Alva, almost three hours northwest of Oklahoma City near the Kansas border.
In the spring, while Jordan built a temporary wall to separate healthy residents from sick ones, Gov. Kevin Stitt imposed stay-at-home orders and closed businesses. As Jordan scrambled to procure expensive, protective gowns in the summer, Stitt reopened businesses and, along with Alva's mayor, shied away from a mask mandate.
In the fall, while Jordan added more temporary walls and isolated residents in their rooms, Alva business owners held holiday festivities and locals rebelled against recommendations to wear a mask and avoid large gatherings, piercing the fortress Jordan hoped would keep her residents alive.
Oklahoma has had some of the nation's highest Covid-19 infection rates, intensifying the struggle nursing home workers face. Long-term care residents and staff account for 3% of the state's infections and 30% of deaths.
At least 765 Oklahomans who lived and worked in a place like Beadles have died. They were somebody's dad. Someone's strict professor. A beloved aunt. A loyal friend.
Pinned on a bulletin board above Jordan's desk are pictures of family, staff and residents. The hand on Dayna Jordan's shoulder in a photo from the 1990s belongs to Linda Krob, who worked at Beadles for nearly 30 years. The wedding invitation of the Jordans' eldest son dangles above, and to the left their youngest son and his wife pose in front of a "go Pokes" sign before a football game. Smiling next to Dayna Jordan in a feathered hat and T-shirt that says "this is my awesome grandma costume" is former resident Phyllis Burkes who died in 2015.
Jordan's been there since 1989 when as a 20-year-old student at Northwestern Oklahoma State University she took a nursing aid job at her boyfriend's family business. They married that December.
Her father died there in 2005 while she was teaching nursing students down the hall.
She took over as nursing director in 2008 when her husband's aunt became ill. When his mother died two years later, Adam Jordan became administrator for Beadles Nursing Home, which has cared for Alva's elderly and infirmed since his great-grandmother, Bessie Beadles, took the first three patients into her home in 1927.
Bessie drew up plans for a single-story building that could serve even more, but she died before the orange, brick building was erected in 1961. Surrounded by homes, the 60-year-old facility remains on Noble Street, where it has become a fixture of the small town.
If all goes as planned, Beadles will pass to a fifth generation when the Jordans' oldest son takes over upon their retirement.
But on this morning, the responsibility is still Dayna Jordan's.
She is consumed with worry about what lies ahead. A reel of worst-case scenarios plays in her mind until a text from her phone brings her back to the bed where she lies inside the two-story rock house less than a block from Beadles. A worker is sick and can't come in.
She skips morning yoga exercises she just started to relieve lower back pain. She brushes her teeth and puts on scrubs covered in flowers and snowflakes in blues, greens, yellows, pinks and purples, a rainbow of colors.
It's still dark as she walks toward the nursing home. She stops under a rusted, white archway with a sign that includes drawings of a cane, a bible and a treasure chest and the words "a place for special treasures."
She can see her breath in the freezing air as she prays a simple prayer: "God, please keep us safe."
Building a Barrier
In the weeks following Oklahoma's first reported infections, Stitt imposed limits on public gatherings, closed nonessential businesses in counties with confirmed cases and issued a stay-at-home order for the elderly and Oklahomans with compromised immune systems.
In mid-March, nursing homes statewide were ordered to shut their doors to visitors and nonessential staff. Group activities and dining were canceled and residents were confined to their rooms to prevent the spread of the virus.
Beadles Nursing Home quickly moved residents from its southeast hall and built a plywood barrier in preparation for a Covid-19 wing.
At the end of April, community members drove past the home in a car parade, honking, cheering and waving to residents and staff who watched and waved back from the sidewalk.
Many restrictions were lifted or relaxed by May as Stitt propelled plans to reopen the state. Oklahoma's nursing and medical associations called the move hasty. But Stitt implemented the plan and implored Oklahomans to act responsibly by washing their hands, social distancing and wearing a mask.
By June, the Oklahoma State Department of Health had a three-phase plan for homes without active Covid-19 infections to welcome visitors. Some facilities were reluctant to open their doors, but Jordan was excited for her residents to reconnect with their loved ones.
Jordan's staff built plexiglass barriers outside for no-contact visits and started developing plans to isolate a room that could provide a safe space for indoor visits.
Outdoor visits and renewed group activities with masks and social distancing kept residents and staff safe and boosted spirits through the summer months. Staff used walkie-talkies to call out bingo numbers across the home when residents couldn't gather. And small groups of residents were allowed to spread out in the dining room for meals until everyone had their turn.
But after students returned to Alva Public Schools and the Northwestern campus in August, the virus spread among Beadles' workers. One nurse and a few aides were positive and several more workers were exposed.
Two miles across town, 51 inmates at Charles E. Johnson Correctional Center tested positive by mid-September.
The state labeled Woods County red on its color-coded map of infections requiring the county's nursing homes to test every worker twice a week.
The federal government provided nursing homes nationwide with a shipment of tests, which Jordan depleted in fewer than two weeks. When Jordan and her husband asked the state health department for help, they were told tests were only being provided to facilities that had active Covid-19 cases, which Beadles did not. The home spent $7,000 a week to have its staff tested at Alva's Share Medical Center and even the hospital couldn't keep up. Beadles ordered more than $4,000 in tests through private companies, but they were on backorder for weeks and it was unclear when more would arrive.
Jordan's husband borrowed tests from Share Convalescent Home, where Alva Mayor Kelly Parker is the administrator.
Parker understood the risk to elderly residents and the workers who care for them. But he feared how residents of the town of nearly 4,600 would react to business restrictions or mask mandates.
The city followed Stitt's charge promoting personal responsibility. But some still ignored the call.
"Out here, we have a lot of people who feel like if the government is telling you to do something, then they're going to do the opposite," Parker said. "I don't want to tell people what to do, but it seems like we're seeing less personal responsibility and that's discouraging."
For years, Beadles hosted trick-or-treaters who would show off their costumes to residents and pick up candy. Jordan and other workers would escort residents downtown to participate in the city's Halloween parade, but the Chamber of Commerce canceled the 2020 event due to safety concerns.
Not all businesses complied. Northwest Insurers used its Facebook account to encourage residents to come anyway, wear masks and social distance. The post listed 23 downtown businesses that would be handing out candy, including boutiques, restaurants, a bar, a cell phone provider and a lumber store.
The office administrator at an Edward Jones branch on Barnes Street reposted the chamber's cancellation notice with the comments: "Parents & children still have a choice. No one can stop them from Trick or Treating around downtown. If someone doesn't feel comfortable, don't go."
Restaurants were packed with customers and residents were seen without masks at many local businesses, Parker said.
Jordan went searching for disinfectant at Walmart, which was sold out at most local stores and too expensive to purchase online. There were signs posted requiring masks, but Jordan spotted several shoppers without face coverings and employees were not enforcing the policy.
"My staff shops there and that's how it's going to get to our residents," Jordan said. "I just wanted to yell at all of them, but there's nothing I can do."
As the virus continued spreading through Alva, one of Jordan's nurses caught it from her husband. Eight Beadles employees started isolation on the same day after a worker at the home's daycare program was exposed. Her daughter was exposed when other students at her school tested positive.
As tests dwindled, Jordan's decisions about who to test and when carried greater risks.
It was 10:30 p.m. on a Wednesday and near freezing outside when a certified nursing assistant stepped inside. She told Marque Bergner, the door greeter who checks every employee for symptoms before they start work, that she had a sore throat and a stuffy nose. Probably from allergies.
No one is allowed beyond the textured brown rug at the entrance without a temperature check and survey.
"Do you have a sore throat, cough or muscle aches?" If the answer is yes, a rapid Covid-19 test is administered, which produces results in 15 minutes. If the answer is no, or if the test is negative, Bergner sprays shoes, lunch pails, purses and other belongings with disinfectant before ushering them inside.
Anyone who tests positive is immediately sent home to quarantine.
The nursing assistant reported similar symptoms the night before. Jordan had tested her and the results were negative. Did she need another test?
Bergner called Jordan, who was at home watching television winding down on the couch with Adam, and asked what to do.
"We only had nine tests left and I just tested her," Jordan said. "I was thinking 'what if we need those for someone else, for a resident?' She was negative on Tuesday and I was hoarding those tests so I decided not to test her again."
"I would do anything to go back to that night."
Two days later, Jordan received a call from the nursing assistant who took the time to fix residents' hair or help with their makeup. It was her day off, so Jordan knew something was wrong when her phone lit up and the worker's name scrolled across the screen. She had tested positive.
Texts on Jordan's phone show her tracing the assistant's steps through the past week. What days did she work? When did the symptoms start? And when was that negative test? Jordan called the local hospital and began testing staff and residents.
Within the week, seven of eight night-shift workers had tested positive. Four were exposed at Beadles.
Within a week, two residents had tested positive. It quickly spread until the Covid wing they set up in March to hold six patients was full. Beadles put up another temporary wall and created an overflow wing to hold eight more patients in the center of the building
Group activities were halted. Residents were relegated to their rooms.
As Beadles was trying to contain the virus, the city was struggling with its own outbreak.
On Nov. 7, the ZIP code that encompasses Alva and reaches the Kansas-Oklahoma border, saw its largest single-day spike yet, according to data collected by Oklahoma Watch. There were 45 new cases reported for a total of 216. The area's first Covid-19 death was reported on Nov. 10.
Cases jumped again a week later and again two days after that.
Alva's hospital, Share Medical Center, was filling up and the Intensive Care Units in Enid, where critical patients were typically transferred, were full.
To curb infections, Mayor Parker and Alva's police chief created a video encouraging residents to take the virus seriously, avoid crowds, wear masks and be kind.
"An attitude of kindness is going to go further than any mandate or lecture to bringing us all together in the fight against this virus," Parker said in the video.
The video was posted on Parker's Facebook page and the police department's page the Sunday before Thanksgiving as the city was experiencing a spike in infections.
A new record number of cases was reported on Nov. 24, the Tuesday before Thanksgiving. And the record was broken again on Dec. 5.
The protections Jordan had been building around her residents had failed. Ten residents were suffering in the Covid wing. On Thanksgiving Day, the first Beadles resident died from Covid-19.
Alan Nusser, 81, was a farmer who loved his wife and kids. Jordan remembers the John Deere tractor on his birthday cake and how he cried when he was happy.
When Jordan got home that night, her barely 5-foot-frame could no longer carry the burden.
She burst into tears and called the Cherokee Clinic emergency line. Jordan has been seeing a counselor sporadically, but she has attended weekly, virtual appointments since March. She needed to talk to her counselor immediately.
She talked with her counselor for two and a half hours.
"I remember saying 'I just don't know what to do with my anger and I just feel so responsible and so powerless,'" Jordan said. "Like nothing I could do was good enough or could stop it."
At Beadles, 25 staff and 20 residents have contracted Covid-19. Of the five deaths in Alva's Zip code, four were Beadles residents.
As of Monday, 872 infections have been reported in Alva's zip code – 19% of the city's population.
"People think they're bullet-proof," Parker said. "And then they act accordingly."
Statewide infections and deaths have also continued to rise. This week, the health department reported more than 306,000 cases of Covid-19 and 2,552 deaths.
Stitt limited public gatherings, ordered bars and restaurants to close by 11 p.m. and required restaurant tables to be at least six feet apart.
Rather than a mask mandate, he asks Oklahomans to follow the three Ws: wear a mask, watch your distance and wash your hands.
"Every time you choose to follow the three W's, you are actively protecting those around you," Stitt said in a press release about the new restrictions on Dec. 10. "You might even be saving a life."
As Stitt's team released that statement, 92-year-old Beadles resident Alberta Bliss died from complications of Covid-19.
Bliss was a frequent visitor at Beadles Nursing Home for years, always cheering up friends who lived in the home, before she moved in. Jordan always admired her loyalty and enjoyed the spicy pickles she gifted at Christmas time.
There were no pickles under the tree this year.
'This Used to Be A Happy Place'
Jordan stands in front of the nursing home where she will spend yet another day saving every life that she can.
She takes a deep breath, puts a black mask over her face and then pushes the button next to the nursing home's locked front door. She smiles at Marque Bergner, the door greeter, who opens the glass door, picks up a thermometer and scans Jordan's forehead.
Jordan continues down the hallway and stops at the closed double doors that mark the only section of the nursing home unexposed. She sprays the bottom of her shoes with Lysol and again coats her hands in sanitizer before entering.
She pauses over a partially completed puzzle on a table with two empty chairs. The residents who used to spend hours every day talking and working haven't touched the pieces in weeks.
"This used to be a happy place but now it's just sad and empty," she says surveying the large dining room where holiday decorations remain unseen by residents who aren't allowed to leave their rooms.
Just down the hall, roommates Earl Prigmore and Norm Lancaster sit side by side in their recliners watching separate televisions.
Lancaster, 80, has four children who live nearby but he hasn't seen any of them in weeks due to the lockdown. It has been months since he has hugged any of them.
"I have a grandson and a great-grandson that live just half a block from here," Lancaster said. "That's terrible to look out the window and see them over there and know you can't go visit."
Prigmore, 95, used to leave the nursing home daily for coffee with friends. His stepdaughter, Nancy, used to visit about once a month and take him to her home in Stillwater for holidays. He spent Thanksgiving with Lancaster, in their room, watching television and eating turkey from rolling tables placed next to their chairs.
"I'd rather take my chances," Prigmore said. "At my age, you're going to have to die from something and it doesn't make a lot of difference to me what it is."
Jordan drops her head as the pair search for something to look forward to.
By the time she returns to her office, she remembers it is resident Heather Kline's 49th birthday and her family is coming to see her. Kline had been isolated in the Covid hall since testing positive a week earlier. She hasn't left her bed for seven days.
A nurse wheels Kline's chair to the chain-link fence that lines the backyard. Kline's family stands across the street with handmade "happy birthday" signs and sings loudly as a dozen workers join in. They stand several feet away from Kline who strains to hear them through their masks. Still, it's a highlight of the day for everyone who's there.
Kline asks to stay outside for a few more minutes before they take her back to her quarantine room. The nurse agrees.
Jordan steps away from the celebration to take a call from a nurse who is sick to her stomach and can't work the night shift - the third employee of the day to call in sick.
As she hangs up, a nurse tells Jordan that Dorothy Arndt, a resident who attended Jordan's church, is throwing up again. Jordan tests Arndt for Covid-19. It's positive. Staff begin preparations to move her to the backup Covid hall.
Jordan barely makes it back to her desk when the greeter calls her to the front door.
Rocky Stewart has come to pack up his aunt's belongings.
Justine Lancaster died early that morning after more than two weeks of fighting Covid-19. Her room is small and cluttered with photographs, stuffed animals and decorated poster boards from her 104th birthday in March. She loved coffee, candy, and playing the piano for residents and staff.
Before his aunt moved in, Stewart's mother-in-law lived at the home. He was a frequent visitor and has known Jordan for years. Jordan wants so badly to hug him as his eyes start to water, but protocols don't allow it.
Instead, she holds a cardboard box while he fills it with his aunt's jewelry.
Stewart leaves a photo of his aunt for a staff member who before the pandemic helped with activities and now works in the laundry room. She holds the picture against her chest with one hand and Jordan squeezes the other. They talk about Lancaster's spunky personality.
It's 4 p.m. and a red bowl filled with lunch from Beadles' cafeteria sits unopened on her desk where a nurse set it five hours earlier.
Jordan fishes through the storage closet for bandaids. She folds a spare pair of scrubs, hands them to a new employee and wonders how long she'll stay. She counsels a distraught employee who fought with her boyfriend the night before over dishes.
There's an update from the Covid wing nurses about Alberta. Her family had been allowed to visit her the night before to say goodbye. Compassionate care visits are exempt from the lockdown, and she's almost out of time.
Jordan finally sits down at her desk and wilts over her keyboard before looking at tomorrow's schedule when her husband walks in. They don't share much about their days. They don't want to burden each other.
But he needs her help convincing staff to get the Covid-19 vaccine.
Jordan's face brightens. In all the chaos of the day, she hadn't once thought about the vaccine.
Recent calls and emails from the state health department had promised that nursing home residents and staff would be among the first recipients to receive the vaccine.
Jordan dreams of a day when she doesn't have to worry about the deadly virus attacking her residents, her staff, her family.
Interrupting her daydream, Jordan's phone beeps. Donovan Reichenberger, a 93-year-old resident in the Covid wing, isn't doing well. Reichenberger was a professor at Northwestern Oklahoma State where he was known for being tough and having high standards. Jordan never took his class when she was a student there, but she was well aware of his reputation.
Nine days later, Reichenberger died from complications of Covid-19.
And ten days after that, the vaccine arrived at Beadles Nursing home. On Dec. 27, Jordan joined about 100 residents and staff who received the first of two shots.
The shots don't help residents or staff who have already tested positive and are fighting for their lives. And they offer no relief from the guilt Jordan carries for failing to protect those in her care. But they do offer hope to the weary staff and residents inside, and to Jordan, who remains focused on preserving those who endure at Beadles Nursing Home.
Oklahoma Watch is a nonprofit organization that produces in-depth and investigative journalism on important public-policy issues facing the state. The organization's website is at http://www.oklahomawatch.org.