With the sun overhead, the sound of traffic nearby and a brisk start to the morning, driving past HonorHealth Scottsdale Shea Medical Center Thursday practically seemed like any other January day.
Unless you work behind the hospital walls.
"With COVID volumes right now, what they are in the hospital, my average day, we would have several transfers to the ICU," said Sandy Mazzio, the clinical director of nursing for the COVID-19 care unit at the HonorHealth Scottsdale Shea Medical Center. "Probably one-to-three deaths a day currently."
Mazzio told ABC15 she is among the nurses who work with COVID-19 patients who, for one reason or another, don't end up in an ICU or on a ventilator.
"They don't want to do it, maybe they've heard stories, maybe they just don't want to be put on a ventilator, it could be that their physicians have given them the medical prognosis that being on a ventilator for them would not have an outcome...that's any different," she said.
Mazzio said ultimately, some patients decide they can no longer battle the virus.
"They really make a conscious decision that they're just done fighting," Mazzio said. "They are tired, and they want the...respiratory support removed," she said.
At that point, Mazzio said the goal is to help the patients as much as possible through their final hours, including connecting them with family via a video call. Mazzio said in general, patients tend to survive anywhere from 15 minutes to four hours after making the decision to forego additional treatment.
"This is very different than anything I've seen," Mazzio said. "I think that pure and utter physical and mental exhaustion just takes over and that's why they're able to make such a hard-lined decision."
Mazzio said in those final moments, patients want to speak with their family and often deal with securing their homes or place they'd been living. Meanwhile, nurses are trying to help the patient become as comfortable as possible.
"I think the role that the nurses, that we're filling, is to be there with them," she said. "We have a program here called 'No one dies alone' and we're always with the patient when they're passing. We play music, maybe their favorite music on our phones, and we rub their back, hold their hands, we give them medication."
Not even lunchtime, ABC15 asked if that process had happened yet on Thursday.
"We're currently doing that with a few people, yes," Mazzio said.
It's a process that happens far too often.
"It's incomprehensible," Mazzio said. "Like over and over again, that's the thing."
According to the state's coronavirus dashboard, 10,855 people in Arizona have died following a battle with the virus.
As deaths can take weeks to officially report, the dashboard now shows the weeks of December 13, 20, and 27 all saw COVID-19 deaths exceed 700 across the state, a mark that was not hit a single time during the summer surge.
"I think that's really important to remember if you haven't been affected by this personally," Mazzio said. "They're not just numbers and statistics. They're people."
Mazzio said she understands the weight of the role she and her colleagues play during those final moments.
"I feel like I know it's the right thing to do, to help that person be comfortable and die with dignity, it's very important," she said. "I feel honored to have that role."