Today I thought I would share a bit about what it's like to be working at a healthcare facility in the middle of the United States these days. All experiences and thoughts are mine alone. Other parts of the country, other hospital departments, and other individuals perspectives will almost certainly vary.
On Friday, at a morning briefing with medical leaders, we learned that we have a total of eighteen COVID + patients in the hospital, 10 are in the ICU, 6 are on ventilators. We have 22 additional patients "under investigation". By today, 3/31 these numbers will have changed.
Elective and non-urgent procedures/surgeries are being postponed. This will enable our hospital to increase capacity to meet the needs of patients we expect to be treating in the days and weeks to come, AND help ensure we have the personal protective equipment needed to care for those patients. I would guess we are at about 60% of our normal capacity presently; which makes it feel eerily quiet in the hospital right now.
Temperatures are checked when you come to work. Visitors are not allowed except in very specific circumstances. Isolation precautions are being re-evaluated and we are all following very specific guidelines for how we protect ourselves with different categories of patients. We have had hospital employees who have tested positive but are all related to community spread, not patient contact.
Clinic visits are being cancelled and we are moving to a "Telehealth" system. The structure and processes for these visits has been in the planning stages and it was predicted it would take 12 months to get up and running. Over 800 visits have happened in the last week.
There are no FDA approved therapies for patients who test positive at this time. Some treatments are being used on a trial basis with very specific criteria. Most of the care we are providing is supportive. This means doing everything we can to help the patient get through the episode of illness- while having no specific remedy.
We are reaching out to colleagues across the country and the world to see how others are handling specific situations. We are talking about the need to have conversations with people to determine their preferences for care in light of COVID-19. Would they want to go on a ventilator? How long would they be willing to stay on? Who will their decision maker be if/when they can not speak for themselves? This is especially important for older patients with other chronic illnesses, but really everyone should be talking about it. We have all seen accounts of young, previously healthy individuals who have become critically ill and died as a result of this disease.
Planning is in place for how we will deal with potential shortages of medications for comfort if this becomes a reality. It is so hard to believe we are discussing this - and not in the theoretical sense.
Meanwhile the moon continues to shine in the western sky as the sun goes down. Venus is currently making an appearance alongside. I only know this because Sister has instructed me to "GO LOOK!". So I do.
The Sunday night sky as seen from Tall Tales Headquarters.
I'm so grateful for your posting about this. Real life, personal, truth, but no shouting in caps and exclamation points, which is how so much is posted these days. It's grounding, and makes me hopeful somehow. Meanwhile, while I know you will, I have to say it: stay safe and stay well.
Can't believe we are having this conversation.
Posted by: Linda Watson | 03/31/2020 at 10:40 AM
Yes, Linda Watson said it all exactly, thanks xoxo
Posted by: Sharron Carleton | 03/31/2020 at 11:07 AM
I am on the Linda Watson team too, you made sense without all the fireworks and whistles. Thanks again, we are so blessed to have you in our lives.
Posted by: jacki long | 03/31/2020 at 11:49 AM
It brought me to tears reading this. Maybe because my daughter is a nurse in the ER at one of local hospitals. I talked to her last night and she is so tired and angry and scared. I'm worried for her and for all the health care professionals.
Posted by: Maureen | 03/31/2020 at 01:31 PM
Linda, Jacki, Sharron, and Maureen: thanks for your comments. I need facts to cope with this and hearing what is real rather than trying to imagine it helps me. Thank you Maureen for sharing your daughters perspectives.
Posted by: Carol | 03/31/2020 at 06:52 PM
I am so grateful for this post. It's easy to despair when in lockdown, as most of us are in the UK. Thanks, Carol. A link to you and others who read your blog is precious.
I LOVE knowing that we are looking out at exactly the same sky as you. 'The moon and her star' has always been a favourite motif of mine.
Keep safe, you and your brilliant team.
Posted by: Chrissy | 04/01/2020 at 03:18 AM
Thank you Carol-for all you do at your work; for all the information you share; and for all the light you bring with your beautiful photos and everyday ramblings about your life.
Posted by: Janet Ghio | 04/01/2020 at 06:29 AM
Hi Carol ~ Remember me? I'm Mary Ann's pal Dorothy! And I found your blog on Jacki Long's blog! I didn't know you are a serious nurse in this serious time. Thanks for your clear words and Very best wishes to you.
Posted by: Dorothy Anderson | 04/01/2020 at 10:41 AM
Thank you Carol. You don't shy away from the hard conversations and I appreciate that. I'm glad to know your blog is a safe space to discuss uncomfortable feelings. A blessing especially in these uncertain times. Stay safe.
Emie
Posted by: Emie | 04/01/2020 at 10:49 AM
Thanks for the report. The professional planning and coordination are encouraging to me. I wonder if stem cell transplants are being postponed too. Those wards are already isolated; maybe they will need to be used for Covid-19 patients. I'm sure any SCT patients are being well cared for though, based on my experience.
Posted by: Mary | 04/01/2020 at 01:44 PM
Thank you for your writing and doing your job everyday. Stay healthy. The photo was beautiful and comforting.
Posted by: Barbara Casillas | 04/01/2020 at 02:18 PM
Chrissy - I think about how we are all looking at the same moon and sky a lot... all around the world.
Posted by: carol | 04/01/2020 at 06:12 PM
Dorothy!!!! Of course I know exactly who you are. Nice to hear from you - and that it is Jacki that brought you here. I recall so fondly the meal we shared and our visit to your wonderful home and the walk on the beach. We shall do it again!
Posted by: carol | 04/01/2020 at 06:14 PM
Mary: I believe if things can be put off without increased risk they are, however if the risks are greater by delaying procedures that must also be considered. There are hard decisions being made everyday.
Posted by: carol | 04/01/2020 at 06:16 PM
Barbara, Emie, and Janet: thanks for your comments, and good wishes.
Posted by: carol | 04/01/2020 at 06:18 PM
I meant to tell you, Carol, that every Thursday evening at 8 in the UK many people go outside, or lean out of their windows, to clap for our National Health Service. People sometimes whistle and hoot car horns. It's a lovely community feeling although we can't see anyone from our house. I know they're applauding in other parts of the world too, so grateful to all health care workers, bless them.
Posted by: Chrissy | 04/02/2020 at 02:09 PM
Chrissy: Mary Ann sent me a link to a woman in the UK who has a you tube channel and she was on her roof and showed what you are talking about! The solidarity makes you want to smile and cry at the same time.
Posted by: carol | 04/02/2020 at 06:37 PM
Carol, bless you and the other healthcare first responders. Stay well!
Posted by: Deborah Pierro | 04/03/2020 at 06:50 AM
Thanks go out to you and other health care workers, first responders, and essential needs providers at this challenging time in our lives. Hubby and I are in the higher risk categories and are grateful to be fine while sheltering in place. Warm wishes to you for continued strength and health as you care for others. We look with love to the helpers. <3
Posted by: Judy H. | 04/03/2020 at 10:24 AM