Fast forward ..... It's been years since I've posted.  But times have changed, and I need a place to write what I'm experiencing without flooding FB.  There's enough stuff clogging up your news feed without me adding my two cents to it .... but if you want to to know what it's like being an ED RN in the midst of the COVID-19 pandemic, I will attempt to share with you as I can. The good, bad and the ugly ...



I slipped into a steaming hot bath tonight all the way up to my ears hoping that the water would somehow drown out what I wanted to scream.  The tears silently slid into the chasm of water softly covering the bridge of my nose.  It's okay to be afraid,  it's okay to cry I keep telling myself as I feel guilty hiding how I really feel from my children.  This IS a big deal.  This IS going to take lives.  This IS going to get worse, much worse, before it gets better.  Our world will NOT be the same after this ... just like 9/11.

I was one of those that initially rolled their eyes initially making fun of the people storming the grocery stores for TP and water (okay ... I still make fun of you because of all the things I've stockpiled TP and water are NOT one of them).  But I was angry that the flu didn't get this much attention ... and  we operated under FAR worse conditions two months ago that we are right now.  But it hasn't hit yet. The storm's not here ... it's just on the horizon.  Like one of my colleagues wrote,
"This is like standing, waiting on the edge of a storm that has undefined boundaries, countless possibilities, and an undetermined magnitude. Some of us may not even be fully in the storm yet or even nearing it but we know it's coming. For some, the tsunami has already hit and it may be the first of several waves. For others, we are watching the waters recede before the first tsunami breaks" (thank you Cristin Scarborough for letting me copy from FB post!)

I'm proud of our management team as they are making life saving decisions in unprecedented times.  They've had the foresight to start with our ICU and work down.  ICU is what's getting hit the hardest right now .... Of our five positive COVID-19 patients all are on vents.  The average length of stay on a ventilator for Corona patients right now is 21 days.  And they're not improving.  They are actually deteriorating.  See the virus is attaching to the peripheral lining of the lungs forming what is called "shattered glass" images on CT scans (google it .... there's lots of information and pics out there).  It basically hinders the exchange of oxygen in the tiniest vessels of the lungs.  It's being referred to as a "lung eater."   Our ventilated patients are having to be turned prone (which means face down) to improve their chances.  Research suggests that when these patients are removed from vents they are often coding because their lungs are not able to function independently any more and their cardiac EF (ejection fraction) is less that 20%.

And the virus has already mutated.  Did you know there are two strands?  One that initially presents with respiratory symptoms and one that does not?  The latter strand presents with abdominal pain and diarrhea first, then respiratory symptoms develop.  These patients didn't initially trigger protocol.  But when they went for abdominal CT scans there was enough lung imaging included to capture the "shattered glass" patterns in lower/peripheral lungs revealing they were COVID patients all along.  So it's changing ... making referred to as "slippery" by epidemiologists.

This virus is NOT attacking the elderly and the comorbid.  I take inventory of our COVID patients and Rule Out COVID patients each shift .... they range from 22 to 95 ... with a mean age probably in the 40s/50s.  They don't have extensive medical histories, if any at all.  So for those of you who think you're invincible or not in the target range think again, you're not out of the woods.

I've been exposed.  I was informed by management that I was exposed to a positive COVID patient on March 9th while not wearing any PPE (personal protective equipment).  It took occupational health 12 days to notify me due to the backlog of exposures we are now experiencing.  I now have to monitor my temp twice per day and log any symptoms.  The sucky part is that I've had a cough for 3-4 weeks now ... and I don't know if it came before or after Corona.  Tomorrow they start screening employees at the hospital employee entrance.  Anyone with temp over 100 degrees or exhibiting cough or SOB (shortness of breath) will be denied entrance.

We are running out of PPE.  Right now we each have a brown paper bag where we keep our ONE N95 mask and ONE face shield.  We are already out of goggles.  We will be reusing these for the duration of the pandemic.  Each shift we are allowed ONE surgical mask.  If it soils or tears you're SOL.  And we've been informed by management that we are going to run out of PPE before this thing peeks ... meaning in the next few weeks we will have nothing unless a miracle happens.

So ... this is a little window into the inside.  This is only a fraction of what we're experiencing.  And I'm gonna give a straight shout out to my ICU friends who are inundated right now!  They're knee deep in the battle while we're still waiting for the second wave.

If you want to know how you can help ... stay home.  I don't care how bored you or your kids are.  Please just stay home.  Pray.  Pray for supernatural protection of your front liners, pray for additional PPE to become available, pray for grants to assist financially when we are quarantined at home without pay.  Drop off a meal.  Cut their grass.  Ask to take their dogs for a walk.  Leave a note in their mailbox.  Have your kids write encouraging messages or verses with sidewalk chalk on their driveways.  Send wine!  It's the little things that are just enough to keep our tanks full!