Never Saw That Coming ....

I'm not special.  Let me start there.  I will not make the narcissistic assumption that my battles are bigger or harder than yours.  We .... collectively .... are all fighting battles we did not see coming six months ago.  It is what it is .... and with that I openly share the unforeseen downside of being a ER nurse during the COVID-19 pandemic.

I'm a PRN nurse which means I work "as needed" by the department.  I have been working 32-38 hours per week the past few months.  However, that has recently changed and I have had to file for unemployment.  Never saw that coming.  In the past months I have grieved for my friends who have been laid off or furloughed but always thankful I didn't have to face that .... until now.

How on earth can nurses be suspended in the midst of a pandemic?  

It all comes down to the bottom line ... as usual.  It should come as no surprise that healthcare corporations are just that .... corporations.  I'd be sticking my head in the sand and playing ostrich if I thought it was actually about the patients.   That's why I work.  That's why I switched professions after 15 years as a financial analyst ... to actually spend my days doing something that bettered the world.  But that's just me.  That's just the bedside people.  Not the stakeholders and board members.

At the end of the day it's still all about the money.

So what we have been told is that our corporation expensed "X" hundred million dollars to prepare for a pandemic that did not generate projected income or patient volumes as expected.  Therefore, we are in the "recovery phase."  As in "cost recovery."  That translates into "we are slashing expenses anywhere and everywhere possible to recoup our money."  They have cut managers' and directors' salaries, mandated 8 days of unpaid (or you can use PTO) leave for non-essential/non-frontline employees, and are implementing "staff-to-volume" structures in the ER.  That means they are cutting frontline workers' hours every day, every shift.  They've reconfigured our staffing models from 3:1 patients:nurse ratio to 4:1 and removed support staff.  That may not sound like much but what that means is balls to the wall when you're on shift.  Higher acuity patients, less staff, less support.  You're getting your ass handed to you 12 hours straight.  But no worries .... the corporation is saving money and you're still saving lives!

Because I'm PRN I'm the first to go.  Our hours got cut first.  Across the board, not just by my corporation.  Two weeks ago I was cut more than 28 hours.  This week I have 12 hours.  Next week I have 8 scheduled hours.  I'm so thankful for my friends and co-workers who are "gifting" me hours to keep me afloat. And our manager is working tirelessly to give me hours as "screener" taking temps and monitoring symptoms at hospital entrances.  I truly am thankful.  But how long will this last?  Single mother of three.  No other income.  In the midst of this my ex is taking me back to court to reduce my child support by 65% and fight for custody of one child.  Feel free to listen to his sermons online.  He's a pastor.  You'll be entertained for an hour but you'll never see the life of Jesus lived out in front of you.  

It is what it is ... I guess none of us should be surprised.  At then end of the day it's always about money.  But I'll think twice before I risk my life and my family's health stepping into a patient's room wearing a 2 month old N-95 mask (that hasn't been disinfected once) and a two-week old surgical mask that's single use in nature .... No worries ... The hospitals get more money for COVID related deaths anyways, right?

Year of the LORD'S Favor

At first glance it seems ironic that the word God gave me for 2020 is FAVOR ... as in this is the year of the LORD'S favor.  Isaiah 61 reads:

The Spirit of the Sovereign LORD is on me, 

because the LORD has anointed me to preach good news to the poor.  

He has sent me to bind up the brokenhearted,

to proclaim freedom for the captives and release from darkness for the prisoners,

to proclaim the year of the LORD'S favor

and the day of vengeance of our God,

to comfort all who mourn, and provide for those who grieve in Zion -

to bestow on them a crown of beauty instead of ashes, 

the oil of gladness instead of mourning,

and a garment of praise instead of a spirit of despair.

They will be called oaks of righteousness,

a planting of the LORD for the display of his splendor.

He has confirmed it multiple times through various channels, and I know that I did not mistake Him.  He told me that in my life this is the year of FAVOR.  But on the surface ..... it's almost amusing ....

The whole world seems to be "paused" and waiting for the other shoe to drop.  There is fear and anxiety abounding as people question their finances, job security, health, lifestyles and priorities.  I walk into a job (which I am thankful for every day) and wonder if today will be the day that all hell breaks loose.  Or if today will be the day I get sick, or even worse the day I get one of my children sick.  Businesses are closing their doors ... some likely for the final time.  People are dying.  Earthquakes, tornadoes, locusts, wild fires .... but FAVOR???

Yes, FAVOR is what He has spoken to me, and FAVOR is what I am seeing daily.  In the midst of the unknown I see God's hand dealing strongly and in favor on my behalf.  And I am so, so thankful.  I am walking into a job everyday by the grace of God.  Because I recently returned to the ED as PRN staff my hours are not "guaranteed" ... I'm not promised a certain amount of hours per week or per paycheck, nor do I have any health insurance at this time.  But God has shown me favor in that I have been able to pick and choose my hours as best suits my family ... often working 9A-5P (bankers' hours) which is UNHEARD OF in a hospital setting for clinical staff.  Now that school is suspended I am able to work earlier in the mornings and still be home to cook dinner and spend time with my kids.

Favor has been evidenced in unusual and unexpected financial gifts, winning contests (I never win anything!!!) and the possibility of being featured in an upcoming TV commercial (completely unsolicited by me).  My neighborhood has been phenomenal in rallying around me, encouraging me, and dropping off sweet surprises.  I have faithful friends who text weekly to check on me, my kids and my parents.   My discipleship group has continued to send meals, texts of encouragement and prayers despite my inability to consistently ZOOM with the group over quarantine.  My mom stocked my fridge one day while I was at work!  Despite the fact that my dogs have recently discovered eating toilet paper rolls (🙀) one of my dearest friends delivered a case of TP to my door step and ran a few weeks ago :-)

Bless his heart 💙💙

God told me in November of last year that 2020 would be the year of His rebuilding in my life ... the year of restoring the years the locusts have eaten.  God doesn't change and He cannot lie.  And when He spoke those words to me He already knew about COVID-19 and all that it would affect.  So I HAVE to believe Him despite .... despite the questions and concerns and at times fear.  I can no longer allow outside circumstances to shape my beliefs .... my "core."  That would mean that my beliefs are as dependable as the wind.  GOD is GOD yesterday, today and tomorrow.  He does not change with the shifting of the wind.   He does not promise and then not fulfill.  He does not bring about labor pains and then not deliver.  He does not speak and then not act.

My greatest prayer for this year is "God, I don't want to live small.  I want to live BIG in YOU!"  I don't want to sit on the sidelines .... I want to risk big and watch God move mightily on my behalf.  So, despite the Rona, I look forward to 2020 with great anticipation and expectation waiting to watch my GOD create a masterpiece from this canvas!

Can I Open My Eyes??

Is it over yet?  Can I open my eyes??  Unfortunately, no.  It's not over and likely won't be anytime soon.  COVID-19 patients are still walking or riding through the doors everyday ... they're just easier to spot now.  We have a better idea of what to look for ... meaning symptoms, presentations, which labs and scans to order, etc. And now we can do our own rapid in-house COVID test that gets results within about an hour.  But they're still coming in and being diagnosed daily.

Side note ... the rapid COVID tests at this point are painfully inaccurate ... and it's probably most likely due to the administrators.  For those of you that haven't had the pleasure of enduring a COVID nasal swab, please consider yourself HIGHLY FAVORED.  I'm not going to lie ... it sucks.  And basically if you don't make your patient cry during the process, then you're probably not doing it right.  And because it is so painful for the patient, many staff are not administering the swab correctly.  They offer a quick apology and a three-second in-and-out of the nostrils just to get it over with ... but doing both the patient and the system a huge injustice.  Yes, it hurts!  And sometimes I've prayed with my patients before doing it because I've scared them so much in the name of honesty.  But you've basically got to shove that swab all the way up to their sinus cavity and swirl it around for 20 seconds .... on.each.nostril.  But because most tests are not being performed accurately, the number of false negatives is staggering.

I don't know if you've heard or read that there is some speculation that the virus may be attaching to red blood cells or hemoglobin in the bloodstream?  I've read various arguments on both sides and honestly it just made my brain hurt.  But what I can share is something I experienced yesterday first hand...

I had a patient who walked into the ED complaining of headache with associated high blood pressure because she had run out of her blood pressure medication.  That's it.  Headache and needed a med refill.  She conversed with ease.  Her breathing was not labored.  No other symptoms.  As I talked with her my eye caught the wall monitor mounted above her bed.  Huh ... that's not right.  I readjusted the pulse oximeter on her finger (it measures oxygen saturation).  It still read 66%.  I reached over to feel her fingers.  They weren't that cold.  Try another finger.  63.  Hmmmm ... is this thing working??  Unplug it and plug back in.  Try her left hand.  Damn, it's still 63.  "Hey Ms. So-&-So ... how are you feeling? Are you feeling short of breath?"  "No baby, I'm good.  But I'm sick of this headache and I'm sick of this place.  It's not that I don't like you but I don't wanna be here.  Can't y'all just give me something for this headache and get me home?"

I quietly finish my blood draws and assessments.  All the time evaluating her respirations and color.  I suggest that maybe a little supplemental oxygen might help with the headache until we can get some pain medicine on board.  I slip a nasal cannula under her nose and discreetly watch the wall monitor.  It starts to climb slowly ... 68 ... 72 ... 80 ... and stops.  Oh wow .... she's responding to the oxygen but it's not nearly enough.  A normal person with no respiratory disease should be in the upper 90s.  I increase her oxygen to 4 liters per minute ... it starts to climb again ... but maxes out around 89.  I double checked her triage stats and she was 97% on room air when checked in.  Uh Houston ... we have a problem.

I step out for a minute.  I bring the provider back in with me.  He orders an arterial blood gas to confirm her true oxygen saturation.  The first test results 38% PO2.  The patient wasn't having it ... cause those arterial sticks hurt too. They call in a second RT for a second ABG.  Then a third test is done.  All confirm Mrs. So-&-So is oxygen starved and doesn't know it ... literally suffocating and is oblivious.  She hasn't missed a beat ... or a breath.  She's been on the phone with her husband of 38 years and both her daughters.  She's now more than a little annoyed with all of us.  She doesn't understand what the commotion's about. "I don't care WHAT you say ... I'M NOT STAYING!!  I don't have that virus!  You can't make me stay!  You can't hold me against my will!"  All the time yelling like she's got more O2 than a scuba tank.

No baby ... you gonna die if you go home.  As in drop dead ... Cause you don't have the symptoms but every test result you have says you are extremely sick and will not survive if you leave.  To a woman sitting upright in bed yelling at you it's hard to convince her otherwise.  XR and CT scan show her lungs are full of COVID.  One hour later she is in ICU and intubated.  And it all started with a headache ...

Oh ... and she hadn't left her home in 8 weeks ...

I'm not saying this to scare anybody.  I don't believe in scare tactics and I'm not afraid myself.  But what I am saying is this happened to me yesterday ... in my ED room with my patient.  She literally deteriorated right in front of our eyes and we never convinced her she was truly sick.  And I think that speaks as to why some people are just dropping from this virus ... they don't know they're sick.    Both of my patients in the ED today had it ... and neither one of them believed it.  One was admitted.  The other left AMA.

So ... the virus is walking around or laying on surfaces all around us.  It's not going away and I believe we will see a second wave once the public resurfaces again.  I disagree with the Governor's order to end shelter-in-place.  It's too soon from a healthcare perspective. However, God gave me the grace to put the shoe on the other foot and hear it from a different perspective over the weekend.  A friend came to my house to cut my daughter's hair.  I've known her for 20+ years.  As she shared what her family is going through as her husband has been laid off from his job, losing his company car and company cell phone.  Three children.  One in college.  Private school tuition.  Just bought a new house 6 months ago.  Unemployment hasn't kicked in.  The pressure of watching their income source be cut off and questioning how the bills will get paid ... what could happen to the house ... only have one car now.  God opened my eyes to the other side of this struggle ... and I was convicted.

I still think it's too early from a healthcare perspective to reopen the state.  But I also saw the stress and fear in my friend's eyes and realized they can't keep going without income much longer.  Many of my friends can't.  She looked straight at me and said, "I mean I get it ... but I'd risk my health to put food on the table for my family."  Yes ma'am, I would too ...  I see it now ... and at risk of being a Debbie-Downer I'm just gonna put it out there ... this is a lose-lose situation.  Damned if we do, damned if we don't.  People are going to suffer either way.  And it sucks.

I don't have an answer.  I'm just thankful that my kids and I are still healthy and that I can pay my bills right now.  That's got to be enough.


And since sometimes you have to laugh just to keep from crying,  I'll share a little of what we've dubbed #coronacockfighting  ... because often laughter is the best medicine!

It was always more than COVID ...

I settle in for my second cup of coffee this morning and light a candle.  My four four-leggers are as close to me as possible making it impossible for me to move even if I wanted and all four are snoring to some degree or another.  The kids are gone.  It's raining.  And I've silenced the music so I can hear the beating of the drops against the window pane behind me.  They echo down the black metal chimney into my fireplace.  I wish there were more days like this.

The COVID curve is softening, and I am thankful.  Although it peaked in many nearby communities it did not "devastate" Newnan as we prepared for.  I am thankful for our leadership teams and management ... despite our shortcomings and limited resources we were well prepared and positioned for war.  And COVERED in prayer.  I don't know if God chose to spare Newnan because of fervent and effectual prayer.  I like to believe that He did because many of my colleagues are struggling and have sacrificed much in this season.  Last weekend we said good-bye to my friend Eric who left his husband Tim and foster son for a 13-week assignment to Coney Island, NY.  They celebrated their one year anniversary apart this week.  Another of my friends said they were operating at a 6:1 patient:nurse ratio in her ICU just last week and many patients had to be transferred out to other hospitals for safer staffing ratios.  So it's taking its toll in other places and somehow Newnan has been allowed to exhale ... even if for just a few minutes.

But as we return to "life" I don't expect it will ever look the same.  What is our new "norm"?  COVID's been the big man on campus these last few months, but in reality that's not all we were fighting.  Many of us were already facing giants .... challenging family relationships, chronic illnesses, financial strains, depression, etc.  All of us already had a battle we were knee deep in when this hit.  I lost a daughter right before we were ordered to shelter-in-place.  She left to go live with her dad.  I'm still adjusting.  My other two children are still adjusting.  I set the table for four all the time ... forgetting that we are now only three.  I fix too many dinner plates and end up having to scrape one back into the respective pots and pans.  I see the sadness in my other children's eyes that they try to be brave and hide from mom.  I cry in my prayer closet and pray that God hears what only tears can  say.

I've been fighting in faith for over a year on a battlefield too personal to share.  Believing God for the impossible, believing the spoken Word of God over my life despite what I see and hear.  Getting out of the way and letting God fight ... for salvation ... for me ... and for His glory.  Experiencing beautiful and supernatural encounters with my Jesus that I never DREAMED of before.  Letting Him recklessly pursue me and transform me.  

This is a season of re-creation.  When all of our recreation has been suspended and God is standing at the door saying "It's time for you to be still a while and visit with Me."  He's not knocking to judge or destroy you.  His intent is not for your harm.  Trust me, I've wrestled that one out for quite a while and I'm now standing on the other side saying He's NOT here to harm you!  He's NOT hear to hurt you!  He's here to RE-CREATE you into the EXACT PERSON you were always intended to be.  Maybe you lost your way ... or maybe you were traveling a parallel "moral" path but not walking in relationship with Jesus, then took a wrong turn.  But regardless, deep down inside, you know that you still feel "lost."  You still feel like you're jockeying for a position in life to fulfill you but after all these years still haven't found it yet.  This is Jesus' invitation to sit and listen to Him .... let Him speak words of Life into you.  Let Him reveal to you WHO you were always meant to be.  Uncover those ugly places, the ones you can't even bare to look at, and let Him start to breathe healing over them.  They will fester and rot without Him.  I know and can speak with authority because I've been there, I've experienced His healing breath and touch.  I've stopped beating the air with my fists at Him and now RUN to crawl up in His lap!!  I've never known before the Jesus that I know now!!  And I'm so desperate for you to know Him too!!

I spent a long time praying and crying in my car on the way back from returning my daughter to her dad's Easter Sunday night.  The snotty, ugly kind.  Begging God to show me something ... anything ... in the natural to confirm what I already know and have been claiming in the supernatural.  After about 30 minutes back home my youngest daughter came into the kitchen and said "Mom, somebody's here."  I walked outside to find no one.  Whoever was there was gone.  But what I DID find was a four-foot wooden cross standing up in my front yard.  No note, no initials, no sign.  It was just THERE.  About an hour later when I went outside to check a few things and close the garage door .... it was GONE.  Like it had never been there.  GONE.  I have no clue where it came from or where it went ... though my gut has an opinion.  But I DO KNOW that I had just spent an hour snotting out ugly prayers for a sign in the natural .... and my GOD placed an unmistakeable wooden cross in my yard.  I don't really need to know where it came from ... or why it was only there a hot minute ... I'll take it at face value .... THANK YOU FATHER.  It was a physical sign of the promised resurrection I have long been claiming.  What was dead is now alive.  Beauty from ashes as I softly heard a voice call "Lazarus, come out!"

My heart is in a weird place and I feel it needs to settle again.  I keep thinking of the verse in Luke 10:41, 42 ..... "Martha, Martha," the Lord answered, "you are worried and upset about many things, but only one thing is needed.  Mary has chosen what is better and it will not be taken away from her."

There are many things to "do" ... gather food, non-perishables, household supplies, (dog food!)  Check on neighbors, check on parents, check on kids' schoolwork ...

Keep up with hourly evolving CDC guidelines, gloves on - gloves off - sanitize - gloves back on - wipe with purple wipes - "oh no, did I touch that bag first?"  Don't cough, don't sneeze, don't touch your face.  Don't hug me, stand 6 feet away, "oh no, my mask broke!  Where's the stapler?"  Shit - did I sanitize the stapler first? Now I have to change gloves again ... gloves on - sanitize - gloves off.  New gloves .... Here comes another EMS gowned up ... yep another Rule Out ... back in full PPE.  At least maybe I'll sweat off weight like the wrestlers do when they wear those plastic bags ...

Come home ... shoes and clothes off in the garage (thank goodness I have a garage door!)  Scream at your youngest to hide her phone since she's FaceTiming her BFF and you don't want her to share your naked butt streaking through the house.  Streak.  Climb into a piping shower.  Scrub down ... every inch ... twice.  No three times.  Who knows what's living in my hair??  Wash it again.  Breathe. Did I get it all?  I don't know, but I hope so.  Climb out of the shower and into my pajamas, cause I'm obviously not going anywhere else.  Make dinner.  Check schoolwork - whatever, I'll give that a pass tonight!  Sit down to eat.  Kid #1 coughs .... silence.  Did I bring it home???  Did I get him sick??  Oh God .... mind racing again.  What if I did??  What if I'm an asymptomatic carrier??  Kid #1 forced to sleep in my room that night ... on the love seat ... so I can listen to him breathe.  Monitor his cough.  Check his temp ...

It's constant internal noise.  And it's been speaking over my peace and purpose the last week.  God has called us to walk by faith and in His presence ... especially in times like these.  "Rachel ... you are worried and upset about many things, but only one thing is needed."   What is that one thing?  Sitting at the Lord's feet listening to what he's saying, not being distracted by all the preparations that have to be made (Luke 10:39, 40).

The situation is real.  The fear is real.  But it does not have to control me.  Fear is always a liar intended to steal, kill and destroy the peace promised in Christ.  I am daily learning to speak TO my fear ... tell it that it has NO AUTHORITY over me.  It does NOT have the final word over my life or my family.  My GOD is bigger than my fear.  And I'm constantly having to battle that out in prayer throughout each day.   You may not believe this but up until about a year ago I had given up on praying.  For more than one reason, but I had decided it didn't work or it didn't matter.  But a whole

lot has changed in a year.  You see, this little picture below is now my favorite room in the house.    

It's where I have hashed out some hard stuff, broken some serious chains in prayer.  I've cried, snotted, yelled, cursed, screamed and slept in this little corner of heaven.  It's been my go-to for months and it's my go-to now.  Even when I don't know WHAT TO PRAY I fall on my face and weep, trusting that tears are a language God understands.  

I think God is forcing us to be STILL, to be QUIET.  To shut down the internal noise and listen for Him, to Him.  So much has been removed or taken away that we really don't have an excuse to ignore Him anymore.  If you don't know where to start I'm just going to throw out a few things that helped me over the last year and maybe they will help you too ....

These are four of the books I've read over the last few months ... they are different styles of writing and backgrounds of authors but each one has challenged and changed me immensely.  

Lastly I want to share a link to a sermon about fear that I pray will minister to you.  I challenge you to take a walk and listen.  Or find a quiet place in your house to hear.  Just 30 minutes to speak peace over your soul in the midst of chaos.  

The Invitation of God in Seasons of Fear By Jabin Chavez, City Light Church

https://podcasts.apple.com/us/podcast/city-light-church-las-vegas-jabin-chavez/id1290676886?i=1000469238388

No lie ... don't put it past me!  We are running low but we are conserving.  I've actually seen nurses staple the elastic straps back onto their masks when one breaks just to spare using another.  The outpouring from the community has been amazing ...  I have come home to find homemade fabric surgical masks made by neighbors on my doorstep, we've had numerous people bring unused or extra N95 masks for donations, local businesses are donating inventory.  And my son is spearheading a community project to deliver more than 500 homemade surgical face masks to the ED and frontliners in the next few weeks!  We are thankful, and we couldn't do this without you!

Also, we are so thankful for the outpouring of meals and snacks that the community continues to provide!  Chick-fil-a has fed us multiple times, Longhorn Steakhouse provided BBQ dinner one night, Congressman Lynn Westmoreland and Senator Matt Brass provided pizzas for the entire hospital, and we continue to receive various snacks, treats, and goodies from so many of you.  THANK YOU!  I promise .... it's the little things that add wind to our sails!  

Though volume and acuity in the ED are picking up, it's not full throttle yet ... we're still waiting.  The mornings tend to be "q-word" (I won't say the word) but it gives us time to stock up our rooms and PPE carts in anticipation for the day.  Patients begin rolling in late morning and it builds throughout the day with many admissions at night.  Most are considered R/O (Rule Out) COVID patients at triage because they are presenting in such a variety of ways now ... even what we would have considered a nephrolithiasis (kidney stone) patient under normal conditions are sometimes pinging COVID-19 when CT scanned now.  

It's a little disconcerting at work because fellow nurses and doctors are just vanishing ... you'll be half-way through your shift and realize you haven't seen so-and-so in a while.  When you start asking you find out they've been sent home or quarantined or developed symptoms.  You're not sure who's just not working that shift or who's sick.  And I do believe that overall management is keeping it quiet as to not create panic among staff.  It is true that a med-surge nurse collapsed in huddle the other morning and had to be emergently intubated.  It is true that several of our staff have now tested positive for COVID-19 but thankfully have been discharged home to self-quarantine til better and asymptomatic.  It is true that a float pool radiology tech was found deceased in her home last week and autopsy confirmed Corona.  The number of admitted R/O COVID patients is growing every day.

We are facing new situations unprecedented until now.  A family decided to withdraw care from a patient I was caring for yesterday but because of our strict no-visitor policy only his wife was able to tell him good-bye.   It's a harsh rule .... but it's necessary.  We HAVE to limit exposure ... we HAVE to break the chain whenever and however possible.  It's our BEST defense until we get ahead of this thing.  It's ahead of us, and until we catch up we've got to stay home and help flatten the curve ... 

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!