Bridging The Gap In These Trying Times

[2018_footprints]

Walking through the closed-door unit of the floors I currently work on and seeing not a few but every person vented, it is as surreal as it can get. The national outcry for the shortage of adequate personal protective equipment made headlines recently and now it’s the ventilators. As a nurse, I am hopeful that supplies can be replenished, ventilators included but what about safe and adequate staffing?

Safe and adequate staffing?

This is week 3 of me and my coworkers continuing to care for 3 critically ill COVID patients each, every shift with no ancillary staff to help. They have been redeployed to other areas in my hospital. Phone rings, we answer, a patient needs to be turned or cleaned, it’s all on us. In a 12-hour shift, we are lucky if we get to eat a quick bite for breakfast/dinner and there’s no lunch/nap break until it’s time to go home. It’s bad enough that we are working in a territory many see like it’s a death sentence (not true but let’s save the explanation for another post or I'll digress). For those of us who walk these lines- we need some relief if we are to continue pushing with the same zeal of compassion, work ethic or we will soon burn out. Some already are.

Case example

I worked last shift on this floor starting with 14 vented COVID patients divided among five nurses. The only nurse with two patients was going to take the first admission- which she did. In the interim, two sadly died including one of mine. So, my neighbor and I helped ourselves, in turn, doing our two post mortem care while still being responsible for our remaining patients. Of the two other patients I had, one was maxed on 3 pressors (medications to keep your blood pressure decent enough so you don't code) and the other with continuous renal replacement therapy(a slow and gentler form of dialysis). Then we get the call that there are 10 patients in the ED waiting for beds and you know how an ER nurse never wastes a time to call the unit to give a report; some even before the room is ready (pun intended). If you are an ER folk, please do not take this as an offense as I have worked in that area myself. So I know your side of struggle too. Had environmental or transporter shown up timely, we would have ended up with the admissions. These workers are also stretched out of their capacities. How fast and meticulously can they work? With a guilty smile, I have to admit it was a breather for a bit to end the shift without the dreaded 4th admission.

NYC area hospitals are JUST stretched beyond capacity

I can't even blame the administrators at my facility for not doing enough because I can see they are trying to work this together. My workplace has been helping to accommodate our staff in various ways. We have emergency childcare options, emergency housing, free parking, shuttle services, COVID related medical leave without incurring a loss of sick time for which I am very appreciative. However, the solution of just deploying a non-ICU nurse to the unit isn’t working either as I saw on one of the floors I floated to recently.

Unfamiliar territory

Some have never charted the computer system like the OR folks. So even asking them to plot the vitals in the computer seems faster done personally than teach. Some are scared to administer medications they are not used to. I get it. I asked one to connect the suction machine to the NG tube and the person turned on the max suction. It’s scary! What we need is trained, qualified folks we can equally divide the workload among. Is that asking for too much in this crisis?

How are we going to then churn out the manpower?

I read that there are still about 10% of the country's population living in areas that are not following the shelter in/stay-at-home recommendations. Does that correlate to a situation not being as dire as ours? Can these states spare their healthcare workers to come to NYC and other harder hit areas? If yes, how can the government appeal to these qualified people? Please don't ask them to volunteer. Nobody is going to want to risk their life, their livelihood to come to NY and not want to be compensated. What's the crisis pay rate travelers think is adequate enough to jump on the wagon?

Please share your strategies

If you are a healthcare worker, can you share what innovative strategies your facility is using to bridge this gap? For now, I can only pray and hope that the curve flattens, declines and we will have a more manageable load.

Tomorrow is not promised to anyone. COVID/No COVID. Today, I will go do my part.

[kbrn2002, ADN, RN]

Thank you for fighting the good fight seems so inadequate but sadly offering my appreciation to those of us continuing to work under these conditions is all I can do.

I am so incredibly fortunate to not be in an area hard hit, at least not yet. I am also more than thankful that I do not work in acute care so while I may end up working with a patient population that has been exposed or may even be positive I will not be placed in the position of caring for patients that are severely symptomatic.

Fortunately from what I am seeing my employer is taking the risk of exposure very seriously and there haven't been any dangerous shortages of PPE, at least not yet. The longer this continues though there's no guarantee such PPE shortages won't eventually affect us.

[sevensonnets]

I know of at least 15-20 RN's from a major hospital system in my area who are in NYC right now to help at their own risk, so yes there are nurses willing to help you the best they can.

[2018_footprints]

@kbrn2002: Lucky you, so far. Seeing how contagious and rampantly this spreads, it is just a matter of time before it gets to even the remote corners of our country. I definitely believe in this social distancing thing even though the implications for the economy concerns exist. Good to hear that your workplace is being proactive.

@ sevensonnets : Bless them! Hope they are coming my way.

?‍♀️

[BSN-to-MSN, ADN, BSN, RN]

The local newspaper wrote: " Hospital lowered nurse-to-patient rations in response to COVID-19 surge". What they failed to mention, that nurses are THE ONLY ONES physically caring for the patients, no tech, no lab person, no PT/OT. Because management does not want to expose "extra people". Case worker the other day got so used to this new scenario, she wanted me to go into non-COVID and non-isolation room to talk to the patient for her.

If my COVID patient is a 2 assist to turn, I call the charge nurse and a manager with a question: "Who is going to help me turn this person, I am not about to break my back doing it myself". And I will call every 2 hrs the patient is due to be turned. So far I have gotten help, which is good.