Covid and Hospitals: How are things now?

Home Health Columnist / Guide · Dec 4, 2020

Southeast PA: There was just 9 ICU beds available in my county's 6 hospitals yesterday. The number of COVID-19 positive cases is higher now than in the first Spring surg. Luckily 3 weeks ago post surgery, I was hospitalized just overnight; minimal elective surgery this week as need COVID bed space. Had junior nursing student from my alma mater as they had just resumed in hospital rotations end of October.

In Montgomery County, ED's holding Covid + admissions due to lack of staff; "County health officials reached out to the National Guard for relief but were told the guard could offer no aid". “There is no spare hospital personnel to come this time,...." Spoke with several nurses -- Burnout reported as some facilities with rapid explosion cases past month due to increasing % of deaths per shift + moral injury.

Philadelphia Inquirer 12/03/20

Philly area nurses reporting ‘It’s just exploded’ .

Quote

..Every intensive care bed in Pennsylvania could be filled by mid-December according to one state planning model, said Val Arkoosh, a physician and chairperson of Montgomery County’s board of commissioners, saying she was concerned about what Thanksgiving travel would mean in the next two weeks for hospitals that are at or near capacity now.

Statewide, 4,982 people are hospitalized with COVID-19 and more than 80% of ICU and medical/surgical beds are occupied. Nationally, 98,691 people are in the hospital with the virus, according to the Atlantic’s COVID-19 Tracking Project about twice as many as there were a month ago....

Nationally today, 100,750+ US COVID + persons hospitalized per the Covid Tracking Project while a record 3,157 Americans died yesterday from covid-19 --that's 1 death every 30 seconds.

turtlesRcool · Dec 4, 2020

It's bad here, but the system is not yet overwhelmed. I live in an area that saw a big surge in the Spring. But even though we have fewer COVID patients hospitalized now than we did then, we are more short staffed because we didn't shut everything else down this time (at least not yet).

So the OR and PACU nurses are doing their usual thing, not helping out with COVID. Ortho and surgical nurses are taking care of their usual surgical patients, though they do get floated depending on census (leaving those units short staffed). Only oncology has been moved out of the building (hospital is an comprised of several buildings constructed over more than a century, so those patients are physically distanced from the infectious ones).

It's exhausting being this short staffed every shift, and everyone is too burnt out to pick up. COVID patient outcomes are generally better because we know so much more about the virus than March-May when we were basically guessing. But when they go downhill, they still go downhill fast. I've transitioned a patient to comfort care on three out of my last four shifts. Not going to lie - that takes a lot out of me. And even with the stable ones, it's hard knowing my patients aren't getting the care they really deserve because there are too many of them and not enough of us. A lot of colleagues are looking to get out of bedside, especially the ones who have been on the COVID floor for 8 months now. The moral injury is real.

Thanks you all for creating this place to share and vent and validate.

Susie2310 · Dec 4, 2020

I think more could have been done to utilize nurses who are not currently working as nurses but have maintained their licenses and kept their training up to date.

There is a volunteer effort for healthcare workers not currently employed to help out, but I still think that more states reaching out individually to licensed nurses who are not currently working , assessing where they could fit into helping out in acute care, and providing them with training where necessary, would have been beneficial. This could have resulted in more licensed nurses being able to help out in acute care.

There has been enough time to organize this. I think that, understandably, with concerns for nurses losing their jobs, there is a certain amount of reluctance to bring in newcomers, but if we actually want to solve the problem of a shortage of nurses in hospitals to take care of patients during Covid 19 this is not the time for lamenting that one's job might be threatened by newcomers.

CrunchRN, ADN, RN · Dec 7, 2020

Thank you very much for the updates. I appreciate it.

Susie - I totally agree. Those volunteers could really assist with the shortages and support the staff nurses. They should have created some kind of program for that by now.

Wuzzie · Dec 7, 2020

My thoughts are with all of my colleagues as this week is going to be the true test of our mettle.

CrunchRN, ADN, RN · Dec 8, 2020

The post Thanksgiving surge?

Wuzzie · Dec 8, 2020

9 minutes ago, CrunchRN said:

The post Thanksgiving surge?

Yes.

allnurses Guide · Dec 8, 2020

We had a slight drop over the weekend, but nothing major. The numbers change pretty much as soon as we get them.

We have a meeting next week for all direct care personnel to review critical triage procedures. It's very sobering.

I went to my doc for anxiety yesterday. My BP was 204/124. Never had high BP in my life, but this stress is really getting to me. Those of us not on the floor anymore are being offered a choice of going back to the floor, working as a "nurse extender" or serving in an ancillary service, such as giving out Covid immunizations to coworkers when they get here.

It feels super bleak right now.

Home Health Columnist / Guide · Dec 8, 2020

2 hours ago, Nurse SMS said:

It feels super bleak right now.

{{{ Virtual HUG / Elbow bump }}} to all on the front lines.

Home Health Columnist / Guide · Dec 8, 2020

89 out of 105 counties in Kansas opted out of Governors mask mandate -- as a result at this critical access hospital...

ABC News

As virus spreads, Kansas hospital is out of staff

Quote

The radiology technician slept in an RV in the parking lot of his rural Kansas hospital for more than a week because his co-workers were out sick with COVID-19 and no one else was available to take X-rays.

A doctor and physician assistant tested positive on the same day in November, briefly leaving the hospital without anyone who could write prescriptions or oversee patient care. The hospital is full, but diverting patients isn’t an option because surrounding medical centers are overwhelmed.

The situation at Rush County Memorial Hospital in La Crosse illustrates the depths of the COVID-19 crisis in rural America at a time when the virus is killing more than 2,000 people a day and inundating hospitals....

...Physician assistant Kai Englert was able to fill in for six days at La Crosse, overseeing several COVID-19 patients, one of whom died after no larger hospital would take the patient. The La Crosse hospital doesn’t have a ventilator and the oxygen it provided wasn’t sufficient with the patient's “chest full of COVID."...

Rush County Nursing positions available here

CrunchRN, ADN, RN · Dec 9, 2020

That is bleak Nurse SMS. Which choice will you take? Pretty shocking about your BP. Hope you can get that down quickly.

I am hoping things will settle down soon, but then of course after Christmas.....

By "hoping" I mean pretty much praying. People that do not work in hospitals are pretty removed and just do not see what things are like sadly.

Wuzzie - thank you very much for the updates. You also NRSKarenRN.

allnurses Guide · Dec 9, 2020

I chose ancillary service but it sounds like that is what everyone is wanting to choose, so obviously many of us are going to be mandated to the floor. We shall see what happens as more info and deeper need arrives.