Curious about how confident nurses here are in testing patients for COVID

[BeatsPerMinute, BSN, RN]

Hello - I have been a nurse for about 7 years (ICU, Pre/Post/Intra op for IR, EP, and Cath Lab, and outpatient procedural world). 

Some things have come up recently that are a bit alarming... as I ask my questions, I ask for the benefit of the doubt, as I have some sincere concerns, and will be speaking about my experience alone about nurses testing patients for COVID in a variety of settings. 

My boyfriend came down with some odd symptoms (SOB, fatigue, fevers ranging from 99.9 - 103.5, occasional cough, wanted to sleep a lot, clammy, chills, lasted approx 2-3 weeks). He was tested for COVID four times in 1 week (3 rapids, 1 PCR). Since I had been caring for him during that time, I was also tested for rapids and PCR. All of our tests came back negative. We were tested at PCP offices, urgent cares, drive through testings, and ED (per instruction of MDs, PCPs, and what was available, etc). 

What bothers me is that I've tested patients for COVID many times after educating myself and receiving comprehensive training on the proper way to test. I've had co-workers test a patient and test was neg. That nurse was quick, wasn't inserting the Qtip far in enough because the patient did not like it / was tearing up (and some patients would scream... OMG -_- ). I was not afraid to do it correctly. Yes, it hurts. I know. I've had MULTIPLE COVID and Flu tests done.  Anyway, those same patients that were "once negative" would now actually come back "positive." There are multiple factors (maybe they caught something within the hospital, or from a staff member, registration, someone not vaccinated, or someone who was completely unaware. However... I've also seen posts here and there on AllNurses who are confused why when a patient they received from the ED or another department who had been tested for COVID before were "negative" and then suddenly they're positive. So, IDK, I guess I'm a bit concerned about the training / quality of the testing being done. 

I watched as my boyfriend got tested by multiples nurses and paid attention how the nurses who tested me. Every time, test was cut short. Even if he or I got teary eyed because of the sensation of being tested, and that it was uncomfortable... I left feeling like those nurses have not been properly trained. It was way to quick to get a good sample... IMO, and in my experience... 

This is NOT about blaming PCP offices, Urgent cares, the ED Rns, drive through test centers, outpatient centers, nor anyone about not "doing their jobs right" when it comes to testing for COVID: my concern is about the training nurses are receiving all over. Do nurses here (no matter your experience, department, whether you're working inpatient, or outpatient, in ICU, ED, a COVID unit, LTC, Peds, something else...) do you feel you have received proper training? Do you feel confident in testing patients for COVID? What are the steps you take to complete a COVID test on a patient? Do you feel confident in the tools that you are using (or have they changed?) as the variants have been becoming a growing concern. 

When I went to the ED with my boyfriend a couple weeks ago (level 1 trauma, nearly 1000 beds). While we were there I received some hash from triage nurses, asking me to leave right away because of their concern about COVID and the variants. I left right away - no problem. Before I walked out, one nurse said to me "Our beds are filling up and we are running out of space. So you need to leave right now." I was a bit thrown off by her tension, and it was alarming to me to hear that kind of response. 

I do not want to see a repeat of 2020 ? and that's why I am asking about all of this. We have all been through a lot and for a long time, with little support, empathy, overworked and understaffed... people have been leaving rapidly (travelers and perm staff) or are making plans to leave nursing / healthcare entirely. Healthcare workers are burning out. The pandemic has been harsher on some more than others. I think we can all agree that things will get worse with time. 

I'm tired and apologize if this post is a bit confusing.... hope it makes sense. Would be curious to hear some thoughts from ya'll. 

Stay safe ❤️ 

[jive turkey]

On 9/12/2021 at 11:06 PM, BeatsPerMinute said:

Hello - I have been a nurse for about 7 years (ICU, Pre/Post/Intra op for IR, EP, and Cath Lab, and outpatient procedural world). 

Some things have come up recently that are a bit alarming... as I ask my questions, I ask for the benefit of the doubt, as I have some sincere concerns, and will be speaking about my experience alone about nurses testing patients for COVID in a variety of settings....

I don't doubt there are occasions where poor samples are collected producing false negatives.  

Anyone who is symptomatic at least has symptoms to justify them quarantining regardless if they think they have COVID or not.  Sick=stay yo butt home and away from family.

The challenge is the asymptomatic having false negatives, roaming about and spreading unknowingly.  

Your concern is among many reasons I support frequent testing and wish there was greater emphasis on that than blanket vaccine mandates.  

[T-Bird78]

I had to undergo an online COVID testing module and a quick test before I was assigned to work COVID testing for preop pts. I went all the way in with the swab, up to the line, and I’d warn pts that it tickles, then it burns like when you get water up your nose, then your eyes water and you go cross-eyed. I had so many yell, scream, cuss, swat at me, one called me a b and grabbed my arm and dug her nails into me so hard that I nearly punched her (if I hadn’t been holding the tube in that hand I would have hit out of reflex), and she drove off and nearly ran over my foot. I had two pts tell me they’d rather not have their surgical procedure instead of getting that test done and drove off (they both came back; one was a planned c-section for her fourth child, the other was a cardiac procedure). I had one pt DEMAND she do it herself, then proceeded to shove the swab vertically up her nose, start bleeding, then cry and blame me. I had to get another swab and do it correctly. There is definitely a proper technique to the swab and I’m not surprised we get false negatives simply because the testing nurse didn’t do it right. I’ve been tested twice so I know what it feels like too. 

[toomuchbaloney]

Anecdotally, I know 4 people who are vaccinated and developed symptoms of covid after their unvaccinated elementary school children were infected with covid.  Only one of them actually tested positive, none were hospitalized and none were eligible for regeneron because they did not test positive. They did feel poorly though with fatigue, intermittent fever and headache. Their providers required quarantine.