How Does This End?

It is difficult to imagine how this pandemic ends. Does it play out regardless of what we do? How do we make sense of a world that is so vastly different? As health care providers, knowledge is power, but it also gives us more anxiety and more awareness of the dangers around us. Nurses COVID Article

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We Watched and Planned ...

My husband and I began watching the Covid-19 numbers in early January. I remember sitting in our living room during a typically dark, cold Minnesota Winter day and discussing how it was going to go down. We debated going to the "big city" the first weekend of February for fear that it had already made its way to the United States. My husband plotted graphs and looked at the exponential growth, and he made predictions about what might happen if it did get out of China. We bought extra food, essentials, and began to save money. We talked late into the night about the potential scenarios that might unfold.

And, Waited

I watched, in horror, as it began to make its way around the world, and everything that we talked about in late-night conversations started to materialize. My husband and I wished that we could be wrong. The lack of PPE and the rate of health care worker infection weighed heavily on our minds. We were already homeschooling and had begun stocking up, so when things shut down, we were already reasonably prepared. Few things changed in our daily routine, except the loss of a once a week preschool for our youngest, church for all of us, and an evening kids club and date night for the two of us. We are both in the high-risk category, so we hunkered down and waited ... and waited ... and waited ...

Now, the Uncertainty

I was fortunate (or unfortunate enough to be high risk) to be able to be off work for a while. I am headed back in a few weeks after spending an amazing, once-in-a-lifetime Summer with my husband and three young kids. I am anxious about how I will assimilate back into nursing. I am apprehensive about how I will feel coming home to my family after 12 hours of potential exposure. I am still fairly worried about the PPE situation. I have little trust in the government agencies who are guiding our direction in this pandemic.

At the end of the day, however, I am just weary. I am tired of seclusion, but also feel safer in it. I am tired of thinking about the future outcome for myself, my family, our finances, my world, OUR world. I am tired of the uncertainty. I am sad for my children and how this is all going to affect their future.

Questions Unanswered

How long do we do this?

How long do I go without seeing any extended family for fear of exposing them, or us?

How long do I hesitantly go out in public, debating whether I should wear a mask when no one else is?

How long do we keep our already homeschooled children away from social networks and peers?

How long do we stay home from church, our community lifeline?

How do we prepare financially, mentally, spiritually?

How do we, as a collective body of healthcare providers, ensure that the career we chose is honored and protected?

I did not sign up to go to war. I signed up to care for people, show compassion, educate, and advocate, but not at the cost of my own life. My family, indeed, never agreed to be exposed to the dangers that I may face when I go to work. How do I justify the costs for them?

These are all rhetorical questions and each of us has our own set of questions, all with no concrete answers. How does this end? I suspect it will play out regardless of what containment measures are put into place. It only takes one moment of weakness to be potentially exposed.

What are your questions? Your answers? How in the world does this end?

On 7/9/2020 at 8:12 AM, MeganMN said:

How long do we do this?

How long do I go without seeing any extended family for fear of exposing them, or us?

How long do I hesitantly go out in public, debating whether I should wear a mask when no one else is?

How long do we keep our already homeschooled children away from social networks and peers?

How long do we stay home from church, our community lifeline?

How do we prepare financially, mentally, spiritually?

How do we, as a collective body of healthcare providers, ensure that the career we chose is honored and protected?

On 7/9/2020 at 5:01 PM, JVBT said:

What I’m hearing most say is that a vaccine is our way out of this. In fact, when I first heard someone say this, about two months or more ago, I thought at the time, how pathetic that that’s the best we can do! Now I’m thinking, well it better be the case! I mean, let’s hope the vaccine works.

Personally, I was hoping for containment and mitigation, but we apparently have nothing but disdain for each other, with this group not caring about that group, and on and on in a boring fashion.

Finally, I was hoping that as a medical system we would re-jigger our priorities because of lessons learned from the pandemic. Specifically around racism and prevention.

Embedded structural inequities like redlining, underfunding of public schools, public sector/frontline employment, inability to afford healthy food, food swamps and the built environment, have contributed to disproportionate Covid-19 rates of infection, complications, and death among much of the country’s minority populations. But it’s important also to realize that, regardless of race or ethnicity, much of the destruction that SARS CoV-2 leaves behind clearly reveals the effects of diets high in processed food. As addictive as nicotine and heroin, processed food is a huge driver of hypertension, obesity, and diabetes – comorbidities one, two and three in Covid-19.

The paragraph above is found here, in a post I started a couple of days ago:

https://allnurses.com/the-case-mass-public-education-t722354/

However, entire groups (cities, states, healthcare companies) must engage in this to be successful. Will people care enough to make the links that ultra refined food leads to an inflamed body, ill health and susceptibility to Covid-19? Will we care enough to educate on mask wearing and protecting the vulnerable? Or will we put all our eggs in the vaccine basket?

Stay tuned.

I think many of the answers to your questions have to be individualized to each person or situation (I.e. geographical locations, hot spots, etc.). We also need to avoid basing our decisions, in regards to the pandemic, on our political affiliations. Our profession (because that's what nursing is) and what we do, is grounded in the best scientific evidence that we have at the time or moment.

How long do we do this?

Until we have a working vaccine or have achieved herd immunity.

How long do I go without seeing my extended family?

That depends. Are your family members willing to subscribe to infection control practices to limit the spread of the virus when your in their company? Two weeks from now, my nephew has a birthday party. I will go, but I'll bring my own lawn chairs, wear a mask, and distance myself from others. We won't stay all day, but long enough to visit and make memories. Truthfully, I've been visiting with my parents and sister for a couple months now. But I feel as if I can trust them. I know their thoughts on the seriousness of the coronavirus and we subscribe to the same viewpoints on who's at risk and how we as a community can mitigate the spread.

How long do I hesitantly go out in public, debating whether I should wear a mask when no one else is?

Why would you not wear a mask because someone else isn't? As a healthcare worker, you should be role-modeling good behavior in the community. There's no logic to your question.

How long do we keep our already home-schooled children away from social networks and peers?

There are plenty of ways to let your child network without being F2F. What about FaceTime or Zoom? Phone calls? Limited time on social media?

My kids have been meeting periodically with peers, but they also know my hard-limits on infection control practices when they're around other people. It might be easier for me because there is not a surge in my local community at this time.

How long do we stay home from church, our community lifeline?

I would only go to F2F church services if the church itself was adhering to the infection control guidelines set forth by the CDC. The church we visit live streams all their services and they've started to open up more sessions to accommodate for social distancing.

How do we prepare financially, mentally, spiritually?

Personally, I think this question falls in line with, "What is the meaning of life? There's no roadmap for this question.

If you're concerned about your future finances, I would start looking for supplemental job opportunities. You have 14 years of nursing experience. I'm not sure what credentials you have, but you could look at adjunct teaching, tutoring, legal nurse consulting, or CEU writing.

One way to help you prepare mentally and spiritually is to start practicing self-care (meditating, journal writing, yoga, hiking, massages, etc.). You need to start putting yourself first sometimes, physically and mentally. It will keep your immune system strong and also teach your kids to think about the needs of others over their own.

How do we, as a collective body of healthcare providers, ensure that the career we chose is honored and protected?

This can be broken down by the unit and hospital you work in and the state you practice in.

State

I'm a member of my state nurse's association and I get monthly newsletters, including periodic emails on new and updated legislative action that has been or is being implemented in my state. It's important to be aware of what's going on in your state and how it could impact your workplace.

You could also look to volunteer to be a board member on a committee for your state nurse's association. Lobbying to influence legislature in your state could be another route for you to go.

Workplace

One of the most important things we can do as nurses, is to conduct ourselves in a professional manner and promote ourselves and our profession with dignity - in all settings. We practice under a robust body of knowledge and patient outcomes depend on us. We are not dispensable.

If you feel as if you have one foot already out the door, there are other options for you. You don't have to stay at the bedside. Nurses can impact the health and wellness of clients and the community in a variety of settings.

Specializes in Psych, Addictions, SOL (Student of Life).
3 hours ago, CATT49 said:

Hysterical article.

I am not sure what you mean by Hysterical? As the article was well thought out and not given to unrestrained emotion. Unless you mean funny which it was not intended to be. I found it to be a thoughtful contemplation of what comes next.

Hppy

Specializes in Community health.

My question is about my child. He is a healthy 8 year old only child. If schools reopened TODAY with no mitigation methods in place at all, I’d put him on the first bus. Not because I’m heartless and don’t care about elderly teachers, etc. But he has had almost zero contact with any other children since March 16. Zoom doesn’t count. A child simply can not develop normally at home, alone, looking at a screen, and occasionally taking a hiking trip or playing a board game with his parents. But the proposals for schools are dystopian: no playing at recess, no chatting, no passing notes, no school bus. I honestly have no idea what to do, how to handle this, or what his future looks like.

Also, my husband and I are well-off. I can quit my job and homeschool him if need be. What about the children of immigrants who don’t speak English? What about the single moms with 4 kids? What about the kids who share a bedroom with 3 other siblings in an apartment with no yard? Distance learning is 100% ineffective but I am not sure what the answer is. I am SO GLAD I am not a school superintendent right now.

Specializes in Emergency Room.

@CommunityRNBSN thank you so much for your post! It is kind of interesting to see the varied responses. I was really hoping more people would post their own questions, not answers to my questions! My question a were just posted as an example of things that I was thinking about. We all have our own. I appreciate all of the responses and am glad that, for the most part, the responses were civil. There is no need for attacking or poking fun at anyone for their own beliefs or anxieties.

Ultimately, there is a whole range of how people are responding to this and it is very individual. I just wish that there were solid, national guidelines for this thing. Despite what anyone wants to believe, this is a serious threat.

As for school and socialization, I often wonder how this will affect my children developmentally. It will probably shape their minds and futures much more than linear this point.

@Rose_Queen thanks for pointing out the quality of life for many that survive. Many people do not seem to realize that this is a serious threat and should be treated as such! When did public health become political? I agree with happy that the government may be over reaching I terms of control over liberties, but that is really a separate issue.

@Kerri Dold Getz your post was great, thank you. I appreciate the thoughts even though my questions were rhetorical, I can still always learn from others experience! Unwanted to respond to your comment about mask wearing. I should have phrases my question differently, but my questionably pertained to two things. One, mask wearing has become an oddly political issue. Of course I wear a mask, but have had odd responses from people who want to make it political, which makes me struggle with it mentally. Two, it is still providing some protection, but the mask wearing is really much more effective if everyone is wearing them, so I sometimes feel it is futile if dozens of people around me are not wearing one. Thank you so much, though, for the thoughtful response.

At the end of theday, we all have to figure out our own response. We have been much more cautious and isolated, and it is okay that others are not, but that is our decision to make. I am not okay with being the possible asymptomatic carrier to all of my elderly family members.

My post really was more about just how very difficult this all feels, and how much it has changed our life, with no end in sight...

Thanks to everyone for responding.

Specializes in retired LTC.

OP - you ask how do we continue to move on. I see 2 areas not addressed enough that I think could make positive impact.

Firstly, TV media - needs to take a more proactive and oversight function in all its videoing/presentations. Like I watched a TV news clip over the weekend. Some group was providing outreach free services incl haircuts for free to needing clients. Very nice gesture, but ... the barber was wearing a surgical mask at his lipline. Totally bypassing his nose & mouth. Like what good was it???

The TV media/editorial crew should have monitored the situation and explained 'WEAR THE MASK RIGHT, OR. NO. TV.!!! HARD LINE!!!

Blatant failure to wear masks correctly DEFEATS the purpose of the masks and provides the public a SUBLIMINAL or false sense of it being OK to do so. Perfect opp'ty for the media to be educational, and in another sense, a chance to monitor & provide oversight.

I'm sure many of us have seen these kinds of situations occurring daily. If social distancing is NOT being practiced, NO TV. And if the parties refuse to conform, oh well, their loss!

Secondly, better employee job screening with RESTRICTIONS - for the record, this one gives me terrible mixed emotions and civil liberties concerns. SOOOOOO many employees work MULTIPLE jobs; some 2 or 3 positions. All this criss-crossing job hopping causes criss-crossing exposure risks. Staff working in day cares, group homes, DDD facilities, NHs are exposed to higher risk clients. Staff come in and go to the next job potentially exposing themselves, their families and the other clients to the increased risks.

Somehow, this needs to be studied and addressed. I did hear of some locality actually doing so. But I recognize the crippling imposition of financial SURVIVAL for so many, esp for those employees who can least afford loss of jobs, and hence, finances & lifestyle.

I have NO CLUE how this could be done. Epidemiolgy tracks trends & exposures now. How to monitor all the jobs potentially out there, incl those under the table and/or unlicensed is mind-boggling.

OP - you asked. These are just 2 types of change that could have major impact that I hope will move society to a better outcome.

JMHO

Specializes in clinic nurse.

@amoLuciaI'm not sure what you mean, exactly, by "no TV!" but I liked your post.

The media needs to be airing commercials constantly about things like proper mask wearing and a big X through the nose jockeys. Big X. There is one hundred thousand million times more that the media could be doing to educate people on how to behave during a pandemic. Where o where are the PSAs when we need them?

We need stricter nurse managers to insist on mask wearing, not to forgive the neck and nose jockeys.

On 7/13/2020 at 5:47 PM, MeganMN said:

When did public health become political?

Literally the same exact time a video of a dog chasing his tail became political. That's the sad reality of our country. Most of us are smarter, but there's a completely moronic minority that can't have anything exist without it being about politics. When the next person finds a cure for a rare disease, I can promise that when you read the comments on facebook, you'll see someone post something bashing the liberals, because in their heads, that's all connected.

Specializes in Adult Internal Medicine.
On 7/11/2020 at 2:06 PM, GracefullyGritty said:

98.5% survival rate.

The case fatality rate is 8% in the US right now, just to be clear.

Specializes in Psych.
On 7/15/2020 at 10:01 AM, BostonFNP said:

The case fatality rate is 8% in the US right now, just to be clear.

Less than 4% as of this writing. 136,368 deaths divided by 3,450,088 cases.

Tracking the novel coronavirus in the U.S.

Specializes in Adult Internal Medicine.
On 7/9/2020 at 8:12 AM, MeganMN said:

How long do we do this?

How long do I go without seeing any extended family for fear of exposing them, or us?

How long do I hesitantly go out in public, debating whether I should wear a mask when no one else is?

How long do we keep our already homeschooled children away from social networks and peers?

How long do we stay home from church, our community lifeline?

How do we prepare financially, mentally, spiritually?

How do we, as a collective body of healthcare providers, ensure that the career we chose is honored and protected?

My two cents based on where we currently stand now:

I think that basic infection control precautions (washing hands, reasonable social distancing, wearing facial coverings when unable to distance, avoiding unnecessary high density enclosed spaces) are here to stay for awhile. They are reasonable and effective and they help reduce more than just COVID.

I think we need to get kids back to school and some degree of normalcy (youth sports, social interactions, etc), taking care when we can to practice basic infection control.

Worship services (church, temple, mosque, etc) are very important to some peoples' lives. They are a calculated risk but that also can be mitigated with some basic infection control precautions, and I think we need to get people back to services as quickly as possible.

As healthcare providers, the most important thing we can do is translate the best evidence based practices to the lay public, and to speak out against pseudoscience and partisian lies with our patients, our families, or friends, and social media/internet.

Specializes in Critical Care; Cardiac; Professional Development.
On 7/13/2020 at 9:17 PM, JVBT said:

@amoLuciaI'm not sure what you mean, exactly, by "no TV!" but I liked your post.

The media needs to be airing commercials constantly about things like proper mask wearing and a big X through the nose jockeys. Big X. There is one hundred thousand million times more that the media could be doing to educate people on how to behave during a pandemic. Where o where are the PSAs when we need them?

We need stricter nurse managers to insist on mask wearing, not to forgive the neck and nose jockeys.

My institution has instituted progressive discipline for people failing to wear PPE according to our policies at this time. This includes masks in all hospital areas and shields if there is any chance you will be face to face with patients. We are encouraged to politely remind one another if a mask is on inappropriately or not on at all. Before the progressive discipline ruling, reminding someone was met with hostility. Now its met with at least momentary quiet compliance.

Specializes in Psych.
16 minutes ago, Nurse SMS said:

My institution has instituted progressive discipline for people failing to wear PPE according to our policies at this time. This includes masks in all hospital areas and shields if there is any chance you will be face to face with patients. We are encouraged to politely remind one another if a mask is on inappropriately or not on at all. Before the progressive discipline ruling, reminding someone was met with hostility. Now its met with at least momentary quiet compliance.

I'm on board with something like that in a healthcare setting because you're being paid by the employer to follow their policies on giving care.

What I'm not on board with, however, is trying to impose such rules on the general public. Here in Texas, our cultural ethos is deeply individualistic and liberty-loving. If you went up to someone in public and upbraided them for not masking, it would be considered harassment. And the best case scenario would be them telling you something that rhymes with "duck off". The worst case scenario could end up getting pretty ugly.

Like I said ad nauseaum, if you want to quarantine and mask, do so to your heart's content. Nobody here is going to drag you out of your home and force you to go to a party or a bar without a mask on, I assure you. But you go around trying to tell others how to live their lives you are soon going to face outright hostility which means you'll learn to amend any sanctimonious prig attitudes very quickly.