How many unvaccinated coworkers are you aware of?

RETNAVYTHENMEDIC2RN, ADN, RN, EMT-P · Oct 3, 2021

8 hours ago, Charlcie said:

I don't think anyone was arguing that. I was speaking to something that was said prior. I work ER and ICU and do them all the time and I agree it takes all of a few seconds and I knock it out

As far as the other part of your comment I can only speak to the geographical areas I've worked since delta and from personal experience people are not getting care they need because of this horrible outbreak which has caused workers to be out sick and an influx of patients. Our ICU is full of covid right now so if we get ANYTHING else in the ER we have to send the patient elsewhere. We are flying people out of state because there are no beds. The staffing issue here is because we are full and the patients are extremely sick so we are tripled with people who would normally be a 1 to 1.

Wow, That is crazy. Hard to imagine having to fly patients out for care, but heard a traveler that recently came to our ED talking about it as well. Sorry you guys are getting hammered there as I truly feel for you.

Traveling has decimated our ED staff. Our younger RN's are chasing the all mighty dollar. We lost 10 full time staff to travelling between mid August and October 1st. We had already lost at least that many more between June and August. I don't know why the floor/ICU areas are short staffed, but I assume it is also nurses following the money. I don't blame them for it, just the system we are currently in. As a result, we "board" floor and ICU patients in my ED due to lack of beds. I almost laughed when you mentioned 1 to 1 ratio, as ICU patients in the ED are definitely not 1 to 1 or 2 to 1. Scary stuff, and the other patient's care suffers when you have patient's like that in the ED. This problem was going on prior to COVID where I work to a small extent. COVID in general has impacted us and exacerbated the issue because staffing needs in hard hit areas drive the economics of it. If a nurse with 2 years experience or even slightly less can go make $4,500/week why would they stay where they are making half that? Camaraderie, loyalty, etc., are things I learned in the service. Today they really are not applicable in nursing from where I stand. I think they may have at one time, but certainly not now. I know when I started in the ED almost 4 years ago, it was like family and the turnover was minimal. The last 18 months has seen a steady increase in it. Until COVID becomes the new "Flu", and I don't mean to try to minimize it but rather to give a normal label to it, the money will continue to ebb and flow and staff fluctuations will be the norm. Hopefully Merck's new anti-viral will get approval for use and will be another weapon that will get us one step closer. Good luck to you and stay safe.

subee, MSN, CRNA · Oct 3, 2021

9 minutes ago, RJMDilts said:

Wow, That is crazy. Hard to imagine having to fly patients out for care, but heard a traveler that recently came to our ED talking about it as well. Sorry you guys are getting hammered there as I truly feel for you.

Traveling has decimated our ED staff. Our younger RN's are chasing the all mighty dollar. We lost 10 full time staff to travelling between mid August and October 1st. We had already lost at least that many more between June and August. I don't know why the floor/ICU areas are short staffed, but I assume it is also nurses following the money. I don't blame them for it, just the system we are currently in. As a result, we "board" floor and ICU patients in my ED due to lack of beds. I almost laughed when you mentioned 1 to 1 ratio, as ICU patients in the ED are definitely not 1 to 1 or 2 to 1. Scary stuff, and the other patient's care suffers when you have patient's like that in the ED. This problem was going on prior to COVID where I work to a small extent. COVID in general has impacted us and exacerbated the issue because staffing needs in hard hit areas drive the economics of it. If a nurse with 2 years experience or even slightly less can go make $4,500/week why would they stay where they are making half that? Camaraderie, loyalty, etc., are things I learned in the service. Today they really are not applicable in nursing from where I stand. I think they may have at one time, but certainly not now. I know when I started in the ED almost 4 years ago, it was like family and the turnover was minimal. The last 18 months has seen a steady increase in it. Until COVID becomes the new "Flu", and I don't mean to try to minimize it but rather to give a normal label to it, the money will continue to ebb and flow and staff fluctuations will be the norm. Hopefully Merck's new anti-viral will get approval for use and will be another weapon that will get us one step closer. Good luck to you and stay safe.

It would be so much easier if everyone just got vaccinated instead of relying on something new, expensive and might become resistent to the next virus down the road. They don't want an "experimental" vaccine but would rush to take an experimental pill.

toomuchbaloney · Oct 3, 2021

21 minutes ago, RJMDilts said:

Camaraderie, loyalty, etc., are things I learned in the service. Today they really are not applicable in nursing from where I stand. I think they may have at one time, but certainly not now.

Nurses have loyalty to the profession and to their patients. Loyalty to an employer would be folly in these times because employers are not loyal to nurses. Employers have developed the habit, over all of my 40+ years of work, of advising nursing staff that they were replaceable. All of a sudden those same acute care facilities are now confronting the reality that the only reason they are open 24/7 is nurses...the only reason that people are staying in their beds is to receive nursing care.

Capitalism runs our health system. Nurses are using that to their advantage for a change.

RETNAVYTHENMEDIC2RN, ADN, RN, EMT-P · Oct 3, 2021

8 minutes ago, toomuchbaloney said:

Nurses have loyalty to the profession and to their patients. Loyalty to an employer would be folly in these times because employers are not loyal to nurses. Employers have developed the habit, over all of my 40+ years of work, of advising nursing staff that they were replaceable. All of a sudden those same acute care facilities are now confronting the reality that the only reason they are open 24/7 is nurses...the only reason that people are staying in their beds is to receive nursing care.

Capitalism runs our health system. Nurses are using that to their advantage for a change.

TOOMUCH. I think you may have misunderstood my point. Camaraderie, loyalty, etc., is not to the institution, its' to one another. Comradery definition is - a feeling of friendliness, goodwill, and familiarity among the people in a group. Screw the institution. Soldiers, Sailors, Airmen, and Marines don't die for the service, they die for the guy or gal next to them when the crap hits the fan.

No offense to travelers, as they can be a Godsend to the short staffed facilities, but continuity in the department is important, e.g. knowledge of "how it is done here", pride and ownership of processes, etc come from a core of individuals who have buy in and see the benefit to being engaged because they live and work here. Perhaps it matters where you work as well? I work in an academic/teaching environment where I am empowered and not run over, but rather respected by physicians as we are expected to assist in training our ED residents. I have heard it time and again from travelers coming into our ED about how our team work is so good and how everyone pitches in and helps one another and how it was not like that at their last assignment. I'm sorry, but that kind of atmosphere comes from camaraderie, loyalty, etc., not to the institution, but to the group you are working with. When our nurses said they were going to travel, EVERYONE of them said it was ALL about the money. They said they were going to miss the coworkers and hoped where ever they went that the place was like here, where everyone looked out for each other. That shows me that the atmosphere does matter. Some even said they waited so long hoping the hospital would fix the compensation because of the way they felt about whom they worked with. My fear is we will begin to lose that with the loss of those nurses who are replaced by travelers who, again not their fault, have no attachment and hence, no affinity or loyalty to the group. My goal personally is to reach out to them as they arrive and orient them to our way of thinking and welcome them as "one of us" and not just some 13/26 (or whatever their contract) week temp person so they feel included and hopefully get them into the proper mindset of being one of us.

To your point of how nurses have been treated over the past decades. I hope nurse do use the current situation to their advantage, by demanding their employers start properly compensating them at their home facilities. Staffing ratios, retention bonuses (we have hiring bonus but not retention bonuses how stupid is that?), improved retirement benefits, education/training, etc. I'll take it one step further, I think they should also engage in the training arena as well to help address the shortage in nursing instructors to increase the number of students to address the overall shortage of nurses. If nurses are not smart enough to utilize this current situation to improve their standing they are not worthy to *** about it. There are tons of intelligent nurses out in the world, most far smarter than I, that fixing the long standing problems can and should be addressed now, while everything is going on and it is painful for EVERYONE, management, nurses and most importantly, patients and family. Allowing management (CEO/CFO), who in large part have zero bedside experience, to dictate everything needs to come to a screeching halt.

toomuchbaloney · Oct 3, 2021

22 minutes ago, RJMDilts said:

Camaraderie, loyalty, etc., is not to the institution, its' to one another. Comradery definition is - a feeling of friendliness, goodwill, and familiarity among the people in a group. Screw the institution. Soldiers, Sailors, Airmen, and Marines don't die for the service, they die for the guy or gal next to them when the crap hits the fan.

Do you think that profit focused health businesses foster a sense of camaraderie among the nursing professionals? The military intentionally builds that feeling among the members, profit focused health businesses do not, IMV. Nurses haven't volunteered to take on some patriotic duty to benefit the country as a whole, they are working in a career.

Changing health care delivery back to the pre-Nixon American concept that health care shouldn't be a profit center for capitalists will help to diminish the capitalist strategies and influences in those businesses. IMV

RETNAVYTHENMEDIC2RN, ADN, RN, EMT-P · Oct 3, 2021

1 hour ago, subee said:

It would be so much easier if everyone just got vaccinated instead of relying on something new, expensive and might become resistent to the next virus down the road. They don't want an "experimental" vaccine but would rush to take an experimental pill.

What did my post say? Take the pill not the vaccine? NO. Let me quote myself: “Hopefully Merck's new anti-viral will get approval for use and will be another weapon that will get us one step closer.”

But since you don’t like me saying that, let me give you a source you will embrace: “White House Covid-19 Response Coordinator Jeff Zients said during a briefing on Friday that the best way to think of such a drug is as an additional tool, to be used alongside vaccines. This is a potential additional tool in our toolbox to protect people from the worst outcomes of Covid," Zients said. "I think it's really important to remember that vaccination, as we've talked about today, remains far and away our best tool against Covid-19.” (CNN.COM) (I even bolded the vaccine part to make you feel better and let you and the world know I agree eligible folks need the vaccine.)

So, we shouldn't try it because even though it may work now, it might not work against the next virus down the road? Are you serious?

“Since the introduction in 1937 of the first effective antimicrobials, namely, the sulfonamides, the development of specific mechanisms of resistance has plagued their therapeutic use. Sulfonamide resistance was originally reported in the late 1930s, and the same mechanisms operate some 70 years later. A compilation of the commonly used antibiotics, their modes of action, and resistance mechanisms is shown in Table Table1.1. Penicillin was discovered by Alexander Fleming in 1928, and in 1940, several years before the introduction of penicillin as a therapeutic, a bacterial penicillinase was identified by two members of the penicillin discovery team (1). Once the antibiotic was used widely, resistant strains capable of inactivating the drug became prevalent, and synthetic studies were undertaken to modify penicillin chemically to prevent cleavage by penicillinases (β-lactamases). Interestingly, the identification of a bacterial penicillinase before the use of the antibiotic can now be appreciated in the light of recent findings that a large number of antibiotic r genes are components of natural microbial populations (43). Which came first, the antibiotic or resistance?” (Davies & Davies, 2010.)

There are multiple classes and generations of anti-biotic because bugs mutate and adapt. Of course this anti-vital may not work for other viruses down the road, so what. The DATA to date shows it is effective in COVID patients and potentially halving the risk for death and hospitalization. (CNN.COM) So, I say push vaccines and use drugs that can save lives. It's not an either/or, its a both when necessary. Why do I say that? We know the data shows we can be infected after being vaccinate. What happens for the high risk patient who was vaccinated and contracts COVID? I say give them the antiviral early and prevent their hospitalization with PO meds at home. You say, its' better to vaccine only, and not have this pill option? What happens when the vaccinated high risk get COVID, do they then wait till they are sick enough to go to the hospital and need IV antivirals as is the current practice?

Expensive? Compared to what? What they are already being treated with, whether they caught COIVD with or w/o being vaccinated? "Remdesivir, is currently the only drug approved by the FDA for the treatment of Covid-19. Remdesivir, which is made by Gilead Sciences and sold under the name Veklury, is administered by intravenous infusion, so it's not as simple as swallowing a pill."(CNN.COM) That option is definitely not cheap. Even just getting it IV in the ED and discharged, which I have yet to see, would be very expensive.

The option Merck presents: "The federal government has placed advance orders for 1.7 million courses of treatment, at a price of about $700 per patient. That is about one-third the current cost of a monoclonal antibody treatment, which is typically given to patients via intravenous hookups. (NYTIMES.COM)

Merck has already sold 1.7 million treatment courses to the US government, if it gets authorization or approval from the FDA. The company said it will offer tiered pricing to provide access around the world, and will work with generic drug manufacturers to speed availability to low- and middle-income countries.

Sounds like this new anti-viral option would be cheaper than current treatments as it would eliminate hospitalizations and use of IV therapy. It would potentially be more readily available and perhaps obtained at urgent care or PCP offices thereby reducing visits to the ED. Also, Merck is actually trying to reduce the costs to those who cannot afford it so there is that as well.

Again, folks, get your vaccine and embrace treatment options that save lives and reduce hospitalizations and healthcare costs. AND, I'll be the first to retract my endorsement of Merck's pill if any data shows this pill is ineffective or unsafe, like I did after first endorsing, then retracting that endorsement, of putting Clorox in your arm.

References

Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev. 2010;74(3):417-433. doi:10.1128/MMBR.00016-10

CNN.COM Oct 2, 2021. https://www.cnn.com/2021/10/02/health/antiviral-pill-covid-19-explainer/index.html

NYTIMES.COM Oct,1, 2021. https://www.nytimes.com/2021/10/01/business/covid-antiviral-pill-merck.html

Bonus source on anti-biotic resistance history for any nerds.

https://youtu.be/U7Dshq5Npdg

RETNAVYTHENMEDIC2RN, ADN, RN, EMT-P · Oct 3, 2021

36 minutes ago, toomuchbaloney said:

Do you think that profit focused health businesses foster a sense of camaraderie among the nursing professionals? The military intentionally builds that feeling among the members, profit focused health businesses do not, IMV. Nurses haven't volunteered to take on some patriotic duty to benefit the country as a whole, they are working in a career.

Changing health care delivery back to the pre-Nixon American concept that health care shouldn't be a profit center for capitalists will help to diminish the capitalist strategies and influences in those businesses. IMV

I sure don't. And it does not have to be a military organization to do that. It's not about patriotism either. Did I even mention that word? Does it even appear in the dictionary next to camaraderie? As I pointed out, it's not about the organization, it's about the people. CRNA's must be in a different world. In the ED we don't survive alone. Selflessness is an attribute I see in many of the ED nurses I work with. We lean on each other as a team. Working a leveled trauma requires team work. There are set duties that are delegated and done within a prescribed timeframe and the environment is not controlled. Knowing each other and what each other can and cannot do is essential. The mutual trust and friendship among people who spend a lot of time together is not something the institution can foster. It is developed by the people. 12 hour shifts in high stress environments are wonderful places for that to occur. I suppose as I reflect while typing this response, most nurses are in it as a career as you say, and I can see why many act the way they do, as opposed to how they are in the ED. You have actually helped open my eyes a little during this exchange.

I see the camaraderie I speak of in Fire and EMS as well. They also work in high stress areas in uncontrolled environments. Again, the camaraderie is not, and cannot be institutionally mandated. It just naturally occurs.

The military is the exception to that rule, as it is a given that cohesion is required for success. That cohesion is not necessarily synonymous with camaraderie either. The current and several administrations have done their level best to break that down that cohesion and camaraderie IMNSHO and that of many in leadership positions today. But I digress.

As for pre-Nixon not for profit healthcare, those days are long gone. I work in a non-profit healthcare system and it is not immune to the issues that have caused the problems we face today. Perhaps it will change, but I don't see it anytime soon. One can only hope.

toomuchbaloney · Oct 3, 2021

5 minutes ago, RJMDilts said:

I sure don't. And it does not have to be a military organization to do that. It's not about patriotism either. Did I even mention that word? Does it even appear in the dictionary next to camaraderie? As I pointed out, it's not about the organization, it's about the people. CRNA's must be in a different world. In the ED we don't survive alone. Selflessness is an attribute I see in many of the ED nurses I work with. We lean on each other as a team. Working a leveled trauma requires team work. There are set duties that are delegated and done within a prescribed timeframe and the environment is not controlled. Knowing each other and what each other can and cannot do is essential. The mutual trust and friendship among people who spend a lot of time together is not something the institution can foster. It is developed by the people. 12 hour shifts in high stress environments are wonderful places for that to occur. I suppose as I reflect while typing this response, most nurses are in it as a career as you say, and I can see why many act the way they do, as opposed to how they are in the ED. You have actually helped open my eyes a little during this exchange.

I see the camaraderie I speak of in Fire and EMS as well. They also work in high stress areas in uncontrolled environments. Again, the camaraderie is not, and cannot be institutionally mandated. It just naturally occurs.

The military is the exception to that rule, as it is a given that cohesion is required for success. That cohesion is not necessarily synonymous with camaraderie either. The current and several administrations have done their level best to break that down that cohesion and camaraderie IMNSHO and that of many in leadership positions today. But I digress.

As for pre-Nixon not for profit healthcare, those days are long gone. I work in a non-profit healthcare system and it is not immune to the issues that have caused the problems we face today. Perhaps it will change, but I don't see it anytime soon. One can only hope.

I mentioned patriotism in relationship to the military because that is our culture... all things military are framed in patriotism, duty, valor and honor. That's substantially different from the culture surrounding nursing, IMV. Nursing was historically a female profession and it enjoys the societal connotations associated with that...

I believe that there is higher camaraderie in health fields and departments where the nursing staff function as a team. Much of nursing work is not team work as much as it is task work. I worked in critical care and critical care transport, there's quite a bit of camaraderie in those areas. The employers facilitated that sense of team and utilized team building to grow that sense of commitment to the team. Lots of general nursing departments or other employment situations don't do a thing to promote that sense of team...individuals are expendable is the overarching and historic message.

I agree that the innocence of our early days of capitalist healthcare are long gone. We've proved beyond a doubt that our profit focused health system is broken and not sustainable nor effective and we must transition to single payer.

guest1152975 · Oct 3, 2021

On 9/9/2021 at 1:35 PM, DesiDani said:

I do. It will let the elephant in the room finally be noticed.

Medical reasons or not, why isn't that person removed from their post or at least placed in a noncontact role. That person can infect someone, or easily get infected by many if they work in a hospital. Sorry, but according to many HERE being unvaccinated is not good in a healthcare scenario. NO EXCEPTION! Perhaps short term disability would be best for this one coworker.

You can be vaccinated and infect someone.

toomuchbaloney · Oct 3, 2021

4 minutes ago, Beardedguy said:

You can be vaccinated and infect someone.

What's your point?

Everyone should vaccinate against this contagion asap.

guest1152975 · Oct 3, 2021

Just responding to a post, that's all. I didn't say they should or shouldn't. Someone stated a person should be removed for an unvaccinated status for risk of infecting others. The vaccinated can also infect. But my opinion is as good as yours. I think It's a personal choice, people shouldn't be forced into doing what they don't think is right.

MunoRN, RN · Oct 3, 2021

57 minutes ago, Beardedguy said:

Just responding to a post, that's all. I didn't say they should or shouldn't. Someone stated a person should be removed for an unvaccinated status for risk of infecting others. The vaccinated can also infect. But my opinion is as good as yours. I think It's a personal choice, people shouldn't be forced into doing what they don't think is right.

I don't know what that's supposed to imply, but it would seem to suggest that the vaccinated and unvaccinated are equally likely to spread Covid to others. That like seeing someone putting on their seat belt and saying "you know you can still die if you're wearing a seatbelt". Not necessarily inaccurate depending on how you interpret it, but also seems to imply it doesn't make a difference.

The Vaccinated Aren't ‘Just as Likely’ to Spread COVID - The Atlantic