I'm Out... (Cue Mic Drop)

[J.Adderton]

In my home state of Alabama, only 33% of residents are fully vaccinated against COVID-19.  The state's healthcare workers are feeling a punch to the gut as new coronavirus cases have climbed 574% over a short period of time.  Fueled by the delta variant, the state's hospitalization rate has tripled in a few short weeks.  I echo the words of many in the medical community by saying "I don't know if I can do this again".

Universally Affected

I work in a hospital, but not on a unit that provides direct care to COVID-19 positive patients. Earlier in the pandemic, I felt guilty whenever burn out began to creep in.  I often thought "Shouldn't burn out be reserved for those caring for COVID patients day after day?”  Today, Alabama's new daily case rate mimics the same numbers as 12 months ago.  And, I now realize everyone working in healthcare has been affected both personally and professionally by coronavirus.  What led up to my own professional mic drop moment?

• Caring for patients with devastating long hauler syndrome
• Maintaining a high standard of care without adequate staffing, supplies and other resources
• Working routine overtime because of your own personal responsibility to support your peers
• Facing the words "there is no one", "you'll have to make do" and "you have no choice" when asking the house supervisor for additional help
• No pay increase in the past 18 months
• Hope that disappears when large numbers of new hires resign within the first 4 weeks
• Frequent floating with high nurse patient ratios
• Alarming number of rapid response calls and code blues

Nurses are only  part of an exhausted healthcare community.  We are joined by food and environmental services, respiratory therapists, pharmacists, physicians, nursing assistants, patient services... and the list goes on.

Public Pleas

A string of public pleas have been issued throughout the state, imploring the unvaccinated to seek vaccination.  The frustration is almost palpable in each plea.

Governor's Harsh Words

Alabama Governor Kay Ivey had harsh words for the state's unvaccinated, stating "these folks are choosing a horrible lifestyle of self-inflicted pain".  Ivey went on to blame the state's unvaccinated population for the rising coronavirus cases.

Quote

"But it's time to start blaming the unvaccinated folks, not the regular folks.  It's the unvaccinated folks that are letting us down”- Governor Kay Ivey

Alabama received billions in relief funds as part of the stimulus package passed the year.  However, the state is not using the federal relief for incentive programs like scholarships and lotteries.  According to the National Governors Association, Alabama is offering a few small incentives: 

• The Talladega Superspeedway is offering the opportunity to drive 2 laps behind a pace car for being tested and/or vaccinated.
• The Alabama Department of Public Health is sponsoring a TikTok contest to encourage vaccination before the start of the new school year.  Four winners will be selected and each will receive a $250 Visa gift card.

Doctor's Emotional Plea

Dr. Brytney Cobia, a hospitalist at Grandview Medical Center in Birmingham, Alabama, posted an emotional plea for vaccination on facebook that has made news across the U.S.  Cobia wrote the post after caring for young healthy patients with very serious COVID infections. She describes patients begging for the vaccine right before they are intubated.  She writes, "I hold their hand and tell them that I'm sorry, but it's too late".  You can read Dr. Cobia's full post here.

Tuskegee Tragedy Lingers

Many Black Alabamians have a deep seeded mistrust of the medical community stemming from the Study of Untreated Syphilis in the Negro Male. In 1932, the U.S. Public Health Service recruited hundreds of rural Black men to participate in a syphilis study, but never explained that the study was designed to withhold medical treatment.  Study participants were not injected with syphilis, but those who had it were not treated, even when penicillin was available.  The suffering caused by the unethical study still echoes today, despite federal laws that prohibit this from occurring again.  This tragedy contributes to vaccination hesitancy within the state.

Mounting Personal Toll

I'm not alone in questioning my ability to withstand another COVID-19 surge in my current nursing position.  Healthcare workers are experiencing burn-out in high numbers and reporting significant psychological distress. Many are responding to the stress and trauma by misusing alcohol and other substances.  It's time for professional organizations and the healthcare industry to do more to support workers moving forward. 

What About You?

Are you considering a mic-drop departure from your workplace?  What do you need to reverse your burn-out?

---

References

In Tuskegee, Painful History Shadows Efforts To Vaccinate African Americans

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

I am starting MSN immediately after BSN - in September! I'm almost done with BSN- 2 weeks to go!

Theoretically, I could quit, but I'm not there (yet). Dropping to part time, though, I do need health insurance for my 2 kids, and husband enrolling thru his work is more expensive. Also, I still want tuition reimbursement ( 3K/year for part timer). 

[martymoose, BSN, RN]

{quote]

Caring for patients with devastating long hauler syndrome

Maintaining a high standard of care without adequate staffing, supplies and other resources

Working routine overtime because of your own personal responsibility to support your peers

Facing the words “there is no one”, “you’ll have to make do” and “you have no choice” when asking the house supervisor for additional help

No pay increase in the past 18 months

Hope that disappears when large numbers of new hires resign within the first 4 weeks

Frequent floating with high nurse patient ratios

Alarming number of rapid response calls and code blues [/quote]

I'm with you on this .  my place got rid of a float pool 2 yrs ago. Everyone's leaving. People floated each shift Robbing Peter to pay Paul If I wanted to float Id join a float pool!! It makes me so angry that they use us to fill the holes, while making our own floor short and stressed, which leads to more quitting. 

We have a few travelers. Most do not return - they say the ratios are ridiculous.

Many of the people leaving are going to travelling- if I have to float, might as well get paid for it!!

[Wuzzie]

On Monday I did an assignment that normally takes 6 nurses. I. Have. No. Words.

[toomuchbaloney]

3 minutes ago, Wuzzie said:

On Monday I did an assignment that normally takes 6 nurses. I. Have. No. Words.

A pandemic of the unvaccinated. They deserve a thank you. 

[Horseshoe, BSN, RN]

54 minutes ago, Wuzzie said:

On Monday I did an assignment that normally takes 6 nurses. I. Have. No. Words.

Wow. I can't even imagine. I haven't missed hospital nursing for even a moment since I left it.

[SmilingBluEyes]

My worry turns to non-COVID patients. Where do they fit in, now?

[toomuchbaloney]

8 minutes ago, SmilingBluEyes said:

My worry turns to non-COVID patients. Where do they fit in, now?

I wonder if the unvaccinated care about that, really...it seems their concern is mostly involved with their fears and their interpretation of individual rights or freedoms.  It appears that they feel that they have a right to overwhelm the hospital systems of the country. They won't worry about that until they require something. The unvaccinated don't like to be inconvenienced. 

[SmilingBluEyes]

51 minutes ago, toomuchbaloney said:

I wonder if the unvaccinated care about that, really...it seems their concern is mostly involved with their fears and their interpretation of individual rights or freedoms.  It appears that they feel that they have a right to overwhelm the hospital systems of the country. They won't worry about that until they require something. The unvaccinated don't like to be inconvenienced. 

They don't care. But I do. My grandson is in the hospital right now and this worries me to death.

[turtlesRcool]

23 hours ago, toomuchbaloney said:

I wonder if the unvaccinated care about that, really...it seems their concern is mostly involved with their fears and their interpretation of individual rights or freedoms.  It appears that they feel that they have a right to overwhelm the hospital systems of the country. They won't worry about that until they require something. The unvaccinated don't like to be inconvenienced. 

I understand the anger and frustration behind the sentiment, but think this might be a bit too simplistic. I don't think the unvaccinated think they're going to overwhelm the hospital systems. Many of them don't think they're going to even need the hospital system. A few perspectives:

1) COVID isn't real. It's all been made up and manipulated by the evil politicians and lying media. Can't get sick from an imaginary disease, so they'll never need the hospital.  

2) COVID is real, and people do get sick, but not them. It's for the old people. The sick people. They are young or healthy or work out or eat well. Their immune system will see them through.  If they get it, it will be like the flu or a cold, and they won't need a doctor.

2A) They live in a rural area, and don't come into contact with many people, so their chances of catching COVID are small. They can always get it later.  Why get vaccinated when the odds of catching COVID are so small to start? They won't need a hospital, if they never get COVID.

3) COVID is real, people get sick, and they might get sick, too, but the vaccine is more dangerous. It was either developed too fast or is a big conspiracy to harm them. It's going to alter their DNA, make them infertile, implant a microchip, make them magnetic...whatever the misinformation of the day is. Some simply lack the health literacy to understand the process by which the vaccines were actually developed and how they work. Last night my brother told me about someone he knows who won't get vaccinated because the vaccines were developed too quickly. Her brother died of COVID, so she understands it's a serious disease, but her fear of the vaccine is greater.

Also, there are many people who are unvaccinated as a result of well-founded historic mistrust of the government and health systems (they're usually black or POC). There are others on the knife's edge of getting by, and taking the time to get vaccinated and possibly missing a day or two of work to recover would have devastating consequences for their families. And of course, there are those who cannot or should not be vaccinated due to their medical history. Oh, and children - about 50 million of them are too young for the vaccine, and others aged 12-17 can't get vaccinated because their parents are opposed.

The unvaccinated are not a monolith. Some undoubtably are selfish, but others are simply hesitant. Many of them can be reached, but only by addressing whatever is their particular barrier to vaccination. Right now we're seeing an uptick in vaccinations as the spread of Delta changes people's perception of COVID's ferocity. When COVID seems more dangerous than the vaccine, more people will get vaccinated.

[toomuchbaloney]

12 minutes ago, turtlesRcool said:

I understand the anger and frustration behind the sentiment, but think this might be a bit too simplistic. I don't think the unvaccinated think they're going to overwhelm the hospital systems. Many of them don't think they're going to even need the hospital system. A few perspectives:

1) COVID isn't real. It's all been made up and manipulated by the evil politicians and lying media. Can't get sick from an imaginary disease, so they'll never need the hospital.  

2) COVID is real, and people do get sick, but not them. It's for the old people. The sick people. They are young or healthy or work out or eat well. Their immune system will see them through.  If they get it, it will be like the flu or a cold, and they won't need a doctor.

2A) They live in a rural area, and don't come into contact with many people, so their chances of catching COVID are small. They can always get it later.  Why get vaccinated when the odds of catching COVID are so small to start? They won't need a hospital, if they never get COVID.

3) COVID is real, people get sick, and they might get sick, too, but the vaccine is more dangerous. It was either developed too fast or is a big conspiracy to harm them. It's going to alter their DNA, make them infertile, implant a microchip, make them magnetic...whatever the misinformation of the day is. Some simply lack the health literacy to understand the process by which the vaccines were actually developed and how they work. Last night my brother told me about someone he knows who won't get vaccinated because the vaccines were developed too quickly. Her brother died of COVID, so she understands it's a serious disease, but her fear of the vaccine is greater.

Also, there are many people who are unvaccinated as a result of well-founded historic mistrust of the government and health systems (they're usually black or POC). There are others on the knife's edge of getting by, and taking the time to get vaccinated and possibly missing a day or two of work to recover would have devastating consequences for their families. And of course, there are those who cannot or should not be vaccinated due to their medical history. Oh, and children - about 50 million of them are too young for the vaccine, and others aged 12-17 can't get vaccinated because their parents are opposed.

The unvaccinated are not a monolith. Some undoubtably are selfish, but others are simply hesitant. Many of them can be reached, but only by addressing whatever is their particular barrier to vaccination. Right now we're seeing an uptick in vaccinations as the spread of Delta changes people's perception of COVID's ferocity. When COVID seems more dangerous than the vaccine, more people will get vaccinated.

The unvaccinated coming to AN to share their fear based rationale for not vaccinating are largely white political conservatives.  Their reasoning is deeply flawed and dangerous.  They aren't here looking for information.  They are here spreading misinformation and fear.  Their delusions are dangerous.

[turtlesRcool]

1 minute ago, toomuchbaloney said:

The unvaccinated coming to AN to share their fear based rationale for not vaccinating are largely white political conservatives.  Their reasoning is deeply flawed and dangerous.  They aren't here looking for information.  They are here spreading misinformation and fear.  Their delusions are dangerous.

I agree.  But I also maintain they don't think they are going to overwhelm the hospital because they don't think they're going to get sick.  It's not reality based.

[toomuchbaloney]

3 minutes ago, turtlesRcool said:

I agree.  But I also maintain they don't think they are going to overwhelm the hospital because they don't think they're going to get sick.  It's not reality based.

Like I said...the majority of those fools who come to share covid propaganda on AN are functioning in a delusion.  It's likely that they suffer from gullibility in other areas of their lives as well.  They don't think...at least not critically...about or through any of this science.  They are lead by their feelings and beliefs rather than facts and evidence. Much of their politically influenced thinking is not reality based...it's narrowly informed and emotional founded.