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

[kbrn2002, ADN, RN]

1 hour ago, capitalsfan83 said:

I'm not at all surprised that half of our population doesn't want to be vaccinated. They simply don't trust our government and medical establishment. I remember when COVID vaccines were first developed our current Vice President said that she would never take it because they were developed under Trumps watch. Multiple left wing outlets repeated the same thing. Our so called medical experts seem to be advocating for constantly changing science from saying "no you don't need masks" to "you must wear masks" to "two masks are better than 1 mask".  We went from "14 days to flatten the curve" to lockdowns for almost a year.  Is it any wonder that people don't want to be vaccinated after all these lies?

 

12 minutes ago, heron said:

You clearly don’t have a clue about how the scientific process works.

Not really a comment that conveys understanding of the scientific process, but maybe it wasn't meant to be.  It is however a pretty accurate observation on the political climate that most lay people seem to believe in more than the science anyway.

That's a big problem in this country, probably is in other countries as well. People are listening to and relying on politicians and reporters for guidance instead of listening to the scientists who actually know what they are talking about.

All the conflicting directions and flip-flopping recommendations have people confused and after more than a year of it many people, way too many people appear to be over it and just are not going to follow any science backed recommendations no matter how sound.

[heron, ASN, RN]

1 hour ago, stevena9 said:

Exactly how did the comment above “clearly” demonstrate how the poster does not have a “clue how the scientific process works?” Nothing was mentioned in regard to the scientific process. What was mentioned is the hesitancy to get the vaccine due to being misled by the government multiple times. Again, there was no reference to the scientific process. You folks who have bought in like to use superfluous terms and phrases that you regurgitate from the media and the government two mask your pseudo-intellectualism. You are not that smart and you are scared, and deep down you know that, but you are too cowardly to do anything about it.

The varying recommendations over time reflect the ongoing data collection and revision of theories and thus the recommendations for prevention. They are not “lies” - they represent the best options given the available data at any given time. IOW scientific process at work. And, yes … the obsession with these “lies” reflects a fundamental  ignorance about the process of scientific investigation. With an infection as rapidly spreading and mutating as Covid, it would be unreasonable to expect the recommendations to stay unchanged from the beginning, especially given the dismal response of the public to any recommendations at all.

 

[capitalsfan83, BSN]

8 hours ago, toomuchbaloney said:

Covidiocy has all manner of people thinking that we can enjoy a fully open economy and educational system without achieving vaccine mediated herd immunity to this novel virus.  It's stunning really.  Listen to the White House press briefings and you will discover that those journalists apparently haven't realized that the level of disease spread is in control of all of that.  It's no wonder then, that they are almost completely unable to convey that fundamental message to the public...there will be no return to anything resembling pre-covid business or education until the pandemic is ended.  We are far from the end at this moment in time no matter how hopeful we were in the Spring.  Until the people living in denial, fear and fantasy vaccinate the country will suffer. 

Mainstream media, white house scientists and their followers seem to think that we can achieve a herd immunity for this virus.  With more data coming out recently you can tell that it's not going to happen.  There are a lot of reasons.  

1.  COVID is rapidly mutating and might render vaccines ineffective after several mutations

2. Vaccine effectiveness drops after 6 months

3. From latest data it appears that current vaccines do not prevent transmission. 

4. Uneven vaccine distribution throughout the world. There are simply not enough doses to vaccinate everybody in the world and with global travel coronavirus will just keep mutating and spreading. 

Thinking that vaccination will solve this problem is not smart. There needs to be a multiprong approach.  Vaccines, antivirals, monoclonal antibodies, and other therapies.  Pushing and mandating vaccines is going to have opposite effect on people that don't think they're safe and will only exacerbate this problem.   

[macawake, MSN]

7 hours ago, stevena9 said:

Did you seriously, actually mention the White House press briefings? I tried to refrain from commenting on this ridiculous thread. But your comment is just so asinine. You present yourself online as being all knowing and an authority, yet you refer to those who are the very root of the problem of all this.

What that  tells me is that a nursing site shouldn’t be the place for dissemination of dangerous Covid disinformation. 
 

---

https://www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19

 

7 hours ago, stevena9 said:

You folks who have bought in like to use superfluous terms and phrases that you regurgitate from the media and the government two mask your pseudo-intellectualism. You are not that smart and you are scared, and deep down you know that, but you are too cowardly to do anything about it.

Can you elaborate? Too scared and cowardly to do what exactly?

I realize that it’s popular in certain circles to try to denigrate nursing professionals who promote vaccines as blindly follow what ”MSM” tells them, but I can assure you that our information comes from scientific publications and other relevant healthcare and public health sources. We take that information, process it using the knowledge and education that we have. So no, it’s not media that has as convinced that vaccines are beneficial and save many lives. It’s the available data.

 

 

6 hours ago, capitalsfan83 said:

2. Vaccine effectiveness drops after 6 months

 

Really?

Drops by how much?

In which subgroups of the population?

Drops effectiveness against what specifically? (Asymptomatic disease? Symptomatic disease? Hospitalizations/severe disease? Death?)

A quality source to support your claim?

 

This is a nursing forum. Vague, unsubstantiated claims with ill-defined parameters have no value at all. 

[capitalsfan83, BSN]

5 minutes ago, macawake said:

Really?

Drops by how much?

In which subgroups of the population?

Effectiveness against what?

A quality source to support your claim?

From 96% to 84% over six months. 

https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v1

[capitalsfan83, BSN]

24 minutes ago, macawake said:

This is a nursing forum. Vague, unsubstantiated claims with ill-defined parameters have no value at all. 

Am I missing something?  I didn't exactly reply to your scientific paper with well defined parameters.  

Nursing scientist.  

[macawake, MSN]

38 minutes ago, capitalsfan83 said:

From 96% to 84% over six months. 

https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v1

Thank you for providing the source. I had read that. One of my pet peeves is people posting information and claims that are uncorroborated. When you make the claim that effectiveness drops after a certain time period, some posters might take that to mean that it dropped significantly and that the vaccines have no protective effect after six months. And we don’t want that, do we? 
 

The conclusion of the preprint that you linked was this:

”With up to six months of follow-up and despite a gradually declining trend in vaccine efficacy, BNT162b2 had a favorable safety profile and was highly efficacious in prevention COVID-19.”

 

We should all collectively be jumping for joy that we have access to vaccines that offer good protection. We always suspected that the vaccines wouldn’t offer lifelong protection and that we would need booster doses at some point. 
 

But are you saying that just because a vaccine that offers extremely good protection, appears to decline approximately 6% every two months, starting from a very high number (96%), then vaccinating isn’t a worthwhile effort? After all, the vaccine still offers very good protection, even after six months.

 

20 minutes ago, capitalsfan83 said:

Am I missing something?  I didn't exactly reply to your scientific paper with well defined parameters.  

Nursing scientist.

Yes. You are. But you corrected your omission by making a second post and providing the source which you based your claim on. As a scientist I’m sure that you agree that ”effectiveness drops” after six months leaves it open to people guessing how much it has dropped by, what that means and perhaps worry that they or people around them, no longer have any protection against the SARS-CoV-2 virus.

By not being precise your claims can be used by anti-vaxxers and might lead others to simply misinterpret what your claim means. So again, thank for providing the link so that people can read the details.

[capitalsfan83, BSN]

1 minute ago, macawake said:

But are you saying that just because a vaccine that offers extremely good protection, appears to decline approximately 6% every two months, starting from a very high number (96%), then vaccinating isn’t a worthwhile effort. After all, the vaccine still offers very good protection after six months.

If you read my post in context, you will see what I'm saying.  My whole point was that vaccination alone is not going to help us stop this pandemic, there are more things that we can and should be doing.  

[macawake, MSN]

19 minutes ago, capitalsfan83 said:

If you read my post in context, you will see what I'm saying.  My whole point was that vaccination alone is not going to help us stop this pandemic, there are more things that we can and should be doing.  

 

1 hour ago, capitalsfan83 said:

Thinking that vaccination will solve this problem is not smart. There needs to be a multiprong approach.  Vaccines, antivirals, monoclonal antibodies, and other therapies.  Pushing and mandating vaccines is going to have opposite effect on people that don't think they're safe and will only exacerbate this problem.   

Alright. I guess I’m wondering why you appear to think that posters think that vaccines alone is the solution? I know I don’t and I haven’t seen any others who do. Supporting vaccines never meant being opposed to finding effective treatments for those who become infected. It was never either, or. Vaccines is the major player in combating the pandemic and it is vital that as many people as possible get vaccinated globally, but they alone won’t suffice. We need to do more.

But I did notice that you only suggested treatment options and no other preventive measures or attempts to mitigate widespread transmission, apart from vaccines?  Do you think other measures; trace-and-test, distancing, limiting crowd sizes, masks etc., can play a role in keeping transmission down in specific circumstances? Are they measures worth taking or do you think we should just focus on treating those who become sick?  I know this isn’t really what we were talking about, I’m just curious about how your ”full pandemic strategy” looks like? 

[Horseshoe, BSN, RN]

I don't know where the OP lives, but I most certainly have not been subjected to ANY lockdowns, much less for over a year. Certain businesses had to close down or were regulated in how many people could come in at any given time, but at no time have I been "locked down". From day one I double masked (surgical masks) and went about my business. I went where and when I pleased. I had to; we had just bought a house and had begun remodeling it and it was uninhabitable. I had no choice but to continue with the process of looking at and selecting flooring, tile, bathroom fixtures, lighting, door handles, and on and on and on. I met with contractors on site, masked and maintaining way over a six foot distance. I went grocery shopping, to the doctor, etc. If it was open, I went. I saw friends outside and masked. My husband and I went out to eat at outdoor establishments at distances properly maintained by the restaurants. I went on walks and rode my bike in good weather. I was never told I couldn't leave my house or prevented from going anywhere by authorities.

My friend's son lives in France, and he WAS subjected to curfews and lockdowns. Didn't happen where I live.

I know a lot of us are weary of COVID. I get tired of thinking about it, but it's clearly not going away soon, so it's going to remain an awful reality for the foreseeable future.

 

 

 

[iNurs5, CNA]

I wonder what people think of condoms and birth control pills. Those aren't 100% effective either.  

Take care everyone with this covid. This virus is something else. It can survive in body temperature and beyond, think about it.

[iNurs5, CNA]

5 hours ago, capitalsfan83 said:

From 96% to 84% over six months. 

https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v1

That's better than zero.