CampyCamp

I can barely get my horses to take an entire tube. (Or the entire dose since some are too small for a whole tube) They tell me it's gross. ? I've been wondering what form people are taking then found out that my local Tractor Supply and family owned livestock shop are out of ALL internal forms- paste, sheep drench, and injectable. I didn't even look at the pour on stock since that's not what I needed. I hope people aren't trying that. I do suspect that much of the shortage is other animal owners panic buying. I hope so anyway. Regardless, when I did find the drench, price has gone up $10 for 8 Oz. The empty shelf at TSC also reflected that price increase.

I left the hospital in PA. I can't do another covid surge in the ICU. I took care of a lot of entitled people who were absolute jerks to staff last time. With so many of these people consciously refusing vaccinations, I expect more of the same. I feel bad for the nurses and innocent patients left behind. I always thought if this sort of thing happened, I'd be giving it my all until the end. But it's gone. I've already given it all. And been called rude names, harassed by patients pushing the call bell or throwing off their bipap to demand water v when they know the answer is no because they desat dangerously without bipap, and had patients call me a liar as I'm opening the intubation tray on their table. Done.

I work in my own state, usually close to home but I'm lucky to live in Pennsylvania where camps are plentiful. I started at the camp I was planning to send my daughter to and we had our first year together. I was a per diem ICU nurse and PALS instructor at the time. Later I took a school job to compliment my camp habit but I didn't love it. After camp this year, I'll be returning to peds home care. Currently, I'm at a one week only camp but if it was a full season, I know home care would still work since many cases are school based. (Of course, some are consistent year round and others like more nursing in Summer)

Hugs. I'm so glad that I happened to leave school last November for my mom's hospice care. However, last Spring, as cases rose in the hospital where I am hired for perdiem *pediatrics*, I started working in the short staffed adult ICU. I was an ICU nurse for 8 years and we did a lot of withdrawal and hepatic encephalopathy in my unit and I've NEVER been treated as badly as many times as I have in the last year by patients or family phone calls. I just want to "do my duty" and get to the other side of this pandemic, give the new grads the best start they can get despite them being cut off orientation prematurely, and never return.

I worked in a small rural hospital for a short period. 25 beds. No vent as such. But there was an OR and the CRNA could come in an intubate in an emergency. Periodically severe trauma patients and codes had to be stabilized before transport.

I'm just going to stick to one part of your question because the rest of the logistics seem tricky. You can give a vaccine that the pharmacist prepared. Nearly everything we give is something a pharmacist prepared. Meds in blister packs sorted into the pyxis or nursing home cart. Antibiotic piggybacks. In some hospitals I've worked in, prefilled injection syringes of Lantus or solu medrol or prefilled oral syringes of Tylenol calculated to a child's weight. Allergy shots at home. They are licences to dispense so we can give things they prepare. Nurses cannot dispense so likewise, we cannot give something another nurse prepares.

Are other hospitals seeing an increase lately in tension pneumothorax/ pbeumomediastinum? It seems like it's 1 in 4 ICU patients with these complications in the last 2-3 weeks. All ages and comorbidities (or lack of comorbidities) We're talking about steroids and barotrauma but we haven't changed dosing protocols or bipap/vent use since Summer. We didn't have these issues in Summer or fall. I hate this disease, it seems like there's always something new just as we start feeling like we can manage treatment.

Does anyone have recommendations for warm up jackets for middle aged ladies with thicker arms? XL jackets fit all in the torso but are so tight on the and that I have no room to push them up. They must be designed by the same people who design long sleeved clothing for target which don't fit my arms.

In 4 hospitals I've worked in, most intubations have been done by the residents or intensivist or anesthesia if they're unable. Respiratory does them if they need the numbers but in teaching hospitals, residents often need them more. The nurses draw up (confirming their calculations against the resident's) and push all the meds and have the necessary supplies ready to pass to the head.

So do we.

Backyard pools of any size and bicycles seem impossible to find now.

I hate PKUs. That's another thing where I used to be efficient but now I make a mess. I'm happy if I don't get any blood on the front/outside of the card or the baby's nose, LOL.

You'd think people would know this but it's obvious many people don't. I at least assumed college grads know it. Even those of us who graduated without doing any online research. My 8th grader just finished a unit on this topic for language arts!

I like assisting with any bedside procedures in ICU. I'm always pleased that I good at catheterization and NG/OG tubes from baby to elderly. I actually hate IV and phlebotomy sticks. I used to be good but once I started working in a high level ICU where nearly everyone had a line and the aides liked to to draws if they needed a cx, I lost all skill. I can't seem to get it back and dread every attempt. My aging eyes don't help. I guess this is why ICU nurses usually retire to PACU, LOL.

I feel like I don't remember the last time I had a patient interaction without a face shield.

I get 3-4 pts in med surg covid, 3 in progressive side of covid ICU and still 2 in the acute side. We have 1:1 only for CVVH. So, for the first time in my career, I don't care if they want me in MS. It's the least stressful place to be even with the baseline confused people and the total feeds. We might have an aide in any of those areas, we might not. We almost always have a clean runner in MS, always in ICU/PCU We are the RNs, aides, housekeepers, tray passers, RTs, PTs, and it seems, sometimes the doctors on MS since some seem to avoid the rooms and just observe the patient through the window while we work.

My unit has had kids 4 days in April. In the beginning there were some covid19+ kids, now there are none needing admission (hooray!) But there's nothing else either! We're floating to the maternity/nicu side of the service or to help out as "helping hands" on the floors or simply furloughed. I'm working ICU since I used to work there and another nurse is back on her med surg floor. I'm grateful for the experience to fall back on.

I've always been unworried about the microbes at work. This one has me scrubbing and wiping and everything. Thanks for what you do in the home. My mom is getting a nurse twice a week and I'm so grateful for her.

They can all find another job. Nobody is forcing them to be in a career that is on hold. Their mother is still forced to be their mother but maybe they don't care if they give it to her for her birthday party.

is there any discussion about dealing with the fit? A correctly fit tested mask feels effective at 7 AM but by 7 PM, my glasses are fogging and I can feel leaks at the side because the elastic stretches out even if it's only removed and replaced once.

New Zealand has a much better approach. (Obviously their geography helps) People are healthy and happy. Paid and fed. There are many articles about it. I have friends there and their experiences are night and day to ours.

I remember the MA1s and the Bears. I always thought the dials were easier to adjust than the buttons and touchscreens.

There are quite a few negative pressure vents in use. Very few iron lungs (a joke about bringing them out of storage just because residents want to try out all the order sets in the computer went around several months ago on gomer blog) but there are many people with chronic muscular disease using cuirass shells and soft wrap vents. I think the key there is muscular disease. They mimic the ventilation effect of chest expansion and the diaphragm but I don't think they recruit alveoli to enhance gas exchange like positive pressure vents. Intubation also helps manage secretions, keep the airway open if mental status changes, get medications deep into the lungs, and provide the doctor with a route to perform bronchoscopy.

I think areas that locked down before it started spreading are doing well. New York closed the barn door after the cows ran away. ...And the cows ran to their vacation home and relatives in PA, NJ, CT, so it spread here. (We're rural but the highway runs through the county)

I work at a 300 bed rural Pennsylvania hospital. We are being hit. They are floating med surg, OR, and peds staff to ICU to work as helping hands or take the least sick patients (no drips or vents) that has never happened, not in swine flu, not our major ECMO use flus, never. I have tripled, I have worked extra shifts, I have offered my first born to nurses to come in- but I have never seen non critical care nurses used in the units. I have not worked ICU in my current hospital, only low acuity family health services (maternity, peds, etc) ICU is starting to put me on the schedule because I wasn't getting enough hours in FHS. (Our covid kids have been stabilizing quickly and ready for DC in a couple days) Your actual question. I used to work in a city hospital, bedroom community to NYC. My friends there and my friends in the city are extremely busy. It's truly unprecedented. hospitals are pretty much as shown on TV (although the media does gloss over some great recovery stories and extubation celebrations) I even have a friend who is in a community health clinic and they are constantly seeing symptomatic patients and doing testing (he's one of my nurse friends who has been covid+, so far, all my nurse friends have done well)