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Article Contest - The New Normal: What Do You Think It Will Look Like?

MunoRN RN

Critical Care
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MunoRN has 10 years experience as a RN and specializes in Critical Care.

MunoRN's Latest Activity

  1. MunoRN

    RN Disciplined While Waiting On Covid 19 Result

    MunoRN replied to INDY RN's topic in Disasters

    As I said earlier, I'm all for complaining about how sick days normally work, including that I get an "occurrence" for a sick day even though it's employee health that says I can't work given certain symptoms, and that these rules should be relaxed for now, but an occurrence isn't itself "discipline" as the OP claimed, it's a record of absences that could result in discipline depending on the circumstances, so it's misleading to claim that they were disciplined, and exaggerated and misleading complaints work against us when it comes to less misrepresented concerns, like appropriate PPE. When I press for more appropriate PPE (and yes, this is as a bedside nurse, I didn't realize I'm seen as such a prick) it doesn't help if we've allowed for the impression that we often exaggerate our complaints and arguments, that just means I'm stuck wearing crappy masks into a Covid room, which argue is a bigger deal than sick-time policies. But I do agree with you on one thing, that's enough of this for me.
  2. MunoRN

    "Warm Weather Will Slow the Virus" and Other Bad Advice

    MunoRN replied to SafetyNurse1968's topic in Disasters

    I get it, it's not particularly true on it's face that viruses have membranes since viruses can't actually make their own membranes, they steal it from a living cell.
  3. MunoRN

    "Warm Weather Will Slow the Virus" and Other Bad Advice

    MunoRN replied to SafetyNurse1968's topic in Disasters

    It's not common to all viruses, but enveloped viruses have a membrane, granted it's stolen from their host cell, but it's still a lipid bilayer membrane, Covid-19 is an enveloped virus. I assume you're disagreeing with this based on some sort of semantics argument? https://www.ncbi.nlm.nih.gov/pubmed/16361349 https://virologyj.biomedcentral.com/articles/10.1186/s12985-019-1182-0
  4. MunoRN

    "Warm Weather Will Slow the Virus" and Other Bad Advice

    MunoRN replied to SafetyNurse1968's topic in Disasters

    Are you saying it's a myth that viruses don't have membranes or that they do?
  5. MunoRN

    RN Disciplined While Waiting On Covid 19 Result

    MunoRN replied to INDY RN's topic in Disasters

    It's the same "occurrence" that one gets for any excused absence at every place I've worked, it's not specific to missing work due to a Covid exposure. It's certainly reasonable to debate whether an "occurrence" is a reasonable label for a sick day and whether it could be construed to be a disciplinary measure, but it doesn't appear that this was a punishment specific to a Covid exposure, it's just what happens when you can't be at work due to a health reason.
  6. MunoRN
    There's no definitive list of "aerosol generating procedures" because there's no evidence to support the definition, none, zilch, nada. It makes more sense to consider potential sources of aerosolized droplets as a whole and refer to them as potential aerosol generating events, which includes coughing, sneezing, talking, and even just breathing. There's no basis for utilizing a different level of protection for any of these procedures than for a patient not undergoing these procedures, but is breathing, talking, coughing, etc.
  7. MunoRN
    I saw that repeated in various new stories today as well, but it should be noted that the study didn't actually find that it can remain in the air for several hours, they postulated that with small enough droplets (droplets too small to keep a virus viable) and with the right airflow a near evaporated droplet could remain in the air for several hours. I think people put too much faith in the "6 feet" distance, there's never been any evidence that droplets aerosolized by a cough, sneeze, talking, or breathing are limited to 6 feet of flight, it's dependent on the size of the droplets and airflow characteristics. Although aerosolized droplets at least don't have the travelling capabilities of true airborne particles, which can land on a surface and then easily become suspended in the air again when brushed up into the air by walking, setting something on a surface, etc.
  8. MunoRN

    RN Disciplined While Waiting On Covid 19 Result

    MunoRN replied to INDY RN's topic in Disasters

    Describing the application of normal excused time off procedures as being "disciplined" isn't really accurate. What the OP describes is how normal illness call-offs work at every place I've worked, whether or not how the normal system works is fair or not is certainly a valid argument, but it's not particularly honest to call it being "disciplined". I certainly agree that employers should be more sympathetic to nurses, or any staff for that matter, than can't work due to a potential COVID infection, but I don't think adding sensationalism helps.
  9. MunoRN

    Using Med Surg nurses in the ICU covid unit

    MunoRN replied to KellyRN86's topic in Disasters

    I haven't had any reason to complain about this arrangement. As you point out, you would be going from 12 to 18 nurses, and while these nurses can't do all of the 'ICU-level' stuff, most of what takes our time are things a floor nurse can do, these nurses are probably more capable in the ICU than you assume.
  10. MunoRN

    A COVID-19 Dilemma:  Where are all the PPEs?

    MunoRN replied to tnbutterfly - Mary's topic in Disasters

    To clarify , the CDC has never lowered their recommendations to anything other than respiratory level respiratory protection; N95 or higher which includes PAPR and other HEPA level filtration is still the recommended level of respiratory protection.
  11. MunoRN

    Acute COVID, What We're Seeing

    MunoRN replied to MunoRN's topic in Disasters

    We're utilizing RN and other staff of all backgrounds, some of it's more of 'busy-work', but there's plenty of things that need done. Our outpatient clinic and procedural staff are given the choice of staying out and using PTO as low census, or we can find things to keep them busy.
  12. MunoRN

    COVID-19 and extinction of human species

    MunoRN replied to DannyBoy8's topic in Disasters

    China only included symptomatic cases in their CFR calculations because that's what a CFR is, asymptomatic presumed cases are included in the IFR not the CFR. Like all CDR data, we consider it in the context of the reliability of the data, China's CFR data for instance is considered in the context that they're reported total deaths appears to be about a tenth of it's actual deaths. I assume your scolding at the end is misstated or that your mistakenly forgot to add that a CFR calculation must be considered in the context of the reliability of the data that went into the calculation, this is just as true now as it is a year out from a pandemic. All data has limitations based on the data that went into it, that doesn't mean we don't calculate the data, we just consider how to view the data based on the context. A CFR of 1% for instance might be far more concerning than a CFR of 10% for instance; if the CFR of 10% was based on a total number of cases in the US of 100 over the course of a year, whereas the CFR of 1% came from a rapidly spreading pathogen that affects half the population and 1% of cases have already died when most of the cases have not yet reached the stage of the course of the illness where death is likely to occur. It of course would be absurd not to analyze CFR data very early in an evolving pandemic, even though this data might bear little resemblance to the data we'll have long after the pandemic is over. This is the data that drives containment measures, which is far more useful than the much more reliable data we get after it's all over.
  13. MunoRN
    The OSBN's answer to the question you pose in the beginning is quite clear from their statements, they do not expect nurses to work without the PPE recommended by the OHA. I don't know who these "other nurse attorneys" are that you're having conversations with, but I would suggest finding a more informed peer group.
  14. MunoRN

    Does Having More Ventilators Even Help?

    MunoRN replied to Randomkindness's topic in Disasters

    There is certainly a subset of patients who may benefit from being on a vent, but no, not all patients who require a vent will benefit from one and we have enough data at this point to know who those patients are. And no, prolonging a non-survivable dying process is not a benefit of putting someone on a vent.
  15. MunoRN

    Does Having More Ventilators Even Help?

    MunoRN replied to Randomkindness's topic in Disasters

    I think more importantly there is the question how many patients can be saved with a ventilator. The number of patients who need a ventilator and the number who would benefit from a ventilator are two very different things. As the criteria that predicts mortality is becoming more clear, I don't think the answer is more ventilators, it's more palliative care consults.
  16. MunoRN
    Don't shoot the messenger on this one, I'm probably as skeptical of any suggestion that Covid-19 isn't anything other than highly transmissible as any of you, but there are surprises in the data we have so far. And coming from Atul Gawande adds some credibility for me at least. The take away is that while Covid will gladly take advantage of any opening it can to spread, it may not take as much to close those openings as we think. When it comes to Covid, less might be more. Keeping the Coronavirus From Infecting Health Care Workers by Atul Gawande, the New Yorker - https://www.newyorker.com/news/news-desk/keeping-the-coronavirus-from-infecting-health-care-workers
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