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  1. There are conflicting reports. The CDC doesn't say it's airborne yet there was some Chinese research that says it is. Bill DiBlasio in his latest update said that if someone infected is in a room and leaves the virus is not going to be in the air. But I noticed how he said an hour. What about 2 minutes? What about 10 minutes. Can the droplets be semi-airborne. Somebody gets on a small elevator whose infected and is coughing. Then they leave. A minute later you walk in and there's no one in there. Could you get it from the air? It seems to be unknown. Yes most of those cough droplets fell to the floor (or wall) but are there some tinier ones still in the air for a minuter or two?
  2. Tiff.jenn.the.RN

    To be a coward, or to be a fool?

    My Dream Job as a New ICU Nurse I have always known that I was meant to be an ICU nurse. Call it intuition, divine planning, or blind ambition. Since I was a child, my dream was to heal the sick, to protect those too weak to protect themselves, and to nurture those in their most vulnerable states. From the moment I enrolled in nursing school, I knew that the ICU was the place I would call my home. No other fields ever interested me; I wanted to care for the "sickest of the sick." Every decision I made in school and during my first year as a nurse, came from an unshakeable need to land a position in the ICU. After pushing myself to the brink of insanity to keep the highest GPA in my graduating class, accepting a new-graduate position on a medical stepdown-ICU, and putting in countless hours of overtime and continuing critical care education, every sacrifice I had made up to that point paid off. I landed my dream job: a position as a Medical-ICU nurse. I had never in my life felt the sense of purpose, belonging, or fulfillment that I felt as I navigated my way through the first few weeks and fell into a rhythm on my new floor. Unprepared and Unprotected It's surreal to me, that this was only a few months ago, in November of 2019, when I felt so elated. In a month that has felt like a decade, my life as an ICU nurse has come to include only 2 realities: walking unprepared and unprotected into a warzone of death and isolation, and hiding in my home, for fear of infecting those I love the most with the very disease I'm fighting so hard against (COVID-19). Where I once felt excitement and purpose, I now feel hopelessness and defeat. I spend my waking hours trying to decide if it's better to be the coward who deserts her comrades on the battlefield, or the hard-headed, idealistic fool who goes down with a sinking ship in the name of duty. As the US assumes the title of "new COVID-19 Epicenter," I can't see a third, "preferable" choice for myself. By now, the internet is flooded with nurses' testimonials, showing photos and videos of the unbelievable lack of resources and protection we have as we care for an escalating number of COVID patients. In one week, my hospital went from having 2 COVID quarantine units, to 6, with even more projected to be converted. My floor itself is not a designated unit, but each of us is sent to the critical COVID unit, at least once a week. This upcoming week will be my third week in a row using the same N95 mask; I was lucky enough to get a new face shield last week, as mine was so beat-up that it finally broke. Last week, my mask didn't even fit to my face, because the elastic straps are so thinly stretched. I have been praying that it lasts me through another shift, because we're just about out. Someone stole almost all the boxes of masks. Skepticism and Mistrust In the blink of an eye, my naivety has been replaced by skepticism and outright mistrust; I cannot believe for a second that the measures we as nurses are being forced to take while we care for infected patients, are remotely safe. We aren't protected; we know we aren't protected; we're offended and resentful over being told that we are protected. ICU nurses are quick thinkers. We know that what we're being told about our protective equipment is a desperate quality control measure, designed to prevent a panic. Unexpected and Unprotected Exposure I had to get tested last week, as well. Our whole floor got exposed, unknowingly, for a solid 6-8 hours. ICU is all about priorities, right? A patient comes in for a cardiac arrest, we're working on keeping him/her alive, and dealing with extraneous issues later. When a patient is crashing, we're also all in the room, helping each other out, working as a single well-oiled machine. Unfortunately for us, after an admission was sent up from the ED without being tested, we learned that this particular patient was from a "hot spot" county, and had been presenting with all the cardinal COVID symptoms for the past week. I can't explain how it felt to hear my child sob when I told him that I couldn't pick him up for a few more days, because I might have the virus that was making everyone so sick, and I couldn't get close to him until I found out for sure. I felt unspeakable shame, like the most selfish human on the planet, for being so devoted to my "dream job." I sat all alone at my house for 4 days, crying and hating myself for becoming a nurse, until the test came back negative. Fear and Guilt Even after my negative test, I still feel the same nauseating fear and guilt, every waking moment. I can't sleep, and the few hours of sleep I have gotten, have been plagued by pandemic nightmares. The fear follows me everywhere I go, sometimes nagging in the back of my mind, sometimes churning in my gut. It's the same questions, every time: "How long before I'm infected? How do I tell my kid that I won't be coming home for a while, and he can't see me, because I'm so sick that it isn't safe? What if I pass it to my dad, who has been the only person I've allowed to keep my kid since this whole thing started? What if he, the man who devoted his whole life to raising, supporting, and protecting me, spends the last days of his life on a ventilator, alone, with no one to hold his hand and pray with him...because of me?" At these times, it seems impossible to set foot back in my hospital. Then, I think about my patients. These patients are living my worst fears. They're unable to be at home with their loved ones, for weeks. If they're sick enough, they can't even talk to their families, because they won't last without a mask...or a tube. They're fighting for their lives, while we have to update their grief-stricken families over the phone, and tell them that they can't visit and be with them at their most critical hour. For these patients, we nurses are the only human contact they get. For the ones who inevitably will not survive, our voices are the last that they hear. Our hands are the last that touch them. Our prayers may be the last said for them, and our tears may be the last shed for them before they leave this world. When I think about the horror these patients and their families are facing, I can't imagine not showing up for my next shift. No Answers - No Happy Ending As much as I'd like to believe the hopeful messages that this pandemic will soon pass and our society will again be safe and free, I don't see it. With everything in me, I don't see it. Never in a lifetime would I have guessed when I became a nurse, that it would mean putting my own life and the lives of those who I love the most at risk, to save the lives of others. I have asked seasoned nurses for an answer, and the answer I've come to is that there's no answer. There's no happy ending. Those of us who have chosen to walk away, have done their best; those of us who have stayed, are doing our best. Unfortunately, right now, the best we can do is nowhere close to enough to protect ourselves and those around us. For the time being, I will keep fighting the outward battle at the hospital against the pandemic for my patients. All the while, I'll keep silently fighting my own internal battle, until I figure out if it's better for me to be a coward and leave, or to be a fool and stay.
  3. Linda Mellace Rice

    Birth Doesn't Wait

    For better or worse Birth doesn’t wait. Not for traffic, birthdays, baby showers. Not for other deliveries. And certainly not for good times. In 21 years as a midwife, I’ve witnessed pregnancy proceed through desertion by spouses, death of loved ones, job losses, homelessness, and yes through pandemics. Its never-ending persistence is both tragedy and hope. Obstetrics is kind of a weird specialty We tend to be in a bubble from the rest of the hospital, yet everything passes through. Disease, accidents, grief, abuse and all of life and medicine don’t pause for pregnancy. And, midwifery is somewhere between medicine and art. It’s the only job in the hospital where most of the time I have a duty to actively do nothing. To honor the wisdom of the body, and protect the ancient process from outside influence while also minimizing risk. It’s normally a tightrope that hospital-based midwives walk gingerly. Since Corona, I feel the tightrope snapping. Birth is above else a letting go The less safe a woman feels, the less her body is able to toil through the work of labor. Worry is always part of the price of parenthood. When women tell me they’re worried about being a good mom, or worried that something will go wrong, after listening to their concerns and making sure they don’t have real anxiety, I reassure them that worrying is how I know they will make good mothers. It is our mother bear instinct that made me, a woman who handles babies for a living, worry about dropping my newborn son as I carried him up the stairs. The normal worry of motherhood is work enough My first rule for my patients is not what they eat or how much they lift, it’s “no googling”. I started as a labor and delivery nurse in 1989, and too much information, especially bad information, always caused more angst than it was worth. Back in the early nineties, the culprits of this excess of data was your mom, your co-workers, or your aunt Linda. As I’ve told my patients, in 21 years of midwifery, not one woman, according to her coworkers, has ever been the correct size. Most are “huge”, some are too small, but I’ve never had a woman tell me, “you know everyone tells me I look perfect for my gestational age”. However, the more modern barrage of internet experts and social media opinions makes for plenty of crazy. It's all about Covid Now we’re faced with many women home, on devices or TV, and it’s all Covid, all the time. And after 21 years of saying, no, the media, or web MD, or aunt Karen is blowing the risk way out of proportion, I now have to say, this time it’s real. If a pregnant woman becomes infected, she knows what the worst case scenario is. The thing about this epidemic is, even the best case scenario is somewhat dismal. Much of it has to do with the environment of birth which has suddenly shifted under our feet. For the first time, women may have limited or no support persons with them in labor. Family that was supposed to come help with other children are now quarantined in other locations. Women that were just visiting are now stranded here away from home, family, and their own healthcare providers. Women who test positive are told they must be separated from their newborns. I know many of us are postponing life events. As heartbreaking as it is to postpone a wedding, graduation, or vacation, birth doesn’t wait. For most of us, the most significant event in our life can no longer be shared by fathers, wives, or grandmothers. The missed, precious first few days of our children’s life can never be recaptured. Difficult decisions Both pregnant women and health care providers are left with agonizing decisions. Should we cut down on prenatal care? If she has abdominal pain, which 99% of the time is normal and 1% is perilous, does she come to the hospital? And then there are the women who have the virus. Everyone else who has mild symptoms is being told to stay home, but birth won’t wait. As the rest of the hospital is organizing around the epidemic, separating into “corona” wards, labor and delivery continues to pulse through the rhythms of labor, birth, complications, and cesarean sections, whether we have an isolation room or not. Like the rest of healthcare, like the rest of the world, we grapple with questions which have yet to be answered. What happens when our first patient goes on a ventilator? Who takes care of the baby after? The mothers who test positive are being separated from their infants, but by definition, aren’t their other family members at risk for being carriers? I sat with a patient to take her history, and for the first time in my career, instead of shaking her hand or giving her a reassuring pat on the shoulder, I sat on the other side of the room. We weren’t wearing masks yet for symptom-free women, because we didn’t have enough. She was alone, had the trepidation of any first-time mom, and instead of getting a midwife, a word that literally means “with woman”, she got a bank teller. This is not our first pandemic ... ... and won’t be our last. Birth doesn’t wait. Not until we have enough masks, not until we have enough nurses, and not until we feel safe to take our infants home. It won’t wait until your husband can share it with you, or until your mother can help you at home. It has persisted through war, slavery, and poverty and disease. Birth is humanity persevering from our ancestors to our grandchildren. Birth is hope when we feel hopeless.
  4. The Coronavirus continues to be the focus of the world as the deadly virus continues to ravage countries and states around the globe. At the beginning of March, just 70 confirmed cases had been reported in the United States. As of this morning, March 27, at least 85,284 people in 50 states, Washington, D.C., and three U. S. territories have tested positive for COVID-19, according to a New York Times database. There have been at least 1,270 Coronavirus deaths. The United States is now the epicenter of the Pandemic. The rapidly-moving virus has wreaked havoc on and disrupted daily life for everyone. Terms like social distancing, sheltering in place, flattening the curve, self-quarantine, N95 and PPE shortage have become commonplace terms for the public and healthcare professionals alike. Watching the news to see the latest stats has become a habit. No one knows this more than the nurses, doctors, and other healthcare professionals who are on the front line of this war we are waging against a formidable opponent. You are the ones who put your life at risk every day on the job as you care for Coronavirus patients. You are the loyal soldiers fighting the war, but you are having to do it without adequate protection. Those who participated in our first survey shared how unprepared they felt. That was 2 weeks ago. Much has happened in the past 14 days. In this survey, you will have the opportunity to share even more information about how things are going in your area of the country. Please take this survey so we can see how nurses from around the globe feel regarding the growing threat to public health and your role in this continually evolving chapter in history. After taking the survey, please return here and share comments and questions. Let us know what things you would like us to include in future surveys. We are having a Coronavirus Article Contest. We would love to hear more about your personal story. Direct link to survey: https://www.surveymonkey.com/r/HH5MWLW
  5. Read article in its entirety: Quarantined Nurse's Scorching Anti-CDC Rant Goes Viral: 'I'm Appalled at the Level of Bureaucracy' on Coronavirus Testing
  6. This article contest will be different than the others we've had in the past. Instead of cash, we are going to give away gift cards to restaurants to the top 3 winners so you can have a break from cooking by picking up food instead. Some of these articles may be featured in our upcoming magazine. Get your article in today for a chance to be featured in the magazine. The winners will be selected by the members in a poll. The top 3 winners will split the $300 prize. We want to encourage you to share your story of what is going on in your life now...how you are coping with the constantly changing protocols that COVID-19 is creating. We know you are having to deal with many shortages and are risking your own safety to care for patients. We thank you!! The topics for your article can be about anything as long as it is about COVID-19... how this is altering your life - emotionally, educational, physically, etc. Here are a few suggestions for topics: Fear Anxiety Paranoia Financial worries Graduation delayed Clinicals canceled NCLEX delayed Nursing programs closed Have you tested positive for and become ill with the COVID-19? Are you in a high-risk group? School closings/children at home Lack of childcare Social isolation Who Can Enter This contest is open to all. You don't have to be an experienced writer. This is open to nurses and students. We all have our own Coronavirus stories to tell... Please share yours with us. Rules of Submission We are so glad you wish to submit an article. Here are the rules of submission: Article tone and content must comply with our rules and Terms of Service. No solicitation. Articles must have a minimum of 600 words. No plagiarism - Your article must be written in your own words and cannot be posted on other websites, blogs, etc. prior to posting on allnurses. Articles will be reviewed and approved by staff for consideration before displaying publicly. Articles must be unique and should not be listed on other websites, blogs, article sites, etc. prior to posting on allnurses. Once your articles have been published on allnurses.com, you are welcome and encouraged to share them on your other sites and social channels. You may submit multiple articles. You grant permission to allnurses.com rights to publish in magazines, books, etc. You will be notified and credited if published. Keep personal formatting choices such as font choice and size to a minimum - use only for headings. Check grammar, punctuation, and spelling before clicking SUBMIT. How to Submit Your Article To submit an Article anywhere on the site, go to the forum of choice and click the green tab on the right: ADD NEW TOPIC When that loads, click, "Article?". Then, click the dropdown menu that reads: "Yes I'm Submitting An Article". Follow the instructions to complete all required fields (TITLE, ARTICLE SUMMARY, and CONTENT), scroll and click SUBMIT TOPIC. Once you have submitted the Article, it will be reviewed and approved by Administration. If Administrators have questions, they will contact you for additional information. Only Articles containing 600 words or more will qualify for the contest. If you have questions about Article submissions, please contact the Admin Help Desk Good luck to everyone! We are looking forward to reading your articles. Panera's Chilis Home Depot Olive Garden LongHorn Cheddars Yard House Bahama Breeze ...and more
  7. Read in its entirety: Amazon deliveryman caught spitting on package in vile video Amazon delivery man caught on video spitting on package outside Los Angeles home I ABC7
  8. Have any nursing schools cancelled clinicals yet because of COVID-19? I hear about colleges moving classroom sessions online, but have yet to hear of clinical cancellations. Are any of your schools requiring special screening for students prior to clinicals? What about travel restrictions? Some hospitals are not allowing staff to work if they have recently traveled to high risk areas. Are such rules being applied to students, too? (I coordinate student experiences for a hospital and am trying to keep track of what's happening throughout the country in this regard.) Thanks to all those who respond.
  9. LauRN3367

    Boyfriend wants me to stay away

    Looking for advice. My boyfriend is terrified of getting the Coronavirus and therefore has told me that he doesn’t want to see me until this blows over. I work inpatient, my hospital has covid patients but I am not directly caring for them. I can’t help but be hurt- I tried seeing him and stopping by his house but he’s hesitating. Doesn’t he know this is an incredibly difficult time for me? Is anyone else dealing with this?
  10. SchoolNurse91

    Working from Home During COVID-19 Shut Down

    If you’re working from home during the shut down, what are you doing? I don’t have access to e-school (our charting and information program). We have to be “doing our jobs” from home.
  11. Covid-19 should not be compared to seasonal Influenza It’s normal to look at the CFR (case fatality rate) of seasonal influenza when considering Covid-19. After all, 20-45 million get “the flu” every year. The numbers vary depending on the year. The “low” was the 2011-2012 season with 9.3 million cases and 12,000 deaths and the high was the 2017-2018 season with 45 million cases and 61,000 deaths.1 Let us look at the worst of eight recent flu seasons. The CFR for that was 0.0014 meaning, 1.4 persons died per 1000 cases. Interestingly, if we look at the “best” of the past eight seasons (the “good” one) the CFR is 0.0013, almost the same number of deaths per thousand cases. So, hold on to this thought... Seasonal influenza’s average risk of dying is about one death per 750 cases. I see and hear CFR for the Covid-19 repeatedly being quoted at around 2-3%. CFR currently (as of 2/27 12:23AM EST) is 3.4%. That is 2,810 deaths divided by 82,550 cases. But to say that the CFR for Covid-19 is 3.4% is not wise. Why? Simply put, the CFR is not applicable are even a number that one can calculate since it's a "look-back" number. For data current as of 2/27, click here. CFR is a “look-back” rate It is very useful when we look back to an epidemic/pandemic that has ended. For instance, when comparing the “good” 2011-2012 flu season to this season’s numbers. CFR is death rate / # of confirmed cases. To divide the known number of cases today by the number of deaths, we get 3.4%. But this is not wise to use because it assumes that ALL of the remaining cases (total cases today of 82,550, minus cases where the person has recovered or died) will be cured. This is “magical thinking.” Many of those remaining 46,488 will recover, but some will die. In short, we won’t know the true CFR for another year or more. CFR is useless at this time, it will be helpful sometime next year. Known outcomes So, let us look at the cases with known outcomes, meaning the sum of the cases of those who have recovered plus those who have died. This population is composed of those 33,252 who have, to today, recovered plus the 2,810 who have died; thus, our population is 36,062. If we divide 2,810 (deaths) into our population of 33,252, we find an overall death rate of 8.45% or about 85 per one thousand cases with known outcome. Please let that sink in for a bit. Today, looking at Covid-19 cases with known outcomes, 85 out of 1000 cases have died. Should this hold, and it may, then 1 out of 12 cases will die. Compare this to seasonal influenza where 1 out of 750 cases will die. The death rate currently for Covid-19 is 62x the death rate of the average seasonal influenza. These two illnesses do not compare, although we’ll really not know for a year or so, at which time we can look back to see what the true CFR rate was. Let us look now at areas/countries to see the current death rate is, of those cases with known outcomes. I’ll call the current fatality rate of known outcome cases: CFR-KO. I shall call the population with known outcomes: PWKO Total deaths / PWKO = CFR-KO or current death rate. World: 2801 / 36,062 = 8.45% or ~85 deaths per 1000 cases. Hubei Province: 2641 / 26,024 = 10% or ~100 deaths per 1000 cases. South Korea: 13/35 = ~37.2% or 372 deaths per 1000 cases. Italy: 14/54 = ~26% or 260 deaths per 1000 cases. We see that regional epidemic outbreaks tend to drop in CFR-KO as time goes by. Whether the true “look-back” CFR will drop to 2 or 3% or some other number (lesser or higher) depends on many factors which are simply unknown. For instance, children appear to be much less at risk for Covid-19, and cases within Africa (other than the one in Egypt) seem oddly absent. Perhaps the virus does not do well in warmer climates. Perhaps the fatality rate will drop as we approach Summer in the Northern hemisphere—we do not know. Perhaps the tendency of the media to quote the 2-3% theoretical CFR comes from the fairly recent 2009 H1N1 flu pandemic. The 2009 “swine” flu was very feared. It infected 10-200 million world-wide with estimates of death ranging from 105,700 to 395,600 and a CFR of 0.03% or 3%. (30 per 1,000 cases). (Wikipedia). It was expected to return far, far worse numbers. The “swine” flu, which was the first pandemic of this century, turned out to be far less lethal than many expected. Triggle wrote in an article from December 10, 2009 titled, Swine flu less lethal than feared, "The swine flu pandemic is ‘considerably less lethal’ than feared, chief medical officer Sir Liam Donaldson says,” adding, “A study led by Sir Liam found a death rate of just 0.026% in those infected, the British Medical Journal reported.”2 Will we be lucky? Perhaps we’ll be lucky this time, too, although I suspect we won’t be as lucky as we were for the “swine flu.”
  12. Read, Reflect, Assess https://www.nursingworld.org/~4ade15/globalassets/docs/ana/ascec_whitepaper031008final.pdf Adapting Standards of Care Under Extreme Conditions American Nursing Association, 2008 https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/risk-and-responsibility-in-providing-nursing-care/ Risk and Responsibility in Providing Nursing Care American Nursing Association Position Statement, Revised June 2015 When a health system is not prepared and puts healthcare workers at risk due to poor preparation to have PPE equipment available, and a virus's potential for harm is unknown due to his newness...only time will tell after scientific studies have been done. Is it a choice to provide nursing care in this setting when you feel unsafe? The second statement mentions nurses have a right to not provide care when faced with a moral dilemma and that is a moral option whether or not to provide care, vs. moral obligation. How do you feel about the current situation RNs are dealing with nationwide? Thank you for your sharing your thoughts and reading if you have time. Sending prayers to those on the frontlines taking a risk for the welfare of others. I hope we don't lose too many healthcare workers in the US. I'm not promoting fear - I'm promoting Self-Care and Choice for RN's. Smart nursing, , because we are professionals who agreed to work in safe, prepared settings.
  13. Carol Ebert

    Wellness meets COVID-19

    Many of us have given our power over to healthcare professionals instead of taking back our power to affect our own health. For example Not eating healthy Not exercising, Becoming obese and developing Diabetes Expecting the healthcare system to fix us with more and more meds And, all of this could have been prevented. Now who is at risk for the virus the most? Those with chronic conditions. As the healthcare system becomes overloaded with patients, our access to providers may become limited if not impossible. So what is the solution? We are left to rely on our own self-care practices to do what we can to keep ourselves as healthy as we can be. That’s where wellness comes in Because of my career focus on Wellness, I am now fortunate enough to be free from chronic diseases and meds, but of course, it took work on my part to develop healthy lifestyle practices that have served me well. The good news is that it is never too late to tweak your health habits to help your body and mind become more resilient and boost your immunity – especially when we need all the immune support we can get right now! Here are some tried and true wellness strategies that you can start today to boost your immune system. Sleep It’s essential for good health any time, but even more so when everyone around you is coughing and sneezing. Make sure you get 7-9 hours starting at 9-10 pm. An increase in sleep actually increases the number of your white blood cells. Lack of sleep, less than 6 hours, increases inflammation in your body which can lower your immune system. Food Eat healthy whole foods like leafy greens that are filled with nutrients. Warm foods will help your digestion too. Stay hydrated as well. Drink only water or herbal TEAS rather than sugary sodas. Remember, for every cup of caffeine, you need 2 cups of water. Coconut water is one of my favorite treats when I need a boost. Avoid sugar and processed foods It appears that high blood sugar unleashes destructive molecules that interfere with the body's natural infection-control defenses. Eat foods that are naturally high in antiviral nutrients Such as coconut oil, raw garlic, oregano, ginger, kimchi, and other fermented foods, walnut, pomegranate, green tea, apple cider vinegar, and medicinal mushrooms (shiitake, maitake, reishi, cordyceps, turkey tail). The probiotics contained in fermented foods have incredible immune-boosting powers. Fermented kimchi, was found to have significant effects in preventing and fighting the H1N1 influenza. Other examples of fermented foods to try include sauerkraut, pickles, miso, kefir, and kombucha. Bone broth Now you probably heard of this one as it’s all the craze at the moment. It’s easy to find in health food stores and it’s pretty easy to make. You just need some bones and parts of meat that you don’t eat and cook it for several hours. Sauté an onion in olive oil, add some chopped garlic after the onion becomes translucent. Use the whole onion, skin and all. Put in the turkey carcass and any meat and skin you have. Now add a bunch of veggies that you’d like. For example, parsley, turnips, carrots, etc. Add 2 tablespoons of apple cider vinegar. Add 1-2 chopped green apples. Fill the pot with water and bring to a boil. Reduce and simmer for 6-8 hours covered. Stir occasionally. Let cool completely. Strain and use immediately or freeze for later. Sneeze into a tissue or your elbow Then wash your hands immediately. Only about 40% of your sneeze makes it into the tissue, the rest ends up on your hands. So wash them whenever using a tissue. If there are no tissues handy, use your elbow to catch your sneeze. If you have a cough or sneeze, then stay home. If you have to go out, wear a mask. Exercise Aerobic exercise pumps up your heart and moves oxygen from your lungs to your blood. This helps increase the body’s natural virus-killing cells and immune response. Meditate daily A daily practice of meditation or even just thinking happy or calming thoughts can boost your immune system. Try 5 minutes of deep breathing, as this will lower cortisol levels, which increase when you feel stressed. STRESS and FEAR have been proven to lower your immune response. Do a media fast Take a break from all the media coverage and do something that brings joy which boosts your immune system. If you want to catch up on the news, my favorite is NPR. It's clear and simple without opinions or hype. It will get you informed without fear. Take immune boosting supplements If you aren’t taking supplements, this might be the best time to start to get the extra support you need right now. Make sure you seek out “pharmaceutical-grade” quality. Vitamins, Antioxidants, Multiminerals Fish Oil (high quality, potent, pure) Vitamin D3 Grape Seed Extract Vitamin C Zinc Beta- Glucan Complex with reishi, shiitake mushrooms, and baker’s yeast extract. Probiotics. Look for Bifidobacterium BB-12® and Lactobacillus rhamnosus LGG®†. Both strands are clinically shown to survive the harsh acidic environment of the stomach, providing a full range of benefits such as sustaining healthy immune function. Hopefully, this information will be useful for you and those around you as we face the challenges ahead. Here is a helpful survival guide from Dr. Oz that you can post at home or work. Dr Oz Corona Virus Survival Tips (2).pdf
  14. Dear Patients and Friends: You are likely seeing stories of people who went to urgent cares or physician's offices and were turned away from being seen. I read one of a man that ended up in the hospital due to COVID-19 with pneumonia. He was upset because an urgent care saw him but did nothing for him. And I don't blame him. It is upsetting to not have anywhere to go or anything to help you. And no idea of why we are being turned away or having nothing done. But as an urgent care provider, I understand why "nothing was done" for this patient. Here is the problem in a nutshell: this is a virus. There is no cure. Just like the common cold has no cure. But at least with the common cold, I can treat the symptoms. With COVID-19, I am limited to the symptoms I can treat. I cannot treat you with mild or medium symptoms. I cannot give you a nebulizer treatment for shortness of breath because it aerosolizes the virus and I do not have a negative pressure room to contain it. I cannot give you steroids because it exacerbates the virus. My hands as a provider are tied. If I let you in my clinic in order to try to give you some symptom management medications, then my clinic will be infected and I have no PPE, no Lysol, no sani-wipes, nothing to protect myself or anyone else. I feel helpless....I am helpless in that I only have my words and my heart to make you feel better. I cannot even give you a hug because of social distancing and not wishing to spread virus (which is so hard for a person like me...I am a hugger). These are frightening times. You will have to stay home and care for yourself or your loved one until you either get pneumonia and cannot breathe or you get well. This is where we are at at this time. Any medications that you may be hearing are helping are reserved for the sickest of the sick or have no proven efficacy. And I cannot access them and neither can you. At this time you will not get tested without severe symptoms. (update: CDC released new guidelines today for testing) COVID-19 Symptoms (You do not have to have all and DO NOT have to have fever!): Fever Cough Shortness of breath...late sign Runny nose Sore throat Headache Body Aches GI symptoms, such as diarrhea Loss of sense of taste or smell If you are sick...assume it is the virus. Stay home! If you have symptoms of a cold, URI or flu, stay home. This is the hardest thing to do, especially when you are afraid. But you will not get any treatment until it is severe, because there is no treatment. If you are not sure about your symptoms, call ahead to an urgent care or clinic and ask if it is something that you can come in for. Please help stop this virus. You can have it with no symptoms and be spreading it. Protect my mom and yours by staying home. Seek help when your symptoms are severe. Yes, you will be afraid for your life. We are all fighting for our lives at this moment. If you are afraid and do not know what to do, ask me and I will try to help you. But please know that your family will be your caretakers at home until it is severe. God help us all.
  15. zillynurz

    Coronavirus mask shortage

    My hospital has resorted to handing out face masks one at a time and you're expected to use the mask for your entire shift unless soiled. If you take it off, you're to put it in a bag and label it with your name to use later. Seems masks are in short supply or maybe people are hoarding them. Is this happening at your hospital?
  16. Coronavirus Hotlines - USA
  17. My mind was rather blown when I read on the CDC site about the last resort of DIY masks. Scroll down to very last paragraph before the footnotes: Strategies for Optimizing the Supply of N95 Respirators: Crisis/Alternate Strategies If that’s the case, please read: Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic? Disaster Medicine and Public Health Preparedness 7(4):413-418 · August 2013  Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic? Then scroll down to the carpenter dude video for instructions: Ashfall protection: 4 substitutes to N95 mask
  18. Read in its entirety: Splitting ventilators to provide titrated support to a large group of patients
  19. If you're a Nursing Student, allnurses.com wants your input. We want your insights regarding a few timely issues which are facing the Nursing Student community n the wake of the COVID-19 pandemic. If you could spare a minute, please click on the button below and complete the brief survey so that we can help to shed some light on the current issues which Nursing Students are facing. Take the Quick Survey!
  20. TeeRN

    Low census and COVID-19?

    Is anyone else experiencing low census at this time? My California hospital is a 400+ bed adult medical center and a 250+ bed children’s hospital. At this time, we are being told we are not admitting any respiratory patients as well as non urgent OR cases (including asthma and PNM). Due to this our unit census is below 50% on almost all units and multiple staff members are being budgeted and/or sent home for low census and told we have to use our PDL to cover our shifts.
  21. LucilleBluth

    COVID-19: Nurse Shortages

    As our frontline nurses are increasingly exposed, how do you think potential shortages in nursing staff will be addressed? Do you find this solution viable and reasonable? In Texas: Coronavirus updates in Texas: At least 325 cases reported in state; Gov. Greg Abbott moves to bolster number of practicing nurses
  22. Here's the thing in 2018-2019 the CDC said that "regular" influenza killed about 34,000 people in the United States and caused 490,000 hospitalizations Estimated Influenza Illnesses, Medical visits, Hospitalizations, and Deaths in the United States — 2018–2019 influenza season Now we don't yet know how many people (anywhere let alone the United States) that Covid 19 will kill, but consider ways that it might "reduce" not only influenza, but death from regular influenza, bacterial pneumonia, and other communicable diseases: a. Canceled "public" events and festivals may reduce venues that would transmit these other diseases. How many less people will go on cruises? That has to save at least a few lives from Norwalk virus and other things people would tend to get on cruises (including sickness from excessive eating and alcohol consumption). b. Increased focus on things like hand washing and not touching your face (and even wearing masks) may translate to other diseased besides Covid 19 not spreading as easily. c. Those people under voluntary (or involuntary) quarantine might be in less of a position to catch or spread diseases other than covid 19. d. Even things like food poisonings and car accidents might be affected in a positive manner by people going out less or being more prudent in their safety behaviors (for example hand washing by cooks can help prevent the spread of Hepatitis A and maybe some cooks will wash their hands more (or longer) due to Covid 19. e. Attempts to "optimize" nutrition to reduce the chances of getting Covid 19 (or reduce the chances of getting really sick if you do) by doing things like taking zinc, magnesium, vitamin C, garlic and turmeric, better hydration, and more sleep might translate into fewer MI's, strokes, and other infections. Also, when people have "subtle" symptoms of MI or CVA that they might otherwise ignore they might be more prone to see a health care provider due to fears that they are "coming down with Covid-19". We should be able to look back in six months to a year to test this hypothesis. Of course there are other aspects of behavior due to Covid-19 such as avoiding hospitals and health care providers due to fear of being around "Covid 19 sick people" that might increase morbidity and mortality.
  23. We first started hearing about the Novel Coronavirus in December 2019. It made the news due to the rapid increase in the numbers of individuals in China who became infected with this new disease. As the deadly virus began to spread, affecting those around the globe, including those in the United States, it has become very obvious that controlling the spread of this virus is going to be a very serious challenge. Since it is a new disease, no one has immunity and there is currently no vaccine available. On March 11, the COVID-19 outbreak was characterized by the World Health Organization as a Pandemic. As such, it is critical that all members of the health care teams have the appropriate knowledge, training, and personal protective equipment to effectively and safely provide care to patients, without unprotected exposure to themselves. As a potential first responder to fight this virus, have you received the training needed to assess and care for potential and confirmed COVID-19 patients in your place of work? Do you have adequate equipment? Does your place of employment have a clear and up-to-date protocol for responding to COVID-19? Or are communications confusing or even nonexistent? Do you feel prepared? Please take this survey so we can see how nurses from around the globe feel regarding the level of preparedness to fight and stop the spread of this threat to public health. After taking the survey, please return here and share what preparations and precautions your healthcare facility and you personally are taking. We would love to hear from you. Direct link to survey: https://www.surveymonkey.com/r/CT77WW7 CORONAVIRUS (COVID-19): We Want to Hear from You
  24. Strategic National Stockpile Anyone have any information, knowledge or experience with this? It states the department of health & human services has to approve its use. So it could help & if so why are we not using it?
  25. Even tho I pride myself on being a Wellness Guru, I am realizing that this current reality is getting to me and I need to pull out all those wellness stops I can think of to survive. In the past, I was a runner but after physical back pain became an issue, I transitioned into walking. But is walking really enough to provide any significant health benefits? I will admit that transitioning from running to walking was difficult because I held the belief that you couldn’t get the same benefit from walking that you get from running. Over time, however, I discovered that was a false belief so I embraced walking whole-heartedly as my new mode of exercise. So much so that at one point in my wellness career, I even coordinated the Shoe Crew, a walking club of 1500 employees from many businesses with challenges, big prizes, and data that showed participants lost weight, lowered their blood pressure and felt better. The Coping Benefits of Taking a Walk So now it is time to revisit the importance of walking outside as a way to cope with what is happening in our lives today. Here are some tips. FACT: You have renewed quality time to share with family members Social support may provide a resource for coping that dulls the detrimental impact of stressors on well-being. Those receiving support from their family members may feel a greater sense of self-worth, and this enhanced self-esteem may be a psychological resource, encouraging optimism, positive affect, and better mental health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954612/ FACT: Your pet will appreciate exercising with you Regularly exercising your pet is just as important as exercise for you. Health benefits range widely but include helping hip joints, reducing digestive problems, and keeping your dog and cat at a healthy weight, which decreases the likelihood of developing other health problems. And your pet will have fewer behavioral problems, as will you! https://www.spcaflorida.org/blog/importance-of-regular-exercise-for-your-pets/ FACT: You will appreciate being in nature and all the benefits Nature is not only nice to have, but it’s a have-to-have for physical health and cognitive function. People who spent two hours a week in green spaces — local parks or other natural environments, either all at once or spaced over several visits — were substantially more likely to report good health and psychological well-being than those who don’t. https://e360.yale.edu/features/ecopsychology-how-immersion-in-nature-benefits-your-health FACT: You will have time to clear your mind Spending time outside improves mood and reduces feelings of anxiety. We can focus better in nature, and our improved concentration can help us address feelings of stress and anxiety. Self-esteem can also receive a boost after time spent wandering outdoors. Peace and mental clarity is a big reason why being outside is important. https://askthescientists.com/outdoors/ FACT: You will think more creatively In one Stanford University study, researchers found that walking boosts creative output by 60%. New insights come to us when we “pause and unload” our minds. This process is necessary for creative thinking since otherwise we would be stuck forever in the same preconceptions and patterns of thinking. https://brainworldmagazine.com/stepping-creativity-walking-meditation-creative-brain/ FACT: You will reduce your stress level Walking is relaxing — it releases tension from the muscles of the body through light exercise and distracts the mind from its own busyness. It is a rhythmic activity. Each step and swing of the arms creates a distinct cadence. Rhythm is known to lower brainwave frequency, as studies of the therapeutic value of drumming have confirmed. https://brainworldmagazine.com/stepping-creativity-walking-meditation-creative-brain/ FACT: You can break away from negative news for awhile Walking is a great time-out opportunity that you control. Unfortunately, a lot of what’s going on in the news is out of our hands, and sometimes we must remind ourselves of that so that we can stay sane and work on what is within our power. https://www.nbcnews.com/better/health/what-headline-stress-disorder-do-you-have-it-ncna830141 So what do you think? Sounds like a great drug-free healthy prescription that we need right now and is free! Let’s get outside and get moving! Here are some inspiring quotes to post and share with others to encourage walking. If you are in a bad mood go for a walk. If you are still in a bad mood go for another walk. Hippocrates An early-morning walk is a blessing for the whole day. Henry David Thoreau It is solved by walking. Latin phrase Solvitur ambulando All truly great thoughts are conceived by walking. Friedrich Nietzsche

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