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  1. 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
  2. MunoRN

    Acute COVID, What We're Seeing

    COVID-19 has been in my area long enough that we're getting an idea of how it plays out, curious what others are seeing. The most surprising thing has been the duration of acute illness, I sort of figured it would be like other respiratory viruses just more severe, but with acute symptoms lasting up to 7 days or so. We've seen timelines similar to what China was reporting; about 10 days from symptom onset to needing ICU care, then critically ill for weeks, the shortest recovery we've seen is 3 weeks of aggressive life support. Time from symptoms onset to death has ranged from 2 to 8 weeks in China. So it's not just the number of patients that will require vents and other equipment, it's the length of time they will need them for. The first week or so on the vent is similar to a bad influenza; lots of vent support, maybe proning, maybe flolan, not typically requiring inotropes or vasopressors, then they seem to have turned the corner and are out of the woods. Then they crump, big time. From nothing to max pressors and inotropes and an EF that drops from normal to 10-15% in as little as 12 hours. Sudden onset renal and liver failure, with impressively severe liver failure in such a short amount of time. Deaths appear more cardiogenic than respiratory, lethal rhythms have varied the full gamut; VT, VF, PEA, and asystole. We've had enough ventilators so far, but what likely lies ahead will be the need to figure out a process for taking ventilators and other life support equipment away from patients less likely to survive to make them available to patients more likely to survive. Things seem dicey now, but that's a whole 'nuther level of dicey.
  3. 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.
  4. Any disaster brings in an influx of patients at a higher rate and volume than most hospitals are staffed for even on a good day. In fact, one hospital I used to work for only ever hired for 78% capacity because they usually averaged this census. If it’s slower, some float, assignments are lighter, or people get called off. If it’s busier, the staff has heavier, potentially unsafe assignments, and some people kindly come in for overtime. Occasionally some institutions utilize mandatory emergency staffing, like another hospital I worked at. Systems Are Not Perfect Unfortunately, these systems aren’t perfect and work even less when disaster strikes. Sometimes, it’s not as bad because if it’s for a shorter time frame, such as after a shooting or explosion, people tighten the bootstraps or other hospitals come in to help. When the high demand is a little bit of a longer anticipated influx, such as during a natural disaster, people from all over can come help. You can get travel nurses or crisis personnel to come for a few weeks to that one affected area. But, what happens when the influx and crisis is all over? The way it is now during this global pandemic? Who is going to come save us and help us save our patients? Once a Nurse ... One thing states and other countries have been doing is calling on retired medical staff to come back into practice. Now, because we know the sayings, “Once a nurse, always a nurse,” and “A nurse isn’t a job, it’s who you are,” bravely many people stepped forward. Yet it still does not seem enough. And let’s not forget staffing continues to fall everywhere as staff becomes ill or exposed themselves. Relaxing the Rules So hospitals are also calling on anyone with a license. We have even lifted rules so that people can practice medicine in a state different from the one in which their license is held. But, how many people who are staffed in one area are really able to move across state lines to help another, when their own state is also in crisis? "Crisis Pay" My friends, colleagues, and I all keep receiving texts, calls, emails, and LinkedIn messages to come work for a few weeks or with essentially entire job offers on the table because of the high demand. Most recently, my friend received an email stating that nurses are urgently needed to help provide care during COVID-19 staffing shortages. The key I want to zone in on is the second part of that email: The compensation. Crisis pay. Up to $4,700 a week. This is more than most nurses make in an entire month, although I suppose it varies a little more depending on your state and cost of living. This offer is for 8-week assignments, 12-hour shifts with 3 or 4 shifts per week at $103/hr. Now, the Questions Why are we not making these offers to our own staff? On a unit level, a hospital level, or state level? This is what I asked my friend when she told me about this email. Because otherwise, the only people they are really appealing to are travelers and those who happen to be out of work at this time. I mean, it’s not like she or I can leave our current jobs and move over to the next state for the next 8 weeks while our own hospital needs more staff and likely wouldn’t accept us back afterward. Nursing Staff Deserve It I am not even saying that we need to suddenly increase base pay to “crisis pay” for everyone already working. I am sure there are those who would argue this and likely with some valid points. However, in the interest of being reasonable, I am arguing that staff deserves crisis pay or at least double pay for anything worked above their regularly scheduled hours. Why? Because there are many people who do not even want to work their regular hours at this time. This is mainly because they are scared to work in these conditions without proper PPE supply or because they are terrified of bringing the virus home to their families. They are also doing a lot more work than on a regular day and under more stressful conditions. However, they would be more willing to do this with fair compensation. Other Compensation Do you know why some healthcare professionals are asking for hazard pay or student loan forgiveness? It’s not because they feel above their work. It’s because they want some sort of compensation for doing at least double the work that should be required of any one person. It’s because they want to feel some sort of support for putting themselves at risk. It’s because they want to feel VALUED. There Are Staff Shortages Everywhere Right Now We can’t keep hoping that somehow people will come out of the woodwork to save our own hospitals because everyone is busy weathering their own storms. However, our own staff would likely be willing to help during these shortages with some incentive because in healthcare we always pull together as a team. I think this would also help hospitals from forcing staff to float to units or specialties they do not feel competent or safe working in. Back to that Email ... Hence, to circle back around to that email my friend got, my response to her was the realization that if our hospitals or even others within our own state did that and on more of “committed per diem basis” if you will, I would pick up a shift at least one day a week. She said the same. I think if we did a poll, a high percentage of healthcare professionals would also agree. Hospitals need to realize this and capitalize on it to create more of a win-win situation (as much as you can consider things a win under disaster). Now is Not a time for Penny-Pinching Our Dedicated Nursing Staff It’s no secret that adequate staffing is linked to better patient outcomes. You can easily search and find that good staffing equates to less falls, less pressure injuries, and even higher survival rates. The list goes on and on. So it is crucial for a time like this. A Win-Win Beyond that, in the long run, I do believe that if someone sat and crunched all the numbers, paying staff either hazard pay, double time for any time worked over their regular hours, or whatever incentive system thought of—this would still equate to a less overall cost loss for hospitals than not doing so. While it is likely many hospitals will suffer costs from workers falling sick, getting these travelers, or buying more equipment, we all know the high costs associated with negative outcomes and these are going to be higher than ever. And while I do not know for sure, I imagine insurance companies will not be cutting hospitals a break about their rule to not reimburse for hospital-acquired conditions. And, who is best at being able to prevent these conditions? It is the staff at the frontline with direct patient contact. So, Hospitals and States ... ... start placing more value and respect into your own loyal team. Rather than forcing your staff to work in other areas while offering astonishing packages to outsiders, give those benefits to your staff for picking up extra shifts or floating elsewhere. This Nursing staff delivers for your organization and community on a regular basis. They deserve the recognition. They deserve the profit. They deserve to receive a taste of what they are worth. This is not a time during which you will be able to pull more staff out of thin air, so it is time to start utilizing your own through those same measures. Loyalty goes both ways.
  5. Hi All, I hope you and your loved ones are happy, healthy and nCV-19 free. Looking for updated information on novel Corona virus-19 formite survival times? And does anyone know how the virus lasted/ survived on the Princess cruise ship? Lastly, my family has heard that the virus likes to stick to clothes and hair. has anyone heard anything about virus viability on clothes, hair or skin? Thank you in advance. Keep up the good fight! T-Wave yea, though I walk ....
  6. Hey all, hope you are all staying safe during this insanity. I was wondering if anybody has started to see crisis/high rate jobs posted yet? If so, post the specialty and company.
  7. Texican

    Reinstating license during Covid

    I haven’t worked as a nurse in almost 10 years and when Texas temporarily waved the requirements needed to reinstate a license Because of the pandemic, I sent my paperwork in. Any other TX nurses doing the same and have you gotten approved yet?
  8. I predict that in 3-4 weeks time there will be significant discussion brought to light by academic epidemiologists on Twitter about COVID-19 as a possible extinction event. I could be wrong, but let's look at the numbers. We have a contagious disease that is as deadly as the 1918 pandemic with all of modern medicine being thrown at it. In 1918, the 5% of critically ill covid-19 cases would surely have died - excluding those rare minor miracles. A higher percentage of patients requiring admission, but not intubation, would also surely pass away. Nobody is certain that we will be able to keep up a sophisticated level of care, and in that case you're looking at a significant jump in mortality rate as critically and moderately ill patients cannot be treated due to the overwhelming surge. COVID-19 is not showing many signs of being susceptible to weather. Hot and humid locations across our own country are seeing their own exponential outbreaks. Any flattening of the curve will only last until social distancing measures are lifted. Nobody can be absolutely certain that active immunity (antibodies made after an infection) will last long enough to prevent yearly reinfection, and so there is the possibility that we'll see this return year after year. Unless we develop a vaccine, we will have an endemic virus that infects 50-70% of our population and has a mortality rate that is 2-5x that of the spanish flu and will cripple a healthcare system that doesn't find a way to grow itself by 3-400% whilst protecting the workers. The birth rate is only 1.8% folks. Essentially, we'll be spending 7% our of money and only getting 1.8% back in returns. The principle won't last forever and the human race will eventually go out of business. Thoughts?
  9. I have worked on my unit for over two years now. My unit has been turned into a "low risk" unit but we still get numerous COVID rule outs, and the pandemic has yet to fully hit us yet. Before this hit, basically I was the sole caregiver for my 93 year old grandmother, in terms of housekeeping, providing care, meals and providing basic care to her as she is very unsteady on her feet and still recovering from a past hip fracture which has limited her mobility. I pretty much live there the majority of the time. There isn't a lot of family and we all have rotated and have taken turns, since someone has to always be present, and with my job I can spend most of my time down there due to my four on and four off. Since my unit has been receiving 3-4 COVID rule outs a a day sometimes I am unable to be there for her, as I am terrified of giving her the virus in case I am asymtomatically carrying it or get exposed to it unknowingly. This has put a lot of strain on me and my mother who also looks after her, and all other family lives various provinces currently on lockdown so there isn't help. I'm at a loss what we can do, we have services in the home but most have been cut back due to the virus. I have contemplated taking a leave of absence, even if unpaid since I am in a position to do so, while my mother (who also is high risk) is not and is also an essential employee. I'm just wondering what my options would be? Is there a possibility of going off for a a couple of months until things settle a bit more? Is there be some sort of medical leave available for caring for family members during this pandemic? There in combination with the evolving pandemic is causing a lot of stress for me in my personal and professional life. Otherwise I may have to quit outright for the time being.
  10. Shauntil07

    Travel Nursing-CNA/PCT

    Hello! I am looking into taking a travel assignment for some of the hard hit areas that contain (or could contain COVID patients). First, I am not a CNA (I am a PCT/MA but can do basically all the duties of a CNA). Some states are waiving the requirement of a CNA (as long as you are a healthcare worker) which is where I fall in. What I am wondering however, is I currently work as a PCT on my floor now in the hospital. 1) Is it possible to keep my FT job (take a leave of absence for emergency purposes) to help these other hazard areas for COVID or... 2)Would I have go PRN or quit my job in order to do so? Or... 3) Would it be more beneficial to try and get a travel assignment closer to home (I live in Dallas) since I have family? I've never NOT had a job and done traveling before so if there are other CNA's or even RN's who can help me out because I know some nurses have probably been in this situation too. Thanks!
  11. Hi, I work in a MICU and as of Wednesday we will be the official ICU for covid patients. There are several other lower acuity floors for covid but if they need to be intubated, etc they will come to us. Any of our normal "clean" MICU patients will overflow to PACU which they have set up as a makeshift ICU staffed with a combo of PACU and ICU nurses from other ICUs. As of Wednesday our unit is also starting to use med surg nurses to "help give us a break" but really it is to stretch the ICU staff when ICU patients overflow elsewhere. What it looks like is this: 4 ICU patients to 1 ICU nurse, and 2 med surg nurses, and that is the team. They are saying the med surg nurses are taking care of the patients and we are doing all the ICU related stuff that they can't do (which, these pts are extremely sick...proned/vented/A lines/drips etc, so that's a lot of stuff for 4 pts). I'm trying to stay positive about it, but they are essentially taking us from 12 ICU nurses for a 23 bed unit to 6 ICU nurses and 12 med surg nurses. My question is, is anyone else having to do this? What are some barriers you've run into, what are some good things, and what are the legal ramifications? They are saying it's "not on our license".... But the med surg nurses have been given a 4 hr crash course in basic ICU stuff, so they aren't technically competent and so how is it fair to them? And how is it fair for us if we have 4 vented patients? If anyone has input I would appreciate it.
  12. I graduated about four months ago and still don't have a job. I'm feel so pathetic/helpless though having a license and not being of any help with the disease. Does anyone know of ways a licensed nurse can volunteer services during the pandemic? (Other than social distancing) Thanks!
  13. Just a few weeks ago, I was helping with a list of classmates from my nursing school class of 1970. Yes, it was so we could plan our 50th class reunion. I was looking at the young fresh faces on my class photo, including my own. I have worked as a patient safety advocate for the past 10 years, as a volunteer. I have not worked clinically for 20 years. It is surreal for me to be out of school for 50 years. All of those anniversary festivities have been canceled. As those party planning emails came, the news on TV was getting more urgent about this new virus. COVID 19 had floated around for a few months. We heard stories about it when a bunch of people got sick on cruises. There were decisions being made about whether or not those people should be allowed back into the US. There were some pretty frightening images of the Chinese who were all wearing masks on the streets and many were dying. Some of the dying were doctors. The news got more and more scary The few nursing home patients in Washington State became the beginnings of an epicenter for this disease. Then New York City, then parts of California. Just a few weeks later, here we are. Every State is affected including Maine with our very small, but older population. The news is dire, every single day. Every day citizens are stocking up on face masks and hand sanitizers and clearing shelves of other necessities like toilet paper and food staples. There isn’t enough PPE for nurses, doctors and other frontline workers. There aren’t enough testing materials so that every single person who is exposed to COVID 19, or who has a risk factor or who may even have some symptoms, can be tested. We are all being trusted to socially distance ourselves, or to self-quarantine if we have a risk factor or symptoms. All of us are being asked to stay away from others and stay at home as much as possible. Basically we must consider every person around us to be infected…it helps us to socially distance. Businesses and borders are closed Still, irresponsible Spring breakers gathered in FL and other warm places, and COVID spread. Some large churches held big gatherings and services in spite of all of the warnings, and COVID spread. A few of our Senators and Representatives got it. Tom Hanks and his wife got it. This virus doesn’t care how famous, religious, rich or powerful you are….it will invade your body. It is a great opportunist. My son is out of work as of Friday. My husband and I have been spending most of our days at home, but we drive somewhere daily. Our little dog has been the star of our isolation show, and we take him everywhere with us. One day we enjoyed a short trip to the coast of Maine, and I am so luck to be so close to such beauty. And, this old nurse is going back to work I knew there was something I could do. I communicated with other healthcare workers and with my patient safety colleagues. The effort to keep patients away from crowded clinics and ERs meant that someone was going to have to keep telling them that it was the safest thing for them, unless they had life threatening symptoms. I called my local hospital. I asked if they had considered using retired nurses for some sort of telephone triage line. They hadn’t but they were very excited about my idea. Some of their staff was working on a phone tree and an algorithm. I offered to work from home, taking calls. I also offered to recruit other retired nurses to do the same. So, I have recruited 5 other nurses. 4 of us have had our physicals and background checks done already. We hope to be working within the week. We all can help ... We all can help, even those of us who are “older’, retired and at a higher risk of disease. Find a way. And for those nurses who are working with COVID 19 patients on the front lines, my hat off to you. Your courage and dedication just blows me away. I do hope that most of you will not face a shortage of needed PPE, and yes, I do know that some of you already have. We are all in this together. Doing what the experts are telling us is our social responsibility, but nurses young and old can do so much more. We all need to stand together albeit remotely.
  14. tnbutterfly - Mary

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

    The deadly Coronavirus Pandemic has evolved into a much faster-growing monster than anticipated by many, infecting more than anyone could imagine. Hospitals are filling up with Coronavirus patients. ICU beds and ventilators are in short supply. As frightening as the virus is, the doctors and nurses on the front line of care are worried more about the lack of adequate personal protective equipment including N95 masks, surgical gowns, gloves, and eye gear. Without the proper protection, doctors and nurses are risking their lives daily as well as endangering their patients and their families as they care for those infected with the virus. Several healthcare professionals have already been infected; some have even succumbed to the disease. Recommended Protective Equipment The Centers for Disease Control and Prevention recommends health care workers should wear protective gowns, gloves, goggles and masks while treating potential and confirmed cases of Covid-19 to avoid exposure. But, to add to the frustration of doctors and nurses, there has been some disagreement over which masks are needed. Previously, the CDC advised this use of tight-fitting respirators like the N95 or powered air-purifying respirators (PAPRs) which cover the entire head. In early March, the CDC updated its recommendation by saying that regular surgical masks are an acceptable option when examining or treating a coronavirus patient. More than likely, this change was based primarily on the "mask shortage" rather than on healthcare professional and patient safety. Due to the shortage, many hospitals are requiring their staff to reuse their masks, whether it be surgical masks or N95 respirators many times, sometimes for up to 30 days, unless they become soiled. Homemade Masks?? The CDC also stated the following: As a result of this statement, mask-making groups popped up all over the country, trying to do what they could to help protect the healthcare providers. So what’s all the fuss about? Isn’t a mask a mask? The FDA website offers a comparison of N95 respirators and surgical masks, both of which are examples of PPEs that are used to protect the wearer from airborne particles and from liquid contaminating the face. Surgical Masks Loose-fitting; does not provide complete protection Help block large-particle droplets, splashes, sprays, or splatter that may contain viruses and bacteria Does not filter or block very small particles in the air that may be transmitted by coughs, sneezes, or certain medical procedures (COVID-19 is a small-particle) Not intended to be used more than once. N95 Respirators A respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles Blocks at least 95 percent of very small (0.3 micron) test particles The filtration capabilities of N95 respirators exceed those of surgical masks Not intended for public use Not intended to be reused From the lists, you can see that nurses and doctors should be using a tightly fitted N95 respirator designed to keep out more particles. What’s Being Done to Get More Masks and Other Equipment? Project Airbridge A planeload of health care supplies arrived in New York City on Sunday, March 29, from China. This is part of an effort the White House says will expedite the arrival of goods that are badly needed to fight the coronavirus pandemic. According to a White House statement, the shipment included 130,000 N95 masks, nearly 1.8 million other face masks and gowns, more than 10.3 million gloves and more than 70,000 thermometers. This is the first of about 20 flights through early April for a public-private partnership it's called Project Airbridge. Thank You Hopefully, all healthcare professionals and frontline responders will receive what they need to provide protection for themselves, their patients, and their families while continuing this battle against a deadly Coronavirus. Until then, nurses will continue to show up and provide compassionate care...because that’s what nurses do. They are indeed heroes, and for that we thank you! Your service and dedication does not go unnoticed. If you want to share your story, we have a special COVID-19 Disaster forum where you can safely and anonymously talk with other nurses.  You can also participate in our article contest - How is Covid -19 Affecting Your Life?
  15. covidletmebeanurse

    New grad RN - feeling alone and lost at sea

    I'm a new grad nurse and I didn't see any of this coming. I was assigned to screen ER patients who have COVID symptoms but am floated wherever they want me. The atmosphere is tense and heavy and clouded with fear. I am afraid. One of my friends, a healthy young individual, just passed away. Many nurses have chosen to quit and stay home with their families because this isn't what they signed up for. When I go to work, I am barely keeping it together. We have barely any PPE and can't wear a mask unless the pt is on a ventilator. It's only a matter of time before we all get sick. Staff are told to come in even though they're sick. I have met many young patients with no significant PMH/PSH who go on from walking and talking to dead in such a short time. We were asked my management to put together advance directives. I called my husband to ask whether I could list him - no response. A month ago I separated from my husband. Just as things started getting bad in our state he disappeared on me. No response to calls or texts and removed me from policies, accounts, credit cards without telling me. Guess I am truly alone during this crisis. He still lives in "our" house and I have fantasized about stopping by and asking him how he went from not wanting to separate to apparently hating my guts so much that he doesn't care if I die. Even if I physically survive through this, I feel like I have already died. I would love any ideas on how to cope with this crisis as a new grad nurse on the front lines.
  16. I'm PRN and have been on call because of low census. I know we have COVID and r/o COVID patients; I'm actually "assigned" to the COVID floor, but because of my status + elective surgeries canceled + people avoiding the hospital, our census is low. I wonder what it will look like a week or 2 from now. In the Denver Metro area for reference!
  17. allnurses

    We Did Not Sign Up For This

    This article was written by someone who wishes to remain anonymous. Due to the topic and emotionally charged nature of the article, the member wanted the topic out in the open so nurses could discuss it. Because she is afraid of retribution if any of her hospital administrative staff should read this article and link it back to her, we offered to publish it for her anonymously. Please add your comments regarding this issue negatively impacting nurses and the healthcare system. COVID-19 is here and it is terrifying. People are scared. People are panicking. I have seen posts that criticize nurses who choose not to work right now because they are afraid. “This is what YOU signed up for!” people say. That is not true. This is NOT what we signed up for. NOBODY has signed up for this. Unlike what you might have seen on TV, there are many different types of nurses and we all have different skills. We specialize in our own fields. The Renal nurse knows how to educate patients who are in renal failure about fluid and dietary restrictions, so they do no overload their systems. She understands shunts and dialysis equipment. For the patient in renal failure, she is an expert. The Cardiac nurse knows how to take care of patients who have just had open-heart surgery. She can read an EKG expertly. She may not know how to connect a patient to a dialysis machine, but for cardiac patients, she is an expert. The Labor and Delivery nurse can check your cervix to tell when it’s time to push. She can read fetal monitoring strips to make sure your baby is not in distress during labor. She may not be an expert at reading EKGs, but for a laboring mom, she is an expert. The ICU nurse takes care of the most fragile patients. She understands ventilator settings, arterial pressure readings, blood gas readings. Drugs that most wards will never see – like Levophed are used here. She cannot check your cervix, but for a critical patient, she is a lifesaver. Each of these nurses (and oh so many more different types of nurses!) are experts in their fields. They “signed up” to care for those patients. They have trained and educated themselves to care for their specific patients. That is why if you are in labor, you want a labor nurse, not a renal nurse, at your bedside. Right now, ALL NURSES, regardless of specialty, are being called to care for COVID patients. Please bear in mind that not ALL nurses have been trained to deal with highly infectious patients who have the potential to go into acute respiratory distress quickly. We are NOT being offered additional training. This is part of the reason nurses are terrified. This is why some nurses are leaving nursing right now. This is definitely NOT what they “signed up for.” For the most part, nurses take care of people who are ill or injured with non-communicable illnesses or injuries like cancer, heart disease, strokes, car accidents, etc. This means we can help without the risk of catching our patient’s illness or injury. We do take care of patients with infectious illnesses as well – the flu, pneumonia, etc. Because these patients do not take up a large part of our hospital normally, we have the appropriate respirators, reverse-air flow rooms, and PPE we need to take care of these patients. These patients are usually on appropriate wards with nurses who have been trained to care for them. Although there is a risk when we take care of these patients, there are also vaccines and known treatments to help us fight if we get infected. COVID-19 IS DIFFERENT. IT IS A HIGHLY INFECTIOUS, POTENTIALLY FATAL VIRUS WITH NO KNOWN CURE OR TREATMENT. Because it is a PANDEMIC, many people are sick at the same time. Hospitals are overwhelmed. Patients are being sent to wards where nurses do not have the correct expertise to care for them. Hospitals do not have the appropriate equipment to help keep their nurses SAFE while we are caring for patients. There are not enough masks. Nurses are being asked to wear bandanas or sew their own masks at home! Would YOU walk into a potentially infected person’s room and care for them with a bandana? So please. STOP. STOP saying “Nurses signed up for this.” We did not. We did not sign up to sacrifice ourselves because hospitals won’t provide us with the proper equipment and training we need. We did not sign up to die of an infectious disease just because “it’s your job!” Do you want a labor nurse trying her best to ‘figure out’ how to operate a ventilator for your child? Do you want a cardiac nurse delivering your daughter’s baby? Do you want a wound care nurse to try and figure out your dialysis settings? No. I promise - you don’t. We understand you need us, but our families need us too. If we are scared right now, it’s because we have every damned reason to be terrified. If some nurses choose to stay home and protect their families, that is their priority. They have a right to protect their own life. No JOB is worth anyone’s life
  18. Freedom42

    RN refresher course online

    I'm an NP. I previously worked ED as an RN. I'd like to go back to ED during the pandemic, but it's been a few years. Can anyone recommend an online refresher course?
  19. Tirednurseandmomma14

    Has anyone left nursing job due to COVID19 virus?

    I am curious to find out if anyone has decided to leave their current job due to the risk of this virus? I work in the Emergency Department and we are now being asked to reuse PPE and to prepare for a surge of COVID 19 patients. This makes me sick to my stomach and concerned for my co workers, other patients along with the risk we bring home to our own families.
  20. Can I Refuse to Work If My Facility Does Not Have Proper Personal Protective Equipment? The number 1 question that I have been asked during this time of COVID-19 is, “Do I have to work if my facility does not have personal protective equipment?” Unfortunately, my response is not going to be popular. The truth is that the Oregon State Board of Nursing issued a position statement declaring that, “The Board has determined that nurses cannot refuse a patient care assignment because the organization is following Oregon Health Authority Public Health Division recommendations regarding PPE and other infection control practices rather guidelines of the World Health Organization or Centers for Disease Control and Prevention." This statement has been updated by the Board to read "Nurses cannot refuse an assignment solely because the employer is utilizing OHA guidelines rather than WHO or CDC guidelines." After conversations with other nurse attorneys, I believe that other states feel the same way as does Oregon. They consider a refusal to work to be patient abandonment or job abandonment. At this difficult time, nurses are the epicenter of this pandemic crisis. You do have a choice. If you believe the facility does not have proper equipment, you can give proper notice and resign. However, if you leave and abandon your job without notice, you can face disciplinary action with the Board. It is unfortunate that our country was not prepared and placed nurses in these vulnerable positions, but you can decide for yourself what is best for you in protecting yourself and your family as well as your license.
  21. sueture

    LTC and Covid-19

    To any of you working in LTC facilities -- are you accepting new admissions, or has your building put a freeze on them?
  22. To begin, I am a nursing assistant on a med-surg ICU floor in Michigan. We were one of the first floors to be designated for positive-only Covid-19 patients, so it's starting to feel like the new 'normal'. However, nothing about this is like anything we are used to. Our first positive patient was what we call a walkie-talkie. They were one of the nicest people I've ever met, and when I found out they were intubated, I was hoping it wouldn't be for long. They had CRRT. They were proned several times. They coded and were brought back. Yesterday they were terminally weaned. I know this sounds familiar to a lot of nurses out there, but I really had a lot of hope for this patient to be the one to make it out of here. They were only 51. These are the things that really bother me: 1. The majority of our patients have no past medical history. This makes it harder for the families to understand why their loved one is so sick and why they probably won't make it. 2. The no visitor policy means that most families are dropping off their loved ones without knowing if they'll ever see them alive again. Some may get to be there as they are passing, while others will have to wait until the funeral. 3. Seeing people die every shift I work has led me into a deep depression. I love the ICU and when I graduate, I plan on applying here. But this is different than the chronically ill/chronically vented patients being put on hospice. This is death out of nowhere. 4. The thing that gives me nightmares is the fact that the majority of these patients are significantly younger than my parents - whom I live with. I try to put myself in these family's shoes, but I can't imagine what they're going through..I never had anxiety until now... I just needed to get this out on paper, because all of my coworkers are either taking this significantly better than I am, or significantly worse by thinking that they have it or are going to catch it. I can't wait until this is all over. God bless everyone else out there going through the same thing.
  23. Just wondering if any retired nurses have responded for the call to rejoin the ranks to covid-19. I just got an alert to my phone requesting volunteers. I question if this is a good option to replace medical staff since older people are a higher risk of complication for covid 19? I'm almost 60, and was chosen to triage (walks in's not phone triage), potential covid patient's by my employer. Refusal of assigment can result in job loss. I'm worried that no job equals no health insurance in these trying times.
  24. Why hasn’t pay increased? Hazard pay, etc.? Especially considering that multiple hospitals lack supplies for PPE and we are frontline workers.
  25. hherrn

    Infected staff

    I tried doing a poll, but had some technical difficulty. At my hospital, if you are infected with Covid 19, it is treated same as an appy, or a car accident. They have no responsibility, and how you fare depends on your PTO bank, insurance plan, etc.. I am trying to find both the norm, and the range of responses from various hospitals. So- how is your employer treating infected staff?

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