What is it like in your hospital right now?

[FloatFNP-C, BSN, MSN, NP]

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!

[malamud69, BSN, RN]

Similar-We are close to NYC: approx 3 hrs-hospital on lockdown… No visitors… Keeping away all the people that call in the ambulance for a broken finger nail etc. etc. etc.… Seems like people are afraid to come to the hospital right now…The effect is now the ED is split between r/o COVID and really sick Trauma/MI/Stroke etc...Drive through testing center shut down because no tests left… Most r/o COVID patients are sent home and told to self isolate…Current data on lab results seem to be accurate, but without a test how the heck are you supposed to know??? PPE is holding up under rationing, but for how long? Very few admits for COVID...yet… Keyword seems to be “yet” Definitely difficult to get a shift as a Perdiem as our census is even lower and they are canceling shifts… We all fear this is the quiet before the storm… Most hospitals in the general region are experiencing the same-Perhaps the worst thing is that multiple doctors/nurses/technicians were coming to the drive-through test center to be tested because their hospital would not test them. Yup

[SansNom]

I'm in a Nashville hospital and our scenario is similar. We have a lot of quarantined rooms, and most of them are with mild-symptom patients awaiting results. Very few positives so far, and even those have been milder cases. There are a handful of critical patients with tests pending, but for the most part they are med/surg, not ICU patients.

The rest of the hospital outside the COVID units are oddly empty. I mean there are patients, but much less than normal. Everyone's maintaining good spirits but we're all just waiting for the surge we're told is coming.

I'm just waiting another week or two to see how this is actually going to play out. I've been curious if our current situation is unusual or not, hearing so many other nurses panic about PPE and ventilators. We're trying to be conservative, but nowhere near a shortage yet.

[rnmi2004]

Very tense atmosphere at the moment. It feels like the calm before the storm.

[SansNom]

3 minutes ago, rnmi2004 said:

Very tense atmosphere at the moment. It feels like the calm before the storm.

of course, but what is it actually like? many covid patients? if so, are they critical or mild cases? many pending tests? I'm wondering if my hospital is an exception with our situation, even though we're a big hospital in a very populated area.

[GOMERSOWNER2]

Per my hospital's press release we have '2 confirmed COVID-19 patients'. But there at least a dozen more who are very probably positive but the tests have not come back yet. We have had no deaths yet. And, that was the situation as of last Friday when I got off at 7PM after working triage in the drive through screening. There were several folk on Friday afternoon at the screening who showed fever & respiratory symptoms and were tested-of course those tests are not back either. My next door neighbor works nights at my hospital and we both have seen at least 7 patients in an old unit that has been designated as a unit to care for suspected/confirmed covid patients. We have been told there will be an additional covid unit opened by the week's end. I feel my hospital is not being candid with the public as to how many potentially positive cases we have. I also am concerned that many in my area have come in contact with at least one of the positive cases; we asked if they had been in our unit, but we were told they couldn't tell us because it would be a HIPAA violation. I get that-we did not want names, procedure, etc only if they were in our unit which we're pretty d*** certain they were. So we go about our work not sure if or when we were infected all the time knowing if we haven't been infected yet we soon will be what with the dreadful lack of PPE. We also are being told by our hospital as so many have that we will not be supplied with N95's unless it is during an intubation, suctioning, other aerosol releasing procedure. We will be using surgical masks as I'm sure a lot of you have also been told. Our N95 masks are LOCKED up. I am almost 63 and in pretty good health except for some orthopedic issues, (recent avulsion fracture L foot; sever plantar fasciitis R foot & recent R total knee...let's just say I walk like a drunk sailor!), and I am wearing an event monitor for the next 3 weeks for intermittent A-fib/PVC'S). When - not if - I care for a covid patient I would really like, and I feel I require a N95 due to my age and possible heart issues. I do not think I will get one, but I will ask for one verbally and via email. I strongly suspect I will be taking care of covid patients by the end of this week, and it would make me feel much less anxious if I had a N95 -but so would we all. Over the weekend we were informed that codes, (I'm guessing any code-need to see if they can clarify that), would be conducted differently now:

only the charge nurse would be given a N95 mask for the purpose of starting the code while awaiting the code team. That nurse is to put a surgical mask on the patient, (who is coding...hmmm....); one additional nurse with a surgical mask on would place and hold the face mask connected to the Ambu bag on the patient and turn the O2 to 15L. Then the charge nurse is to start chest compressions-NO USE OF THE AMBU BAG--no 'bagging'...wait for the code team, (hope they are not busy or far away - the hospital is a quite large teaching facility). The crash cart is to be left outside the room - even when the code team arrives. We will only be allowed to take the AED in. So, yeah, that's my hospital. Administration is being evasive about cases of covid, is subjecting us to be more easily exposed to the virus, and is deciding that all the ACLS protocols need to be changed during this crisis

[waufah, BSN, RN]

I am in Dublin,Ireland we just started our week 2 on lock down of schools,pubs,outdoor and indoor events. No visitors allowed in the hospital,non essential procedures cancelled,oupatient clinics closed,massive drive to recruit health professionals by the goverment. You ask what it will be like in 2 weeks? Unless there is a vaccine,unless people take social distancing seriously,the storm will hit.

[Ayylmao]

A few in our state but right now I am likely seeing a once in a lifetime silence in the hospital. Rooms empty, ED green, only a handful of staff on. The staff are all guessing the trajectory of the curve that will take place. There are silly jokes, a sudden abundance of food in the staff room, and frank conversations about what's to come. We are all hoping the everyday person will do what's right and needed, as hard as it will be, else no amount of preparation from us will help and we will end up on a curve similar to Italy.

[FloatFNP-C, BSN, MSN, NP]

13 hours ago, GOMERSOWNER2 said:

Per my hospital's press release we have '2 confirmed COVID-19 patients'. But there at least a dozen more who are very probably positive but the tests have not come back yet. We have had no deaths yet. And, that was the situation as of last Friday when I got off at 7PM after working triage in the drive through screening. There were several folk on Friday afternoon at the screening who showed fever & respiratory symptoms and were tested-of course those tests are not back either. My next door neighbor works nights at my hospital and we both have seen at least 7 patients in an old unit that has been designated as a unit to care for suspected/confirmed covid patients. We have been told there will be an additional covid unit opened by the week's end. I feel my hospital is not being candid with the public as to how many potentially positive cases we have. I also am concerned that many in my area have come in contact with at least one of the positive cases; we asked if they had been in our unit, but we were told they couldn't tell us because it would be a HIPAA violation. I get that-we did not want names, procedure, etc only if they were in our unit which we're pretty d*** certain they were. So we go about our work not sure if or when we were infected all the time knowing if we haven't been infected yet we soon will be what with the dreadful lack of PPE. We also are being told by our hospital as so many have that we will not be supplied with N95's unless it is during an intubation, suctioning, other aerosol releasing procedure. We will be using surgical masks as I'm sure a lot of you have also been told. Our N95 masks are LOCKED up. I am almost 63 and in pretty good health except for some orthopedic issues, (recent avulsion fracture L foot; sever plantar fasciitis R foot & recent R total knee...let's just say I walk like a drunk sailor!), and I am wearing an event monitor for the next 3 weeks for intermittent A-fib/PVC'S). When - not if - I care for a covid patient I would really like, and I feel I require a N95 due to my age and possible heart issues. I do not think I will get one, but I will ask for one verbally and via email. I strongly suspect I will be taking care of covid patients by the end of this week, and it would make me feel much less anxious if I had a N95 -but so would we all. Over the weekend we were informed that codes, (I'm guessing any code-need to see if they can clarify that), would be conducted differently now:

only the charge nurse would be given a N95 mask for the purpose of starting the code while awaiting the code team. That nurse is to put a surgical mask on the patient, (who is coding...hmmm....); one additional nurse with a surgical mask on would place and hold the face mask connected to the Ambu bag on the patient and turn the O2 to 15L. Then the charge nurse is to start chest compressions-NO USE OF THE AMBU BAG--no 'bagging'...wait for the code team, (hope they are not busy or far away - the hospital is a quite large teaching facility). The crash cart is to be left outside the room - even when the code team arrives. We will only be allowed to take the AED in. So, yeah, that's my hospital. Administration is being evasive about cases of covid, is subjecting us to be more easily exposed to the virus, and is deciding that all the ACLS protocols need to be changed during this crisis

This is so crazy. My hospital has the exact same "advanced droplet" precautions and I'm using my OWN n95 mask. Currently shopping on amazon for shoe and hair covers to supply myself too. ridiculous.

[nursemols, ADN, BSN, RN]

Census is so low most of us are worried about having a job and are job hunting...

[Kharis, BSN, RN, EMT-P]

We have 2 Covid units. I worked in the "ICU" designated Covid unit last night. We took 4 admissions and that unit is now full at 24 beds. It is a locked down unit. Once you are in, you cannot leave. Scrubs are provided. We draw our own labs, designated RT, no techs.

We opened the overflow "MedSurg" Covid unit with 2 new admissions. That unit will also hold 24 beds, also. All private rooms in both units.

I cared for a patient in negative pressure on Cpap, a lady in hi-flow O2, and a confused lady on room air. So, I was in airborne precautions wearing PAPR for two of my patients and contact/droplet for one patient. N95s are only available in the Go-Bags for intubation (codes).

I normally work a progressive care unit (cardiac) as charge. The house is 50% capacity right now (like most of you). We closed the unit below us. Those patients went to the floor above us and those nurses are sharing hours with the normal staff of the 6th floor. ED is also down. At one point on Saturday night, we only had 5 patients in the whole ED and by 7am, the ED was empty. It is eerie.

There is still a lot of mixed messages when it comes to making a patient "rule out" Covid. I know our nurses have been exposed due to sluggish responses of doctors not following decision trees. We have had one death that we know is Covid, but because she was DNR-CC, it was not worth it to test her (according to the doctors). That lady was taken out of precautions at one point, had a roommate...it was a mess. And we have seen that same error repeated over and again. This is how our frontline staff (RT, PT/OT, nurses, Lab, dietary, EVS, etc) will become ill.

[OUxPhys, BSN, RN]

My floor was turned into the corona positive/rule out floor. No visitors. All elective procedures cancelled and appointments have been pushed to telemedicine. Daily changes, which is very frustrating.