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What is it like in your hospital right now?

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Has 3 years experience.

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, ADN, BSN, EMT-B

Specializes in Emergency. Has 11 years experience.

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

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.

Edited by SansNom

rnmi2004

Specializes in private duty/home health, med/surg. Has 10+ years experience.

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

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

Specializes in ICU/CVICU/PACU. Has 39 years experience.

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

Specializes in ICU,Tele,Interventional Radiology,PACU,Research. Has 14 years experience.

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.

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.

FLOATnureCO

Has 3 years experience.

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

Specializes in PCU Neuro/Cardiac. Has 6 years experience.

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

Kharis, BSN, RN, EMT-P

Specializes in Neuro, ED, Cardiac, Workflow, Project Mgmt. Has 16 years experience.

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

Specializes in Cardiology. Has 4 years experience.

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.

12 hours ago, nursemols said:

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

Yeah, this is not a problem I expected to have. I'm in a float pool so we are the first to get cut, and I've been called off two days in a row. All of our full time staff from other areas that are shut down are looking for hours in a hospital that's way less busy than normal.

I'm fine now, no big deal, but if this continues then I'll be looking into taking a travel position in a crisis pay area. We're still expecting that "surge" soon though, so we'll see.

I've been wondering if this is happening all over the country, particularly the areas already getting hit hard by the virus. Any NYC or Washington state nurses out there care to comment?

nursemols, ADN, BSN, RN

Specializes in PCU Neuro/Cardiac. Has 6 years experience.

11 hours ago, SansNom said:

Yeah, this is not a problem I expected to have. I'm in a float pool so we are the first to get cut, and I've been called off two days in a row. All of our full time staff from other areas that are shut down are looking for hours in a hospital that's way less busy than normal.

I'm fine now, no big deal, but if this continues then I'll be looking into taking a travel position in a crisis pay area. We're still expecting that "surge" soon though, so we'll see.

I've been wondering if this is happening all over the country, particularly the areas already getting hit hard by the virus. Any NYC or Washington state nurses out there care to comment?

Yea I do travel contracts for a health system instead of an agency so I get benefits of staff and travel nursing. I just signed an extension too and now it’s all low census. My manager said I could pick up shifts at other facilities but I I wish I had taken a crisis contract instead of extending

malamud69, ADN, BSN, EMT-B

Specializes in Emergency. Has 11 years experience.

11 hours ago, SansNom said:

Yeah, this is not a problem I expected to have. I'm in a float pool so we are the first to get cut, and I've been called off two days in a row. All of our full time staff from other areas that are shut down are looking for hours in a hospital that's way less busy than normal.

I'm fine now, no big deal, but if this continues then I'll be looking into taking a travel position in a crisis pay area. We're still expecting that "surge" soon though, so we'll see.

I've been wondering if this is happening all over the country, particularly the areas already getting hit hard by the virus. Any NYC or Washington state nurses out there care to comment?

I agree “this is not a problem I expected to have” we are very close to NYC and all the extra/per diem shifts were just cancelled. Census low w/ daily shifts cancelled -daily updates/check-ins as needs change-testing tent very limited due to lack of test kits-Feels like they are keeping the extra staff ready/healthy before the hospital gets hammered.

T-Bird78

Has 6 years experience.

I’m not in a hospital but in an office that is part of a healthcare system that does have several hospitals, urgent care, long-term care, hospice, physician offices, and surgical centers in 10 counties in my area. Our practice has 3 locations, 4 physicians, and front desk/clinical staff in each location. We’ve closed one location indefinitely and only have one physician in the other two locations at a time; the other 2 docs are “work from home”. We’ve cancelled all elective surgeries. The physicians reviewed the schedule and we’re only seeing urgent pts and new pts must be approved by a physician. The few pts we do see are scheduled at least an hour apart so we can clean the exam room and waiting room completely between each pt, and so we don’t have a full waiting room with 15 people at a time. We’ve gone from seeing 40-50 pts a day down to 2-3 depending on the physician. The docs are doing telephone visits for follow ups/CT reviews, etc. We’re looking at starting video visits next week. The drive to work has been a breeze though! The two LPNs in our practice are on standby to help with other practices or in the hospital if needed. I admit, I feel useless when there are so many in our local hospitals (almost all of our hospitals have at least one case of COVID-19) that are being run ragged.

I am at medium to small rural hospital. We are sterilizing N95s and goggles. We do not have any facemasks but we do have goggles. We are using blue isolation gowns on the floors and a surgical gown in the ED. So far we have enough supplies because we are rationing them. So far no positive covids. We have an isolation area with 8 beds on medsurg and all of our ICU beds are negative pressure. We have alot of sick rule outs, but most are sent home on self-quarantine. Our tests result in 4-7 days. We have 6 ED negative pressure rooms and they are usually in use.

Does anyone else hate starting IVs in goggles? WOW! not easy!

Also no visitors in the hospital and emergency surgeries only. Lots of family phone calls alllllll daaaaaay. Lots of scared patients, listening to the news. All patients are especially sick and we are doubled up in non covid rooms, admissions are for the ones who really need hospitalization.

I was looking at the Taiwanese nurses who have a low nurse infection rate and they seem to use N95 with surgical mask over top. The have a face shield over that. Would be great to have all that available, as the goggles seem to dig into the face badly when pulled tight. Cannot complain after hearing about how so many of us are working without supplies altogether.

So far holding steady, anxious about the future.

Gampopa

Specializes in Adult M/S. Has 10 years experience.

Like others have stated our ER has been really quiet and census is low. Our hospital has been financially marginal for the past 2 years and there is deep concern COVID19 will bankrupt us. No elective surgeries or outpatient procedures and the extra cost of COVID is making things really tenuous. We've had 2 deaths and several rule outs. We're making all kinds of plans for when the wave hits and hoping that the Federal economic package will have some money to keep us afloat.