What is it like in your hospital right now?

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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!

Specializes in Family medicine, Cardiology, Spinal Cord Injury.

The last day in my bedside nursing position was on 2/14/2020 before this whole situation unfolded. I now work in an outpatient clinic as a cardiology provider. The unit I left was a 30 bed spinal cord injury unit. It has since been converted to a med-surg unit in anticipation of the surge. All the SCI patients have been moved to the remaining 2 wards. Census has dropped from the 60s to the 40s. My unit's staff has been split. There are now cases of positive covid-19 among the SCI patients. The hospital is locked down pretty tight, no visitors. My current affiliated hospital has 18 positive cases with 18 suspected awaiting confirmation. Cath lab is only for emergent cases.

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Specializes in SICU Nurse.
4 hours ago, Texasmama72 said:

Where are u?

South Ga

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Specializes in Ortho, CMSRN.
On 3/31/2020 at 8:38 AM, turtlesRcool said:

"Um, no. The incubation period is 2 weeks. You're looking at a decrease over 2 days. If your patient numbers are decreasing, then one of two things is happening. 1) you're still in the calm before the storm and it will ramp up. 2) the isolation is WORKING, so don't send people out to mingle and infect each other."

It appears as though my optimism was a bit premature. Yeah, they're increasing. At a slow rate, but we're getting more and more. I was really hoping that it might disappear with the flu in the Spring, but so far it doesn't look like it shows signs of slowing just yet. We are now projected to reach our peak in a month.

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I'm in LV, NV. At my hospital one unit has all covid patient and one is rule out and positives. There are no visitations

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I think things are starting to pick up in middle Tennessee. We've expanded our covid units to 2 ICUs and 2 med/surg floors. Have a bunch of positives (a few critical) and a bunch more waiting test results who we're getting in and out as fast as possible.

I had what might be a first glimpse of what's to come a couple of days ago. Was working in an ICU overflow-turned-covid unit admitting a patient with some respiratory trouble from the ER, with a very covid suggestive CXR and pending test results. Some dyspnea, but only requiring 4L o2 on arrival, so not too bad.

While I was gowned and masked in the room doing the admission, I get a rapid response to my other room from med/surg unit with a covid+ patient who had been up walking an hour before but was suddenly crashing quickly. We intubated, started a few lines and IV drips (central line, a-line, OG, esophageal temp probe, foley, sedation, pressors) and got them fairly stable and evened out over the next 3-4 hours.

During this time my ER patient is slowly requiring more and more oxygen and is now on about 8L high flow. About mid afternoon, when I'm trying to sit down and chart the day's worth of events, a tech is in the room helping the patient out when she calls me urgently through the glass. Sats in the 60's, patient pale and panicked. We intubate, same routine as before. I think both patients were going to be proned last night.

It was a super busy but manageable day thanks to good teamwork, but the whole time this was happening I was thinking what a disaster it would be if anyone else was crashing at that time. 2 crashing a few hours apart is busy enough, if we had even 1 more that had slipped in that time we would have been pushing our limits (I was the only ICU nurse in the unit).

Projections for Tennessee are actually pretty encouraging at the moment, but I have no doubt we'll see another few days like this and worse before this is through. My facilities are doing the best we can with PPE. I got one N95 to use, and was supposed to use it the whole shift, but we also had our "hallway masks" we wore outside the rooms, and then separate masks for each room.

Anyway, thought I'd share my first face to face critical experience with covid. Hope everyone's doing well and staying safe.

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On 4/3/2020 at 4:47 PM, Texasmama72 said:

The CDC is reporting over 5000 deaths to dste. I look on this forum and read the stories, it doesn't appear that is possible? Thoughts?

The nurses posting here are the nurses whose facilities haven't been hit. The nurses experiencing the surge are too exhausted to come and post here. Many parts of the country are still in the very early stages.

It's ramping up here. On Tuesday, the med-surg COVID unit I was working on had three patients (out of about 40) die within about an hour of each other. By that point, they had all been made CMO. Around 7:15 am, I went in to find one gentleman on a non-rebreather with sats in the 50s-60s with respirations in the 40s. The doctor didn't want a fast team, as they'd been moving towards comfort with the family. Really, the only thing left to do was to intubate, but he was DNI. Poor guy was struggling to breathe, and kept trying to take off the mask, I think because he felt like it was stifling. Anyway, we were able to get him comfortable after the family agreed to CMO, and he was one of the patients who passed that evening.

One of the nurses was near her breaking point, and said, "I just can't deal with having a patient die every shift." Fortunately, no one died yesterday, and this nurse has a long weekend off (was supposed to host Easter this year), so hopefully she'll be able to regroup before coming back next week.

Once the volume of COVID patients goes up in your hospital, you'll start seeing that uptick in deaths.

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On 4/3/2020 at 3:47 PM, Texasmama72 said:

The CDC is reporting over 5000 deaths to dste. I look on this forum and read the stories, it doesn't appear that is possible? Thoughts?

Think of it like a tornado. It doesn't hit everywhere at once at the same time. It moves slowly, sometimes destroying one building while leaving the one next to it with a blown over trash can.

The places we're seeing on the news are like neighborhoods directly hit by the tornado. If the news reported the neighborhoods that weren't hit, no one would even believe there was a tornado at all, or they would think tornadoes really aren't that bad.

If you're not seeing your covid admissions and acuity pick up it's either because it hasn't made it to you yet, or you will be one of the fortunate facilities who won't get hit as hard as some, due to either social distancing or the natural factors of where you're living (population density, demographics, etc). Death toll is over 14,000 in the US now as of when I'm writing this.

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Specializes in Geriatrics/Med-Surg/ED.

Covid19.healthdata.org has a lot of information

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Specializes in Critical Care, Public Health, Addiction.

Working in 140ish bed hospital in a PA city (but not in center city, more suburban-y).. One 10 bed ICU - but now they just opened up a second ICU for the overflow. PCU is packed, ED is packed. Staffing is horrible, 3 to 4 ICU patients per nurse - sometimes without any help on weekends or nights (ie extra set of hands from OR nurse or CNA). It seems very unsafe and I feel like we are providing the minimal amount of care (breathe, keep vitals stable and have some fluids and calories, oh and stay sedated), just to keep someone alive due to lack of time in a 12 hour shift, having to stop and refocus on emergencies, and just inadequate staffing (obviously a sad reality). Apparently several codes and a death or two this week. Lots of covid patients, no spearate units for covid vs noncovid or rule out.. Running out or low on some specific tube feeds, IV/feeding tube pumps, vents... We have the IV pumps outside of the rooms now to prevent us from having to gown up and go in frequently. No staff have gotten sick from being exposed yet that I am aware of. Discussions regarding to trach or not to trach- OR vs bedside procedure. No covid patient have trachs yet and some have been intubated for awhile now. Knowing the illness can last 2 to 3 weeks is giving families hope that their loved ones will recover. Stressful.

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I don't work as a nurse yet but as a tech. We are preparing for the surge in cases. It is pretty slow for me since our unit does elective surgeries. They keep saying there is going to be a surge in COVID cases. For me, it doesn't not seem very busy. In about 1-2 months we will see though.

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We are slowly but steadily rising however it seems to have dropped off a bit. Our state stats are as follows. Last week we were increasing by 13-17% per day. This past week it has been dropping finally to 6% increase today. Hospitalizations are steady at 30% and ICU admission are 30% of that number. Our CFR is about 3.9% which has been steady. In my hospital I believe we have 14 COVID + ICU patients. We’ve had 2 deaths including one of our physicians. No idea how many + or PUIs we have. They have turned one of the hospitals (there are 6 hospitals connected to each other) into a COVID hospital and one of the floors of the heart hospital has been turned into another ICU. Our surge is supposed to hit at the end of next week. We are low on PPE. All staff is masked at all times. We are expected to wear the same mask until it is too soiled to use. We have a paper bag to store it in. They want us to try to use it for a week. ?We can get a new one but they scan our badges to track it. No visitors at all including the ambulatory areas after COVID + patients got by the screeners and exposed the staff on at least 5 different occasions. Our hospital census is at 44%. In my clinic alone we normally see between 140-160 patients per day. On Friday we had 12. Nurses are being low-censused. Never in my life have I been worried about having a job when this is over. We are being cross-trained to in-patient. I fear this is the calm before the storm but my state locked down early and hard. I have no idea what’s going to happen. I want to be optimistic but this virus is sneaky. ?

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Specializes in orthopedic/trauma, Informatics, diabetes.

Our census is low but pos Covid pts has increased 4x over the last week (I work weekends). Expecting peak in the next 2-3 weeks. NC

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