What is it like in your hospital right now?

SansNom · Mar 25, 2020

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 · Mar 25, 2020

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, BSN, RN · Mar 25, 2020

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 · Mar 25, 2020

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.

magickbubble · Mar 25, 2020

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 · Mar 25, 2020

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.

pastudent · Mar 25, 2020

In South Carolina - we are waiting for the storm.

I'm wondering if any hospitals/ units are cohorting staff. Right now we are over staffed - as positive cases start to come in the chance of staff getting sick will increase. If one gets sick, our co workers may fall ill. It seems like it would be a good idea for us to divide into teams - so that we won't all be mingling together. Thoughts anyone?

otgd8 · Mar 25, 2020

12 hours ago, Kharis said:
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.

My hospital ICUs are all COVID now. 40+ COVID positives with tons of R/O on respiratory floors, med/surg, and ED units. Once ICUs fill up post anesthesia area will be used. We do not have enough negative pressure beds so we will be using filters (false sense of security in my opinion). RNs are told to cluster care and not go into COVID rooms more than 3 times and enter less if they could help it, told not to do mouth care and minimal to no turning of patients. N95s are to be used throughout the duration of the shift and will be cleaned at the end of the shift, they will be providing clean scrubs at start of shift and checking temps. IV pumps will be outside of the COVID rooms, tons of PPE on backorder already. I wish my hospital did not let the techs go in the room. Initially, they said they would not but I was apprehensive and thought there is no way that policy is going to stick when the COVID patients increase and lo and behold they changed the policy. I am actually a tech right now (accepted to a BSN program but the start date is on hold from all of this madness with COVID) and my hospital management is telling everyone to buy their own PPE or ask the community to make it and send it in. I no longer feel safe and am considering leaving. I am a tech after all. But I would strongly consider staying if my hospital provided temporary health insurance to per diems but they do not. Instead, they are giving 2-4% raises. Money means nothing if you do not have your health.

Naturally Brilliant, BSN, RN · Mar 25, 2020

You guys are gonna hate my guts for this...

I work in an inpatient psych hospital. The top administration decided to block various numbers of beds on our units and have kept the patient census count lower than normal. They also take our forehead temperatures when we enter the building. We have some protocols in place for dealing with Coronavirus patients but *knocks on wood* haven't had such a patient yet. They're not admitting walk-in patients and the patients that get fed into this psych hospital have to be screened first for this stuff (like their travel history, etc.) before they can be accepted. It's actually been quite nice having less patients!

otgd8 · Mar 25, 2020

@Naturally Brilliant I don't hate you! Consider yourself blessed.

brap740, BSN, MSN · Mar 25, 2020

Well I’m glad a sample from the entire country shows much of the same.

no PPE, no clear directive and massive amount of hours being cut to save the bottom line.

Seems to me nobody knows how to bend and adapt for a crisis. If there is no policy written then nobody in administration knows what to do or how to provide clear focused direction. It’s just hammer mass emailing everyone 3-7 minutes with a new poorly written guideline that’s 9 pages long to which nobody has the time to read anyway?

Clear...simple...direction. 5-7 sentences. Twice a day. Keep it simple. Supportive care. Staff as if you are full even if you aren’t. Those that aren’t caring for patient engage in triage and mass triage exercises. Keep your employees working Atleast for 7-14 days. Then lay off if need be. But don’t ask people to stay home without pay and tell them they can’t apply for unemployment when the census is low. What’s going on is insane.....

PeachyERNurse, BSN, RN · Mar 26, 2020

Is anyone else’s facility refusing to allow staff to wear masks (including plain old surgical masks) unless they’re caring directly for a COVID-19+ patient?