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Due to the COVID-19 topic’s nature and strong language, the reader’s discretion is advised!
I write how I speak, that’s a problem when writing because, more often than not, it doesn’t translate well in the written form of communication. In fact, I went through several drafts of this blog but seems that they were too formal, good but too damn formal.
So here’s my week… little preface, besides my photography career, I work as a nurse in a local hospital. Until recently, we were considered the Geriatric/Infection/Vent/non-acute Telemetry (heart observation) unit. Our unit was the first one to receive the COVID-19 rule-out patients, and we were prepared for it… mentally/physically … so we thought…
For years, and I honestly blame upper management for this, we felt like the neglected part of the organization. Our unofficial anthem was “Loca People” by Sak Noel—feel free to look it up (user discretion advised) to get an idea of our vibe. It wasn’t until our previous and current managers took charge that we, as a team, finally began to feel that our needs were being addressed. However, a lot changed several weeks ago when COVID-19 officially entered the United States. Personally, I, along with many of my colleagues, believe that the virus had been here for months before it was officially recognized; we just didn’t know how to identify it at the time. We are part of the team that works with the ‘statistical’ population at risk. Nevertheless, here we are…
I came in on Tuesday, received my assignment, and got to work. I spent the day preparing for interdisciplinary rounds, answering phone calls because we don’t have a unit secretary, assessing the current state of the patients, and addressing situations where people aren’t washing their hands. Seriously, it’s so frustrating! Wash your hands between each patient! This was an issue even before COVID-19. Here’s a fact: just because someone has a specific job title doesn’t mean they are a nice person; it just means that’s their job. When it was time to distribute medications, it might seem like an easy task, but for every patient, I needed to gown up, glove up, and enter the room. I had to wait for the patient to finish taking their medication and ensure they weren’t choking on the pills.
After that, I’d come out, rewash, and head to the computer—hoping it hadn’t logged me off—and repeat the entire process. I was also waiting for the pharmacy to bring in medications that weren’t available on the floor. After finishing with patient #8 (or #9 or #10), I had to go back to patient #1 to bring the meds that weren’t there earlier because the pharmacy didn’t restock. I’m not blaming the pharmacy; they have to verify the safety of the medications first. It’s frustrating when the doctor who wrote the order didn’t check the blood work! When the pharmacy tried to call the doctor to clarify, he wasn’t picking up the phone. At the same time, I saw another doctor who suited up, gloved up, and helped a patient with a bedpan. Have you ever seen this? I have, and it’s the kind of compassion I admire. Those are the kind of people who truly care!
I stepped off the unit to get a bite (it’s around midday), my first bite in my mouth since I woke up at 4 am, and the code is announced on my unit. I run back (yes, nurses run, not like in movies or overdramatize, but we RUN) full code in progress. The COVID-19 patient didn’t make it. FUCK!!!!!!!!!! Another statistic. Clean the patient, while MD notifies the family, then file the necessary paperwork – phone call from another family member who is checking up on their loved one (talk about having multiple personalities – I’M PISSED B/C I just lost a patient but have to switch and talk about another pt, know and reassure that they are safe, currently comfortable, know they pertinent labs/test/vital signs results).
Now I’m thinking and second-guessing if I missed something with?! Notify Bikur Cholim to wrap the body and take her to the morgue. Did I miss something on my assessment?! Did I allow her to die in pain and agony? What if it were my grandma? Well damn, it was in 2011, my grandma while being on the ventilator who taught me a LIFE LESSON. Now I want to drink and/or use the bathroom, but no time to do that. Earlier,I notified the ICU MD about another patient who doesn’t look so good. For the Intensive Care Doctors, every time there’s a rapid response or code activated, they have to go. After 4+ RRTs throughout the hospital that Wednesday, I lost count of how many more there were.
Another COVID-19 patient on our unit, with oxygen saturation of 60 (90+ is ideal) is crashing – call the Rapid Response Team – 40minutes later, RRT finished, he is intubated, somewhat stabilized; back again to my earlier request of a patient who doesn’t look so good, ICU Doc, sends me an ICU fellow and THANK G-D for her; I give her two patients to evaluate and now we are running TWO more RRTs nearly at the same time – one ICU doc in one room and second doc in the other room, two patients being intubated & stabilized. FUCK!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! That’s only my unit, not even end of the day; what about the rest of the hospital and their codes, their RRTs?!
Finally, it is 7 pm, my relief is here, my friends from night shift (I’ve started on the nights and had an opportunity to go to day shift), and they’ll take over. I go home, I think about my family, I call my grandma and tell her again, – if you want fresh air, go on the balcony!).
Two days later, on Friday, I return. My main unit is short-staffed, more staff are out sick with (+) COVID-19, I’m being sent to our secondary unit/wing. Luckily, I’m working with two other nurses who are amazingly smart, kind-hearted people -teamwork. I’m also assigned to be in charge, and I’m orienting a newly hired grad. nurse. First, I LOVE orienting and teaching new-hires, I feel like I’m being intellectually challenged and kept on my toes, I also feel like it’s an opportunity for me to give back to the nursing community/education, but I hate being in charge, b/c it usually means dealing with extra administrative duties.
Normally, when I teach, I’m known to be hard-core: I teach a lot, I cover a lot of ground, I don’t take easy and give easy 1-2 patients, I give everything. We work together, I cover as much info as I can as to what we’re doing, why we’re doing and how we’re doing it. What is supposed to take 10 minutes, while teaching, takes 40 minutes because I need to explain the thought process, normal and abnormal findings. Add 8 patients to that, and being in charge – Oh FLUFFFF MY FEATHERS!!!!!!!!!
Then a code is heard overhead, and a few minutes later another one is announced. My main unit calls a code, then a second in a different room – that’s FOUR CODES at the same time in the hospital… phone rings and family wants to check on their mom. Mom isn’t doing so well. Earlier in the day, her blood sugar was 36 (critically LOW), luckily it’s up now and she’s more alert, but she’s on my eye as a critical one. This woman has been in the hospital 1 month, daughter is crying on the phone how she wants to see her and and speak to her, but mommy is too damn tired to press a button on the phone and talk with her daughter. Another family calls for a different patient; more teaching for my new student.
A local pizza store baked an incredible number of pies for the staff and delivered them. Now, the bosses are distributing them to the units—what a wonderful gesture! Thank you, thank you, thank you! There’s another code somewhere, and another Rapid Response Team (RRT) alert on my home unit (not my wing), which means more teaching opportunities. My daughter calls and asks me a question about science. At the same time, I really need to use the restroom. Then, a relative texts me to let me know that my uncle, who is positive for COVID-19, is now experiencing symptoms that may require a hospital visit. I’m managing that discussion over text. Meanwhile, another patient had a bowel movement, and since she is morbidly obese, it takes both myself and the PCA to clean her up, as one person cannot handle it alone. I also receive a call from family about “Mom,” the one who has low sugar levels in the morning. They mention that she is not picking up her cell phone. There’s an overhead call for another RRT. I feel the urgency and think, “I need to do whatever it takes to keep this woman alive so her daughters can hear her at least one more time!”
640pm, My shift is coming to an end, the unit with 19 COVID-19 patients is being told that we only have ONE nurse available. I ended up staying and continuing the best I can possibly to care for now 10 patients. Another nurse became available and he got in around 1130, I handed off to him and finally SIT DOWN, since 630am. I change out of scrubs, take my stuff, and my home unit calls a code. I grab the crash cart and assist remotely (mind ya, I’m in my regular clothes now). My home unit, 35patients, has 3RNs, 4 PCAs, a respiratory therapist, an MD, PA, working up a code. I get the ‘go ahead’ from the charge RN and head out.
It’s midnight, I thank again everyone with whom I worked these past hours – people who provide physical and more importantly, emotional support to get through the Covid-19 pandemic. I finally go home. More than any other day, I’m thinking if “mom” will get to speak with her daughters and sister at least once more if 54 y/o confused woman will be stable enough to go home in the AM, if my other patient will break the fever..
I spent nearly 17 hours wearing the same set of masks and face shield b/c in truth, WE, as the hospital system, DON’T HAVE ENOUGH to go around and reuse after every COVID-19 patient. Damn gowns, are great to work out in and get a sweat on, but keeping one for hours at a time while running between patients is…. something else.
My daughter calls me, it’s midnight, I’m wondering why she isn’t sleeping :). I’m seeing signs on the trees and garbage cans by the hospital. Signs of hope, signs of appreciation, signs that maybe there’s somebody out there who understands the darkness we are facing with COVID-19.
Ironically, its photography (skills that started honing in the 90s) used to preserve these memories….& found out that local channel 7 news reported about this message of hope.
I get into the car, my wife sends me a quick text, before I get to open it, she calls me, and we talk while I drive home. We talk about her day – homeschooling four kids and managing their fights, we talk about my Uncle who went to the hospital, we talk about our parents, we talk about photography and how much we miss it.
Finally, a chance to turn in for the night, send a quick text to staff I worked with, thank them for making the day easier, another set of texts of staff/friends who are ill… thank you all!!!
