Living On The Edge

It looks so calm outside. The sun is shining. There are cars on the road and people walking around. It looks like any other spring day in Chicago.

It’s not any other day because here I am, at home, feeling like all the worry and anxiety I suppressed about this virus bubble up. I should limit my social media time. Really. The private Facebook group for my fellow nurses at my hospital is informative, but sometimes it takes me down the dark, winding path of despair. Issues are brought to light that are familiar in other institutions across the country, even the globe. The same pressing issues are at my hospital.

Not enough Personal Protective Equipment… Inadequate Personal Protective Equipment… Not enough COVID-19 tests… Not being notified if you take care of a COVID-19 patient… Not being tested after exposure to a possible COVID-19 patient… Changing guidelines from the CDC based on availability of supplies in this country and not because of science… Finding out that someone you worked with was just diagnosed… Worrying you might bring the virus home to your loved ones…

I try not start my day on social media, but then the fear of missing important information sucks me in. Then the stress… Why do I do this to myself? And on my day off no less…

Do nurses ever really get a day off in a crisis even when they are not at work?

I am also in a Facebook group called COVID-19 FOR HEALTHCARE WORKERS. Based on posts from frontline healthcare providers in Italy and other parts of the world, I am anticipating that our situation is about to get worse. I’m gearing up by seeking out Best Practices. It is so sad that I may benefit from the horrific experiences of my fellow nurses. May God have mercy…

I wonder, is everyone awake and ready? I hope so…

Calm Before the Storm

Unprecedented has to be my least favorite word these days. It feels like every news report (over)uses that word. Basically, what I’m hearing is that no one – not our government, the CDC, our hospital administrators – really knows what to do and is figuring it out on a day-by-day, hour-by-hour, minute-by-minute basis. I was hoping was that, at the very least, our elected officials had an emergency plan in place. Makes sense, right? There has been sufficient warning by epidemiologists in the past about possible global pandemics. When I am in a procedure, I have a plan for emergencies like a cardiac arrest, excessive loss of blood, etc. The likelihood in most cases is low, but I am always ready. Why aren’t our elected officials held to the same standard when their decisions affect the lives of many?

I am frustrated and frightened by the whole situation….but I press on.

Over the last week, I have tried to stay as updated as possible by trying to find reliable sources about the prevention, diagnosis, and treatment of COVID-19, the challenges shared by frontline healthcare workers all over the world, and the developing situation in my home city. Needless to say, it is difficult and completely overwhelming. And !@#$-ing scary.

The first time I heard about COVID-19 in a work e-mail was in late February. At that time, no alarms were going off. It felt more like a head’s up than a warning. Then information went from a slow trickle to a continuous flow. Currently, e-mails are packed with paragraph after paragraph of what the hospital is doing, what the city is doing, what we should do in various scenarios, what numbers to call, etc. All this makes my head spin. Ugh. How am I managing all this information? I created a COVID-19 folder in my work account just so that I could track the updates and make sure I know what’s what.

Needless to say, there has been confusion, anger, and anxiety among my fellow staff members in the OR. Totally understandable. We are accustomed to knowing what to do, even when a trauma comes in. We are used to seeing the worst of the worst. We are at a Level I Trauma and Research Center on the south side of Chicago, for Pete’s sake! Our preparation for COVID-19 was nothing like our Trauma Readiness Training two years ago. The hospital was all over it. But now? Why is this different?

Go ahead… Say it… UNPRECEDENTED.

So there have been a lot of What If discussions floating around the unit. Personally, I try not to participate. It is not helpful unless the What If’s are followed by a plan. I want to hear a plan.

Can someone PLEASE give us a plan???

Last Tuesday, St. Patrick’s Day, was the first day of the cancellation of elective surgeries. Our whole Ambulatory Surgery OR was shut down and the staff sent home on Low Census with a possible re-open date of April 15th. It was a shock that rippled through every OR (and we have 3 different OR units – Adult, Pediatrics, and Ambulatory). So many question followed… I still have questions.

The cancellation of elective surgeries also impacted the Adult OR (the Main OR) where I work. It has slowed down so much, that adjustments have been made to our schedules to low census some of us on different days. Still, we are “on reserve.” All of us in the OR know that it is just a matter of time before there is a need to float us to other areas of the hospital. Already some of our surgical techs have been asked to go to the units to monitor providers while they don and doff (put on and take off) Personal Protective Equipment (PPE).

Instead of sending us home, why don’t they set up training for other possible roles? Why aren’t they taking inventory of skills? They should be asking the OR Nurses who have experience in the ER, ICU, or MedSurg Floor. Unfortunately, I have no such skills, but I am willing to learn. How about organizational and management skills? Isn’t that good for crisis management? I’m just wondering…

Practicality Not Panic

These are strange times…

As I was getting ready for work this morning, it dawned on me that I was one of the few residents that would actually leave this 40 unit low-rise condo building to go to WORK. This gave me a sense of purpose that I hadn’t felt in a long time. Or was it just a heavier weight on my shoulders?  Yeah, that’s probably it.  Since COVID-19 started making its way through my city, my neighbors, family, and friends have been working from home, even having to self-quarantine after an exposure to the virus.

Not me.  Not yet.  I’m a nurse.  This crazy pandemic is calling.

Hello, Nurse…  I’m waiting for you.

When I arrived at the hospital, it felt like I was in a new world.  The vibe was intense.  The normal glut of visitors at the security desk were missing.  No medical students rushing past me running late for rounds.  It was almost like a lockdown.  Almost.

As of today, our ambulatory surgery center was officially CLOSED.  All those nurses and surgical techs sent home until April 15th.  What the…..???  Our main operating room OR (where I work) cancelled all elective surgeries per the recommendation of the American College of Surgeons and our government (I’m assuming).  The monitor with our status board was depleted of its normally extensive list of cases.  Instead, a teeny tiny list.  It was so surreal.  We are talking a BIG surgery department that typically performs a lot of procedures now down to a select few.

Makes you want to rub your eyes to make sure you’re not seeing things…  But no…  Hands away from your face!

Because of the small number of cases, some nurses and techs had already been asked to stay home.  We called this “being low censused”.  Basically, this means that there isn’t enough work for them so they are being mandated to stay home, and use their vacation time if they want to get paid.  One day here and there isn’t bad…  But what if the hospital does the same thing to us as our ambulatory surgery colleagues who are off for a whole month?  I hate to even think about this…

I was assigned to circulate three orthopedic cases which kept me busy most of the day.  During slower moments, my mind kept spinning different scenarios on what would happen to me and my co-workers should the number of COVID-19 patients rise in our institution.  It is too soon to say.  Many nurses want answers as if this virus was planned or as if our administrators had been through this kind of crisis before.

NO ONE HAS EXPERIENCED THIS BEFORE.

What a scary thought.  We are looking for guidance, but sometimes those above us cannot figure out the best course of action fast enough.  I would like to believe that everyone is doing the best that they can.  The only thing any of us can do it take it one day at a time, be practical and not panic. 

I know in my heart, we will get through this…  We just need to hang on to hope and find a way to be kind to each other through this frightening time.