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Sinking

/ Marjorie / Leave a comment

It was the beginning of the COVID-19 pandemic when last I posted. To summarize where I have been over the last year feels impossible. I have not quite come out of the Pandemic Funk. Actually, I’m not sure I know anyone who has. People may say it has been quite the roller coaster ride; to me, it has been more like traveling through the Swamp of Sadness in the Never-ending Story. In order to get through it, “you must not let the sadness overtake you.”

I’m not winning…

At work, we went from stopping elective surgeries in April 2020, to having a committee decide which surgeries we could do, to finally opening it up to business as usual by June 2020. We started vaccinating staff in late December 2020, which I was part of the lucky first group of staff to get a shot. The vaccine clinic was happier than the happiest place in the world, Disney World, everyone said. Masks have been required in the hospital since the start of the pandemic. Only recently has my institution changed its policy, now requiring surgical masks onsite instead of cloth ones. Thank you, Delta variant…

Last year I thought that the OR staff would be redeployed to other areas of the hospital. It never happened. As it turns out, we have a very particular set of skills (think Liam Neeson, but opposite): saving people via Trauma Surgery. I never thought about this before, but it is true. As challenging as it is for med-surg nurses or other unit nurses to go to the ICU, they would be able to handle that. Going from floor to surgery? BAD IDEA. Covering trauma surgery? WORSE IDEA! Our OR staff can set up in 4 minutes or less to take care of a trauma patient. The upper leadership concluded that it would be wise to keep those of us with these crazy but necessary skills out of COVID units, so that someone can take care of victims of gun violence and other traumas.

Gun violence in Chicago… Sigh. That is one thing that did NOT stop during this pandemic. And it seems like it is getting worse. Honestly, I thought it was just me who thought this. Today I asked my OR crew of friends and everyone agreed: things are getting scarier in Chicago. We don’t need to look at the stats… You can actually see how many patients with gunshot wounds are rushed up to surgery. Who knows what the city’s Powers That Be will do, IF they do anything, about this violence. All I know is, my desire to leave the city that I love is growing each day. The shootings, the taxes, the traffic, the cost of living, The Cubs; this city hasn’t been the same for me for a long time.

This is all too much…

I feel like I have been in a constant state of mourning since the beginning of the pandemic. So much has been taken away from me….from all of us.

Sadly, days after my last post (March 24, 2020), I lost my Auntie C. (my mom’s sis-in-law) to COVID. She was an ICU nurse for over 33 years in Florida. Auntie C was taking care of patients infected with the virus until she couldn’t anymore. By the time her COVID test results came in, she was already at death’s door, unable to breath. COVID-19 was so new, so many unknowns, that doctors were unsure of interventions. She died on March 27, 2020. Auntie C’s funeral was live streamed via Facebook. I watched on my laptop while Facetiming one of my cousins who could not see it via her computer at work. No one in my family could go down there and stand beside my uncle as he laid her to rest. It was so surreal and made an already tragic moment worse for my family.

I watched as other family friends went through the same thing. They lost loved ones to COVID and were not able to properly lay them to rest.

My personal list of losses, other than my Aunt, have accumulated. I realize they may not be terrible in the grand scheme of life; however, if added up, weighs heavy on me mentally and emotionally.

I am mourning what I once knew…

My family has changed. Over the last four years, the family dynamic became uncomfortable, even hostile, because of political views, Democrat/Independent versus Republican. In comes the COVID-19 pandemic and then it became Science versus Nonsense/Politics. My family has never been so divided… I mourn the loss of joyful family gatherings focused on food, music, dancing, laughter. I am sad that I have to step on eggshells and think carefully of how I phrase things when speaking to certain family members for fear of triggering an argument about truths and non-truths, leading to anger, frustration, and hurt feelings. When a conversation starts going down that path, I try to pump the breaks before it ends up in a family feud.

Will my family ever recover and go back to the way it used to be?

Recently, I moved from one home to another. It is a big change, exciting in many ways, but very stressful. My partner of four years, aka The Bear, believes that the move triggered ALL the feelings I have swept under the carpet. I have been more irritable, moody, negative, and impatient. That isn’t my baseline emotional state and it is scary.

When I feel like my world is out control, I tighten up the reigns on whatever is mine: my things, my time, my compassion. I can’t share. I close up shop. Knock, knock. No one is home. This doesn’t bode well for all my relationships, especially the one with the love of my life.

Things finally came to a head the other day. The Bear had a “Come to Jesus” talk with me. He was brutally honest. But he was right. I knew he was right. I have been sinking in The Swamp of Sadness and have not been myself lately.

Tears, tears, tears. Then more tears.

I decided and he agreed: tomorrow is a new day with a new mission — Saving Myself.

Nurses, like many healthcare workers, are not good at taking care of themselves. We advise our patients on better health but completely ignore our well-being. Now, more than ever, we need to stay healthy – mentally, physically, emotionally. This pandemic is far from over.

“The woods are lovely, dark and deep,
But I have promises to keep,
And miles to go before I sleep,
And miles to go before I sleep.”

No more sinking… I promise.

Calm Before the Storm

/ Marjorie / Leave a comment

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…

A Heartfelt Letter

/ Marjorie / 2 Comments

Recently, the nurses at the University of Chicago Medical Center (“UCMC”) have called for a one day strike for the second time this year.  This is the result of unsuccessful bargaining between the unionized nurses and hospital administration over safer staffing, safe working conditions, and benefits.  A hospital-wide e-mail was sent out by one of the administrators depicting the nurses as cold and heartless.

The message made its intended impact as UCMC nurses expressed hurt, upset, and outrage on social media.  One nurse posted a response on Facebook which activated overwhelming support from her fellow RNs.

Here is that eye-opening, heartfelt letter from the UCMC PICU Nurse….

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WRITTEN BY A PICU (PEDIATRIC INTENSIVE CARE UNIT) NURSE AT THE UNIVERSITY OF CHICAGO MEDICAL CENTER IN RESPONSE TO AN INSTITUTION-WIDE E-MAIL FROM A HOSPITAL ADMINISTRATOR.
Dr. Polonsky,

We’ve never met, but I recently heard you speak at the service awards in October. I was there celebrating my five year anniversary at UCMC. It was quite a celebration for me; I’ve worked at UCMC for five years, I’ve been a nurse for five years, I’ve lived in Chicago for five years. That night, I thought the University of Chicago did an incredible job of making me feel valued, appreciated, and immensely proud of the work I do, and the place where I do it.

Tonight, receiving your email has undone all those feelings. I am a dedicated employee of this organization; I am a natural rule-follower, I hate being in trouble, and I hate conflict. However, I feel compelled to write to you, someone I’ve never directly met, and someone who sits well above me in status (and pay) at our organization, in order to convey some sentiments and facts that I feel you have grossly misrepresented in your earlier email.

“Once again, rather than stay at the table and engage in the hard work of reaching the compromises that will produce a new contract, the Union is ordering nurses to walk out on their patients and their co-workers during a holiday.”

This is simply false. The union has called a strike on Tuesday, November 26th. Thanksgiving is Thursday, November 28th. While the union has called for a one-day strike, it is hospital administration that is choosing to lock the nursing staff out for the Thanksgiving holiday. Additionally, “walking out on their patients” is hyperbole, and spins a narrative that paints the nurses, the backbone of your organization as heartless and unprofessional. I can assure you that no patients were walked out on during the last strike. I can promise you, it broke every single RN’s heart to leave that building, knowing that unqualified, inferior and, at times, incompetent replacements were going to be attempting to deliver the unmatched quality care we provide at UCMC. As a PICU nurse, I didn’t have any patients to walk out on! I worked the night before the strike, completely alone in an empty unit, because the hospital administration had shipped out every last PICU child to a different hospital. So, you’ll understand if I take offense to this comment.

“This is not a strike against a nameless, faceless institution.”

This comment is quite ironic: You are correct; this strike is not against a nameless, faceless institution. However, I’ve been a nurse at UCMC for five years, and your email has made me feel like a nameless, faceless pawn in this organization’s bottom line. I know your name, I know Sharon O’Keefe’s name, and I know Deb Albert’s name, but I’m sure none of you know mine. The nameless and faceless members of society are not typically the ones whose paychecks end with seven 0s.

“This is a strike against our patients and their families. This is a strike against our community — one of the most vulnerable in Chicago where residents face high rates of serious conditions and life-threatening diseases. This is a strike against neighborhoods that rely on us for life-saving emergency and trauma care.”

Trust me, the people at UCMC who truly understand how vulnerable and critical our patients are are your nurses. If we didn’t care about our patients, we wouldn’t want more nurses, more IV pumps, more resources, and a safer work environment. The people who care the most about our patients are the ones who are willing to lose money to defend them. On September 20th, I walked out to picket line to find many former patients and their family members earnestly supporting their nurses at the strike. We are the face of this organization. We are what makes the care at UCMC excellent. Our patients and their families know that better than anyone.

What personal sacrifices have you made recently in service to the patient population at UCMC? When our PICU patients were shipped away to hospitals throughout the Chicagoland area, I went and visited one of our patients who didn’t have family members in the area. Each time I went, I stopped to pick up his favorite toys and coloring books and movies. I was out of work, not receiving a paycheck, but I didn’t care. In fact, my coworkers often bring clothes, food, and toys to work for their patients, using their own money. Can you honestly say you have a similar connection and responsibility to the patients we serve? If not, maybe you shouldn’t have included these comments in your email.

Finally, the heart of your email was read as an expression of frustration that you, as well as other hospital leaders and middle-managers, may now be forced to work more than you were planning around the holidays. Dr. Polonsky, I have worked 4 holidays at UCMC every year for five years. I am not from Chicago. It is an eight hour drive for me to get home to see my family. I have missed Thanksgivings. I have missed Christmases. I have missed funerals and birthdays. I have family members who are ill. I have family members that are elderly. And until now, I have never really complained or resented this aspect of my job. Nursing is a 24/7, 365 profession. I’m sorry you are now having to experience ¼ of what 2200 of your nurses experience every year in the rescheduling or cancelling of holiday plans. Maybe this will be beneficial to you and your colleagues; you may walk away with a greater appreciation of the sacrifices your nurses make for our patients and our organization, and a greater understanding of how valuable our profession is (and why we deserve to be valued and appreciated in the manner in which the Union is asking). The reality is that every holiday where you are home spending time with your family, thousands of employees are at UCMC away from theirs. Attempting to belittle my profession and my character by making me feel responsible for “robbing” you of one Thanksgiving with your family has opened my eyes to how out of touch you must be in your current role with the reality of your employees.

I understand that you are also in a difficult position. You are a leader at an organization that has to deal with a strong union that is pushing their agenda against yours. That can’t be easy. I imagine the past eight months have been stressful for you as well, trying to negotiate a fair contract for 2200 nurses. Well, take a moment and put yourself in my shoes. I work in the PICU; I do CPR on infants. I help police officers take pictures of beaten and battered babies. I sing Frozen songs to frightened 5 year-olds while trying to put in an IV. I hug parents after the doctors give them the devastating test results. I guess we both have tough jobs.

Dr. Polonsky, you have the privilege of earning a lot of money to make decisions that impact thousands of people’s livelihoods. The next time you find yourself at the bargaining table with NNU, I hope you can remember your own words. We are not nameless, faceless nurses. We have names, and faces, and families and friends and lives outside of work.

We do this for our patients. We do this for our patients’ families.

That’s why I come to work. Why do you?

Happy Thanksgiving.