So trends this week on the #COVID19 ward. We’re full. The ward above us is full. The ICU is full. Same as I said at the beginning: average age 50 something male, Hispanic or Latino (now approx 70% of our patients). CLOTS. PEs, DVTs, thrombi. Everywhere, clots. False negatives 1/n
About 30% false negatives. We test and retest. Chest CT is definitive. O2 reliance stays high long after extubation. Young patients 30s/40s - debilitated. Tachy with any activity. Fatigued, poor PO intake. New influx: 80-90 y/o nursing home/assisted living pts. Come in to ED 2/n
Looking at the tracking I see many of these elderly patients, many DNR, not admitted. Assuming the trend is - decide to admit and expect isolation and poor outcome, vs home - and be with loved ones, palliative care. Some admitted as full code, now DNR no facility will accept. 3/n
ED very busy with usual suspects because stay at home was eased, are coming to the hospital again. And we’re very short staffed, not enough supplies to handle the very rapid influx. Some staff opted to go to other hot spots for $$, and now we’re going to peak. Frustrating. 4/n
I get it. We’re not getting hazard pay here. The team that is here - mostly have volunteered for these units, and they are an amazing team. Couldn’t get through this without them. RNs on isolation units also deliver patient meals, and even pull trash to limit others exposure. 5/n
We use iPads so MDs can do telehealth in the rooms, to limit exposure. That means we’re being exposed the most - and we’re not ICU. We’re pre-ICU, or post-ICU typically. And our ratios are higher. Other than tele, I’m the only one monitoring my patient behind 2 sets of doors. 6/n
Media has focused on ICU, vented patients, I just want to make sure that med-surg RNs who are crushing it get their due. Our patients are on the brink, and we’re the eyes ensuring that when that O2 demand goes up, we make the moves that gets that patient to the vent in time. 7/n
It’s made worse by the focus on my state. #Georgia is in the spotlight for all the wrong reasons. I promise you the staff of our hospitals are not the ones in line for haircuts, or at the salon. We’re at work. We’re trying to find time to even get to a store between shifts. 8/n
We’re already tired. And it’s only going to get worse now - this was when the peak was predicted, weeks ago. The models didn’t even account for the fact that our governor doesn’t believe in science and would embolden people to go out and ruin our chances to flatten the curve. 9/n
Please stay home. Keep up your quarantine life, baking bread, distance learning, crafting - whatever. We will keep doing this. But also raise your voices against government officials who don’t believe this pandemic is serious, and who are spreading dangerous pseudoscience 10/n
I invited @GovKemp to my hospital. To go into our isolation area with only a home made mask to shake hands with my patients. He won’t. But he’s fine with asking the people of Georgia to do that. Because everyone should be treated like they are infected. Because we don’t know 11/n
Myself, my colleagues have all talked about our vague symptoms. We’ve statistically spent more time with COVID positive patients than anyone else in our hospital. And no one is going to test us until we get sick. So when I’m not at work, I’ll stay home. And I hope you will too.
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