Author Topic: Any other nurses/doctors here working during the outbreak? (Read 12910 times)

SpareChange · « **Reply #50 on:** April 03, 2020, 09:44:40 AM »

They've essentially eliminated visitors at my hospital. Entryways are restricted, and we have our temp taken as we come in. We're doing ok on PPE. Had an ER patient that was leaving ask me in the hallway if he could buy my n95. ER is a ghost-town...at one point we had 3 patients there yesterday evening.

the_fixer · « **Reply #51 on:** April 03, 2020, 10:38:55 AM »

Quote from: Caroline PF on April 03, 2020, 07:42:36 AM

Just got issued my 2 N-95 masks. These two will have to last me for the duration. We literally have to write our names on them. Wear one one day, while the other is being sterilized.

How are they sanitizing them?

Sent from my iPhone using Tapatalk

Bettersafe · « **Reply #52 on:** April 03, 2020, 11:41:34 AM »

In our country they just started steam-sterilization and plasma-sterilization for masks. Instead of using it once you can use one up to three times.

erutio · « **Reply #53 on:** April 03, 2020, 12:43:33 PM »

Quote from: the_fixer on April 03, 2020, 10:38:55 AM

Quote from: Caroline PF on April 03, 2020, 07:42:36 AM
Just got issued my 2 N-95 masks. These two will have to last me for the duration. We literally have to write our names on them. Wear one one day, while the other is being sterilized.
How are they sanitizing them?

Sent from my iPhone using Tapatalk

UV, at this hospital.

poetdereves · « **Reply #54 on:** April 03, 2020, 01:05:30 PM »

Our hospital is also using UV sterilization for PPE that is usually for one-time use.

Caroline PF · « **Reply #55 on:** April 03, 2020, 06:23:50 PM »

Quote from: erutio on April 03, 2020, 12:43:33 PM

Quote from: the_fixer on April 03, 2020, 10:38:55 AM
Quote from: Caroline PF on April 03, 2020, 07:42:36 AM
Just got issued my 2 N-95 masks. These two will have to last me for the duration. We literally have to write our names on them. Wear one one day, while the other is being sterilized.
How are they sanitizing them?

Sent from my iPhone using Tapatalk

UV, at this hospital.

Yep, told it's UV light sterilization. We have to ship them to another city, and our administration is "hoping" that the turn-around time will be only one day. We're not overrun yet, so they have about a week to get it working well.

Wanttobehome · « **Reply #56 on:** April 04, 2020, 04:09:26 AM »

RN based in operating theatre, most anaesthetic ventilators moved to a new cv19 ICU area along with team. Across the hospitals in group 99% patients attending with CV19. Lots of overtime and shift changes, worrying times. We are managing to operate on some of the most urgent cancer cases. PPE is an issue, being released in batches.

BikeFanatic · « **Reply #57 on:** April 04, 2020, 04:53:19 AM »

That is SO stressful. I heard an average patient can be on ventilator for 3 days but the avg coved patient requires 3 weeks. Lots of young coved patients where I work, but majority just need oxygen not ventilator. The ICU are full, made at least one floor an icu, and many health care workers are getting sick. Glad I don’t have to be a hero, admire those at the front lines. Especially Nurses and health care workers who have to be up close and personal.

poetdereves · « **Reply #58 on:** April 05, 2020, 07:33:30 AM »

I just received an email that our hospital has tested many asymptomatic patients positive for covid, so effective immediately any healthcare worker active in patient care has to wear a mask for the entirety of their shift. At first we were not allowed to wear homemade cloth mask, but they are now encouraging it because PPE is so low. We are required to wash them every night and can use them for up to a week before they have to be changed.

Icecreamarsenal · « **Reply #59 on:** April 05, 2020, 09:37:56 AM »

I'm an anesthesiologist in NJ. The person with the most experience intubating intubate the covid patients, so that duty falls on us.
I've intubated more than a handful and run codes on the covid patients at night. The sickest die anyway from myocarditis and their sats drop even on 100% and highest PEEP settings.
We've run out of ventilators and wait for the covids to die to move their vents to the next covid patients.
I think most won't see what I see, and therefore there are still crowds and parties out there.

poetdereves · « **Reply #60 on:** April 05, 2020, 10:49:41 AM »

Icecreamarsenal: it’s starting to be that heavy out here as well. Just yesterday I had a patient in their 30’s on FiO2 100% and PEEP of 20 and still couldn’t get their sats up. Their ABG showed O2 at 62%. They only made it a couple hours and the teenage child had to make the call to discontinue care over the phone. Our visitation because of covid meant that the patient’s five children couldn’t even come say goodbye. Definitely makes me wish we took this seriously a lot sooner.

Caroline PF · « **Reply #61 on:** April 05, 2020, 12:35:09 PM »

Quote from: poetdereves on April 05, 2020, 10:49:41 AM

Icecreamarsenal: it’s starting to be that heavy out here as well. Just yesterday I had a patient in their 30’s on FiO2 100% and PEEP of 20 and still couldn’t get their sats up. Their ABG showed O2 at 62%. They only made it a couple hours and the teenage child had to make the call to discontinue care over the phone. Our visitation because of covid meant that the patient’s five children couldn’t even come say goodbye. Definitely makes me wish we took this seriously a lot sooner.

That's horrible. I'm sorry that you had to deal with that situation (and very sorry for the family! I cant imagine what they are feeling). These cases can be emotionally devastating. I hope that your area clears up soon and that you don't have too many more like that.

fuzzy math · « **Reply #62 on:** April 05, 2020, 01:52:35 PM »

Quote from: poetdereves on April 05, 2020, 10:49:41 AM

Icecreamarsenal: it’s starting to be that heavy out here as well. Just yesterday I had a patient in their 30’s on FiO2 100% and PEEP of 20 and still couldn’t get their sats up. Their ABG showed O2 at 62%. They only made it a couple hours and the teenage child had to make the call to discontinue care over the phone. Our visitation because of covid meant that the patient’s five children couldn’t even come say goodbye. Definitely makes me wish we took this seriously a lot sooner.

Are you in Louisiana?
Does your center do ECMO? Pt. in their 30s would have been an ideal candidate :(

Icecreamarsenal · « **Reply #63 on:** April 05, 2020, 02:23:20 PM »

Even the large centers could probably only run 3 ECMOs? Maybe, for 3 cardiac rooms.
I didn't take it seriously a month ago. There's an element of selection bias because we see the worst of the worst.
I hope I don't get it.

Abe · « **Reply #64 on:** April 05, 2020, 04:03:53 PM »

That sucks. I agree the Max we can have is 5 adults on Ecmo with a backup circuit. Same at most other centers around here and that I trained at. They didn’t have much success with it in Italy from second-hand reports. Hope you stay safe!

Tom Bri · « **Reply #65 on:** April 05, 2020, 09:06:48 PM »

RN here. After a week on our rule-out floor (we are normally critical care/cardiac/stroke) last night I was moved to the new covid ICU.

PPE in the ICU is adequate, but just barely. We have one N-95 mask each which is placed in a paper bag at the end of the shift and sterilized with UV. Next shift we go pick it up and reuse it. Not all staff have been fitted for an N-95 yet so some were wearing only paper masks. We are using old-style silk gowns, one per shift per patient.

We are a small midwestern hospital, and a week or two out from the big expected surge.

The worst is the lack of information. Doctors are wandering about, asking random nurses if they know where to get an N-95, or if we know what the rules are for this or that situation. There seems to be little coordination or information sharing.

ice_beard · « **Reply #66 on:** April 05, 2020, 10:31:33 PM »

In a county of 1.2m people, very close to SF, we have 390 documented cases. I feel lucky.
Our C19 ICU is appropriately staffed and PPE is not typical but somewhat adequate. We use the same surgical mask all day outside of iso and use the same n-95 or PAPR hood all day. The MDs have the drill figured out. We tube and line (central/art) in one push and have pre made kits ready to go when the time comes. We've got pre-made RSI kits loaded in the pyxis so no worrying about contaminating the tackle box during each intubation. We've done a lot of education (manual proning, etc) as things change. The situation is very fluid.
People around here remain nervous but are cautiously optimistic. We have no idea what the future holds. The community has been helpful providing food and some supplies.
I'm thankful Bay Area leaders got together and closed schools early and initiated a shelter in place rule early. I'm thankful people seem to be taking it very seriously around here too. And thank you Governor Newsom for making the difficult but bold move to essentially shut down the entire state, the first one in the country.
I hope those dealing with high Covid census are able to work in a safe environment and the numbers start to trend down.

poetdereves · « **Reply #67 on:** April 06, 2020, 08:22:39 AM »

Ice_beard: That’s awesome that you guys have it running so smoothly. Hopefully by the time it hits the peak (in an estimated two weeks) our hospital has worked out the kinks and can keep things under control.

Currently I work in the least healthy state in the US with the patients with the most comorbidities. Our state is already on record to have the highest hospitalization rates for covid patients and some of the worst outcomes.

Morning Glory · « **Reply #68 on:** April 06, 2020, 05:18:04 PM »

No cases in my unit yet. We had a couple rule out people but they came back negative. My state has relatively few cases or deaths so far, but I am expecting we will get lots of helicopter patients soon.

Anyone know why some of the masks we are getting smell like garlic? At least we have masks.

Dicey · « **Reply #69 on:** April 09, 2020, 02:38:25 AM »

Quote from: poetdereves on April 06, 2020, 08:22:39 AM

Ice_beard: That’s awesome that you guys have it running so smoothly. Hopefully by the time it hits the peak (in an estimated two weeks) our hospital has worked out the kinks and can keep things under control.

Currently I work in the least healthy state in the US with the patients with the most comorbidities. Our state is already on record to have the highest hospitalization rates for covid patients and some of the worst outcomes.

Are your state's rates of obesity and diabetes higher than average?

Abe · « **Reply #70 on:** April 09, 2020, 10:11:13 PM »

So far not bad in Southern California. Knock on wood but the distancing is working I think. We’ve had an uptick in cases but I think that’s do to more tests being done. Hospitalizations and deaths remain low relative to the population.

Buffaloski Boris · « **Reply #71 on:** April 10, 2020, 02:44:56 PM »

Quote from: Abe on April 09, 2020, 10:11:13 PM

So far not bad in Southern California. Knock on wood but the distancing is working I think. We’ve had an uptick in cases but I think that’s do to more tests being done. Hospitalizations and deaths remain low relative to the population.

That's really good to hear.

It'll be curious to see the comparison and contrast with regard to outcomes between various countries. Or if there is any real difference when you control for age and comorbidities.

poetdereves · « **Reply #72 on:** April 10, 2020, 04:01:28 PM »

Dicey: Nearly all my patients have hypertension, type 2 diabetes, COPD, and are obese. Unfortunately that’s the life here in the south.

BECABECA · « **Reply #73 on:** April 10, 2020, 04:46:42 PM »

Is anybody’s hospital encouraging covid patients to lie in the prone position before they’re at the point of requiring intubation?
https://emcrit.org/pulmcrit/proning-nonintubated/

Tom Bri · « **Reply #74 on:** April 10, 2020, 07:17:05 PM »

After bustling last week, this week our covid rule-out and ICU floors have been quiet. Not sure what's up with that as county numbers continue a slow rise.
In a smaller city west of Chicago.

Dicey · « **Reply #75 on:** April 11, 2020, 01:43:52 AM »

Quote from: poetdereves on April 10, 2020, 04:01:28 PM

Dicey: Nearly all my patients have hypertension, type 2 diabetes, COPD, and are obese. Unfortunately that’s the life here in the south.

Between those factors and lack of healthcare, I guess it's no surprise that some groups are getting hit harder than others. Sucks.

ice_beard · « **Reply #76 on:** April 13, 2020, 11:10:54 AM »

Just worked four days in our C19 ICU. It could be a lot worse. We have enough beds (we have maybe >50% of rooms designated for these patients available). We have PPE. We get an N95 every shift and a face shield that we clean between uses and use all day. There are shortages of things like MRI tubing (extra long IV tubing that allows IV pumps to be kept in the hallway instead of in the room with the patient) and some meds like propofol are getting sparser. The mood is not bad, most people have just accepted dealing with the PPE is part of the drill and everyone is trying to be as helpful to each other as possible.

We have been extubating patients (taking them off the ventilator) and some have even been discharged home.

Anecdotally, it seems to me that the patients who are getting hit the hardest (beyond being elderly) and having the most difficult time recovering have DIABETES and/or HYPERTENSION. Both of these conditions can be asymptomatic for a long time, but both can also be identified and treated IF you are seeing a primary care provider regularly. However, not everyone has that opportunity in this country, unfortunately. I have a feeling the final death statistics are going to be an incredibly devastating indictment to the inequality in our current health care system. Poor people are dying at much higher rates because their chronic health conditions don't ever get treated (shocker).

MayDay · « **Reply #77 on:** April 13, 2020, 11:22:42 AM »

Quote from: Icecreamarsenal on April 05, 2020, 09:37:56 AM

I'm an anesthesiologist in NJ. The person with the most experience intubating intubate the covid patients, so that duty falls on us.
I've intubated more than a handful and run codes on the covid patients at night. The sickest die anyway from myocarditis and their sats drop even on 100% and highest PEEP settings.
We've run out of ventilators and wait for the covids to die to move their vents to the next covid patients.
I think most won't see what I see, and therefore there are still crowds and parties out there.

Are you taking people of vents if they don't respond, to give others an opportunity to get on one?

rosarugosa · « **Reply #78 on:** April 15, 2020, 05:55:44 AM »

Are those currently working in hospitals and other medical environments distancing themselves from family? Curious as to how people are handling this aspect.

Tom Bri · « **Reply #79 on:** April 15, 2020, 04:31:03 PM »

Quote from: rosarugosa on April 15, 2020, 05:55:44 AM

Are those currently working in hospitals and other medical environments distancing themselves from family? Curious as to how people are handling this aspect.

Yes, but not 100%. After work I strip in the garage, put clothing in a bucket with detergent, shower in a separate bathroom and sleep alone. I wear a mask in the house. My kids are grown and living away, so it's just wife and me.

poetdereves · « **Reply #80 on:** April 15, 2020, 05:37:01 PM »

Quote from: rosarugosa on April 15, 2020, 05:55:44 AM

Are those currently working in hospitals and other medical environments distancing themselves from family? Curious as to how people are handling this aspect.

I also strip in the garage and have quarantined myself at home. No grocery trips, no drive thru, etc. I still sleep in bed with my wife and we just took in two foster kids last Wednesday. Not great timing with covid and my job, but it was between the possibility of the kids being exposed to covid or definitely being exposed to physical abuse at home. There is one toddler and one infant and no school/daycare, so I am trying my best to keep my distance when possible. It’s tough.

Tom Bri · « **Reply #81 on:** April 15, 2020, 09:47:58 PM »

[/quote]

I also strip in the garage and have quarantined myself at home. No grocery trips, no drive thru, etc. I still sleep in bed with my wife and we just took in two foster kids last Wednesday. Not great timing with covid and my job, but it was between the possibility of the kids being exposed to covid or definitely being exposed to physical abuse at home. There is one toddler and one infant and no school/daycare, so I am trying my best to keep my distance when possible. It’s tough.
[/quote]

You do what you can. Sounds like you are doing more than most. Thanks.

Abe · « **Reply #82 on:** April 15, 2020, 11:23:02 PM »

I wear a mask before getting out of my car at the hospital, and wear it the entire time I'm there. I wear scrubs provided by the hospital, and change back into my clothes just before leaving. At home, I keep those clothes separate and immediately shower and change into different set of clothes. I haven't been anywhere other than work and home in over a month. I sleep in a separate bedroom for now. If we have a surge of patients (only 10/500 inpatient beds so far), I'll be staying at a hotel across from the hospital that the State of California notified will be commandeered for housing hospital staff.

My wife does the same thing when shopping for groceries or picking up food from a restaurant. She's been furloughed so hasn't been to clinic or anywhere other than those places or home in over a month. My son hasn't been anywhere other than home and rarely the neighborhood park.

hops · « **Reply #83 on:** April 18, 2020, 07:19:38 PM »

Some of our friends are sleeping in RVs instead of their basements because they're so afraid of infecting their kids.

BikeFanatic · « **Reply #84 on:** April 19, 2020, 05:43:02 AM »

There are free rooms here for hospital workers who are infected with covid, and they added reduced rate and some free rooms for staff that are afraid of bringing covid home.

Tom Bri · « **Reply #85 on:** April 20, 2020, 03:24:38 AM »

Is anyone getting tested? I searched my hospital website to try and figure out where to get tested, and found nothing. County health department, ibid.

JoJo · « **Reply #86 on:** April 20, 2020, 12:50:39 PM »

My RN sister is being furloughed tentatively for 8 weeks. She normally works on a post-op recovery floor. They are absolutely empty.

Gronnie · « **Reply #87 on:** April 20, 2020, 06:48:57 PM »

My wife (an RN at Mayo Clinic) just started furlough today. They are paying through the 28th then unemployment for a while.

The nice thing is with MN paying the highest amount for unemployment in the nation plus the CAREs amount, at least through July she will be making almost as much as when working. Hopefully it doesn't go longer than that, they are trying to work towards 50% patient load over the next few weeks.

Bettersafe · « **Reply #88 on:** July 21, 2020, 12:09:40 PM »

Just checking in to see if everybody is doing well?
My patient care is back to normal, we do see a slight increase in Civid-Patients again though so I anticipate a second outburst might be around the corner.

I came across this article published yesterday and found it worth mentioning since it might indicate there's a new treatment mix worth considering for the very ill:
https://ard.bmj.com/content/early/2020/07/20/annrheumdis-2020-218479

MudPuppy · « **Reply #89 on:** July 21, 2020, 04:50:37 PM »

Our cases are high as they’ve ever been. Still stripping as soon as I’m inside and straight to shower. Still reusing masks.

TartanTallulah · « **Reply #90 on:** July 22, 2020, 10:00:34 AM »

I'm a primary care physician in the UK, theoretically retired and working freelance, and have been working throughout lockdown. We have been fortunate in having PPE supplied by a local industry. Our practice has changed. Initially we were doing telephone consultations and bringing very few patients in. Now we're back to doing mainly face to face consultations, with recommended PPE.

It's been surprisingly tiring and stressful to cope with the change in work practices, but it's been good to have a defined role and not have to scratch around for ways to be useful.

Abe · « **Reply #91 on:** July 23, 2020, 09:12:25 PM »

In a COVID hotspot at a safety net hospital. Our COVID+ numbers are stable to decreasing. ICUs are near capacity but we are continuing operations not requiring ICU care. It's fairly routine now, main stress is whether or not we'll have to shut down again. This seems less likely, at least until the fall. My wife's clinics are not back to full schedule due to ongoing fear in the community about getting routine medical care. All the health systems here are hemorrhaging money, but no permanent layoffs yet.

News:

Author Topic: Any other nurses/doctors here working during the outbreak? (Read 12910 times)