What have you learned from the frontlines of fighting the coronavirus that you most want policy makers, health care administrators and your bosses to know? If you were in charge, what is the first thing you would change to ensure we never go through this again?
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Moral distress regarding pain management
Wondering if anyone would be willing to share a time of having moral distress with me, particularly around pain management?!Read the Full Response
Nursing School in Philadelphia
Great nursing forum, Also check PITC Institute, It is one of the best Nursing School in Philadelphia. offers the nursing course (AST) for a period of two years under the course you will get training from professionals who have been working in this field for years. For more information, visit https://pitc.edu/Read the Full Response
Wikiwisdomforum is a great place. I want to ask that I have a skin problem. I saw some natural products on a website ( https://www.natures-bloom.com/aaron-lal/ ). Can I use these products? Can anyone guide me about these natural products?Read the Full Response
CNA practice test
Best forum for nurses. I want some help about the CNA practice test. I read one article about the CNA test, article is here (https://allhealthcarecareers.com/cna-practice-test/) but I don't know, It is helpful for students or not. Can anyone guide me?
Tammy Bagley , RN ED , ICU , Patient Safety
1.- We must take what we have learned and use it - really evaluate it , listen to frontline and compile the common themes .
2. Take those themes and start the change needed . The theory that a Hospital will always be able to provide any care needed has been challenged and our Vulnerability was made apparent. Hospitals cannot ALWAYS provide everything needed in a community .
3. We must consider the emotional and spiritual side of any pandemic or disaster - while taking away all support from family at a time when a person is…
We need detailed, and rehearsed, plans for the rapid set up of field hospitals in every community in case hospitals overflow. Actually set them up whenever it looks like there might not be enough beds within a month.
We need to make moving to a field hospital for post-ICU Covid recovery mandatory now. Doctors and nurses need to be in charge of triage, not patients.
Every community needs a place or places for new Covid patients to go when they can't manage their care at home during the first few days of infection, but…
Re-Opening in Wyoming
I'm a public health trained school nurse who practices health education, prevention and promotion. Even with imperfect knowledge and fully understanding that science is inherently self-correcting, it is my obligation to know most everything about this unusual disease of COVID-19 as I would hand, foot and mouth, strep throat, diabetes, etc. I am a small part of an entire team of caring, dedicated professionals whose business it is to keep school children healthy and safe and learning every day.
It is undisputed this virus is extraordinary in its capability to transmit explosively. The case count went…
We was never prepared, in spite of preparing. We need to always be sure from this year on that we realize what can happen in these pandemics and not be so lax to think it won't happen here (USA). So much I can say, it all boils to ill preparation. Lack of ability to test initially.. no PPE, no guidelines... Daily, sometimes hourly changes- no clear guidance..Read the Full Response
RN, BSN, CEN
What I've found the most striking in what I've learned is that there are political motivations. The number of patients that I don't see, the lack of actually critically ill due to covid doesn't match the hype. I have been somewhat confused and silenced when asking what this means?Read the Full Response
Nation Reliant on HCW to Take on Enormous Personal Burden - Beware the Future of Nursing
What I most want policy makers, health care administrators, and my bosses to understand is the untenable nature of the immense personal burden that we are relying on healthcare workers, including nurses, to take in the absence of resources, infrastructure, policies, and support. We consistently lack: adequate PPE, adequate staff, adequate mental health resources, adequate risk management resources including alternate options for housing or childcare, adequate testing for the community and for HCW with sufficiently fast turnaround time, adequate screening for employees/visitors, adequate safety measures/infection control practices at work, adequate policies for keeping sick or potentially sick HCW at home…Read the Full Response
Still Issues With PPE
I apologize it has been a while since I last checked in. I wanted to share what I have been able to gather through colleagues, and personal experience. It is now July 9, 2020. From accounts in various healthcare and public health settings, PPE supply remains a challenge. I have spent the last 3 days, trying to obtain either real N-95's or purchase a 3M Respirator, that is plastic, reusable and relies on filters or cartridges to protect me. I can not find any of this equipment anywhere i have looked. I contacted 3M…
Let the staff wear ppe if they feel they need to. We should never have to justify a situation in which we feel the need to protect ourselves. Ever. Especially with a disease that no one knew and still knows nothing about how to fight or protect against. If we are going to save lives, personally I dont need to be called a hero or be thanked. I want to feel protected and supported. And that was not the case from day 1.Read the Full Response
RN MSN MS
I am currently on maternity leave, but was working on a surgical trauma ICU. I am most concerned with the lack of communication between nurses and management as well as the economics of the hospital as a business. With hospitals generally run by administrators that have no front line experience there is little respect and voice that nurses have. The nurses in administrative roles are faced with adhering to metrics and analysis of PPE equipment use and the like without advocating for the well being of staff nurses. A previous hospital I used to work on punished nurses for using…Read the Full Response
RN, MSN, Pt. Safety Specialist
Do not forget those who are vicariously traumatized.
Mandate de-stressing and debriefing sessions for all HCWs with a minimum number of contact hours per month as part of license renewal. Time in session should be compensated by employer. (OSHA has various requirements for similar situations that mandate employer responsibilities when employee is exposed to known hazards and this pandemic should be considered an known hazard)
Hospice team making an impact in an Acute Care hospital
We are an inpatient hospice located in northern New Jersey and our highly trained staff provides care for patients at end of life. When the Covid crisis began we worried about the health and well-being of our staff and residents. All of our nurses were deployed to assist in care for patients at the hospital . Our team was stressed but we all showed up. The nurses, home health aids, and team members worked MedSurg units, quickly getting up to speed on the procedures at the hospital and patient care protocols. The hospice team wanted to make a meaningful impact.…Read the Full Response
Walk in our shoes
I appreciate that many people including our hospital administrators are terrified of contracting Covid, but all of them need to walk at least a few hours in our daily lives.
Perhaps they would see the awfulness of our daily lives better and offer more support and be better advocates.
I’d like to believe that everyone is doing their best, but ignoring problems is not doing our best.
I work in a facility where it feels like most leadership especially senior leadership are ghosts. We are short-staffed, we reuse…
Daily changes, modifications inconsistent with Best Practices
In the beginning, the daunting daily changes were maddening as administrators would ask a group of nurses to research best practices.
We did well at keeping up but realized the short cuts were being instituted.
The disregard for our safety felt demeaning and disrespectful and the standard answer became, “it’s not us, it’s COVID.”
Safe practices with floats being given “preceptorship training” with no didactic. When we explained the safety of our patients was at risk, they gave NOEP Modules to them.
A group of…
Mr Sam Spatula RN
would like every one to realize that you as a nurse do not necessarily have to deal with active virus patients my job is to make sure that the donors we get are adequate to donate we do not screen for covid 19 we rely on the donor to answer questions truthfully so at any given time myself or my coworkers could be exposed and not know it there for we are at risk just as any nurse working in the hospital setting at least you know who you're at taking care of and you know who has the virus…Read the Full Response
I am scared. If I cannot get PPE I will still have to do my job. I feel nurses have been seen as disposable. A fireman would not be sent into a fire without his equipment. We are human beings, not machines. Employers need to start putting safety first and not just patient safety. Employees need to be protected. I feel that it has always been ok with employers to not provide adequate PPE and to turn a blind eye because it costs money. This has to change. Slips, trips, and falls and back injuries are not the only things…Read the Full Response
1) It seems that N95's have formaldehyde in them. When I wear one, I can't breath both because of the tight seal and because of the antimicrobial whether formaldehyde or other. I don't chart in the patient home because I can't think straight until I leave the home and take off my mask to breath oxygenated non-anti-microbial air. My skin used to get inflamed and burnt like a sun burn even on my cheeks and neck that didn't directly touch the N95. My eyes, my throat all burned and itched.... until I outgassed my masks before wearing them (airing out…Read the Full Response
I work in outpatient hemodialysis as well as acute dialysis which includes hemodialysis as well as other modalities. When COVID-19 arrived and multiple policies were implemented, the outpatient setting did a very good job designating clinics where patients would receive their treatments who were classified as Covid positive or other designations of PUI. As time passed however, I started to notice (exceptions) in the outpatient setting regarding prescreening of patients. There are multiple examples but one is a patient with a fever of unknown origin >101 degrees and shortness of breath. I would like to clarify that many hemodialysis patients…Read the Full Response
Have enough PPE on handRead the Full Response
How unprepared my hospital was and is. I am interested in how other operating rooms and PACUs around the country are recovering patients. As a Florida PACU RN, the hospital I am working in is seriously putting patients and staff at risk. We are told that patients can not have elective surgery unless they have a Covid test. However, they do not have to have the RESULTS of the Covid test. If they do not have results (sometimes even if never tested) the PACU RN is required to gown up, N95 and all, and recover the patient in the OR.…Read the Full Response
I am ER trained and worked in critical care for many years, however the last four years I have been doing primary care. The administration realized my background and immediately sent me back to the hospital; to the ER first, then to the units. This was uncomfortable, but I was able to re-align myself to acute care.
I think the first thing we need to do is train all (or many) of the nurses in the hospitals to be ICU savvy. We are all RN's. No matter where we are in the hospital, we need to be…
Professional Practice & Development Specialist
Coronavirus pandemic highlighted the healthcare system's deficits with PPE, hospitals' response to a pandemic and the lack of guidance from the administration. the hospital continues to lack adequate PPE - if the country was at war, all industries would halt production and focus on equipment. I feel the USA should be doing the same for frontline staff, not waiting for PPE to be shipped from China.
Administration should acknowledge the amount of nursing care required in ICU for the Covid patient. the staffing ratios need to be addressed- having a 1:3 ratio is dangerous from a safety standpoint…
Empowering Future Nurse Leaders
The nursing profession must accept responsibility for and excel in training future nurses, APRNs and nurse scientists to lead others and to collaborate with other future leaders. As a nurse educator, I am reflecting on my own education and the pedagogical approach I take with my students.
- Do we focus so much on an APA adherence that we neglect leadership skillset development?
- Do we focus so much on essential clinical competency attainment that we relegate our social responsibility to those with less clinical training and expertise whether they are esteemed professionals or elected officials?…
During the pandemic what we learned most as outpatient infusion nurses was how many unnecessary visits we had pre-pandemic. Patients would come to the city for a lab draw, hydration, perhaps just for a simple long term follow up visit. They came because they are connected to the facility, to the attending, to the staff. Maybe they came 5 years post BMT follow up because they are always worried. The would spend co-pays, time, energy and stress. But during the pandemic, unnecessary appoints were put on hold. Visits that were just follow ups were pushed back. Most appointments were able…Read the Full Response
Hindsight, or informed requests
What have you learned from the frontlines of fighting the coronavirus that you most want policy makers, health care administrators and your bosses to know? If you were in charge, what is the first thing you would change to ensure we never go through this again?
A pandemic shines painful, sharp light on the limitations of both our nation's business-model of healthcare delivery, and our global supply chain. Preparation saves lives, but it's expensive. Yet scrambling to keep staff safe when supply chains have collapsed is more expensive. We have an ethical duty to plan as a…
Preventative Health Care
During my time spent at the Jatvis Center I saw people from all over come together to provide "crisis management care". I could tell you we needed more trained staff, better equipment,better testing procedures but I think being in the military you are use to making the most of the resources you have been given and I truly believe my unit provided the best care with what we were given. I know people will probably disagree with me because we always have those outliers(i.e. super healthy medical personnel with no pre existing conditions gets sick and dies from COVID) I…Read the Full Response
There should be designated units within hospitals that are specifically prepared for a pandemic. In our unit we had a good stock of N95s, but they were so old that the straps were dry-rotted and snapped (and I hate to think about how effective they were at filtering since we made new straps and used them anyway until we rounded up as many PAPRs that could be found in the hospital). These units should have a PAPR for every nurse/CNA/respiratory therapist/doctor working there. There are many other things that could be improved, but being able to protect the staff should…Read the Full Response
Sharon Praigrod, BHSc, RN
So a month so ago I wrote a small piece that no paper I sent it to wanted to print. At the time I wrote it I was sad, upset, angry, and felt left out. So I thought that maybe this is the place to post it.
WE CARE TOO:
If I were to honest of how I feel every time I watch the news coverage of the Horror Story we are living through, I would say I am feeling demonized by most of the coverage concerning Nursing Homes.
The media and the public need…
I find there have been almost equal changes to daily life both in and out of the hospital. Every shift, we are updated on policy changes, supplies/PPE status, COVID cases in the hospital/COVD mortalities/discharges, and availability of ECMO/CVVH/vents, etc. We have shut our doors to visitors in almost all circumstances and have only recently started to reopen floors like ortho that were changed to COVID units over the last two weeks.
In life outside the hospital, in the early days of COVID, I noticed an immense amount of support from the community and people in my…
Now the wave has receded
Now we can breathe a sigh a relief
Now the weight has lifted
Now we look back and remember
Now we hope this is just a memory
Now we learn from the lives lost
Now we rebuild and reflect
Now the patients are recovering
Now we recognize each other in our superhero disguise
Now we laugh and smile
Now we are used to the new…
A peek inside the ICU (4/3/20)
Everyday people ask "Is it better at the hospital?". This is question that is difficult to answer. Yes, admissions are down, yes the chaos has lulled but no it's not better. What is "better" anyway?
Entering the ICUs on a daily basis you are immersed in what COVID has created. Patients are "better" in a sense that they are more stable and will most likely be discharged instead of deceased, but again they aren't "better".
They lay there in their beds, unable to speak, move or breathe on their own. Tubes that…
The beginning (3/20-4/20)
As a nurse, everyday can be a challenge. Over the recent weeks this has been proven even more true. When I first became a nurse, I knew it would be hard and I would be helping people. But with the pandemic is full swing being a nurse is more than what it used to be. We are "superheroes", that's what everyone is saying. I don't feel like a superhero. I feel like I'm doing my job but also people understanding what we do for the first time is 12 years.
When the pandemic was…
My family offers great support and this helps me through the daily struggles of working in a dangerous environment.
Moral dilemmas in hospice
I never imagined the nightmare that hospice nursing has become since COVID-19. Our philosophy of care is to support the entire family unit, and hospice nursing before the pandemic looked much different than it does now. Only 6 months ago, families were able to sleep at the bedside of their loved one in my inpatient hospice unit - where the most symptomatically sick are cared for by an interdisciplinary team consisting of a nurse, physician, hospice aide, social worker, chaplain, and volunteers - and there was no such thing as visiting hours. All hours were for visiting. We conducted weddings…Read the Full Response
The past few weeks have been incredibly challenging. I have not been very successful in managing my anger and frustration with the overt racism and prejudice that continues to fuel disparities in health, opportunities, and the right to simply live in our country. Injustice has managed to eclipse the continued burdens of COVID, and even some unexpected burdens at home. My wife, who is in a very high risk category for COVID due to multiple heart problems, was hospitalized about 2 weeks ago and last week, my nearly 2 year-old daughter and I needed to be tested for COVID. My…Read the Full Response
A Lesson from Hospice Care
Our own Theresa Brown had another moving column in the NY Times this week:
I Accept Death. I Hope Doctors and Nurses Will, Too.
A lesson from hospice care might help.
Bodies being moved into a refrigerated truck outside of Wyckoff Heights Medical Center in Brooklyn, in April.
Bodies being moved into a refrigerated truck outside of Wyckoff Heights Medical Center in Brooklyn, in April.Credit...Dave Sanders for The New York Times
Nurses crying. That’s what I hear from the front lines treating Covid-19 patients. A nurse will begin the shift crying…
It will never be the same
I am a Director if Nursing in a skilled nursing facility. I take pride in my team and take every opportunity to work right by their side. This usually allows me to see first hand what our process issues may be. Where the room for improvement is going to come from.
Yesterday, like every other day, I walked down the hall in our Covid unit (sweating in 15 pieces of PPE and exhausted because in 4 days I have already been away from home 62 hours). I am doing my morning rounds and going from one to the…
Caring for Ourselves
In Honor of all nurses everywhere
https://www.youtube.com/watch?v=wrDF7q5CW14&feature=youtu.be With gratitude and admiration!
Honoring nurses at the front line
With gratitude and grace
As I wait along with my peers to participate in training, course, and certifications that require a true classroom setting, I have explored the many options for professional development and growth, that exist via short online delivery methods. Platforms such as Coursera for example offer access to many courses, certificates, and provides resources to explore new ways of learning. One of the areas of study I have seen many courses covering involves Agility or Agile. I still have to look further into this concept and it’s application to the healthcare system. However, from the information I have read so far,…Read the Full Response
"This was supposed to be our year" - Never Again Is Too Late
I spoke to one of my mentors earlier and she said something I've heard many times lately. We were discussing some of the current challenges and she said “and this was supposed to be our year, the year of the nurse.”Read the Full Response
Never Again Is Too Late
I just learned of this page and platform after reading a LinkedIn post and article. Thank you for providing this critical platform!Read the Full Response
Another powerful piece
I’m so proud of the nurses who put pen to paper and SHOUT so that we might know what is happening on the frontlines.
Check this out: I’m a nurse in a Covid-19 unit. My hospital’s leaders frighten me more than the virus. https://www.statnews.com/2020/05/06/nurse-frightened-hospital-administrators-more-than-covid-19/?utm_source=STAT+Newsletters&utm_campaign=fa04697cf7-MR_COPY_01&utm_medium=email&utm_term=0_8cab1d7961-fa04697cf7-149585849
I have been re-deployed from my school clinic to a primary care pediatric clinic. It has been a major challenge to essentially be in a new role among strangers and patients I do not know, and managing the ever changing daily practice needs and ever changing Covid-19 management guidelines, and the suffering of my patients and their families.
My workplace has been in crisis trying manage the new practices with few resources and leadership, and thus professional support has been minimal.
I am coping with good family support, internal resources and mindfulness,…
I continue in vigilance; being careful and more deliberate in all my actions becomes exhausting. Some days are of course better than others, for no particular reason. My nursing homes are still clear of covid, but it is all around me. My colleagues home has 22, including 6-7 staffers. I am always aware that my own residents of about 70 depend on my caution and my choices at home and in the community carry greater weight.
I am grieved at watching my colleagues struggle in other states, we are all family in nursing and health care). Hearing friends…
We don’t currently have any cases but we have lost 3 of our 7 nurses in the past month so I’m alone this weekend. Last nurse quit because she was afraid of potentially bringing it home to her newborn and is also considering a complete career change.
I run around doing all I can and pray every day that this isn’t the day symptoms start to pop up. I’m finishing my prerequisites for a LPN to RN program as my goal was always to end up in a hospital setting... but I’m questioning everything since COVID.
Proud to be a nurse
I read this article this morning https://www.republic-online.com/coronavirus/louisburg-nurse-practitioner-fights-covid-19-on-the-front-line-in-new-york-city/article_c576b4b4-88a4-11ea-981a-ffed899839cb.html and I just felt proud to be a nurse.
It highlights the story of a nurse practitioner from Kansas who flew to NYC to join the frontlines.
Since Florence Nightingale - remember this is the year of the nurse in honor of her 200th birthday - courageously joined the frontlines of the Crimean War, nurses have showed up for their fellow humans in every crisis or war.
What is the right thing?
I am a single mother who has been in Preop/PACU for 15 years now. With elective surgeries cancelled we are being pulled to the IMC/ICU. Not only are we being pulled from our area but we are now being forced to work nights and weekends. I can understand being pulled to different units but with a 12 year old at home, a heart condition myself and an elderly mother who is strictly self quarenteened, it poses great difficulty. I am willing to help but the nights and weekends to staff the ICU is a bit much. Anyone else going through…Read the Full Response
Message from someone who is not a nurse
We had a post from someone named Andy F who admitted that he is not a nurse. Because this Forum is for nurses only, we removed him from the conversation. However, his comment was aimed at helping you all. He is quoting from a study reported in the peer-review journal, Nature, about how to extend the life of PPE.
I am reprinting his comment here is case it is helpful to any of you. But please note that he will not see your comments because he is not eligible to participate…
The Reason Hospitals Won’t Let Doctors and Nurses Speak Out
The NY Times today carried this moving and powerful column from our own Theresa Brown. If you, too, are frightened that speaking out will endanger your job, please know that we are committed to protecting the privacy of everyone who joins this Forum and shares his or her experience. Only your first name and last initial will show publicly on the site, along with any personal information you choose to share.
Here's Theresa's experience, as she told it in today's newspaper:
I know what it’s like to face a gag order after calling…
Thank you Theresa Brown
I had posted here, but then when I became aware through an email that a reporter was reading along, I became fearful that my employer would find out I had written about my work - even though I never named the employer- and I deleted my posts.
Thank you for today’s NYT piece, Theresa Brown. Thank you so much.
Today you are my children
The majority of the nurses caring for COVID-19 patients on general medical surgical units are young, like in their 20s young. Most have only been out of school for a few years or months and some are just starting their careers during this crisis. Most don’t have years of experience behind them to guide them through the challenging clinical aspects or a lot of life experience for that matter to help them cope with the emotional challenges that come with caring for patients on designated COVID-19 units. They are scared! On a typical day under normal circumstances, my role is…Read the Full Response
Two RN as parents to small kids
It is a very scary thought for me to imagine my kids without parents should both me and my hubby get infected with this disease. I pray every night that one of us will be spared. I did bring up the subject of our Will for practicality of the situation. He works in ER and I work in Mother Baby, both are mode of entry to this Covid 19. This by far are my biggest challenges as a nurse in all of my nursing career.Read the Full Response
Hospital's own stockpile of PPE
each hospital should have their own stockpile of PPE that will last at least two months so that lack of PPE would never be an issue again.Read the Full Response
Should I stay or should I go? I am plagued by this question as I receive calls from both New York (where I used to live) and North Carolina (where I live now) to deploy in an unknown capacity in an unknown area with an unknown assignment. There is no doubt that, if I were untethered to family, I'd go wherever I was needed. But, with elderly parents who are completely on their own without me and my husband, I'm torn. What kind of daughter would I be to put my parents last on the list of priorities? What kind…Read the Full Response
Lack of PPE especially during the early stages placed healthcare professionals at risk.
Lobby for US and other Governments to promote production of PPE at in their respective countries.
Ongoing training needed to prepare for this
As I was deployed from my specified unit as a Gyn/Oncology nurse to the ICU was indeed a huge change. I however was eager to go represent and help save as many lives as I can. Learning 80 percent of ICU work within 36 hours was overwhelming, while also facing every covid patient that arrived to the unit with 85 percent chance that the pt will and was intubated was challenging. I think that as a deployed nurse now looking on the sidelines all nurses should be trained basic skills on these critical care units. All nurses should know how…Read the Full Response
Mental health supports for frontline nurses
First of all, THANK YOU to those of you who are on the front lines each and every day. Your efforts are heroic in the truest sense of the word.
As this pandemic unfolds, my heart breaks in a million different ways, not the least of which is because I cannot be on the front lines. Thanks to a hefty dose of chemo 9 years ago, I am immunocompromised which precludes me from being anywhere near a health care facility. Not being able to suit up and show up, side-by-side in the trenches is excruciating for me.…
NO N95 - how can I purchase my own?
We don't have enough N95 masks but are allowed to bring in our own as long as it is NIOSH certified. I can't find a place to purchase a N95 mask. The companies that have stock are only selling directly to institutions. I'm at a loss. Any how I can get aN95 masks?Read the Full Response
Any input on skin breakdown prevention on N95? As a skin champion in my unit I plan to use the mepilex dressing, lotion, just to prevent abrasions or breakdown on bridge of the nose. Will it not disrupt the seal of n95?Read the Full Response
Nurse-Led Healing Circles for Self-Healing During Times of Crisis and Beyond
Hi everyone, I'm a holistic nurse practitioner, a health coach and a healing circles facilitator.
I am a member of the American Holistic Nurses Association. The Austin Texas Chapter of AHNA was planning a regional conference in May focusing on self-compassion and self-healing for nurses and one medium for this is healing circles.
This all changed with Covid-19.
In response to hearing the needs from the front-line nurses, my colleagues and I decided to offer healing circles with the intention of self-compassion for self-healing for nurses.
Read the Full Response
No N95 at Kaiser
I work at Kaiser Santa Clara, Stroke Tele and we are not being given N95. We bring our own. The ANM said we are suppose to wear surgical mask, gown and gloves per CDC guidelines. I reported this to our union and OSHA but no response yet. I dont know what to do next. I feel like Im committing suicide everytime I enter a COVID patient’s room. We need help.Read the Full Response
The trail of the N95 mask is potentially as follows: Given to ICU RN by the hospital. The RN in the ICU uses the same N95 mask on two different patients, keeping it in an envelope on the desk outside the patient's room. So it is never discarded, simply removed and put on multiple times in a shift and used in two different patient rooms. The nurse then takes the mask home in the same envelope and spreads it the community. The nurse then brings the same N95 back to the facility for another 3 shifts because x1 N95 mask…Read the Full Response
I work in a 16 beds ICU but since the COVID pandemic, we have added the step down unit as part of our COVID -ICU. It has been such a traumatic experience, caring for young and old population with or without medical co-morbidity.
So far our facility has been very good in providing PPEs, we also use PAPRs as well.
Anytime, i work into the unit to care for the COVID pts, i get this overwhelming anxiety anyways i pray to God each morning for protection.
Pls be safe everyone, we are truly heroes!!!!
I work the Covid 19 floor in the ICU, along with other ICU nurses, and the biggest challenge is the lack of N95 masks and hospitals not allowing nurses to use PAPR masks for patients with secretions and also the risk nurses are in, with the use of aerosols and nebulizers and high Flo oxygen, which spreads droplet infection. A lot of ventilators in the USA also have external humidifiers versus built in humidifiers which you get in Europe and other countries. We need to urge hospitals to get sterilization machines for the N95 masks because masks are designed to…Read the Full Response
I couldn’t agree more
https://mnnurses.org/want-my-death-make-you-angry/Read the Full Response
Closing the Loop for Patients in the ED
With Covid in our ED we are collaborating as interprofessionals (RNs along with our MDs, NPs, and PAs) to reduce exposure for all ED staff, such a using a straight stick for blood draws vs. starting an IV. As RNs we are noting that some of our providers are resistant or hesitant to return into patient rooms to “close the loop” and share the patient’s disposition. Have any of your EDs changed the process for conveying a patient’s disposition to them or started to use telehealth options to complete ED discharging?Read the Full Response
Working as a nurse in NJ while + with covid
Anyone aware of anything? Was told if I'm asymptomatic I can still work. I'm just worried I'm helping spread ththe virus.....Read the Full Response
A DAY IN ED
Considering as an ED front-liner RN, in the midst of this ongoing pandeminc, I am proud to share a day that I have experienced in our ever bustling ED.
It happened, 4 days ago when luckily I am only assigned in the Resuscitation and cast room for the entire shift. I know some of you might think that I am mental for describing those assignments as lucky. Well, nowadays you wouldn't want to be assigned in our Pedia observation room (now PUI room) or Isolation room for it is 100% sure that you will spend the…
RN'S need to be in charge of our nursing practices to include identifying our personal safety needs. In our clinic, nurses are being ignored by non-medical administration which has left everyone, to include patients, vulnerable. Despite the constant interference, the RN staff is doing our best to maintain proper infection control and follow ever changing CDC guidelines.Read the Full Response
Using non FDA approved untested dangerous combinations of medications
The hospital I work at has adopted the Plaquenil/Azithromycin protocol which means the 14 hospital Franciscan system is using it. I do not administer medications because I am a rounding nurse. Im really thankful that I do not have to participate in this. I have read the study results and there are serious flaws reported in the limited studies that have been done. Its fact that both drugs prolong the QT wave. Ethically, it is wrong for President Trump to tout these drugs as miracle cures when there is documentation that the drug manufacturer paid his lawyer 100K for access…Read the Full Response
challenges: there are about 12 RNs (2 NPs) in our Health Dept in a city of 500,000. There is political pressure to set up shelters and drive-thru testing clinics that we cannot possibly staff or oversee. We are getting spread too thin in the community which causes such hopelessness in the staff.
When we are through this I certainly hope that Americans demand healthcare for all. The economic hit for many Americans, with a loss of insurance, is adding insult to injury.
On one hand, I feel so fortunate to be able to work and continue to bring…
A matter of National Security
I continue to wonder if my career is worth the risk to my health and potential to bring illness and death to my family.
I cannot fathom how the CDC can be so fluid with their requirements for personal protective equipment: they have lost all credibility in my mind.
The question of how we can be more prepared in the future is so inextricably linked with other problems in our society as to require a major change in consciousness. Perhaps this will be the gift of COVID. First of all the move to a Global Free Trade…
RN, Surgical Services Lead
My biggest challenge has been advocating for the appropriate PPE for myself and coworkers. It is very disconcerting to go against everything we have been taught about infection control, to see other nations using more protective PPE, and to have our CDC change the recommended guidelines for PPE based on what is "available" versus what we know we need to keep us and our patients safe. I am apalled that I have had to argue for an N95 mask and the little brown paper bag to keep it in to reuse on ALL patients. I am afraid for my family…Read the Full Response
Not frontline but still anxious
I used to manage an assisted living facility, but moved into school nursing for more hours. Our school is one of the few that hasn't shut down amid this pandemic, because we are a residential treatment school. Girls still come from all over the country to receive therapy at our place. I have asthma and allergies. My normal O2 is 90%. So, I'm having a tough time keeping myself emotionally centered. I want to help and have a job, but my situation also makes me afraid... Any support is welcome.
Thanks for all you do, you who are REALLY…
Shared Colleague Stress
Shared with peer RNs
This crisis and tragedy so underscores for me the silent, but effective role of public health measures. If done well, you rarely hear about it. But if botched, then of course, apocalyptic. We did not do the basics. Testing was and is still is a disaster in many places so you can't properly identify and isolate. Hard to contain without aggressive and ambitious mitigation.
I have to tap down my anger as I know some 'leaders' were not taking this seriously even though we had 4, 6, maybe even…
Challenges of COVID
Submission to my Elementary School Newsletter this week:
Hello dear Jessup Families: Dr. Leiseth has asked me to write but during this very sad and uncertain pandemic and infodemic, I’m searching to provide something meaningful and heartfelt. All our lives have drastically and, I feel, forever changed. This crisis has magnified so many issues that need attention however remembering the faces and personalities of your children has provided much comfort as we all navigate through and out of this tragedy.
Public health is my first passion but a critical and perfect complement to school nursing.…
I kind of view it like my past job. Each call is different. Each patient deserves my best. I signed up for this and will stay till the need has been met. I think it is the most noblest of jobs , to care for others with nothing to gain. But, I am rewarded often, a smile, a thank you. That is truly my reward. Used to get hugs.now I really miss those.........Read the Full Response
I have had to perform education to frontline staff that has caused me great stress. On the verge of tears, I get up and go back into this situation and I don’t know each day of how I’m going to have to compromise what I know to be true. I’m trying hard to embrace a public health perspective-I just was not prepared for this.Read the Full Response
The biggest challenge in the home care and hospice area are being recognized in new emergency regulations and laws is being included as essential workers we have had to ensure that at the state and federal levels we are seen an as vital component to keep frail and elderly at home with needed medical and personal care. the Second is as with everyone lack of adequate PPERead the Full Response
Challenges of Covid
Biggest challenge is fear of getting sick from work and bringing home to my family. Other challenges work changes by the minute - constantly floating to the Covid floors.Read the Full Response
An I.C.U. Nurse's Coronavirus Diary--A New York Times Op-Ed
Theresa Brown, Nurse-Writer here, honoring and giving credit to another Nurse-Writer, Simone Hannah-Clarke. This beautiful piece should be widely read. In telling the story of one nurse, it honors all nurses.
These are not new challenges
Based on your experience as a frontline nurse dealing with COVID-19, what are your challenges, ethical dilemmas and fears?
Challenges that we are facing in dealing with the pandemic of CoVid-19 are the challenges that we face every day multiplied and magnified. The broken system that has allowed multibillion dollar for profit health care systems to embrace productivity, reactivity and reimbursement over preparedness and an adequate resource supply is a daily struggle. When I say adequate resource supply I mean PPE, ventilators, doctors, nurses and support staff of all kinds. You will never convince me that the…
So many challenges
As a nurse with a wide variety of experience in multiple specialty facilities from Floor nursing in Florida to Nurse Management in Nevada I can state definitively that the challenges we face exist in Both the patient population we treat as well as amongst the maze of oversight providing conflicting information and directives. Our understanding of the coronavirus is fluid and ever evolving. Our response too has been inconsistent and created much confusion amongst health care workers and patients alike. To compound the situation large corporations that run the healthcare facility often seem to be placing profit above the safety…Read the Full Response
For Next Time
For next time, and there will be a next time, I would like to see nurses in the leadership role of the preparation and response. For every patient that has a physician at the bedside, there are more nurses to carry out the orders, monitor the vitals, give the meds, notify the physician of changes in condition. We know this. Our knowledge of the art and science of caring is specialized and distinct. Why are we underrepresented in the planning and preparation for the response, both at a national level and on our state and local levels too? I see…Read the Full Response
How many will die
I can’t get the chorus of Crosby Stills Nash and Young’s song Four Dead in Ohio out of my head.
How many of my fellow caregivers will die from Covid. How many dead in the ICU? How many dead in ED? How many will, like so many people who are suffering from this pandemic, die alone.
I found this list today https://www.medscape.com/viewarticle/927976 John Kerry famously asked about the Vietnam war “How do you ask a man to be the last man to die in Vietnam? How do you ask a man to be the…
Corona virus testing
I think testing should be done more broadly. I dont think we really have an accurate number of how many people are really infectedRead the Full Response
We'll never have an accurate number of cases
I work 2 days/week at a free clinic here in Maine. We are a volunteer model clinic with 4 part-time paid staff people: two nurses (I am one of them) and two clerical staff. On Mar 10, the other nurse started feeling sick with flu-like symptoms. He'd been in NYC from Feb 28-Mar 2. He called out sick from work on Mar 11. His symptoms worsened and he was tested for COVID-19 on Mar 12; test was reported + on Mar 13--confirmed corona virus case #2 (CCC#2) in Maine. Our clinic is in a building run by the city of…Read the Full Response
RN Case Manager
I am discharging people at a rate that is unprecedented, in conditions that are more than limited (lack of staffing in home care, backlogs in DME, virtual PCP follow ups, hospices that are beyond full, and EMS systems that are challenged to provide transport). AND WE ARE NOT EVEN CLOSE to the peak of this. I am stunned that we could be caught so off-guard.
Why are we beholden as professionals to the whims of political leaders. As a scientific community, preaching evidence-based care--how did this happen?
I got my first mask…
This is comforting...
I really believe these reflections will empower an increasingly diverse group of established and emerging HCPs. By building an online community that is helping people in their actual lives come together to heal the deepest wounds during this tragedy and in our profession. Thanks for the thoughtful, forward-thinking perspectives and visions. Nurses will most certainly be a big part of this crisis.Read the Full Response
Staying "plugged in" so much more with work from home and Telehealth increases my need for connection to nature and three dimensional life. Making time for a 5 minute sun break on the deck, daily walk with the dog, and weekly hikes and biking in the state parks. Easy to socially distance while sharing physical activity in nature. Smiles can be felt from several feet away as I come across others seeking respite from the stress. I come back to the computer revived and ready to resume work. Makes me more positive and a support to colleagues, students and patients.…Read the Full Response
In response to - "handling the emotions – from fear to joy – stirred up by working during a pandemic?"
On weekends, I work as a supervisor in a tiny hospital in Niagara Falls, NY. There is a window that I like to stop by, just outside of the ICU. I can see the mist from the falls over the city. It's always there, no matter the weather or what is happening in my shift.
Today is my first shift wearing a mask. I'd forgotten how it feels, having been in administration for the last five years. Feeling your breath recycle itself against your face, adjusting and readjusting the straps, pulling it down when it rides up…
I am not afraid of storms...
I have always thought that we (healthcare system) waste so many valuable resources. Time documenting nonsensical assessments, infection control gowns, gloves and masks on patients that tested positive to MRSA 10+ years ago, etc... It makes me cringe when I think of the thousands of masks, gloves, and gowns I've thrown in the garbage over the years.
Now we are in this position where we don't have what we need and our nursing brothers and sisters are falling down all around us- I see it in their eyes and read about them in news articles. I…
Gratitude & Pride
Let me be the great nail holding a skyscraper through blue nights into white stars.
What does it mean to save a life? To lead? To care compassionately for someone else when one’s own health and safety is potentially at risk? Ask these questions of any frontline caregiver in the world today and you will likely find more questions, and answers replete with uncertainty and fear. We’ve never seen anything like this before.
People are dying – some, already compromised, some, otherwise healthy; young and old, patient and caregiver. The…
Looking for Leadership
“There was a time when I thought brains were everything. That view has dimmed recently. I think brains are important, but now I also look for good team-builders, good communicators, and courageous people who do not get stuck with an idea. You need people who are more nimble, who have the ability to lead organizations in changing and tumultuous times comfortably, without panicking.” Larry Bossidy, CEO, Allied Signal, Inc.
What is leadership? Without thinking deeply about what constitutes an effective leader, I suspect we can all recall good and bad leaders whether in our past…
Am I Enough?
I doubt I’m the only nurse who feels she needs to think ahead as far as possible, and do her very best to protect her loved ones, patients, and community. Nurses are taught to think critically, and at our best, proactively. There’s so many variables though, so many things I might not have thought of in advance. It has surprised me how much this feels like the stress I felt as a pediatric intensive care nurse at the beginning of my career, waiting for an admission known to be near death, and wondering, “Do I have all the equipment I…Read the Full Response
The virtual health offices of NJ certified school nurses are open
I co-authored this message with my colleague Eileen Gavin as an open letter to describe the work of school nurses during COVID19.
New Jersey certified school nurses are working throughout the state to keep our students safe, healthy and ready to learn from our virtual health offices. Our buildings may be closed, but we are actively working for our individual school districts by collaborating, cooperating, and consulting with our school staff, parents, and community partners as we navigate this unprecedented pandemic. As certified nurse educators, many of us are using online platforms to connect with students,…
I wish this crisis was not happening. It hurts to be far from my own family, and that's something I have in common now with my patients. My sister sent a text last week: "Healthcare workers are The Wolf!" (Referencing Harvey Keitel's character in "Pulp Fiction" who is the last line of defense when John Travolta and Samuel L Jackson find themselves in a world of trouble. "That's 30 minutes away. I'll be there in 10" says The Wolf.)
That's how we roll as nurses. One co-worker wheels the bedside computer up to his ICU patient's…
I just attended a meeting where our COVID surge curve model was presented. I have been preparing for the overwhelming wave of COVID cases we all will face in the few weeks, and the graph I saw still took my breath away. But I am bolstered knowing this is not forever. Things will change. And when I think too much about the horrible things that might happen to my loved ones, patients and coworkers, I need to match those images in my head with the just as likely best case scenarios of everyone faring very well.Read the Full Response
Each day is dynamic and changing. There are often changes in practices from what was learned the day before or the morning. What doesn't change is the job we do and the compassion and care we give to each other and our patients. I am grateful for my profession, co-workers and friends.Read the Full Response
Being afraid is ok
I honestly think a lot us are afraid of the unknown. COVID-19 is real and it's scary. Since becoming an ICU nurse I have learned to mask my feelings very well. What has helped me is knowing that a lot of co-workers share the same feelings as myself. When I'm having a rough day I reach out to my peers for guidance. I also make sure I time for myself each day, wether it's working out for 30 minutes or reading a book. I also take full advantage of having a Mepra moment in the medication room. I take 10-30…Read the Full Response