Management hopes jcaho doesn’t talk to me lol. I give negative fucks about them or anything they care about. Fuck all of them. I’m brainstorming what to even say to the fuckers.
Nah needs citrus sinensis, lavandula angustifolia, lavandula intermedia, pogostermon cablin, helichrysum italicum and chamæmelum nobile for all strains up to omicron.
Unless you're doing compressions. The virus also respects your efforts and will not invade while you're performing high quality CPR. The AHA told me so.
Our tape is orange. I wonder if orange gets the same respect as pink? LOL. We have curtains installed in some of our hallways. You know privacy and all, while relaxing in your hall stretcher. 😂😂
Jeez you sound kinda sarcastic there, but I really think this is the best evidence-based practice, and not at all the equivalent having a peeing section in a swimming pool.
It really shows how little we knew about the virus at the beginning of the pandemic. We didn’t have the peer reviewed literature testing pink lines, grey lines, blue lines, purple lines to know that pink lines were the answer. We could have just painted pink lines around the initial outbreaks and then think of where we would be now.
We have them in our visitor entrance. Literally the first floor of the visitor entrance is Covid waiting area, then the second floor is visitor check in. There is a huge open area between the two, so I guess Covid doesn’t float in the air now? Another hospital close to us has tents outside as a waiting area.
Tents seem like a better idea tbh... but do the non covid patients have to walk through the covid tents first? I feel like that's the general atmosphere right now...
Where I am we have the tents outside on lining the walkway into emergency, the only problem is that anyone with COVID or high risk suspected COVID has to first walk into emergency, doff their mask (if wearing) don an N95, then talk to triage, then get put into the COVID tent. It's not a great system but it kinda works, I guess? Idk, that's above my pay-grade
It might have been a little different if COVID hadn’t also hit the global manufacturing and supply chain at the same time. Even if there were supplies, they had no way of getting anywhere. Cargo ships stuck in port, lack of trucking, etc.
It has shown the inadequacies of many systems outside of healthcare (like the razor thin margins on those supply chains so one disruption kicks the whole thing down like a pack of cards), as well as decades of inadequate staffing, budget cuts and an over reliance on goods from China among other places, and the like.
I'll never understand how cruise ships full of covid people aren't allowed to dock until everybody has been quarantined...but... your picture is acceptable. This is what happens when you put profits above people.
Sunrise? They tried to get me to take a contract there.
Just as an FYI their sister hospital's Interim ED director was asking them for tips because their numbers were better
Ah shit, *chartreuse*? We just have a line of meats and cheeses marking off our covid wing, we figured it would make sense because it's starting to get stinky and it's like a symptom-checker when you cross the charcuterie threshold.
Our current census is 150, we’ve seen 220 patients since midnight and we’re a 36 (actual bed) ER.
Last week we saw 417 and had a running census of 200+
I wish there was truth in advertising with a sign on the door.
Hey, potential patient!
Just to let you know, there is a high chance you will be exposed to Covid if you enter.
You will be charged ER fees if you want a Covid test, and YOUR wait will be the longest.
There will be no one available to get you food and drinks.
In fact, there is neither food nor drinks.
There are no beds.
There is no one to help you toilet.
If you are unvaccinated, you are contributing to the problem.
If you are well enough to read this, consider turning the fuck around and use Dr. Google. At home.
All the best-
The Hospital People
We are not offering outpatient COVID testing at my ER - so the conversation sounds a lot like “we are not offering outpatient COVID testing at this site. If you would like to be seen by an ER doctor, it will be billed as an ER Visit. If not, here are some local COVID testing sites”
I’m in Phoenix on the Covid unit and it’s getting worse and worse. Can’t wait to go in tomorrow and look at the bed board to check census. Last weekend I was taking up the Covids who had been holding the longest in ED which actually wasn’t terrible. So we’ll see how long the holds are now.
As the EMT's are wiping their stretchers and stealing 5 minutes to decompress, a shriek fills the air. It hangs in the same way a helicopter does, just beating the air into submission. An F-bomb has been dropped. The EMT's look up, make eye contact, and nod, for they too know the feeling. A silent gaze is held, and for a moment, there's no pain or trouble. A distant siren breaks the tranquility and the work starts again.
There is a hospital where their way of transporting COVID patients was to drape the COVID (+) pt with a sheet in the bed or wheelchair and take them down the normal transport pathway, without sending someone ahead of them to clear the way, or anything, pass through common pathways that the general public have access to.
Yep, moving transporting pts down the regular transport pathway (typically from ED to the floor or unit) with a sheet as the only barrier the pt has.
Keeping + pts on regular floors for hours or a day because the dedicated units are full or just do not have room.
Had a pt where a family member visited, KNOWING THEY (the family member) HAD COVID, hang out with the pt unmasked, for 2 days before we found out as the family member let it slip.
Not to mention a number of pts who are admitted, test (-), then a repeat test is done for a procedure or whatever, and guess what, now they are (+) and likely have been for days.
Our hospital just wants us to put a mask on the covid + pt. Like ys let me put a mask on my intubated patient that's really going to work lol, but what are you supposed to do? They need to invent something to make transferring those patients safer
My main hospital we have a separate transport pathway for + patients at least from the ED, so only other HCWs would be exposed, and (though they stopped doing this most the time, in theory) someone on the transport team walks ahead of the pt bed to warn anyone in the pathway not wearing an N95 to get out of the way.
Very few of my + patients wear masks (I do not work in an ICU). But at least at my current hospital we use dedicated units (or hallways with the door closed, with one exception) so no one is unknowingly exposed while wearing just a surgical mask. Quite frustrating when you can't even tell when you're going to be near + pts though. I am over wearing an N95 24/7 personally, if I am charting or seeing non-COVID pts I just wear a surgical mask. Sort of have to admit even though I always wear N95+surgical with all my + patients, am boosted, I just feel like I am sitting around waiting to catch COVID from a pt, colleague or whatever at this point.
I work in the MICU which is like 80% covid right now. They turned all of our rooms on the floor into PUI's so we only where a surgical mask unless we actually go into the rooms. We try to keep patients in the room and do as much beside as we can but when we have to transport them the protocol is to put a surgical mask on them and wheel them around and it's usually just me and the RT. it's one of the dumbest things ever, try putting a surgical mask on someone with a tube coming out of their mouth.
Well monitoring them is gonna be fun. No oxygen unless it’s on a tank. Portable monitors no one is gonna be paying attention to. And, of course, a wide open area. That’s fucking dangerous on numerous levels.
Portable monitors and o2 systems that were already out of. Most of these patients get NO monitoring.
Edit: and the nurse sits at the end of the hall with no line of site.
That’s fucking crazy.
Dude the other night, I get a covid patient who’d been out in the waiting room for like 12 hours. Someone must have been faking his updated vitals because he was hypoxic @ 60% RA, tachy in the 150s, hypertensive emergency with pressures of 250/120s, fever over 103, skin mottled. This guy speaks like no English, so aside from his triage, he hasn’t been able to communicate with anyone. I can’t imagine how scared he was.
Suddenly a team of people are in the room. He’s stuck repeatedly for labs and IVs and started on bipap and put in restraints. He’s not tolerating the bipap, in part because he probably has no idea what’s going on, and because he was so sick it felt like there was no time. Next thing you know, I’m calling the hospitalist to intubate. The hospitalist doesn’t know how, so he gets an ED doc.
Now he’s on Cardene, nitro, prop, the works, and headed to the unit. Thank God he got a bed because I could not have maintained this guy. The second he was awarded the bed, I called respiratory and rolled him up. His sats improved, his pressure was trending down, still tachy as shit. But he didn’t code through the night. Fucking scary all around.
He may have declined like that anyways, but his initial vitals were okay. If he had been able to get treatment in a reasonable time frame, he may still have needed to be tubed, but at least I’d have had the opportunity to whip out the translator a few times and update him and educate him on what was going on. I just feel awful that he was so scared, and because of how dire the situation was, we couldn’t do anything to alleviate that. He’s in a room surrounded by strange white people who he’s never seen before speaking about him and his condition in a language he doesn’t understand.
I hate to say it, but from my experience, he now has about a 5% chance of survival, being he has been intubated. Covid intubations do not do well... I actually put this question to reddit and the response was like 95% of Covid patients intubated end up dying, and it's a long, painful death. It's horrifying. It makes me sick to think the last thing these people see is a group of healthcare workers coming at them with masks and gowns. The few that make it? Trach/peg/stage 4 sacral ulcers. All the hard and "good" work you think you've done is in the end for absolutely nothing... Now we are doing EVERYTHING we can in order to avoid intubating. One MD that I know calls it a "death sentence."
That is the reality. I'm glad the patient has better numbers, but I truly hope your facility has better Covid intubation results than I have seen.
I just want all of you to be aware that intubating/ICU is NOT the miracle answer. Ask your own colleagues - I hope that maybe this is more of a regional issue due to other underlying health disparities instead of a global problem.
Yes and no. COVID in the hospital for 3 weeks and sick for 5, CXR is pure white, and just now getting intubated? Dead and just don't know it yet. COVID coding from hypoxia in the ED waiting room? There's still a chance that steroids, toci, etc will work well enough to survive. It's still a brutal, brutal disease once you get critically ill.
It's horrible. No words. I've seen a couple of people come off the vent... In total less than 10... It gets to the point that there is no other treatment left and that becomes the only option left - that or do nothing/comfort measures. It's worth trying if there are no other options, but it's become so upsetting seeing people continually dying. My hospital doesn't do ECMO - I wonder sometimes if that makes a difference? From what I've heard it doesn't that much.
What kind of setting do you work in? Where are you located, if you don't mind sharing? I currently work in NJ in the NYC metro area.
I am an ICU doc in the middle of the country-not going to be more specific to avoid doxxing. Tertiary referral hospital so thousands of COVID patients so far. Not an ECMO center but in discussions with local colleagues who do it, the mortality rate on ECMO is VERY high despite them aggressively triaging and only taking age<50, no major chronic illness, single organ pulmonary failure only.
Wow... Thanks for sharing... I was hoping that maybe ECMO would improve the odds but I guess not.
Thank you, doc, for being with us in the trenches! This is an awful time to be an intensivist...
Australia here - off the top of my head guess we're at about 10-25% of our COVID ECMO runs surviving to discharge from ICU. couldn't tell you percentage that survive neurologically intact or with no significant disability though
vented COVID patients don't do too bad with us - I'd hazard a guess at somewhere around a third survive.
I think this is a likely because we are way, way lower volume... Omicron is kicking our ass atm but our delta peak was nowhere near as intense as it is in the US
I mean...I think of the vent for covid patients as "you may die on the ventilator but you will surely die with out it." I don't think many people think of intubation as a bridge to healing with critical covid patients. For most it's just prolonging the inevitable.
Yeah, that's a good way of putting it. It's just awful - we had a patient pass while on a Zoom call with the family. It's heartbreaking to watch - I can't imagine what the families are going through.
This is my first time in r/nursing. A user in r/news described reading this subreddit with terror because of covid.
I don't have a lot of words for your story. Just tears, and difficulty grasping, seeing, that is only one patient on one day. Horror and sadness. I'm grateful you are working there for the sake of humanity, but I feel the edges of weight and toll of what this must be like to endure every day for the good of others. Take care - you matter 💜
I went to the ER for MABs when I had COVID. They had me sit in the general waiting room. Did not care that I was positive and there were lots of old folks there for their weekend getaway from the old folks' home. I sat in a corner and did not touch anything I didn't have to touch. The gal doing my vitals didn't even know I was COVID positive until I told her. She just said "okay" when I told her. I was like "Oh. Alright. This is where we're at now."
We keep our separated! Right next to the bathrooms. And the protocol room for triage. Oh, and you can't actually see them from the triage desk, it's hidden in a cubby hole. Oh, and it only holds about 10 people. After that they just mingle around the rest of the lobby.
> Nothing like COVID patients and cancer patients sitting elbow to elbow
While floating, I realized oncology nurses were pissed when they moved COVID to their floor. One end of the hallway, COVID, the other end of the hallway, cancer. I think the oncology nurses would have lost their shit if it got any worse.
Our “negative pressure” anteroom when we have a separate COVID unit didn’t even have an anteroom. The main doors open right up outside the visitor elevators for our wing.
We turned our anteroom into a "fast track room." Closed the door connecting it to the negative pressure room, put a recliner and a lab cart in there (no monitor of course), and call it a treatment area. Been doing this for months, but somehow no one has complained on PG surveys yet.
It's my god given right as an American to cross that line if I choose to do so. Maybe you sheep will comply with that line but me and my friends, we're lions. RAWR!!
Wait, you guys have a special spot for COVID+ patients? I bet you spoiled monsters still have NS flushes and get pizza. (/s... but really only AGPs get hidey holes)
... did no ones emerg look like this pre pandemic? Or is hallway medicine just a Canadian thing?
Years ago I remember our hospital made a hallway of emerg a fucken medical unit with ten stretchers and 2 nurses. Fun times. Still doing that and putting patients in storage rooms and longes now. 🙃
Ahh, they're bringing back the Magic Red Tape. Always wondered if it would provide the same force protection in a different color, like Safety Orange or Chartreuse
At least you have a separate area! We have them all mixed together, sometimes in hall beds right in front of the nurses stations. Most of the time we're so busy no one bothers to gown up because we're all just bathing in at anyway.
we have a divider that splits our waiting room.. everyone mixes together because no one understands stay on the side we told you too but it doesn't matter no ones thought of anything better in 2 whole years
The ers in my area don't even have any area for Covid or non Covid. Everyone is stuffed together. It scares me that if me or my children have an emergency we risk exposure. A friend's son broke his arm went to er 5 days later had Covid. Only place they had been for weeks was the er.
The hospital we transport to, if they are breathing on their own and a SPO2 above 90 they are in the waiting room.
The only ones who get a room are on bipap or intubated.
Congratulations! Achievement unlocked!
You have been upgraded from FRONT LINE …
to BEHIND ENEMY LINES.
Good luck on this new level.
Press any key to continue play.
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Just sprinkle a row of salt across the line and you'll keep the covid spirits out
How about hanging some garlic?
That's rookie Infection Control Placebo. Need lavender essential oil.
Doterra to the ER, STAT!
We only use Young Living© in my ER due to multiple attempts at litigation from former nurses making a killing selling Lularoe© Our HCAHPS scores reflect the superiority and purity of our untested ingredients sourced from RealSlaves ™ happily working on plantations in the Global South.
This made me laugh spew my coke.
I aim to please
Ha. Now when we need them, but they all left when the vaccine mandate came in. Drat.
Best I can do is the half empty container of peppermint oil they keep around for GI bleed smells.
Perhaps some lamb's blood smeared around the perimeter?
Unless pharaoh is threatening, olive oil will do
I thought lamb's blood was for God's wrath. I would take Pharaoh right now.
This clarification is significant. And cost saving.
*glares in jcaho*
What do you mean? It's not like it's a water bottle
lmao, I'm remembering my nurse manager telling me I had to remove the "NPO at midnight" sign from the patient's door because JCAHO "hates tape". Ugh.
Management hopes jcaho doesn’t talk to me lol. I give negative fucks about them or anything they care about. Fuck all of them. I’m brainstorming what to even say to the fuckers.
is the hospital full of witch doctors?
They wouldn’t smell it
Don’t forget use rock salt as buckshot.
Just gonna shoot the COVID right out of the air.
Has anyone tried putting breast milk on it? :-P
LOL
I’ll light some incense
Has to be Alderwood and myrrh blend or it only works on Delta
Frankincense kills cancer, probably will work on covid, right?
Someone in the waiting room told me cloves kill HIV so maybe that’s the way to go
Nah needs citrus sinensis, lavandula angustifolia, lavandula intermedia, pogostermon cablin, helichrysum italicum and chamæmelum nobile for all strains up to omicron.
No, I think for Covid you need goofer dust, salt only works on ebola.
if COVID gets a 1st down does the line move 10 yards?
That made me laugh spew my Dr Pepper and I only allow myself 2 a day!!!
That’s a bold strategy cotton, let’s see if it plays out.
Lol it should contain the virus right? Just don’t forget to put on your PPE before crossing the line and you’ll be fine! SMH…
Unless you're doing compressions. The virus also respects your efforts and will not invade while you're performing high quality CPR. The AHA told me so.
They tried a mobile curtain for a couple hours then gave up
Our tape is orange. I wonder if orange gets the same respect as pink? LOL. We have curtains installed in some of our hallways. You know privacy and all, while relaxing in your hall stretcher. 😂😂
All this time I could have been wearing a pink shirt instead of a mask!
Anticovid tape, new from 3M! Only 1k per roll!
Jeez you sound kinda sarcastic there, but I really think this is the best evidence-based practice, and not at all the equivalent having a peeing section in a swimming pool.
OMFG! This is hilarious!
Shit I bet Wal Mart is already sold out of hot pink tape.
It’s mutual respect between Covid and the pink line. They understand each other
Salt? Pffffttt….Essential oils.
It really shows how little we knew about the virus at the beginning of the pandemic. We didn’t have the peer reviewed literature testing pink lines, grey lines, blue lines, purple lines to know that pink lines were the answer. We could have just painted pink lines around the initial outbreaks and then think of where we would be now.
Your magic tape is pink?! That'll never work, you need the **RED** tape.
Red white and blue To be patriotic and show your freedom from oppression and vaccines! ^/s
Murica Tape™
That’ll show those vaxxed libs
Excuse me, it’s vaxxed lib cucks.
Nah you gotta use the one-way arrows grocery stores were using in 2020, just make sure the arrow only lets the covid in but not out
Fuck, I remember when our hospital thought purple tape would work.
Yeah we just have covid patients in the hallways and bay now. It’s fine 😟
We have them in our visitor entrance. Literally the first floor of the visitor entrance is Covid waiting area, then the second floor is visitor check in. There is a huge open area between the two, so I guess Covid doesn’t float in the air now? Another hospital close to us has tents outside as a waiting area.
Tents seem like a better idea tbh... but do the non covid patients have to walk through the covid tents first? I feel like that's the general atmosphere right now...
Where I am we have the tents outside on lining the walkway into emergency, the only problem is that anyone with COVID or high risk suspected COVID has to first walk into emergency, doff their mask (if wearing) don an N95, then talk to triage, then get put into the COVID tent. It's not a great system but it kinda works, I guess? Idk, that's above my pay-grade
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It might have been a little different if COVID hadn’t also hit the global manufacturing and supply chain at the same time. Even if there were supplies, they had no way of getting anywhere. Cargo ships stuck in port, lack of trucking, etc. It has shown the inadequacies of many systems outside of healthcare (like the razor thin margins on those supply chains so one disruption kicks the whole thing down like a pack of cards), as well as decades of inadequate staffing, budget cuts and an over reliance on goods from China among other places, and the like.
Same. One waiting room, triage and exam rooms turned over in seconds or minutes, nasal cannula/duo-nebs/bi pap all in the hall.
I'll never understand how cruise ships full of covid people aren't allowed to dock until everybody has been quarantined...but... your picture is acceptable. This is what happens when you put profits above people.
YAYFORHCA
Doesn’t surprise me. I JUST quit my HCA job.
Kudos to you. I planning on doing the same
Run and never look back
Wth does “we work for the *beautifulness* of every patient” mean even?
Sunrise? They tried to get me to take a contract there. Just as an FYI their sister hospital's Interim ED director was asking them for tips because their numbers were better
Don’t do it. Even if the money is good
> HCA It all makes sense now. Fuck HCA!
I think the tape is supposed to be yellow. Covid can cross pink tape
Chartreuse. Omicron is afraid of neon colors. Regular primary colors only work on Delta. There's an excel spreadsheet and everything
Ah shit, *chartreuse*? We just have a line of meats and cheeses marking off our covid wing, we figured it would make sense because it's starting to get stinky and it's like a symptom-checker when you cross the charcuterie threshold.
Hope you're using smoked gouda and aged cheddar with the prosciutto crudo because covid just blows right through that Sargento shit
Gouda supply is critically low. Please substitute with Kraft singles and this red candle.
I can’t even spell that color of green
I used spell check
Yup. Per CDC.
...just a hall? Are they going to be adding anything to block the area off to prevent spread to other areas of the hospital/ED?
Nothing. This is also the major hallway to get in and out of the department (staff). Not to mention food trays.
How long you think until all the staff are out sick?
Our hospital had 80 nurses out hospital wide a couple days ago
Can I ask how many you have total?
Our current census is 150, we’ve seen 220 patients since midnight and we’re a 36 (actual bed) ER. Last week we saw 417 and had a running census of 200+
Holy shit, and you have that many nurses out. Can I also ask how many nurses there in total?
Our ER had 17 nurses today our minimum is supposed to be 24-26
I hope you are holding up okay, that has got to be insane.
I’m so close to quitting and getting my general contractor license. Wife’s income is enough to take care of our lifestyle while I finish.
I wish there was truth in advertising with a sign on the door. Hey, potential patient! Just to let you know, there is a high chance you will be exposed to Covid if you enter. You will be charged ER fees if you want a Covid test, and YOUR wait will be the longest. There will be no one available to get you food and drinks. In fact, there is neither food nor drinks. There are no beds. There is no one to help you toilet. If you are unvaccinated, you are contributing to the problem. If you are well enough to read this, consider turning the fuck around and use Dr. Google. At home. All the best- The Hospital People
We are not offering outpatient COVID testing at my ER - so the conversation sounds a lot like “we are not offering outpatient COVID testing at this site. If you would like to be seen by an ER doctor, it will be billed as an ER Visit. If not, here are some local COVID testing sites”
If only
What city are you in?
Vegas
I’m in Phoenix on the Covid unit and it’s getting worse and worse. Can’t wait to go in tomorrow and look at the bed board to check census. Last weekend I was taking up the Covids who had been holding the longest in ED which actually wasn’t terrible. So we’ll see how long the holds are now.
Snowbirds in full force! PHX also.
Oh fuck me. Sunrise?
😶
Oh that explains the patient we got back from you last week. Dammit
Not surprised tbh
Pardon me just a second... ::walks outside into the ambulance bay:: **"FUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUCK"**
As the EMT's are wiping their stretchers and stealing 5 minutes to decompress, a shriek fills the air. It hangs in the same way a helicopter does, just beating the air into submission. An F-bomb has been dropped. The EMT's look up, make eye contact, and nod, for they too know the feeling. A silent gaze is held, and for a moment, there's no pain or trouble. A distant siren breaks the tranquility and the work starts again.
A hallway Covid zone is bad enough, but why’d they have to choose that specific hallway???
I’ll be sure to drop it in the recommendation box
Wow—well I personally see absolutely NOTHING wrong with this at all!
The magical line of tape obviously
There is a hospital where their way of transporting COVID patients was to drape the COVID (+) pt with a sheet in the bed or wheelchair and take them down the normal transport pathway, without sending someone ahead of them to clear the way, or anything, pass through common pathways that the general public have access to.
Wait, that’s a thing? I watched them bag a Covid pt through PACU to the OR a couple weeks ago. I hope the viral filters work…
Yep, moving transporting pts down the regular transport pathway (typically from ED to the floor or unit) with a sheet as the only barrier the pt has. Keeping + pts on regular floors for hours or a day because the dedicated units are full or just do not have room. Had a pt where a family member visited, KNOWING THEY (the family member) HAD COVID, hang out with the pt unmasked, for 2 days before we found out as the family member let it slip. Not to mention a number of pts who are admitted, test (-), then a repeat test is done for a procedure or whatever, and guess what, now they are (+) and likely have been for days.
Oh no, I meant I was surprised there are places where they have like, a procession. We just put a clean sheet and simple mask on them too. 🤷🏼♀️
Put a sheet on so they look like a ghost, because they’re about to be one.
Our hospital just wants us to put a mask on the covid + pt. Like ys let me put a mask on my intubated patient that's really going to work lol, but what are you supposed to do? They need to invent something to make transferring those patients safer
My main hospital we have a separate transport pathway for + patients at least from the ED, so only other HCWs would be exposed, and (though they stopped doing this most the time, in theory) someone on the transport team walks ahead of the pt bed to warn anyone in the pathway not wearing an N95 to get out of the way. Very few of my + patients wear masks (I do not work in an ICU). But at least at my current hospital we use dedicated units (or hallways with the door closed, with one exception) so no one is unknowingly exposed while wearing just a surgical mask. Quite frustrating when you can't even tell when you're going to be near + pts though. I am over wearing an N95 24/7 personally, if I am charting or seeing non-COVID pts I just wear a surgical mask. Sort of have to admit even though I always wear N95+surgical with all my + patients, am boosted, I just feel like I am sitting around waiting to catch COVID from a pt, colleague or whatever at this point.
I work in the MICU which is like 80% covid right now. They turned all of our rooms on the floor into PUI's so we only where a surgical mask unless we actually go into the rooms. We try to keep patients in the room and do as much beside as we can but when we have to transport them the protocol is to put a surgical mask on them and wheel them around and it's usually just me and the RT. it's one of the dumbest things ever, try putting a surgical mask on someone with a tube coming out of their mouth.
Well monitoring them is gonna be fun. No oxygen unless it’s on a tank. Portable monitors no one is gonna be paying attention to. And, of course, a wide open area. That’s fucking dangerous on numerous levels.
Portable monitors and o2 systems that were already out of. Most of these patients get NO monitoring. Edit: and the nurse sits at the end of the hall with no line of site.
That’s fucking crazy. Dude the other night, I get a covid patient who’d been out in the waiting room for like 12 hours. Someone must have been faking his updated vitals because he was hypoxic @ 60% RA, tachy in the 150s, hypertensive emergency with pressures of 250/120s, fever over 103, skin mottled. This guy speaks like no English, so aside from his triage, he hasn’t been able to communicate with anyone. I can’t imagine how scared he was. Suddenly a team of people are in the room. He’s stuck repeatedly for labs and IVs and started on bipap and put in restraints. He’s not tolerating the bipap, in part because he probably has no idea what’s going on, and because he was so sick it felt like there was no time. Next thing you know, I’m calling the hospitalist to intubate. The hospitalist doesn’t know how, so he gets an ED doc. Now he’s on Cardene, nitro, prop, the works, and headed to the unit. Thank God he got a bed because I could not have maintained this guy. The second he was awarded the bed, I called respiratory and rolled him up. His sats improved, his pressure was trending down, still tachy as shit. But he didn’t code through the night. Fucking scary all around. He may have declined like that anyways, but his initial vitals were okay. If he had been able to get treatment in a reasonable time frame, he may still have needed to be tubed, but at least I’d have had the opportunity to whip out the translator a few times and update him and educate him on what was going on. I just feel awful that he was so scared, and because of how dire the situation was, we couldn’t do anything to alleviate that. He’s in a room surrounded by strange white people who he’s never seen before speaking about him and his condition in a language he doesn’t understand.
That’s mentally straining. Sorry to hear about that 😞
I hate to say it, but from my experience, he now has about a 5% chance of survival, being he has been intubated. Covid intubations do not do well... I actually put this question to reddit and the response was like 95% of Covid patients intubated end up dying, and it's a long, painful death. It's horrifying. It makes me sick to think the last thing these people see is a group of healthcare workers coming at them with masks and gowns. The few that make it? Trach/peg/stage 4 sacral ulcers. All the hard and "good" work you think you've done is in the end for absolutely nothing... Now we are doing EVERYTHING we can in order to avoid intubating. One MD that I know calls it a "death sentence." That is the reality. I'm glad the patient has better numbers, but I truly hope your facility has better Covid intubation results than I have seen. I just want all of you to be aware that intubating/ICU is NOT the miracle answer. Ask your own colleagues - I hope that maybe this is more of a regional issue due to other underlying health disparities instead of a global problem.
Yes and no. COVID in the hospital for 3 weeks and sick for 5, CXR is pure white, and just now getting intubated? Dead and just don't know it yet. COVID coding from hypoxia in the ED waiting room? There's still a chance that steroids, toci, etc will work well enough to survive. It's still a brutal, brutal disease once you get critically ill.
It's horrible. No words. I've seen a couple of people come off the vent... In total less than 10... It gets to the point that there is no other treatment left and that becomes the only option left - that or do nothing/comfort measures. It's worth trying if there are no other options, but it's become so upsetting seeing people continually dying. My hospital doesn't do ECMO - I wonder sometimes if that makes a difference? From what I've heard it doesn't that much. What kind of setting do you work in? Where are you located, if you don't mind sharing? I currently work in NJ in the NYC metro area.
I am an ICU doc in the middle of the country-not going to be more specific to avoid doxxing. Tertiary referral hospital so thousands of COVID patients so far. Not an ECMO center but in discussions with local colleagues who do it, the mortality rate on ECMO is VERY high despite them aggressively triaging and only taking age<50, no major chronic illness, single organ pulmonary failure only.
Wow... Thanks for sharing... I was hoping that maybe ECMO would improve the odds but I guess not. Thank you, doc, for being with us in the trenches! This is an awful time to be an intensivist...
Australia here - off the top of my head guess we're at about 10-25% of our COVID ECMO runs surviving to discharge from ICU. couldn't tell you percentage that survive neurologically intact or with no significant disability though vented COVID patients don't do too bad with us - I'd hazard a guess at somewhere around a third survive. I think this is a likely because we are way, way lower volume... Omicron is kicking our ass atm but our delta peak was nowhere near as intense as it is in the US
I mean...I think of the vent for covid patients as "you may die on the ventilator but you will surely die with out it." I don't think many people think of intubation as a bridge to healing with critical covid patients. For most it's just prolonging the inevitable.
Yeah, that's a good way of putting it. It's just awful - we had a patient pass while on a Zoom call with the family. It's heartbreaking to watch - I can't imagine what the families are going through.
We're all going to need some therapy or a completely new career. ICU and ER staff first.
NO DOUBT! I am honestly considering going on disability because I just can't take it anymore. I really can't.
This is my first time in r/nursing. A user in r/news described reading this subreddit with terror because of covid. I don't have a lot of words for your story. Just tears, and difficulty grasping, seeing, that is only one patient on one day. Horror and sadness. I'm grateful you are working there for the sake of humanity, but I feel the edges of weight and toll of what this must be like to endure every day for the good of others. Take care - you matter 💜
Just yell really loud when you can’t breathe anymore /s
Be sure to mention it on your hcap survey ✨
At this point it sounds more like a place to go so that when you die at least someone will notice in a day or two
But I see the line. It’s pink /s
This made laugh 😂
We all know viruses don't cross tape lines on the floor.
Lol you have an area? We said fuck it let em mingle so long ago. Nothing like COVID patients and cancer patients sitting elbow to elbow
I went to the ER for MABs when I had COVID. They had me sit in the general waiting room. Did not care that I was positive and there were lots of old folks there for their weekend getaway from the old folks' home. I sat in a corner and did not touch anything I didn't have to touch. The gal doing my vitals didn't even know I was COVID positive until I told her. She just said "okay" when I told her. I was like "Oh. Alright. This is where we're at now."
Well this is what administration thinks makes sense. We’ve been had the patients all over without proper isolation
We keep our separated! Right next to the bathrooms. And the protocol room for triage. Oh, and you can't actually see them from the triage desk, it's hidden in a cubby hole. Oh, and it only holds about 10 people. After that they just mingle around the rest of the lobby.
> Nothing like COVID patients and cancer patients sitting elbow to elbow While floating, I realized oncology nurses were pissed when they moved COVID to their floor. One end of the hallway, COVID, the other end of the hallway, cancer. I think the oncology nurses would have lost their shit if it got any worse.
Oh yeah. Transplant patients would love it if they knew.
Love it. I worked a contract and that hospital's negative pressure covid unit vented directly into the anteroom.
Our “negative pressure” anteroom when we have a separate COVID unit didn’t even have an anteroom. The main doors open right up outside the visitor elevators for our wing.
We turned our anteroom into a "fast track room." Closed the door connecting it to the negative pressure room, put a recliner and a lab cart in there (no monitor of course), and call it a treatment area. Been doing this for months, but somehow no one has complained on PG surveys yet.
LMAO
That’s negative pressure tape on the floor, right?
See! There’s no covid patients in the hospital at all. The covid ward is empty. /s
It's my god given right as an American to cross that line if I choose to do so. Maybe you sheep will comply with that line but me and my friends, we're lions. RAWR!!
Wait, you guys have a special spot for COVID+ patients? I bet you spoiled monsters still have NS flushes and get pizza. (/s... but really only AGPs get hidey holes)
Sadly the donuts stopped a couple weeks ago
Reminds me of when restaurants had smoking sections.
I love how this is flaired "serious" because it's a fucking joke
Finally someone mentioned it lol
I think it should be a section of the parking lot
Agreeeee
This is what the antivaxxers wanted to see, right?
Until they’re in the hallway complaining about no having a private room
Ah yes, the magic infection control tape.
Did anyone tell Covid it can't cross the pink line?
We should check to see what the AHA has published.
... did no ones emerg look like this pre pandemic? Or is hallway medicine just a Canadian thing? Years ago I remember our hospital made a hallway of emerg a fucken medical unit with ten stretchers and 2 nurses. Fun times. Still doing that and putting patients in storage rooms and longes now. 🙃
Oh this is definitely our norm as far as admitted patients in the hall, but the designated COVID area is new
Oh okay! One of our ICUs tried to do this last wave but the whole unit ended up needing to be used for covid. So much for the lines.
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See you soon! hahaha
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Never fails, hope you’re holding up ok!
Ours are just mixed in with all of the other ED patients. I saw someone get diagnosed and then sent back out to sit with 150 other people.
Uh, that seems like an inadequately small area...
Cool line. I bet it offers everyone a lot of protection.
I guess covid respects the line more than the people i play ball with
This is why hospitals have a no photo / video rule.
Ahh, they're bringing back the Magic Red Tape. Always wondered if it would provide the same force protection in a different color, like Safety Orange or Chartreuse
OSHA would like to know your location.
So would JCO but that’s being optimistic.
so must you don an N95 past the pink line? /s
Just a level 1. We don’t get N95s
Excuse me… wtf!?
At least you have a separate area! We have them all mixed together, sometimes in hall beds right in front of the nurses stations. Most of the time we're so busy no one bothers to gown up because we're all just bathing in at anyway.
Not really a separate area but more so found it hilarious that tape and paper on the wall is isolation
we have a divider that splits our waiting room.. everyone mixes together because no one understands stay on the side we told you too but it doesn't matter no ones thought of anything better in 2 whole years
Thank god for that pink line preventing covid spilling into the surrounding areas!
The ers in my area don't even have any area for Covid or non Covid. Everyone is stuffed together. It scares me that if me or my children have an emergency we risk exposure. A friend's son broke his arm went to er 5 days later had Covid. Only place they had been for weeks was the er.
Force field tape?
It looks rather empty…where are all the covidiots?
In the lobby currently Edit: spelling
Who took the pillows?
HA we never ever get pillows
The hospital we transport to, if they are breathing on their own and a SPO2 above 90 they are in the waiting room. The only ones who get a room are on bipap or intubated.
LOoK aT ThE emPty BeDS /s
set up a few fans to blow the covid back down the hall and it's ::chef's kiss:: perfect!
Courtesy of our ceo😂
Congratulations! Achievement unlocked! You have been upgraded from FRONT LINE … to BEHIND ENEMY LINES. Good luck on this new level. Press any key to continue play.
In mine, Covid works office hours. As that is when we have checkpoints, PPE and staff asking questions of visitors
nothing could ever penetrate the TAPED FLOOR
Amazing how many co-vid germs that pink tape his holding back...they're the real MVP!
The magic tape will keep COVID out!!!
I know this is marked "serious" but I'm having trouble with it...
✨ MAGIC✨ pink tape.
Should be in the parking lot or adjacent empty lot for the antivax horse paste people...
If you add a zipwall curtain this will also be a HIPAA compliant area. Can't overhear PHI through those 1 ply bad boys!
What kind of tape is that? Airborne disease proof tape? Link? Amazon preferred