COVID Nursing...Ask Me Anything

[Dcinmd]

How badly is it going to affect you if Canada shuts down the border to the 1,600 nurses working in the Detroit area?

Amyotte is one of some 1,600 Ontario nurses who cross the border to work in Detroit. Now, as Michigan suffers one of the worst outbreaks of the deadly virus in the United States, some Canadian officials are calling for curbs on their travel — a move that could devastate U.S. hospitals.

 

[ru4por]

How badly is it going to affect you if Canada shuts down the border to the 1,600 nurses working in the Detroit area?

Devastating. Four of our hospitals are within a thirty minute drive from the border crossings. Most of those 1600 work at one of those facilities. Canadian nurses have been an important resource for all of my career.

 

[Dcinmd]

Devastating. Four of our hospitals are within a thirty minute drive from the border crossings. Most of those 1600 work at one of those facilities. Canadian nurses have been an important resource for all of my career.

It didn't sound like good news when I read it. I hope it works out for the best.

 

[b-mart]

One thing I haven't seen addressed is how we get people OFF of ventilators. My Dad had a couple of seizures from unknown causes last summer and wound up with pneumonia and on a ventilator in Fort Wayne, Indiana. He was there for about a month and a half before being transferred to a small hospital in Kalamazoo, Michigan that was probably an hour and a half away. He was sent there because he was so reliant on the ventilator that they had to send him somewhere to be weaned off. I don't think the Michigan hospital was big enough to handle more than a few cases like his though.

I'm sure that not every case of COVID-19 that requires a ventilator makes the patient as reliant on the machine as my Dad was, but I'm also sure that some cases are doing exactly that. So I guess my question is if you've seen people needing to be transported to specialists like that or if they're trying to do everything in one facility like yours? I feel like if enough people became dependent like my Dad did it would overwhelm our hospitals even more and we'd be hearing about it.

 

[ru4por]

One thing I haven't seen addressed is how we get people OFF of ventilators. My Dad had a couple of seizures from unknown causes last summer and wound up with pneumonia and on a ventilator in Fort Wayne, Indiana. He was there for about a month and a half before being transferred to a small hospital in Kalamazoo, Michigan that was probably an hour and a half away. He was sent there because he was so reliant on the ventilator that they had to send him somewhere to be weaned off. I don't think the Michigan hospital was big enough to handle more than a few cases like his though.

I'm sure that not every case of COVID-19 that requires a ventilator makes the patient as reliant on the machine as my Dad was, but I'm also sure that some cases are doing exactly that. So I guess my question is if you've seen people needing to be transported to specialists like that or if they're trying to do everything in one facility like yours? I feel like if enough people became dependent like my Dad did it would overwhelm our hospitals even more and we'd be hearing about it.

We are not sending out any vent patients. All of our facilities are pretty good sized acute care hospitals. The percentage of vent recovery was pretty low a couple weeks ago, though I am not sure if that has changed.

I don't work in the ICU where all of our vented patients are, so I really don't have the answers for your questions. From what I understand though, patients are either able to be weaned off of a vent in a couple weeks or they just don't make it.

 

[b-mart]

We are not sending out any vent patients. All of our facilities are pretty good sized acute care hospitals. The percentage of vent recovery was pretty low a couple weeks ago, though I am not sure if that has changed.

I don't work in the ICU where all of our vented patients are, so I really don't have the answers for your questions. From what I understand though, patients are either able to be weaned off of a vent in a couple weeks or they just don't make it.

Yeah my Dad didn't make it either. He got weaned off and immediately took a turn for the worse. At that point he couldn't have been intubated again because he couldn't have survived that either. I think with him it was more difficult too because he wasn't responsive enough to take commands most of the time. Word is that he had conversations, but I never got to see that when I visited. So I'm guessing that a lot of the people who can be weaned still have the brain function to communicate, and because of that they can be weaned off without having to have a trach put in.

Anyway, I'm sure you're getting lots of "we appreciate what you do" comments because what you do is so amazing. But I'll add another one. The whole experience of spending days in a hospital room with my Dad last summer really made me appreciate nurses more than anyone else. I don't know if I'd have the capacity to do it, but I sure appreciate people who do!

 

[JedV]

Cardiac Ultrasound tech from BC. b-mart is right, nurses do a lot more than most of us know or appreciate. ru4por and his kin are rock stars.

 

[Tripper]

The time may come when your own mask protects your own health---from somebody hitting you with a 2x4, for being in public unmasked.

Thanks David! This made me LOL.

 

[ru4por]

Yeah my Dad didn't make it either. He got weaned off and immediately took a turn for the worse. At that point he couldn't have been intubated again because he couldn't have survived that either. I think with him it was more difficult too because he wasn't responsive enough to take commands most of the time. Word is that he had conversations, but I never got to see that when I visited. So I'm guessing that a lot of the people who can be weaned still have the brain function to communicate, and because of that they can be weaned off without having to have a trach put in.

Anyway, I'm sure you're getting lots of "we appreciate what you do" comments because what you do is so amazing. But I'll add another one. The whole experience of spending days in a hospital room with my Dad last summer really made me appreciate nurses more than anyone else. I don't know if I'd have the capacity to do it, but I sure appreciate people who do!

Thanks b-mart, and I am really sorry to hear about your Dad. Losing a parent is one of the most devastating life experiences.

As a platform for one of my public service announcements, I would encourage everyone to look into advance directives and durable medical decision documents. Getting in writing, what you would like to have done medically to you, or not, in the event that you are not able to make those decisions. Most state governments have fine online documents to make use of. Make sure to file these with your local hospital for use, if anything were to ever happen.

 

[esdubya]

How are things going?

 

[ru4por]

How are things going?

Hey, thanks for asking.

Started chapter 2, of my adventure. The system I work for has closed the 100% COVID hospital I had been working at. Displacing me, and all the staff that usually works there. I have been waiting for a few days to get placed into a new position. I have been turning down 12 midnight shifts, I am just too damn old to do it. With all the closed hospital nurses getting priority over me, I have taken a job at a skilled nursing facility. It has a sub acute rehab area, a "memory" unit (looks like it is Alzheimer, dementia, combative) and a long term care area. The sub acute area is another 100% COVID area. I have volunteered to be placed there on 8 hour afternoon shifts. Certainly outside of my acute care expertise and definitely not the shift I was looking for, but I do want to help. It is a much different animal than working in the hospital. Only orientation today, so we'll see how it goes. It is a good chance to see what another side of nursing looks like.

 

[BogeyNoMore]

Genuinely hope the change works out well for you!

 

[DiscFifty]

Continued much respect for what you are doing on the job (old and new) and taking the time to reply to our questions here. Thank you. :clap:

If you were going to try to calculate a revolving number of active cases (based on new cases per day, recoveries per day, unfortunate deaths per day) over a period of time, how long would the period of time need to be in order to reflect a decent guesstimate? My guess would be 3 weeks. Thx.

 

[NDABRUSH]

Is Covid all that it's cracked up to be? If you had to give us the top five most common symptoms, what are they? Have all of your patients also been tested for the flu?

Thank you for what you're doing, by the way. When I said that you had been drafted, several days ago, I had no idea that you were gong to an all Covid hospital. I have faith that PPE will start to become more plentiful, as production has greatly increased. You should find some relief in that very soon. In the meantime, take care of yourself as best as possible.

That's funny you mentioned him being drafted. A week ago I told a coworker that hospital workers ARE the military in this situation. We are being protected from a foreign invader by the health care profession instead of the military. I never thought I would say that in my lifetime. Good work guys/gals.

 

[JedV]

Good luck with the change ru4por. I'm sure you're up to the challenge. Stay strong.

 

[Halcón]

Any updates Ru4por? Any trends? You keeping your sanity? Holding up physically? Wishing you the best out there, along with anybody else who is on the leading edge of this fight.

 

[peabody]

1. Remdesivir
2. Baricitinib
3. Soliris (eculuzumab)
4. Actemra (tocilizumab)
I know you are not working around it but are we a little closer to some sort of death slowdown if we can fast track these drugs?

 

[Monocacy]

1. Remdesivir
2. Baricitinib
3. Soliris (eculuzumab)
4. Actemra (tocilizumab)
I know you are not working around it but are we a little closer to some sort of death slowdown if we can fast track these drugs?

Pretty sure they are still doing clinical studies, testing for dosing, safety, efficacy, etc.

But yeah, treatments that reduced mortality would be peachy.

 

[ru4por]

Pretty sure they are still doing clinical studies, testing for dosing, safety, efficacy, etc.

But yeah, treatments that reduced mortality would be peachy.

I think that is what Peabody was saying. I personally think a vaccine is still a long way down road, but a couple decent treatments would make a huge difference.

 

[ru4por]

Any updates Ru4por? Any trends? You keeping your sanity? Holding up physically? Wishing you the best out there, along with anybody else who is on the leading edge of this fight.

SMH....when I made the decision to go back to nursing, I certainly did not have, what I am doing, in mind. Don't get me wrong, I am still working with all COVID patients and what I do makes a huge difference, to the patients I help. But, I am essentially working in a nursing home. It is the skilled nursing area of the nursing home, but such a different animal than the hospital. Equipment, supplies, quality of nurses, nursing assistants, even administrators are all sub-par and sub-optimal.

When I went back, I allowed myself to be at the mercy of my hospital system, as to where they would place me. Well, I am certainly in a place that needs my help.

I now really having to scrap for PPE. The cavalier attitude toward PPE use and self protection here is staggering. Most of the employees in this place seem to just do whatever the hell they want. Some are in and out of COVID + rooms with nothing...no gown, no mask.

I am not a shy guy, but dang I am tired of being the new guy yelling at long time employees. The virus has run straight through this facility and there is NO wondering why. Again, I am just struck by the fact that we are wiping out a generation with this virus.

I am vigilant without exceptions. I even go eat in my car now.....or down by the river that runs along side the joint. Saw a snowy owl on Tues. :thmbup:

Thanks again to all of you for your very kind words and allowing me a place to vent. For the time being, I am just keeping my head down and busting my ass.

Emotionally, I am a lot better. I have been able to compartmentalize a lot of it (a skill that I used to be pretty good at, back in my first go around with nursing). Physically I am getting better. I have lost some weight and seem to be getting my legs back. Nursing is a grueling physical profession and definitely a young persons game, but this aged hippie is holding his own.

I have the weekend off and I am pretty sure Oberon will help.