• Diary Entries

    Hope

    Hope…Less

     

     

    During morning huddle we were not briefed on anything regarding Coronavirus… except that the neuro ICU on the 7th floor was under construction.  These rooms were being modified to become negative pressure rooms.

    Now, any nurse knows what this means.

    RESPIRATORY ILLNESSES COMING OUR WAY!! Shit.

    Hope

    The hurried construction on the 7th floor was noisy and hectic. Plastic sheets hung everywhere. Hammers were banging and the noise of the electric saws were menacing to the ill patients.

    I knew why they were working so quickly. I just didn’t want to believe it.

    New Orleans is a pretty big city with an international airport and interstates. Tourism is a major industry here. TONS of people come here everyday to experience NOLA. People mean virus to us.

    Coronavirus in NOLA

    The charge nurse came to the 7th floor at the end of the day informing us that the Neuro ICU section has been walled off to become the “positive cases” section of the unit and the MSU side of the unit is supposed to be for the, “presumptive positive cases”.

    We didn’t have to ask which cases.

     

    Quote of the Day

    “This is our most desperate hour. Help me, Obi-Wan Kenobi. You’re my only hope.” –Princess Leia, Star Wars: Episode IV A New Hope

     

    What’s for Dinner?

    Liver and Onions

    Liver and onions
    Liver and Onions

     

    P.S. Today really was Friday the thirteenth. It truly is a Cursed season.

     

    • Trump declares a national emergency in response to the spread of the virus. The declaration begins the process under which state and tribal governments can seek federal dollars for help responding to the virus. Louisiana becomes first state to postpone its presidential primary.

     

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  • Diary Entries

    Pearl Harbor

     

     

    Pearl Harbor…I mean, we knew this was coming. Right?

    On this day I was assigned 5 patients on the 7th floor. Michael has a beard and couldn’t wear proper PPE (personal protective equipment) to care for Coronavirus patients so, we adjusted the assignment to accommodate him. He will shave tonight or lose his job.

    Pearl Harbor

    Coronavirus is in New Orleans

     

    One of my patient’s on this day was the first suspected Covid 19 patient on the unit… that we knew of.

    I’m not gonna lie, I was a little scared.

    I don’t know if I was scared because I didn’t know what to expect or, if it was because I was scared of contracting the virus.

    I have been in scary situations before, especially as a police officer, but nothing like this.

    At least as a police officer you have laws, guidelines and your training to rely on in hairy situations. But this?!! There is no training or guidelines. This has never happened before. This is uncharted territory. The wild west so to speak. Thousands of people are dying from this virus and more get sick every day.

    No one here feels like they know what they’re doing. We don’t know how to fight this and we don’t have any guidelines to follow except for the guidelines the CDC gives us and those are changing every day.

    Here we go…. grab your proverbial balls and be a brave and great nurse to this patient.

    You may be the last person they see…SOBERING.

     

    Pearl Harbor

    We Knew This Was Coming

    How do you process this?

    My mom is crying because I won’t come home.

    I understand. Really I do but how can I leave? How can I look at myself in the mirror knowing I left all the healthcare workers, fighting to save lives, behind. I can’t turn my back on the country when the country is relying on us to keep them safe.

    This is how you process it…You don’t think about your individuality.

    Don’t be selfish Missy.

    Be a good nurse.

    Wear your PPE.

    Wash your hands.

    And, pray to God you don’t get sick.

           

     

     

    Quote of the Day

    “Come home. You don’t have to do this” –Mom

     

    What’s for Dinner?

    Nothing

     

    P.S. 

    Pearl Harbor reminds me so much of the timeline of the Coronavirus and how the U.S. government has handled it. Long story short… A U.S. ambassador to Japan alerted Washington to a possible attack and Washington denied the intelligence. Nearly 11 months after the warning, on December 7th, 1941 Pearl Harbor was attacked and World War II began.

    Our government was warned of Coronavirus in December of 2019. It took less than a month to reach us.

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  • Diary Entries

    Wake Up

    Reveille

     

    Wake Up! It is time we wake up to the severity of this virus.

    Yesterday, I had five patients and one of them was a suspected Covid patient and this pissed me off.

    What the fuck?! Why was I given four non-Covid patients and one possible Covid patient?

    That’s not fair to my patients and it’s not fair to my conscious. I am going to say something to administration about this at work and, in the future, I will refuse to take mixed Coronavirus patients.

    This is stressing me out.

    Reveille

    According to the news, the country is running out of PPE for healthcare workers. What the hell are we gonna do if the healthcare workers get sick? We are fucked and all POTUS can say is, “We have this totally under control”.  Why does he keep saying that?  We do NOT have it under control and we definitely do NOT know what we are fighting.

     

    Levity

    I woke up this morning and it dawned on me that today is St. Patrick’s Day. This gave me hope that it will be a good day. I put the corned beef, cabbage, potatoes and carrots in the crockpot. Next, I made sure the Guinness was getting cold in the fridge. This is the perfect dinner for St. Patrick’s Day. Ahhhh, levity.

    Then, I realized… it’s not St. Patrick’s Day.

    God damn it! My brain is so scattered.

    Oh well, who cares. My family usually celebrates this day together and I love it. There’s no stupid presents, pretenses or expectations just family, food and fun. St. Patrick’s day is my favorite holiday. I even named my youngest son the middle name of Patrick.

     

    Closed

    Louisiana Shuts Down

    On the news –the fucking news. It’s everywhere.  TV, social media, in every conversation, and at WORK! I can’t get away from it. The news is like a song that gets stuck in your head and makes you want to scream. Ugh…

    The President and his medical staff made recommendations for social distancing, closing schools, restaurants and businesses to combat the spread of this virus. Shortly afterward, the Governor of Louisiana did just that. The Governor ordered schools, restaurants and the majority of businesses to be CLOSED- effective immediately.

    I wonder how weird that would be? To be a police officer and walk into a casino or a bar or something and say, “By order of the governor, you must shut down!”.

    That would feel slightly apocalyptic don’t ya think?

     

    Quote of the Day

    “Be safe for fuck’s sake!” -Brandy Cannon

     

    What’s for Dinner?

    Corned beef and cabbage

    Corned Beef

     

     

    P.S.

    I am not looking forward to work tomorrow. I have a feeling it will be nothing we expect or have experienced.

     

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  • Diary Entries

    Happy St. Patrick’s Day

     

    Happy St. Patrick’s Day! Wish Us Luck. 

    Today, we were walking up to the employee entrance of the hospital and there were tables set up outside and nurses wearing PPE standing next to them. They were obviously going to take our temperatures and, it was strange to say the least. There was no explanation, they just walked up and put a ‘No Touch’ thermometer close to your forehead and read your results aloud.

    Mine was 97.2° and Michael’s was 97.9°. They placed green wristbands on us to let everyone know we were fever free. I assume the color green wristbands were for St. Patrick’s Day.

    Happy St. Patrick's Day: Nurse taking a temperature

    As I was walking inside I almost turned around to look at the long line of nurses waiting to have their temperatures checked. I decided not to. I didn’t want see if anyone was turned away.

    It would be too…I don’t know…discouraging? Maybe that’s the word I’m looking for discouraging.

    Happy St. Patrick’s Day… yay.

    Typically, I like working holidays because they are fun work days. Staff usually has a potluck or we do something special for the patient’s.

    Hopefully the luck of the Irish is with us today.

    Order in Chaos

    We finally get to the 6th floor of our unit and the nurses station is buzzing with activity and nurses talking. During morning huddle, the charge nurse explains that the 7th floor is now dedicated to Covid positive patients and we will be moving the Covid rule out patients that remain on the 6th floor up to the seventh floor today.

    Okay, I finally see a plan and we have some direction. I don’t necessarily agree with the plan but, okay. There is finally some order in the chaos.

    The hospital admins had mentioned this a few days ago but, we really didn’t see it happening. The logistics of moving sick patients can be difficult. Apparently, something has changed and now things were going to start happening in a more fluid fashion. Good.

    I get my assignment and see that I am assigned to the 7th floor (Of course I am). After receiving report from the night nurses, I start my day. I start to look at the patients charts and labs and, yada yada, as all nurses do.

    And then it happens…

    I read orders in the patients charts for the nurses to draw all labs and complete all respiratory treatments. Wait….What!?

    No way. I’m not a phlebotomist and, I’m definitely not a respiratory therapist. I am not trained nor am I certified in those areas.

    My head is roaring with questions and confusion.

     

    I Need Clarification

    This ridiculousness requires clarification so,  I call the charge nurse.

    “Must be a mistake. We’ll look into it.” she says, and I go about my day.

    About an hour later, I see the doctor who wrote the aforementioned orders talking on the phone and looking into one of my patient’s room window.

    Puzzled, I walk closer and I see he is obviously conversing with the patient via telephone while observing them through the window.

    What the hell is this unprofessional shit?

    So, I wait.

     

    Essential Personnel Only

    After he hangs up the phone, I inquire about the orders. The doctor told me this…

    “Nurses are to all draw labs and complete all respiratory treatments to reduce employee contact with these patients. This comes from the Medical Director of the hospital. Oh! and also, housekeeping is not allowed in the rooms. Essential personnel only”.

    Okay, hold the fuck up. What? So, I have to be the nurse, the phlebotomist, the respiratory therapist and the housekeeper? Not gonna happen.

    Next, I calmly ask him why he was talking to the patient through the window and, the doctor proceeds to tell me that this is the way they were directed to interact with the patients in order to reduce their exposure to the virus.

    Happy Fucking St. Patrick’s Day!

    My jaw must have dropped wide open and my eyes must have been huge because he stepped back staring at me with a strange look on his face.

    My anger was obvious to him.

    I said, “Are you kidding me? You are the doctor. YOU ARE ESSENTIAL!  How are you completing your assessments through the window?”

    His answer… “Verbal assessments”.

    Unbelievable.

    I am dreaming right?

    I am not here.

    This is all an illusion.

    A figment of my imagination.

    Shenanigans.

     

    Quote of the Day

    May the road rise up to meet you.
    And the wind always be at your back.
    May the sun shine warm upon your face,
    and rains fall soft upon your fields.
    And until we meet again,
    May God hold you in the palm of His hand.
     -Unknown Author

     

    What’s for Dinner?

    Colcannon

    Colcannon recipe
    Colcannon

     

    P.S. 

    • Ireland confirmed 69 new cases, the largest to date. 292 total confirmed cases and 2 deaths

     

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  • Diary Entries

    Vantage Point

    .Cross Hairs

     

    When someone is backed into a corner a vantage point is a good thing to have.

     The 7th floor of MSU is only Covid positive patients now. I had 5  of those patients. It’s too much to handle effectively and give quality care. Nurses are still expected to round on the patients every hour, update the whiteboard, give our meds and care for the patients in addition to all of this other crap! Not to mention having to put on and take off the PPE for every room every time.

    Today was exhausting to say the least.

    Some members of administration came to the unit to ask if there was anything they could do for us.

    Vantage Point

    I spoke up first. I rarely say anything off color to administration but, I HAD to say something about this.

    The staff nurses aren’t going to say anything for fear of losing their job or retaliation. Not to say the hospital is like that but, you know how shit goes with administrative people. They might view you as negative or, if you have hopes of getting ahead saying something negative may impede that. You see, I have an advantage in this situation. I DO NOT work for this hospital. I am a contract employee. There is no retaliation for me. There is no promotion to worry about.

    Voicing Concerns

    With that said, I voiced our concerns.

    Me: “Yeah, I do… Why are nurses expected to take on three more duties in addition to an already overloaded workday?”

    Them: “What do you mean?”

    Me: “I was told by Dr. (insert whatever name here) that we are to be drawing the patient’s labs, complete all respiratory treatments and housekeeping is not allowed in the rooms. It is an actual order in the chart, and he said it came directly from the medical director.”

    Them: “We didn’t know about this.”

    Me: “If we are expected to do all of this then our patient to nurse ratio needs to be way less, like 3:1 , if you want things to be done safely and with competence because right now we are stressed out to the max, and we are practicing in a VERY UNSAFE WAY. Everyday that I step foot in this building not only am I afraid of contracting this virus, I am afraid of losing my license or one of my patients lives because I am too busy updating whiteboards, cleaning rooms, completing respiratory treatments, drawing labs, charting AND doing my MANY OTHER duties as a nurse. This is too much to expect of us.”

    Administration does not like to hear the word ‘unsafe’ in the same sentence with patient, nurse or license.

    There was a pause, an exchange of glances and some writing in a notebook.

    Them: “Thank you for letting us know. We will look into this and get back to you”.

    Vantage Point

    I walked away shaking my head.

    Now, if you know me you would know I would NEVER- EVER say anything like this ( Not because I’m spineless but, because I have no dog in hospital fights). I am a contract employee and I work for my patients. I care about my patients and, as a nurse, I am bound by my nursing oath to advocate on their behalf.

    The questions I posed to administration was not for me. The question I asked them was for the benefit and safety of the PATIENTS.

    The patients… You know, the very people that hospitals get their billions of dollars from.

    Rosie the Nurse

     

    I can only hope they take this matter seriously.

    Thank God I am off work tomorrow. I seriously need the break.

     

    Quote of the Day

    “Our lives begin to end the day we become silent about things that matter” -Martin Luther King Jr.

     

    What’s for Dinner?

    Potato Soup

    potato soup
    potato soup

     

    P.S.

    I really think this Covid Pandemic is going to reveal how bureaucratic the hospital systems in the US are. After the dust has settled nurses need to get together as a country and demand better working conditions which include clinician ran institutions. There is a doctor who makes videos and supports nurses who completely supports this idea.

     

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  • Diary Entries

    Victory

    Small Gains

     

    Victory!

    When we got to work today we found the circumstances had changed… again. This is no real surprise these days. The hospital administration calls it “fluid” and
    “changing hourly”.

    If that’s not the understatement of the year I don’t know what is.

    We are learning as we go and we have to be flexible. As I said before, this has never been done before so, we have to adjust to what gets thrown at us.

    Now, the entire 7th floor of MSU is being converted into another ICU for the hospital. Previous to now, only about half the unit was a negative pressure ICU. (See Mach 13th post)

    Our goal today is to get all the non-Covid patients off the 6th floor and disperse them to other units in the hospital.

    After we do that, we are to move the presumptive positive Covid patients from the 7th floor down to the 6th floor in order to completely empty the 7th floor for construction.

    We did just that and, it went smoothly. Thank God.

    Victory: Nurse Mitch keeping it humorous
    Nurse Mitch keeping it humorous

    Victory

    Remember my earlier post about how the nurses are expected to do the work of nurse, housekeeper, phlebotomist and respiratory therapist?

    Well, today, we were told that we are only to enter the patient rooms when absolutely necessary. There are actual orders in each patient chart that state this. We are to cluster our care while in the room to limit how many times we go in and, we are to tell our patients that these measures are being taken is for safety of the staff to reduce our risk of exposure. The doctors have been told to streamline the patient’s medication times so we aren’t going in the room every hour or two. I’m curious to see how that works out.

    We were told only necessary staff will be going in the room and services such as housekeeping a food service will not be going in the rooms. BUT, phlebotomists and respiratory therapists will be necessary and therefore they WILL be going in the rooms…I think I smiled bigger than the Cheshire Cat in that moment. They listened! Administration actually listened to little old me. We win!

     

    VICTORY

    MSU Nursing Unit
    Nursing Staff on MSU in NOLA

     

    This is gonna be a good day.

    This is exactly the light I need in all of this darkness.

     

     

    Quote of the Day

    “Sincerity of conviction and purity of motive will surely gain the day. And, even a small minority armed with these, is surely destined to prevail against all odds.” – Swami Vivekananda

     

    What’s for Dinner?

    Grilled Ribeye with Veggies

    Ribeye Steak
    Ribeye

     

    P.S.

    I had to send two of my patients to ICU today. The virus is very fast acting in the body. In one minute the patient is fever free and is breathing okay on a few liters of oxygen and then, all of a sudden, they are burning up with a high fever, shivering and requiring 15 liters of oxygen on a non-rebreather.

    This is scary but there may be a light at the end of the tunnel. Apparently, China reported the amount of cases they have is coming to a halt. Three months. It took three months for them to see a decline…can we make it?

     

     

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  • Diary Entries

    Silence

     

     

     

     

    Silence. The Sound is Deafening. 

    Today was totally weird. I have never experienced a day of nursing like this.

    It was so strange not going into the rooms very often. Talking to every single one of my patients wearing a mask, goggles, gloves and a gown is awkward. It feels so…I don’t know…robotic?

    I just kept thinking of that experiment with the baby monkeys and the wire mom and the cloth mom. This psychologist named Harlow basically tortured baby rhesus monkeys but, what he discovered was really neat.

    In short, the baby monkeys were given two ‘moms’- one wire mom and one cloth mom. What he found is that the monkeys preferred the cloth mom even when the wire mom was the only one with food showing that ‘contact comfort’ is essential in development. That speaks volumes without saying a word. The monkey would rather starve to death just to have have physical touch and comfort.

              I wonder how my mask and protective gear makes my patients feel

    They are sick and they are scared. The patients cannot have visitors (The hospital banned all people from the hospital that are not essential employees). On top of that, now they cannot be touched unless necessary. In a time when they most need a hug and a reassuring touch, we cannot give it without great risk. Nurses are supposed to be caring, empathetic people who actually touch their patients. It’s just weird. The whole situation is sad.

    Today we all had 4 patients each so the stress level was surprisingly pretty low among the nurses. In combination with the lack of people that are normally walking up and down the halls like, visitors, food services, housekeepers, physical therapy, speech therapy, imaging and maintenance personnel, and all the people that make up the hospital… they are all gone.

    It’s like a ghost town… Eerie

    We have to re-use our PPE when ordinarily this would be a HUGE no-no. The world is in a shortage of hospital supplies and we must preserve what we have.

    MSU Nursing Unit
    Nursing Staff on MSU in NOLA
    The doctors are being so nice to us now.

    They weren’t really rude or anything before but, everything was so rushed and quick. Now, they come to the unit and sit with us and ask us what we need from them. They answer our phone calls promptly. Everyone is working like a well-oiled machine and THAT is very uncommon in a hospital setting because things change so rapidly.

    Now, all of our patients on the unit are the generally the same. They all have the same type of symptoms and the treatments are the generally the same. For example, none of these patients are getting IV fluids so, we are not constantly hearing IV pumps going off.

    Yeah, that’s another thing… It’s Qui…- Wait! We never say this word in the hospital because it always brings chaos- Quiet. It is so freaking quiet.  Most of these patients are alert and oriented and therefore their bed alarms aren’t going off because they don’t need them. The IV pumps are silent because there are no fluids. There are no visitors asking a million questions. The noisy carts that are usually being wheeled up and down the hallway are gone. There aren’t the chattering housekeepers in the halls and rooms. The maintenance men aren’t pounding and banging. Physical and Occupational Therapists aren’t walking the patients in the halls with the clangy walkers. Hospital volunteers aren’t handing out magazines and crossword puzzles and coloring books and books and other things to the patients to keep them entertained. The animal services volunteers aren’t walking the dogs in the halls to visit the patients. The priests are not giving communion unless called upon…. The hospital normally has so many sounds.

    Sounds that irritate the shit out of us on a daily basis. Sounds that make the hospital a hospital.

    It was so quiet

    My charting was done before lunch. UN-Fucking-HEARD OF! Hell, I actually ate lunch for that matter! The whole day felt surreal. I was half-expecting leprechauns to come out and tell me I found the pot of gold. I would liken this day to a day at a telecommunications office that didn’t receive or make any phone calls.

    Silence: Nurse Mitch keeping it humorous
    Nurse Mitch keeping it humorous

    Is this how it’s going to be for a while? Was it a fluke day? I guess we will see. Everything is so bonkers right now.

    No sports, no going anywhere unless it’s necessary, no restaurants, no unnecessary business open. The traffic is low, the planes are very few.

    Usually, this campground we are staying at is fairly loud. We are right next to a four-lane highway, the main New Orleans airport, train tracks and the Mississippi river. Typically, every hour on the hour the train blows its horn approximately 7, 654 times (it’s so annoying), planes are constantly landing and taking off, the boat’s fog horns blow regularly and the cars driving by are loud with road noise and music and such. And now, it’s almost silent.

     

     

    Quote of the Day

    “We need to find God, and he cannot be found in noise and restlessness. God is the friend of silence. See how nature — trees, flowers, grass — grows in silence; see the stars, the moon and the sun, how they move in silence. We need silence to be able to touch souls.” – Mother Teresa

     

    What’s for Dinner?

    Zuppa Toscana

    Zoppa Tuscana
    Zuppa Toscana

     

    P.S. 

    3.3 Million people filed for unemployment today which is a record. More people filed for unemployment today than they did in The Great Depression. Wow!

     

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