In the midst of a pandemic, this nurse feels betrayed

This nurse notified his hospital unit director testing availability for novel coronavirus on January 26, 2020.  This nurse asked his hospital unit director if signs could be posted discouraging visitation unless necessary on March 10, 2020.

The response was, “People need to take care of themselves.”

She said this standing next to the signs that restrict children under the age of 12 from coming into the hospital for RSV season.  This nurse wore a mask at work on March 8, 2020, and noted the disapproving looks of some physicians and support staff.  This nurse is saying that masks for health care workers outside the emergency department and ICU aren’t recommended at this time because there are not enough.  This nurse is saying that screening hospital visitors, which begins today, March 16, 2020, is too little and too late.  This nurse is saying that the health care system has likely spread this pandemic in a nosocomial manner, directly into the populations most vulnerable to it.  This nurse does not see a wide-spread testing solution employed currently, and this nurse also understands that testing is too late.

What do we do?

Stop “planning” and meeting.  Start working.  The hospital I work at has contingency plans for surges up to 30 percent capacity.  We have not drilled once.  We have not started outfitting or modifying any equipment or rooms.  Start training all of your bedside staff on progressive oxygenation therapies.  Obtain as many oxygen condensers as possible, seeing the potential for no wall accessed oxygen if capacity swells considerably.  Obtain every breathing training device in abundance possible.  Maybe if we have patients with some reserve left hitting the incentive spirometers or flutter valves hard enough, we can delay or negate the need for forced air assistance or ventilation.  Obtain every pulse oximeter possible.

Start utilizing some of the considerable ingenuity and brainpower from your own workforce.  There has not been an opportunity for staff other than leadership to present ideas.  Admit you need help: Ask for it; take it.  Stop worrying about staffing right now.  We’re blocking off beds and sending staff home during this lull before the storm.  Everyone available should be training.  Respiratory therapy needs to take the lead in educating staff and extending their reach and capabilities.  Come up with a plan for when staff testing occurs, and positive results are confirmed amongst staff.  So far, quarantine of staff sends chills down our spines.  We won’t be able to maintain quarantine standards; we need a place for exposed asymptomatic healthcare workers to continue working with exposed patients only.

“Behind the scenes” means behind the scenes.  Just because this nurse is not working in the emergency department, ICU, or leadership, does not mean that this nurse is a fragile part of the public.  Quite the opposite: Keeping us in the dark has built mistrust and resentment at points of failure.

The author is an anonymous nurse.

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