Things are as bad as they've ever been here.
Seems like we'll make it through this stupid coup attempt by our President- we're lucky he is as dumb as he is, they thought they had the results baked in, and weren't prepared to lose. A halfway competent fascist would have had the country sieg heiling already. But, then again, Trump isn't a typical fascist; he doesn't like America and has no interest in America being strong like Hitler or Mussolini did for Germany or Italy. He just wants to go the Gordon Gekko route and slash and burn the country, take the profitable parts for himself and leave everyone else with the bill.
But the damage is done largely. For instance, while there is enough manufacturing capacity to make enough N95 masks for all nurses and doctors and such, the federal government refuses to assist them in doing so. These companies are terrified they'll make billions of masks and then the pandemic will end, leaving them with excess stock. I get that- though it's sickening their bottom lines take precedent, but, still, I get potentially not having the excess cash flow to ramp up production to "wartime" levels- but that's where our federal government is supposed to step in. And they won't, not until 12:01pm on the day Joe Biden is sworn in. So we’ll have to wait weeks, if not months, beyond that- maybe if we’re lucky, production will catch up as we end the pandemic via vaccination, but too late regardless. Good thing, as it seems that wearing an N95 mask more than a couple times is useless.
And that's just the tip of the iceberg of dysfunction.
God, I hope they don't have an inauguration celebration for Joe. Do it inside, quietly. I'm afraid he'll get shot. Seriously, lurk around the online forums, on Parler or private Facebook groups or Discord for some of the Trump folks in this country, if you replaced the phrase "MAGA" with "Allahu akbar!" you would think you were eavesdropping on a Syrian ISIS cell. And I wish to hell I was joking or exaggerating.
COVID is way worse, even than the summer surge we had here- and no signs of slowing down. We had to intubate a college kid in their mid-twenties; we had been doing really good at not having to ventilate patients, using high flow oxygen and proning (tummy time), but now we're starting the bad stuff again... patient was on day 9-10 of their symptoms, which is classic for the danger window. Another person, under fifty, we had to intubate- and then they threw a clot. COVID had given them a constellation of pulmonary embolisms, clots in their lungs, and one broke off and went to their heart, apparently, because they went into cardiac arrest. They're not dead, yet, but the suspicion is they've had an anoxic brain injury, so even if they survive they'll be a vegetable for the next 20-30 years.
And these are not any more unhealthy people than the mean American, which, I get, isn't perfect. But still, 20 pounds overweight isn't normally a death sentence for people.
As nurses, we were reaffirmed that, if we end up being infected with COVID, that's not an excuse to call out unless we are effectively ill enough to require hospitalization. We'll have to wear an N95 mask for the entirety of our shift (the only time we're actually assured to be allowed to have a brand new, unused N95 mask for an entire shift), we're not allowed to go into the break room, and we're certainly not allowed to tell patients we have COVID. We also now have mobile refrigerated morgues stationed nearby.
Brilliantly enough, since our "patient satisfaction scores" have plummeted during a pandemic, administration's bright idea to fix this was to allow patients "the ability to have a member of their personal care team with them at all times during their stay". Which is, to say, they're letting visitors come back with patients now. Now, I have hated not letting patients have visitors. People having a loved one with them... I've just seen too many people die alone. I cannot abide it. But that's not what is driving this decision- it's money. Lower patient satisfaction scores means lower reimbursement from health insurance companies.
So now- as the virus is surging to all time highs- we're told we have to allow patients to have visitors in the ER with them, be it in the waiting room, or anywhere the patient may be. Which is great, because it's not like I've had COVID patients coughing in triage for six hours or more before we're able to see them. Let's just expose even more people and overburden us even more. Masks work, but they're not perfect. The surgical masks most people use are like wearing a lightweight bulletproof vest. It might work against 'small stuff or a glancing blow, but an ER Triage waiting room in a COVID hotspot is the metaphorical equivalent of being embedded with the US Marines in Fallujah during the Iraq War.
Of course, we already have enough people who think it's all fake/overblown/etc that . A colleague of mine in the city I went to college in told me they had to slap a loaded handgun away from a dementia patient who objected to the COVID restrictions ("I don't need to wear no mask!"). This patient, at their nursing home, apparently existed on a diet of extreme right-wing propaganda, like Newsmax and OANN. Can't believe they would let nursing home patients have loaded guns or watch that kind of crap all day, but I suppose it's sorta like handing your toddler a tablet with YouTube Kids on it. Honestly, thinking about it, it’s probably the family that sets them up with that stuff- and the nursing home staff don’t dare to interfere. Way easier that way; let grandma and grandpa rot what’s left of their mind on propaganda, and you don’t have to ever go visit them, right?
Anyhow, I figure it's only a matter of time until that situation is followed through to its logical extreme somewhere in our country.
We're preparing to turn our labor and delivery unit (almost our entire "Women's Pavilion") into a COVID ICU if need be. The birthing rooms are big enough for ICU patients, and the unit locks down for security reasons anyway, so easy to isolate, easy to get there from the ER, etc. I'm not sure where they're going to have babies, now, though a couple other places have been suggested and we've talked with one or two other hospitals/facilities in the area to utilize temporary space there to get it done. Also not sure what effect that'll have on future moms-to-be... having your kid in a room where someone choked to death with a tube down their throat. So I'm sure we'll put ICU patients in hallways before administration risks that, since labor and delivery is one of the "flagship elective services" we use to make money to pay for things like the ER.
Something that people forget- when we get overloaded, everyone suffers. Everyone. I think they don’t get it, because going to the ER isn’t something that they need to consider on a day to day basis, and they’ll think, well, no way I’ll have to worry about that, anyway.
Keep seeing significant long term problems in COVID patients- long haulers. Dialysis. Heart attacks. Chronic fatigue. Mental health issues. Beyond that, I can't imagine the damage this is doing to healthcare providers in our country. I think there are tens of thousand who are holding on until the crisis is through, and then will leave the healthcare field forever. We've always known how much society relies on us for letting their normal day to day lives go on. But what I think we didn't realize was the extent to which our society simply doesn't give a frick about any of the sacrifices we make so they can go about their day without worrying.
We are a country where too many are fat, dumb, and totally disconnected with the real world. Hardship absolutely exists in America, particularly if you're not a white anglo-saxon protestant, but things like the Great Depression, World War 2, all the people who experienced that first hand are dead. There is not central unifying experience of hardship that required national sacrifice to fight for a common goal. Greed is good, and it's all about "I got mine, f*** you!" We're a nation of college libertarians, snidely quoting Ayn Rand at one another; like trust fund kids who were, to use an American baseball idiom, born on third base and think they hit a home run.
As crisis events go, COVID-19 is showing us how rotten our society's structural support is. If we had to face anything bigger... well. We're barely hanging on as is- and the issue is still very much in doubt.
Money is tight in this economy. I have been living light, as I have purposefully been refusing all the screaming offers to pick up shifts at my hospital for more money- some at time and a half, or even double time pay- and working as little as possible until the vaccine comes online, which will hopefully be in just a couple of weeks. This has irritated management, because they’ve been banking on us picking up unlimited overtime hours instead of having to hire new people. But I have made it this far without getting infected. I am terrified I won't make it until I’m able to get a vaccine, and the closer we get to it coming out, the more worried I get about that.
The first thing I'm doing when I do is saving up my money and going to New Zealand. I want to hike the mountains. I want to find a bach with a hot soaking tub. I want to drink wine. I want to just be somewhere where being in public isn't like dodging bullets, worrying I'll have my health permanently impacted, where I can go to a pub or a coffee shop and just sit and decompress and relax and not worry.