Author: AM

Sooooo, finally ready to post thoughts and feelings at my own Dad’s bedside.

8/3/2011

The machines made low beeping sounds, the one with the hose whooshed in a rhythmic way. I could hear the chatter of the nurses and doctors out in the nurses’ station, joking and laughing. I held my dad’s hand. It didn’t squeeze back, it was limp, like a doll’s hand. Soft, almost rubbery. These hands held me as a baby, guided my bike down the road as I went for the first time without training wheels. Held my hand as he walked me down the aisle to my husband. Now it was still, he was still. He looked peaceful at least. It did still look like him. I was glad. I’ve seen some people whose face got so swollen that the tape and tube for the vent made them unrecognizable. I looked at his face, really stared, a way that you never could normally without fear of the person waking up and catching you staring at them. I wanted to memorize him, his face, even the smell of his shampoo and aftershave combo that made a unique scent to him. This might be one of the last times I ever see him. Someday, maybe this week, he might be buried forever and I’ll never see him again. That thought made me gag, almost wretch, I couldn’t imagine never seeing him again. Never hearing his voice. I was somewhat relieved when I realized I still had a voice message from him on my phone.

My hand was soaked. I didn’t realize that I was crying, it was an ugly cry too. My hands, his hand, my lap from sitting, all soaked in tears.

8/5/2011

Lessons Learned as a Nurse, Now Family Member

As she moved around his bed she never acted as though I was in the way. She treated me as an extension of him, that I was right where I was supposed to be. She was smart, thoughtful. But there was a delicacy of touch, a softness in her manner. This didn’t make her weaker or less competent. I was ashamed looking at her. I thought about all the times I was more concerned that the patient and their families understood that even though I was the nurse and not the doctor, I was just as smart. I didn’t want to be relegated to “just” being in charge of sponge baths and making beds. My stomach sank as I remembered being so irritated that a daughter asked me if I was going to shave her dad because he didn’t like looking scruffy. I explained at the time that it was far more important to ensure that the pilot balloon for his breathing tube not get accidentally cut as I had seen once happen. That had been a rare occurrence and could be avoided when I really thought about it. I was a pompous ass. My dad right now had a nice smooth shave and fresh tape for his tubing. His hair was combed just like he would normally have it. He had a light scent of lotion. His nurse hung another bag of antibiotics quietly. She didn’t interrupt my time with explaining all she was doing so I knew all the “important” things she was so busy with. I vowed right there that I would change my attitude when I went back to work.

8/6/2011

Running felt good. It was like a release. I blared the music in my headphones and let it pump through my core. My breath filled me, almost pushed everything else out. It felt good. The waiting room, the phone, the constant talk about strokes, brain, bleeding, rehab, funeral plans, they were behind me. I ran from it and pushed the questions, plans, anxiety out of my head. I concentrated on the breaths, the footsteps, the trees and houses. The sweat started to flow, purging my system. No one could talk to me here, ask me questions, tell me stuff. No numbers, temperatures, vital signs. The song rocked louder, I ran faster, pushing myself. This will undo all the sitting in the waiting room, the muscles that continuously shook my leg when I was anxious. The constant pumping of my leg up and down while waiting around. The rest of my body just tensed. The waiting room. Waiting for what? I now know the expectant glances that I was used to whenever I just walked by at work, not realizing that every time I passed someone held their breath. Wondering is she coming for us? What’s going on? What do we wait for in that room anyway? Is it control? That anything could happen if we were at home but since we’re here in the building our loved one won’t code, won’t have post-op complications, won’t start bleeding again? I know no one’s going to come in and say “Hey, it’s all just been a nightmare. Your dad is fine, you can wake up now.” We wait. Your body sits, tense, anxious. That’s why these runs are such a release. Move the static out, pump the blood, run.

The Beginning

It was interesting this week, I ended up discussing with some of my nursing students how clinicals were going. I was so happy to hear that they were vastly different from mine which I didn’t expect with the way everyone is short staffed now. Twenty years ago we knew that we would be headed toward a nursing shortage with the fact that the Boomers would be both retiring and presumably needing more health care at the same time. It makes me crazy that we’ve known this all this time yet it’s only the very recent time that anyone has really started to sound the alarm. Now after a pandemic and a great amount of nurses walking away from the bedside we are still lucky enough to have people who want to enter this career.

I thought back to my very first day of my nursing clinical. I was so nervous, it would be the first time that I got to use my new skills on real people and I would be under the direct supervision of a nurse. We had spent the night before gathering the information on the patient we would be working with the next day. Mine was a post-op gallbladder. These were the days before smart phones and being able to easily access journal articles. I went home and poured over all my nursing books reviewing everything that you would ever want to know about gall bladders and the care of people who had theirs removed. The pain meds, the doses, what side effects to look for, how the labs will change. I barely slept.

My clinical group was quiet the next morning as we rode the elevator to the 3rd floor of St. Francis Hospital. My friend Annie looked like she was going to puke. Our instructor just sucked down her coffee. I checked my pockets, 3 multicolored pens, a hemo stat, scissors, St. Jude prayer card and a sharpie. My brand new stethoscope was around my neck bad ass style over the dorkiest translucent white student uniform. It might actually get used today on a real patient. As we exited onto our unit, Lucy finished off her coffee and told us our last minute instructions. “I’ll be rounding to check on you but remember, the nurse you’re assigned to is really your go-to person. As instructor, I’m just here to observe how you are doing. Have a great day, meet back here at 1500.”

The five of us moved as a tight group over toward the glass enclosed nurse’s station where we stood quietly as we were ignored by every staff member imaginable. After about 15 min Elena, one of our top students, couldn’t stand there anymore. “Excuse me! Is- is the charge nurse around?” her voice cracking.

“Hang on,” the woman who made the mistake of making eye contact with Elena said. “Julie, I think you’ve got some students here.”

A tired dirty blonde haired woman headed over towards us, clearly figuring the shaking college aged, white uniformed clad group were indeed the students she was told about.

“Oh yeah, we have students today, let’s see,” she looked over her clipboard. She then started to point at us randomly and stated names,” You, Katie. You, Kim…”

She pointed at me and stated Denise.

We split immediately and went looking for our nurses. I looked at the assignment board and saw that Denise had 7 different rooms. I jotted them all down and went looking into each one. I couldn’t find her. Not one staff member made eye contact with us so I figured I wouldn’t ask where Denise was. I decided to go to my patient’s room and figured I’d meet her when she came to see him.

I stood in Mr. Woods doorway, not committing to completely entering yet. He had his eyes closed and looked comfortable. I didn’t think I should go in and start talking to him until I spoke with his, really, our nurse.

“Are you holding the doorframe up?” I was startled by a gruff voice behind me. As I turned I came face to ID badge with a quarterback dressed as a nurse who as her badge said, was indeed Denise.

“Oh, hi! I’m Kerry. I’m your student so I can give baths and do vitals and-“

She cut me off and put her finger in my face.

“YOU are the LAST thing I need to deal with this morning.” she made a motion with her hand clearly telling me to get out of her way.

I absolutely wanted to get away. Far, far away. But I had to pass this clinical. Oh my God I had to spend the next 6 weeks with this nurse.

I followed her into the room. Mr. Woods was awake now so we had an audience.

“I can help you, just tell me what to do. I’ve looked up all his labs and-“. Again she cut me off.

“I don’t want to see you, just stay out of my way.”

OK. That was worse than I imagined when I couldn’t sleep last night and it wasn’t even 30 minutes into shift.

I found Jen and grabbed her.

“Did you meet your nurse yet? Is she nice?”

“She’s a he,” she corrected me, “and so far he is super cool. We’re getting ready to pass meds.”

Damnnit.

“Is there any way I can tag along with you guys?” I went on to explain my glorious morning.

“Shitttttt, that does suck. I guess you and me can tag team. I don’t think Rick will care.”

Thank God.

Jen and I went to town on her patient, a cute little old lady who had broken her hip. We assessed her, gave her her meds crushed in applesauce and bathed her. I even put lotion on her hands and feet. She probably thought she was in a spa. All this time, Rick just let us do our thing, never asking if I had a patient of my own. I did take some breaks to check in Mr. Wood’s room to see if he was still there and I also peeked into his chart and made note of any new orders. It had become almost a game. It was made easier by the fact that most everyone else was not talking to each other. Not the camaraderie I pictured after seeing medical TV shows but I was fine with laying low.

Trust me, You’ll Have a Great Time

It was really strange setting up the room for the simulation lab I was going to be teaching. I put my ambu bag and O2 mask up on the oxygen flowmeter behind the hospital bed. I felt like I was setting up a room for a new patient. But this time I wasn’t getting a new patient, I wasn’t in the ICU. I didn’t have to run through my mind all the things my new patient would need because my patient was the manikin in the bed already. I had the familiar butterflies in my stomach though. I was going to teach my 1st lab today. I was going to have a bunch of new faces that had to listen to me explain the different ways to give someone oxygen. I started to get way ahead of myself. I wanted to show them everything, the 20 plus years of nursing experience in my brain to just hook up to their brains like a download from The Matrix. There is so much to know, then so much to become an expert on. I was excited in a way I had not been in ages.

The class came in as I had the bright idea to set up my camera to video myself. I had given talks occasionally before and found that I had a tendency to say “um” quite a lot so I wanted to make sure I could look back and troubleshoot my teaching. As I looked at the students coming in I really started feeling my heart race. I was running the show the next hour, there was just me to look at and listen to. I’m awful at names too so I was already trying to cover that up. All at once I wanted to just dump everything in my brain out. This was simple stuff, they would need to know just how often they’d be using all this equipment, that someday it would be something so simple and obvious but they looked like how I felt too. As I started I had so much to say all at once, I had to slow myself down. When I’m nervous, like giving book reports throughout my school career, I was always interrupted and told I was talking too fast. I already speak fast on a normal basis. I was trying to speak slower, be interesting and not say “um”.

I started with the nasal cannula, the clear tubing that people wear that goes over their ears and gives oxygen into the nose. As I handled it and showed it to them I was very aware that while a few of them were pretty new to nursing and might work in clinics or other places that don’t use these, there were definitely some for whom this was super basic. I got more anxious. I thought about the millions of times I’ve had to put these on a patient’s face or remind them not to keep pulling it off. I thought of the people who insisted it wasn’t working and there was no air so I’d dip it in a cup of water and show them the bubbles. I started joking with my class about the ways I’ve seen such a fairly simple device put on by the patient or their family or even by other nurses in completely wrong ways. How people will sit their bare bottom on it and stick it on their face before I could wipe it off. The ways people would chew on them or how sometimes you get panicky as a new nurse and you see that your patient’s oxygen sats are going down so you crank up the flow only to finally notice its not in their nose or the tubing is disconnected. As I started going through each piece of respiratory equipment, it was nice to simply explain why you use one over the other. I wasn’t having beeping going on with a patient suffocating and crashing. I was simply discussing oxygen masks. I started to relax, they were so polite and sweet, looking interested and laughing at my dorky jokes and when I reminisced about a few unrelated ICU nursing stories where me and my friends had some nutty situations. The hour was up before I knew it and I felt utterly exhausted but still excited. I was teaching!

Later on after work I got my phone out and watched my video. It was awful! I said “um” pretty much after every word. I also put the phone so it just focused on my double chin and from a particularly unflattering angle. I sniffled and had an annoying nervous laugh, I couldn’t watch the whole thing. I wanted to get myself a shock collar for every time I do something annoying. I immediately called my friend Alison and we had a great laugh. It was already funny thinking I was teaching since I was known for being pretty sarcastic and someone who regularly cursed like a sailor. I knew I had some homework for myself as well.

Yes, It is me still

So, as you may have been reading this blog from the start, it is a downer. It wasn’t really meant to be of course. Now, fresh from some therapeutic EMDR sessions and a new job that I am totally excited about, I come writing from a different perspective. I was angry, so intensely angry at what we were forced to go through during COVID in my ICU that I wanted to take people there, right up to the horrific visuals that were haunting me in my nightmares. The blood overflowing off the mattress of an exsanguinating patient that we had cared for for weeks, the clots of bloody tissue that was getting stuck in people’s ETTs and the iPads that we held up to a comatose person’s face while their family said good bye to them. I was so angry at the people who felt that they were affected by COVID stress when they didn’t even have to leave their home. I especially had someone quite close to me who lives in a very large beautiful home who would tell me she “understood” and “was having panic attacks about COVID”, all while she didn’t work. She would then post her political feelings on masks, vaccines and kids in school. She had and has every right to her feelings but I just felt unheard and was getting so angry.

I loved being an ICU nurse. It wasn’t sunshine and unicorns but it was a job where I felt I was making a difference and saving lives where I could and bringing comfort when there wasn’t a chance to save. I was put in a position where it was a legitimate nightmare and I had to walk away. There is a new chapter here however. I have worked on healing my psyche, my soul and even my body. That anger is not there seething anymore. I’ve become a nursing instructor and I feel it is where I am supposed to be. I teach students that are already LPN’s and in nursing so I don’t feel that I’m taking innocents off the street and sticking them in this awful healthcare system (more on that later) that we have right now. I can take my years of experience and help strengthen the incoming RNs so we may have a group of change makers. I also want to help this new, younger wave of nurses be the best they can since the hospitals are turning their backs on properly training incoming employees.

This blog is really going to be about Nursing. What it was like throughout my entire career, places I goofed up, times I really learned about people and hopefully some poignant times that have always had a place in my heart. Luckily in this field there is a lot of funny stories too. So, hopefully if you continue to read in the future, you won’t be wondering if someone stole my password and decided to stop being morose and angry. Merry Christmas and Happy New Year. Peace.

Get in line, the fun starts here

0410 someday in October 2020

I hunched over the ceramic bowl, staring down at what had earlier been a frozen yogurt with all the toppings I could put on. It’s a treat I told myself even though it meant I had to get out of the car instead of driving straight home from work. I was starving too anyway. A shift in COVID cove meant sneaking sips of water and deciding that lunch wasn’t worth getting undressed out of what we called “PPE”. Our cafeteria was closed anyway and instead of planning a lunch for the next day I just slept. I gobbled it down while I drove home, barely tasting anything. Senses were numb. I got home, took my nighttime meds and an extra pill prescribed “for anxiety”. I had to get to sleep, I was exhausted and I knew what a mess I was facing tomorrow morning. No surprise that I couldn’t fall asleep at all. I was wide awake. I snap chatted Noods figuring she was still awake too. No-one at work was bragging about their new sleep cycles. She answered right away. We had our alerts off so I knew I wasn’t waking her.

“Man, dude, I just can’t sleep and I’m fucking exhausted”

She immediately snapped back with video of her lying in bed with her dogs dead to the world. Our husbands went to bed at more normal hours so they were doing what not.

“Five dead today. Five! when the fuck did we ever just have 5 people just die in a day, after a week of 2 here, 3 here? I feel like a nurse in a fucking funeral home,” she half whispered.

We talked awhile since at work it seems we have to yell over our respirators so most of us don’t have the energy to bother. Everything is hard in there. We don’t want to “waste PPE” so no phlebs to draw our labs, no PT/OT, no dietary taking orders for the skeletal patients still managing to stay off the vent. They couldn’t even hold their breath long enough to swallow and they were our healthiest patients with oxygen levels around 85%. We didn’t have environmental services so no rooms were cleaned until that pt left. One pt had been in there 28 days. His room was never cleaned by anyone but the nurses. It was the nurses wiping EVERYTHING down with virex. We had to figure out the elaborate dial a suds thing that was used to fill up the mop and bucket with the correct cleaner. The hallway/entry point where we placed the morgue cart with dead bodies for pickup was as far as the meal trays would go. We got huge carts full of new linen and switched them out with our biohazard laundry. We cared for patients, monitored them, cleaned their rooms, washed the unit floors, gave meds, told family that their loved one was dying, held iPads up so they could say good bye, charted bc by God a nurse has to chart.

Talking with Noods always made me feel better though. We’d worked together so long we had old long standing jokes that made us laugh that no-one else got.

“I think I’m finally getting tired”, I yawned.

“Me too, I’ll see ya tomorrow, same place right?” she laughed. Where the hell else would we be.

I laid my head down and closed my eyes. Suddenly I was overcome by this incredible rush of not even nausea, it was straight to vomit. I barely held it in as I reached our bathroom and just vomited. I was one who never threw up. I only puked a little when pregnant with one of my kids and I still think that was something I had eaten. This was sudden and explosive and it scared me bc it was happening a lot lately. I tried to brush it off as laying down too soon after eating a lot after eating nothing all day. But I was now starting to wretch in the morning before I even got report on my patients.

Since I was already an award winning hypochondriac I was able to sit there and really work myself up. It wasn’t covid, none of our patients were nauseated or vomiting. I stared into the bowl, feeling fine for a moment and then wretching again. There were my night time pills clear as day. That’s great. But as I analyzed this Pollack wanna be that my body tried to make, I started to panic. There was a lot of red. There were other colors as well, clearly from the candies on my dessert but red could mean I have an upper GI bleed. I could hemorrhage, it could be an ulcer. Esophageal varices that I’ve seen pts die of, suffocating on their own blood. What was wrong with me? The familiar fingers of panic were on my shoulder guiding me down into the deeper recesses of “Everything I Learned in Nursing School That Can Kill You”.

Luckily Mike heard me and came in to check on my. He could see I was pale, not a typical greenish pale but my usual panic attack pale. As gross as I knew it was for him, not having a health care job, he was able to convince me that it was the red from the candy and we’ve seen it before with the kids. I was exhausted and he made me feel calm again. I rinsed my mouth out and gave it another shot at trying to sleep. I had 3 hours before my shift started again.

November 2022

I had a lot of emotion that I didn’t realize was squashed down inside me before today. I’ve had heartburn, itchy rashes with a whole eczema breakout, a tough time sleeping and my ovaries seemed to have said “peace out, dude”. I’ve been taking prescription meds just to tamp down the nightmares that make me sit up in a sweaty mess while screaming. I didn’t “feel” like I was stressed although today was on my mind constantly. Last night I got about an hour’s worth of sleep. I think my mind had gotten somewhat used to pushing emotions away and manifesting them physically.

Today was my last day in the ICU. As an ICU nurse, this was my persona. It was who I was as much as I was a wife and mother. Its been a shitty two years. Our COVID numbers are jumping. Our COVID ICU and regular ICU’s are all full. Our staff is decimated. So many on our unit have left to travel nursing and then ultimately learning that its awful everywhere. For some the better pay and ability to lay on a sunny beach after an awful shift is enough. Those of us with families don’t have the option to go someplace like that. You start to feel trapped. A good number of nurses are just leaving period. Emotionally, mentally, physically scarred. I subconsciously touched the bridge of my nose where the masks have destroyed my skin. Its been hell. I think I finally realized today what happened.

When the pandemic hit we couldn’t imagine that it was going to change our lives for as long as it has and obviously how it did. When we got our vaccines last December it was the finish line. Now we’d all get vaccinated and COVID would go the way of the other SARS viruses and Zika. Then in March we had to reopen the COVID ICU after it was closed for only a couple weeks. That’s when the nightmares started and the anxiety. Not back when I was packing like I was camping to go to work, showering there and changing clothes. Not when people acted like I was selfish because I chose to still live in my home with my family instead of just staying at the hospital until “it was over”. Slowly the breakthrough cases started coming through, including my own child who ultimately caught it at school. The vaccine was letting us down. It was our only weapon, the thing that would allow the world to come back out of hiding. Then…the politics.

The politics of vaccinators vs. anti-vaxxers vs. mask wearers vs non mask wearers devolved into a situation where grown adults that had been cooped up inside seemed to suddenly emerge into society as complete assholes on all sides of all the arguments. It was ridiculous and we were stepping back into a world we didn’t recognize. There was more division, so much hate. I was so sad, anxious, feeling like I was losing myself. However after today’s shift I knew one thing for sure, I had to get away. I had witnessed family members yelling at doctors I’ve worked alongside for over 10 years. Doctors that I knew were intelligent, caring and kind. People were telling us to give IV concoctions that didn’t exist. I was all for using any medication that we believed would help but the things people were demanding were ridiculous. I’m not talking about the “Trump drugs” as some people called them either like Plaquenil. We had legit tried some of the meds people argued about and didn’t see any helpful aspects. The politics drove me crazy. People would assume I was from one political party or the other based on the fact that I had to stand there and listen to them rant without offering my own views because I knew I couldn’t win anyway. They were angry and frustrated and it didn’t matter where I was politically they just needed someone to offload onto. I took care of people who were sick who had been vaccinated as well as non-vaccinated. I just wanted people to stop dying.

Saturday March 14th, 2020 (as written in my journal)

Well, welcome to 2020! We are currently stuck inside the house and schools are closed for at least 3 weeks. Church in Massachusetts is actually cancelled but not here and people are literally hoarding toilet paper. It’s a scary time. In January which seems ages ago, we were super close to war with Iran. In the meantime Kobe Bryant, a famous basketball player was killed in a helicopter crash. While all that was going on there was a virus going around in China. I thought it would be like SARS and just kind of go away. Two weeks ago we were kind of joking about it. Then it spread overnight to Italy. It’s killing so many people there. It has killed I think 200 people from Tuesday into Wednesday. It hit a nursing home in Washington state and killed 27 residents. My son had spring break this week and we planned on going to the museum and the aquarium. Monday we hung out and took it easy, I was just kind of watching the news and following the story, especially since I’m a nurse. Tuesday we went to the museum and spent the day like any other day. When we got in the car to go home the news was covering more about people getting sick in Italy. By Wednesday our state had its first patient within an hour of where we live and the Governor closed all schools for 3 weeks. Suddenly no-one was able to meet in groups greater than 100 people. Other states also started following suit. No March Madness, no waterparks were open. Disney was closed! The late night TV shows had no audiences and now I think they aren’t even able to film new shows. I’m supposed to work tomorrow but there are only 4 patients in our ICU right now. But then again, yesterday there weren’t any “coronavirus” patients in our state except for 2. Today there’s a case in the county next to us and one in my hometown on the east coast. I’m terrified my mom might get it and that I can’t get to her so I’ve lectured her about how serious it is to stay inside and away from people. She’s a widow and loves to go out and walk around. I don’t know what’s worse, overreacting to this virus that we barely heard of last week and making her stay away from friends or having her get sick. I mean she has friends that could visit but one just had a grand daughter who developed a high fever after flying from someplace like Florida. It originally was if you traveled to or from China people worried. Now its become fear of anyone who has traveled anywhere. It’s “community spread”. No-one seems to understand what that means because it seems like its more of “community spontaneity” because everywhere someone gets sick with it, people are trying to figure out who the local Trojan horse was. Some have no-one who has traveled or been around someone who has traveled.

So, now the kids are home for three weeks, my husband will be working from home and I just continue to go to work. I worry about the kids being loud while he’s trying to work. Somehow our house is going to be a work office, home and 3 different classrooms. I’m heading to bed planning on having to go to work. I can’t picture them giving LOW time with all this going on. Tomorrow could be the first case in our county and shit could hit the fan or it could be Monday. They say it’s deadly for the elderly. They also thought it wasn’t droplet but now it might be. I don’t know. Gonna need some melatonin to get some sleep.

Tuesday March 17th, 2020

Today I came pretty close to a straight out panic attack. I only had to work four hours on Sunday as charge nurse and we still had just four patients. We’re trying to clear out the unit of patients that can go to other units in case we need room for coronavirus patients. No unnecessary surgeries are being done. Dentists are only doing fillings and things, no cleanings, to conserve masks. I think our state has 57 cases today. I went into work today to learn this new piece of equipment that they believe will be needed for these Covid patients. (I’ll refer to it as a vapor machine since I don’t know if it is a brandname) and we know that all we hear is that we don’t have enough ventilators to care for the amount of patients that we could end up getting. They say the entire country is short ventilators. As all the nurses gathered around for our in-service we started talking about whether we were going to need to have bags packed and plan on staying in the hospital. We didn’t even know where we would sleep or what we’d pack or how long would this be for. I didn’t want to be away from my family but I certainly didn’t want to bring something home and make them sick. I shaved my legs and clipped my toenails the other night thinking darkly how I’d hate to have hairy legs and a nasty pedicure in case God forbid I needed my own toe tag.

So after discussing whether I would live at the hospital away from my family or possibly infect them with a deadly illness I decided to go to the post office to mail the St. Patrick’s Day cards I had. I didn’t know if it would be open since voting got cancelled today.

All the fast food places are closed except for the drive thrus. No-one is supposed to be within 6 feet of each other, even the news anchors are separate like someone farted. The weather guy I like is in the basement of his house doing the weather report and occasionally his kids get in the frame. Yet, at the same time, not one person I know knows anyone who has it thank goodness. So far.

I decide since I still have to go to work and be out and about I might as well go to the store since we have nothing really to eat for lunches since everyone ate at school and what the hell, its St. Paddy’s day still, lets get some corned beef and cabbage. Normally I like this store the most because there’s a coffee shop and sushi bar and even a regular bar. I know, crazy. Well, today it sucks ass like the rest of the world. No coffee, no sushi. Salad bar empty. I headed to the meat department like a seagull flocking there with all the other people. Most of the meat shelves are empty so I just get whatever I can.

When I get into my car it hits me. It was like shopping during the apocalypse. So surreal. What was it going to be like in a month? What will I be expected to do?

Wednesday March 18th, 2020

They are opening our old ICU that’s been used as a storage area/dialysis area and turning it into a “Covid ICU”. We will have to dress up into gowns in an “ante room” which will be a room that is between the hospital ventilation system and the Covid ICU’s negative pressure HEPA thing. I don’t understand it completely but it is like the covid area will be the “pool” of virus and nastiness and that area will have its air sent somewhere but we aren’t to breathe any of it in. Consider everything contaminated. When we go in we will be wearing green hospital issued scrubs covered by a gown. I found out today that we’ll be wearing a helmet/mask thing called a CAPR. Continuous air cleaner something I don’t know. A respirator. We look weird like Storm Troopers. My nose runs constantly normally so this will be great that it can run and I can’t blow my nose or touch my face. Air runs across your face and there’s a battery that you wear on your belt. If your battery gets low you must get out of the negative air area and get a new battery or you might start breathing in the contaminated air. Then when we leave we take off our gown, gloves, booties and head covering and then take a shower and change into our own clothes. Dr. Evans said he’d work still even if he got it so his ICU doctor partner wouldn’t be put in more than she needed since she was younger. Are we going to be making these decisions? He has a wife and kids. No-one is worth more or less than anyone else.

I got my hair done today and was literally out of the salon an hour when the Governor closed all salons, nail places and barbers.

People are out putting Christmas lights up so my hubby is too. I guess it’s an unsaid way to brighten the world. I don’t know.

I took a run when I got home and some anti-anxiety meds. My daughter made a joke about how it wasn’t even 5pm yet. It was 4:30 but who cares when there’s nowhere to be and nothing to do.

Thursday March 19th, 2020

I’m buzzed right now off some $40 per 1/2 bottle wine that doesn’t taste that great. I’ll have to watch it or I’ll become an alcoholic by the end of this. I just want an escape.

Soooooo a current day right now. Mike’s been getting up at 0430 to get to work 0500-1700 and he wakes me up because the dogs decided that’s now when they need to go out. Then I have trouble falling back to sleep but eventually do and get up around 10. Ailis is up for computer class at 0900 then Hannah sleeps until her class at 1pm. Innis has been going to sleep late but getting up early.

Today the 1st patient in our area tested positive for coronavirus. He’s in his 70’s and from our town. I’ve been doing laundry and getting ready to pack for work at anytime. I’ve heard he’s at the more local smaller hospital right now but they can’t handle vents so if he needs one he would get transferred to my hospital.

I’ve cleaned a lot of our master bedroom to keep busy. There are some really depressing stories coming out of Italy where they are proning their patients not using the fancy proning beds we use here. (Proning is when you put the patient face down on the bed. The specialty beds we rent will encase your patient and roll them like a rotisserie chicken at the touch of a button so that we can help the really sick patients get in a position where they can use more of the back lower part of their lungs, a larger area to help get more oxygen but an area that when you lie in bed often gravity pulls fluids into and is no good at getting oxygen then. These beds take up an entire ICU room and are so weird looking that visitors will just stare into the room as they head to see another patient.) To see patients proned and on ventilators like they are doing in Italy looks creepy to me, almost like they are already dead.

35,713 cases in Italy

2,978 dead

4,025 recovered

They are supposed to be ahead of our curve by just a few weeks. It’s mostly affecting Milan and Northern Italy. Venice has canals that are so clear you can see the bottom because no-one is out.

Thursday March 19th, 2020

Waiting for the now daily update from our Governor. I had a sore throat this am but since I cleaned yesterday and I’m severely allergic to dust I blamed it on that. I feel better now. I also took a calm the fuck down pill so I think that’s the only reason I’m not in the fetal position thinking I got the “vid”. As usual, pop culture has kept up with even the darkest times. Coronavirus is now covid or the Vid. The kids call their time off from school a “Coronacation”.

The emails from work are beginning to be not so friendly. We’re being yelled at for “hoarding” the special masks people say are the most effective one for this. The masks are ones that we have to be specially fitted for every year since we use them for TB patients. They mostly are never used since I can’t remember the last TB patient we’ve had. The boxes for these N-95 masks are in cubbies where anyone can grab them. To be honest, I have some at home for when I’m doing something dusty since they seem to keep out the dust.

One of my co-workers started wearing a surgical mask when she worked and was yelled at for it in front of all of us in the nurse’s station. The CEO said “if you feel you need a mask because you’re scared you shouldn’t be at work”. Ouch. Then last night the last paragraph of the “Hospital Incident Command center” email said “we are looking at something never before seen in our lifetimes and to use this time to rest before we start getting patients”.

Update- The 1st covid patient in our state just died. They lived just an hour away in another larger county and was a businessman.

Sounds like the plan is that we’ll work 4 hour blocks with all our equipment on then have a 2 hour break, then go back in and continue to work 12 hour shifts when they open the Covid unit. They plan on using the people from the outpatient and billing departments to be “scribes” to help the ones that are in the contaminated areas with charting. Not sure how that is going to work.

Friday March 20th,2020

So I’m scheduled to work tomorrow 0700-1900. They have finished the work to convert the old unit into a “Covid unit”. We are considered Pop culture heroes. People on Facebook are thanking nurses, calling us “frontlines”. Its interesting because back in the winter 2019 I took care of 2 shooting victims in the same day, unusual for our area. Because of the ages and circumstances, we had my own 1st ever debriefing where we meet and talk about our feelings with some counselors. Our CEO was there at the beginning and said that they are told not to refer to us as the Frontline because it is so militaristic. Well, we are frontline now. People are dying everywhere in NY and WA. Everyone is yelling that there is no PPE (personal protective equipment) and they’re forced to wear trash bags. I better have my helmet that they told us about or I’ll be pissed. The CEO has been sounding pretty harsh in his emails but seriously, NO ONE uses N-95s and suddenly there aren’t enough in the whole country and our hospital. And I drive my happy ass to work once a year to get fitted for one and told to keep it dry, use it once and change it every time I enter a patient’s room BUT once we actually need them, fuck that, don’t do anything we’ve told you. I’m gonna be salty going to my next fit test like fuck you.

Anyway, we had our 1st covid patient in my hospital’s county and 2nd state death.Same guy. We aren’t clear what hospital it was because it wasn’t ours. We’re all texting each other asking if he was in our hospital. The way the state is keeping track of patients isn’t clear. We don’t know if its done by where the person dies or is hospitalized or where they are actually living.So our local county people could be at the big city hospitals. Or he could have been at our hospital. My friend says when she left this am there were 4 patients waiting for their test results to come back. We wait forever for these fucking test results.

My bags are packed. Some PJs, socks, undies, extra scrubs if they let us wear our own, meds, glasses, contacts, toiletries. Not sure if we should wear contacts, they might protect our eyes or the covid could stick to them. Overthinking. So far, 2 bags. I’m packing water and food too and my sleeping bag. I’m not sleeping on hospital linens. They closed one unit for pediatric oncology since it was decided those patients should go to the bigger hospital in the city. So we have cots and can shower there.

So, it’ll be interesting. I think having my bags packed and now passing the milestone of now having covid enter our county has made me feel like “Lets do this”.

Sunday March 22nd,2020

Went into the hot zone today. Officially donned the helmet thing respirator where I wear basically a helmet with a giant windshield that seals around my face and pumps filtered air in. I wore the OR scrubs that I grabbed from the former Peds unit. Put on an OR bouffant hair cover, then the helmet and plug that into a battery pack that goes around my waist. Then we actually have yellow isolation gowns so I put that on and finally booties over my shoes. All with gloves on of course. About 4 of us are getting garbed up in this little ante-room and we’re accidentally elbowing each other. Normally we’re a group that jokes around and is kind of loud. We’ve worked together for years and hang out outside work sometimes. Kyle is married and his wife works in X-ray, Joe who has been dating Kristen from our department for ages, and Aly who we all call Noods because she’s got curly blonde hair like noodles. But today its quiet. I ask if everyone has their stuff on before I open the door that could allow this invisible demon out.

As I enter the negative pressure of the unit I’m expecting it to be quiet there too, I think I’m expecting it to be like the space Odyssey movie. It’s not. Everything is beeping and the constant whoosh of air in my CAPR is already annoying. I feel like I’m on a plane and I hate flying.

I am already sweating bullets by the time I’m done getting report on my patient. There’s a problem with the HVAC in this new unit and they’re working on it.

My patient is from my town, lives close to the school my older kids go to. I know some of her relatives.We don’t have a great way to test for this new virus yet because it’s new and it’s annoying me. What we do is do our rapid panel test that tests for influenza, all the usual respiratory bugs. If it’s negative then we start to assume its covid based on symptoms and other tests. I have a sheet of paper that Ethan, one of our Critical Care docs gave some of us. The story is that one of the residents caring for the 1st covid patients out in Washington state made a cheat sheet of stuff he noticed with his patients. Almost all covid patients had a cough and high fever but their white blood cell counts were low. Normally it would be the opposite, a person fighting a sickness and having a fever will usually have a high white blood cell count because that’s how the body fights infection. Another thing was almost all the patients had very high platelet counts. Platelets are what stop bleeding if you cut yourself and cause clots. And all these patients chest X-rays showed what’s called “ground glass opacities” which made their lungs look almost fluffy in the x-ray.

Either way, we treat as covid and hopefully we’ll have the test results tomorrow.

No family or friends are allowed in the hospital, so its just me and her when I enter her room. She’s coughing but not loudly, her oxygen is low so I adjust the sensor on her finger. I’ve been told that you could put the O2 sensor on a finger, ear or even if desperate enough on someone’s nostril, but if they have Corona, unless its your own finger, ear or nostril you’ll never get above that goal of 88%.

Pre-covid, which is hard to believe only weeks ago, the thinking was no-one should ever have their oxygen saturation (O2 sat) below 88% for an extended amount of time. Oxygen is obviously vital and if your patient was that low you fixed it. You applied supplemental O2 via nasal cannula, or mask or worst case scenario, you intubated them with a tube down their trachea and put them on a vent that blew the O2 into the patient. Then we’d be satisfied that their numbers got better. Since it was such an emergent alarm, the monitor makers in their infinite wisdom used 88% as the usual setpoint for its incredibly annoying alarm. That way it obviously can’t be ignored. Unlike the heart rate alarm however, you couldn’t adjust the numbers. With heart rate alarms you could adjust the numbers for the alarms. Some patients had low heart rates and we could turn down the alarms to only go off if the rate went below 40 beats per minute. A healthy college age swimmer could have a heart rate of 42 when asleep and be perfectly healthy with a very efficient heart.

This whole boring passage about alarms gives some insight into how my shift went today. Every patient in that unit had alarming O2 sats and nothing would bring them up. I have never seen where high flow oxygen and breathing treatments all did nothing on otherwise healthy looking people.The unit was full of coughing, alarms, air-whooshing, call lights, my phones going off because I was also in charge and the damn bell sound they picked for the doorbell for people dropping things off for our unit.