Insights from a Girl Who Knows Better

Nov. 18, 2020

For Brian...

I am sitting in the waiting room adjacent to the covid ICU. I shouldn’t be here, I’m not allowed. But I am here. That’s what you do when your friend asks you to show up.

It’s been almost 9 months since this pandemic began to run our lives. Nine months of mask wearing and debating. Nine months of sifting through new guidelines just to resort back to the old ones a few weeks later. Nine months of watching people rip each other apart over whether or not to believe science.

Today I am sitting in a waiting room next to the COVID ICU. A room that is filled with couches that are pushed to the side, elevator doors that are blocked, bins with reusable gowns, extra ventilators, intubation equipment, and the recycled PPE of the staff... Earlier an excited nurse came in. She began digging through dozens of paper sacks on an industrial wire rack. She had been looking for about 5 minutes when she snatched a paper bag and said, “YES! Thank goodness!” She then remembered that she wasn’t alone and turned to look at me explaining that she had just remembered that she put her OTHER N95 in this room in September, that her current mask was beginning to get fuzzy and she had been inhaling fibers all day...
I am sitting in what used to be the waiting room of the covid ICU. I am sitting here because one of my dearest friends is finally being allowed to visit her father. He’s been alone in the hospital since the last week in October. He has COVID pneumonia. He’s in his mid 60s and has a history of some lung disease. People feel so relieved when they hear that...mid 60s...preexisting health conditions...those two things make the average person feel safe. It leads them to believe that because they don’t have any health problems and they are 20 years younger, they are in the clear. I hear so many people say so many ridiculous things. “Everyone’s going to get it eventually, we might as well just get it over with”.... “Masks don’t help”... “This disease is a government hoax”...”It’s only dangerous for the elderly and those with underlying health conditions”... or my personal favorite, “When it’s my time to die, it’s my time to die.” 
It’s funny how brave we are about death and dying until it’s something we are actually faced with. When we are under the impression that we have all of the time in the world, time doesn’t matter. However, the minute that we find it slipping away we begin to regret the time we didn’t spend wisely. 
I am thinking about this while my friend is sitting next to her father in his ICU bed. She is holding his hand, trying to say things to help him fight. He hears her, I believe that. He is intubated and on a ventilator. He has tubes protruding from his chest and his face. He is swollen from IV fluids and steroids. But he hears her. He can’t speak or squeeze her hand but he feels her holding his. He feels her and he is loving her back. I know this because I know him. THIS family knows that COVID is real. THIS family knows the pain of separation in a time when closeness is needed. I have painted a picture of my friend’s dad for you...A picture of a 66 year-old man with lung disease that is now fighting for his life in the ICU, but that isn’t who he is. This is a 66-year old man who still holds a full-time job in healthcare. This is a man that sees his family, swims with his grandkids, plays jokes on people around him, and makes the world a better place. He has devoted his life to the people around him. He is active. He is healthy enough that you probably wouldn’t even know that he has underlying health issues just by looking at him. This is a man that came to visit my son in the hospital more times than any other person in our lives did. He prayed with us. He laughed with us. He called and texted frequently. THIS is the picture you should have of him in your mind. He is not feeble. He is strong. He is my friend. If it wasn’t for COVID, he would still be doing all of these things. COVID has taken all of these things from him. I hope he can get those things back. I PRAY he can get those things back. Only time will tell...
I guess my current take-aways from all of this are that time is precious and COVID is real. Do what you can to find a balance between living your life to the fullest and taking the precautions needed to prevent the spread of COVID to your fellow man. Whether you like it or not there has to be a happy medium somewhere in between reckless and recluse. Please be safe out there. We have got to find a way to navigate through this together..our futures depend on it.

Jul. 14, 2020

Exhausted.  Overwhelmed.  Belittled.  Mocked.  Contaminated.  Doubted.  Unimportant.      Sacrificial lambs… Nurses went from Hero to Zero in 3 months.  Before the “Political Agenda” went viral, nurses were seen as heroes willing to put themselves at risk to help save the lives of all patients, including those with COVID-19.  We were hailed as some of the most insightful, caring people on the planet.  We received calls from friends and families asking for our professional opinions. We had people stopping by for house calls and assessments.  We were respected.  Who would have thought that all of that would change the minute we asked you to wear a mask?  A mask.  A stupid mask.  Why is there so much doubt over the efficacy of masks? Five months ago, if your surgeon would have presented herself to you before your surgery and proclaimed that she and the rest of the OR staff weren’t going to wear masks during your operation, you would have cancelled your surgery.  You would have said that they were putting your health at risk by not wearing face coverings while they were cutting you open.  You would have reported them to hospital administration and the department of health.  But the minute a politician tells you to wear one in the interest of infection control, a mask is no longer something to keep you safe.  That politician asked you to wear a mask because the medical community urged him to do so. That little mask is the answer to reopening our economy. Unfortunately, a mask has now become an area of contention.  A mask is now a way to control you. A mask is now an infringement upon your constitutional rights.  

How many laws are already in place for the greater good? Driving while intoxicated…Seatbelts…Vaccines…Attending school as a child…Catalytic converters… The list could go on and on.  But wearing a mask during a pandemic seems to have pushed everyone over the edge.  All of these stupid, fake articles on social media have turned everything upside down.  

If I hear one more proclamation that the death rate isn’t high enough to warrant all of these precautions, I might scream.  There are fates much worse than death.  This virus is taking away people’s lives even if they aren’t dying.  I know a 20-something RN that contracted COVID while caring for patients.  Yes, they are alive, but they now need a lung transplant. Of course, they will never get one because many of you think that every single death is being counted as COVID-related and thus there will be no applicable donors from which to get the lungs. (People with infectious disease cannot donate their organs.) Do you see how ridiculous that sounds?

Every day I read posts about people refusing to wear masks. The interesting thing is that soon after, the same person is posting about a medication their doctor has placed them on for blood pressure or cholesterol.  Why is the medical community trusted on one hand but not the other?  It is truly maddening.

I wish that politicians were able to stay out of the business of healthcare, but they can’t.  We cannot rely on the decisions of our fellow citizens to keep us safe.  Apparently, it isn’t enough to know that YOU wearing a mask can prevent ME from getting sick. That just seems so selfish to me.  I would personally do anything that I could to keep you safe.  I love my fellow humans.  I used to love being a nurse. These days it seems harder than it should.  My face is tired of being covered at work.  I can’t speak.  No one can hear me or understand what I am saying.  I cannot truly make that human connection that I so crave through my practice.  It’s difficult to assess my patients because I cannot see their faces.  I now have to act as sole emotional supporter for my patients.  (They don’t have their family at the bedside, reassuring them, supporting them.) Nurses are the ones filling in those gaps.  We are being pulled at from every angle while at work.  We have to wear gowns that are essentially shower curtains with ties. We sweat all day.  We have doctors that won’t enter patient rooms because they don’t want to be exposed.  Nurses don’t have that option.  

After work, it is impossible to escape the backlash from our acquaintances, friends, families, and the media.  Everyone knows more than we do.  Everyone is now a nurse, a doctor, an epidemiologist, a fact-checker, a protestor, a lab technician…everyone knows a friend of a friend that got a positive test result but was never tested.  (Insert eyeroll)  On that note, please let me inform you that people are absolutely still dying of cancer, heart attacks caused by cardiovascular disease, trauma, and strokes.  No, the medical examiners aren’t padding the data by labeling all deaths as COVID. That is completely ludicrous.  If they were, can you imagine how high the death rate would actually be? There are roughly 8,000 deaths each day in the US alone. That would be approximately 1.2 million deaths since March caused by COVID in the United States.  I urge you all to try to find a balance between conspiracy theories and truth. 

People want definitive answers about this virus.  The sad thing is that we really don’t have any answers.  We don’t know how to treat it.  We don’t know what the final repercussions will be for those who have contracted it.  We don’t fully know how to prevent it from spreading.  The important thing to know is that we are working around the clock trying to figure it out. Please be kind to us during this grueling process.  It is personal to us and it is personal to us because we are living it.  While you are sitting at home wasting your days on social media reading conflicting articles, we are watching this all unfold first-hand.  While you are worrying about a face-covering, we are watching people suffer with each breath like a fish on the banks of a river.  It is not a hoax.  It is real.  Please be patient with us.  We will figure it out. Until then, my prayer for you all is that you keep yourselves safe. My prayer for you is that your only contact with COVID is through your social media platforms.  

Sorry to infringe upon your constitutional rights.  I just wish you would wear a mask…But hey, if you don’t and you end up as one of the critically ill, so be it.   Guess who will be there to hold your hand through it, pray for you every day, and do everything in their power to give you the treatment you need to survive…Your Nurses.  

 

“Nurses should chart in the patient rooms.  Nurses should leave the computers at the desk for the doctors. We need to limit their (Doctors’) exposure.”  -ER Doctor

“For the first time in my career, I’m not proud to say I am a nurse.  I feel belittled and mocked.” - RN

“Healthcare professionals are not alarmists- We don’t want you to get sick.” -RN

 “You’re afraid of a virus so you want me to wear a mask?” -Anonymous

 “It’s none of your business if I wear a mask or not.” -Anonymous

 “Wake up people.  Masks aren’t filtering the virus.  The particles are too small.”- Anonymous

 “I have never hated being a nurse until now.”-RN

 

 

 

 

 

May. 9, 2020

For the past few months I have been reading and listening to everything I have been able to get my hands on in regards to COVID-19.  I have read medical studies,  looked for trends in lab results,  listened to doctors, and literally have learned everything I can learn from reliable sources.  Having said that, I am no expert on this crazy virus.  I still have so much to learn, we all do.  The one thing that I keep coming back to over and over again is the complete division it is creating in our world. People are angry.  People are scared.  People are confused.  People don’t know where to turn for the answers.  From speculations that numbers are skewed to the government wanting to microchip everyone,  the conspiracy theories are running rampant. 

 

I have watched so many videos that were uploaded to the internet…videos in which people pose as experts and make claims that play on people’s emotions.  A few days ago I watched a video where a “nurse practitioner” (she didn’t give her name) said that her friend, a “nurse” (she didn’t give her name, either) said that the hospital she worked at (she didn’t give the name of that hospital) was just letting patients lay there and die…she claimed that they were “murdering” patients.   She said that the hospital was refusing to give life-saving medications (surprise, she didn’t tell us which meds) and other treatments (again, no specifics given) and that patients were so critical and that the doctors weren’t even bothering to gain consent for emergent procedures. (Newsflash- in an emergency, doctors don’t have to gain consent, they do what is right for the patient)  I also watched the hour-long video where two doctors claim that this virus is no worse than the flu. (Pretty irresponsible for them to do this…especially because they can be immediately discredited by the facts that their urgent cares were failing due to the stay-at-home order and thus they had financial ruin in their immediate future, not to mention that one of the doctors isn’t even a Board Certified Physician)  However, so many people gave them 100% credit because they are doctors. Why? Because those doctors were saying what so many of us want to believe.   None of us want to be social distancing.  None of us want to wear masks.  None of us want to believe that a virus could take out hundreds of thousands of people across the globe. None of us want to be inconvenienced in any way whatsoever.  That’s why it is so easy for us to listen to the naysayers regarding COVID-19.   Yesterday I watched the video of some attention-seeking doctor that was essentially kicked out of the medical community for falsifying studies and tests. The sad thing is that people are actually believing what she says.    In my eyes, she is a waste of good, clean oxygen.  People who knowingly place others in harm’s way are literally doing the devil’s work for him.  She is no better than a drunk driver.  (I am also a little creeped out that she looks like Carole Baskin.)   

 

I have heard people saying that most patients aren’t “that sick” and that this virus is no worse than the flu.  This is partially true although it is much worse than the flu.  But wow.  Just wow.  When they are sick, they are SICK.  I have been a nurse for longer than I would like to admit.  I have always worked in inner-city ERs that see thousands upon thousands of patients each year.  I have only seen a handful of influenza patients that are as critical as the “sick” COVID-19 patients we are taking care of.  IT IS NO JOKE.  Pronating patients who are on the ventilator? What kind of madness is this?  It is bad, people.  I cannot tell you with enough passion…THIS VIRUS IS REAL.  I can also tell you that hundreds of thousands of people are walking around with CHF, COPD, and countless other diseases.  Those people are living full, productive lives.  If they contract COVID and die from it, THEY DID NOT DIE FROM CHF OR COPD.  THEY DIED FROM COVID.  If it weren’t for COVID, they would still be leading productive lives with their underlying health conditions.  I just don’t understand the disconnect with this subject.  I do know that when you make light of this virus, it feels like a slap in the face to those of us dealing with it in our lives.  Whether it be medical professionals or loved ones of those who have succumbed to the virus. 

 

I am also a little tired of hearing how Bill Gates is responsible for this virus and that it was released from a lab so that he could make millions from the vaccine…or microchip us…whichever version you want to believe.  (or maybe both?)  I don’t know if you guys realize this but Bill Gates is a capitalist.  He is a brilliant mind who has served himself well.  It is no surprise that he might seize the opportunity to invest in something that might bring him millions of dollars in revenue.  Why is that a bad thing?  The virus is real.  We need a vaccine.  We need someone to fund the research behind the vaccine.  I really don’t care how it gets here as long as the vaccine gets here.  Vaccines don’t cause autism.  Vaccines save FAR more lives than they cause harm.  You don’t want the vaccine?  Fine.  Don’t get the vaccine. I don't think the government should mandate this vaccine.  I am actually thrilled about how many people are now on board with "MY BODY, MY CHOICE".  (I have been arguing this point for decades.) Let me repeat myself...Get the vaccine or don't get the vaccine. But you can bet your bottom dollar I will get it, my husband will get it, my children will get it…hell, even my dog will get the vaccine if the DOCTORS and their PEER-REVIEWED RESEARCH says we will benefit from it.  And guess what? That beautiful vaccine will allow me to doff that PPE for one final time in regards to this god-forsaken virus… I.  CANNOT.  WAIT.  

 

Moving on to censorship…Yes.  YouTube and Facebook have removed several videos that “don’t meet community standards.”  This has people in an UPROAR.  Is this censorship? Maybe.  The disconnect comes into play when you consider that both of these are companies owned by people and not by the government.  The videos they are taking down are videos in which people are posing as “experts” and influencing those of us who aren’t sure where to turn.  They are preying on our fears and our lack of knowledge.  They are speaking to us in terms we can understand.  They are saying exactly what we want to hear and we are collectively giving them their 15 minutes of fame.   I pose this question to those of you bothered by the removal of their videos…  Which side of the argument were you on when a private business owner refused to bake a cake for a gay couple who was getting married? For me, that was a hard one.  While I support a business owner’s right to operate their company as they see fit, I do not support discrimination.  I also find it ludicrous that anyone would want to provide revenue for a company that doesn’t support their personal beliefs.  (Disclaimer:  I fly my rainbow flag high in the sky.)  Don’t like the fact that FB and YouTube remove videos?  Remove yourself from YouTube and Facebook.  Quit supporting a company that you don’t feel supports your right to free speech.  I mean in all honesty, both of those platforms are robbing us of true-life experiences anyway.  We scroll through social media and watch videos in lieu of spending time with those we love.  We are wasting precious time and there is no one to blame but ourselves.

 

I don’t know where we will all end up after COVID-19 is finished with us.  What I do know is that I applaud those of us who have given pause to all of this governmental control. There have definitely been negative impacts from the shutdown.  Companies are failing and families are suffering financially.  It is horrible.  I do, however,  think it has truly helped us to better prepare for the impact of this virus.  We have learned more.  We understand better how to care for the critically ill.  We have since learned that this virus isn’t airborne transmission and is instead droplet transmission.  (WHEW)  We are more aware of infection control in general which makes me happy.  I am also happy that we are reopening our state.  I hope that we can do so with caution and intelligence.  The truth is that COVID-19 is here to stay.  We cannot stay shut down forever.  But let’s take this opportunity to make a commitment to each other…Let’s take this opportunity to be better, to do better, to communicate better, to seek understanding better, and to look to actual experts for guidance.  Yes, you can get lost in all of the speculations but that is exactly what they are…speculations.  I for one hope I can look back on all of this and be forced to make a public statement regarding how wrong I was about the severity of this outbreak.  I don’t think that will be the case but I assure you….No piece of humble pie will have ever tasted so sweet.  

Mar. 30, 2020

This is the calm before the storm. We are on Day 20 since the area’s first case of COVID19. Our emergency department has been working diligently attempting to get into a new routine. PAPRS and gowns...wear this mask today but not tomorrow...hold onto this mask for 7 days...it’s airborne...it’s droplet...it needs a negative pressure room...a neutral pressure room is fine...did the patient travel recently?...travel no longer matters...did the patient have fever?...not everyone has fever...the list goes on and on...

 
I am a girl from West Texas, the Panhandle actually but most Texans group us together with West Texas.  I love so many things about that part of the world but one of my favorite things is watching a storm roll in. It’s different out on the plains than it is here in the metroplex. In West Texas, you can literally see the storm for a hundred miles before it gets to you. It grows and it changes as it moves nearer and nearer to you. You can actually see it building. You can see it getting taller and more powerful. You know it’s coming and you can see how bad it is going to be. It’s mesmerizingly beautiful and yet terrifying at the same time.  You know without a doubt when it’s going to be a bad one. 
 
That’s exactly how I feel about COVID19. It is definitely moving in quickly.  On March 10 we had our first case in the area. It has been chaotic since that day to say the least. Our daily census is down but we don’t really feel it. All of the donning and doffing takes extra time and extra effort. What used to take 5 minutes now takes 20. Even a simple IV start takes triple the amount of time because you are trying to do your job through protective goggles that are fogging up with every breath you take. It’s uncomfortable. It’s hot. You feel disgusting and dirty...contaminated. You are scared that you will contract it and either die from it or give it to someone you love and then they will in turn die from it. You are scared that before this is over your hospital will run out of PPE leaving you vulnerable while
fighting this war against an invisible enemy.  Some days you cry at work. Some days you cry after work. Some days you cry on the way to work. This pandemic is already taking its toll. We read about the horror stories from China, Italy, Spain, New York, and New Orleans. We know it is coming. We can look at their numbers and know that any day now we will be seeing double the number of patients that we are used to seeing. That is what every ER is facing right now. I cannot imagine seeing 600 patients per day. Many of which will need to be intubated and admitted, to where I’m not really sure. Who will take care of these patients? Logistically, if we normally see an average of 300 patients per day we will need another entire ER staff (days and nights) to care for the number of patients that are getting ready to walk through our doors. We will also need another entire ER. I can tell you 100% without a doubt we aren’t ready. Please don’t misunderstand me. I truly believe the administration from my hospital is working around the clock trying to solve these issues. They know. They, too, read the headlines. They can see the storm coming. They have been present and accounted for.  In my entire career, I have never been able to more easily identify the face of the president of my institution before now. Multiple times a day he is in our department and interacting with the staff. He is worried. We all are....Even scared. We are scared because we see the storm coming. I look into the eyes of my coworkers and wonder which of us will lose our lives in this battle. It will happen.  We all know it will happen and yet we continue to show up...shift after shift...This isn’t political. This isn’t a hoax. This doesn’t discriminate.  If you have the luxury of staying home, please do so. Keep yourself safe. If you work in healthcare, wear your PPE. Conserve your PPE. Save your masks. While right now wearing a mask for 3 weeks might seem disgusting, a dirty mask will be better than no mask at all.  Listen to those who have already been fighting. They know. And for God’s  sake,  look up from your phone...glance up to the horizon and look for it. The storm is coming. I can see it rolling in and trust me...it’s a big one. 
 
May. 31, 2017

One of the funny things about trauma nursing is the fact that we are always there at the beginning of a crisis.  We swoop in like a swarm of bees, working together in critical situations.  We can literally start IVs, calculate critical medications, put tubes in every orifice… all within minutes…sometimes even seconds. What we do can literally determine whether a patient is given a chance of survival or not.  We are irreplaceable.  We are fierce.  We are masters of time manipulation.  We are all of those things and all of those things are imperative in the beginning of a crisis. 

Moving forward, patients are often rushed off to the OR and then the ICU where they will spend weeks healing.  It is during those weeks that the patients and their families form a bond with their doctors and nurses.  They don’t really think about the ER and what happened there.  Most likely, the patients don’t even recall being in the ER. Their families don’t either.  You can’t really blame them.  People are in shock in the ER.  The patients are in shock…  The families are in shock… 

When a trauma makes the news, you will hear the patients and their families thank the first responders, the doctors, and the ICU nurses.  Rarely is the ER even mentioned. I often joke and say that the ER is like the ugly girl in the movie who decorated for the prom but didn’t get invited to go.  It’s sad but true.

Having said that, you should know that ER nurses are built a little bit differently than most people.  For the most part, we don’t need recognition.  We do our jobs because we love it. We do our jobs because it’s our passion.

Today, I watched in awe as someone near and dear to my heart was being discharged from the hospital.  I think I have been holding my breath since the day they were admitted.  The nurses who cared for that patient didn’t need pomp and circumstance.  They didn’t need to be remembered.  What they needed was to see their patient live…and that’s exactly what they got.