Mar. 30, 2020

The Calm Before the Storm

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.