What a difference a few months makes. In late March, many of us were being forced to use PTO for one shift a week due to low census. Now I'm getting begged to come to work every night with huge shift bonuses.

Our census is running very high, very unusually high for the month of July. Our Covid volume hasn't spiked in terms of inpatient hospital stays, but we have many nurses and ancillary staff popping up as positive and who are on quarantine. Nurse staffing is becoming a huge problem.

This is the side effect of the virus I've been worried about more than the actual virus itself. We were at the point last night where we didn't have enough staff for the acuity of patients we were trying to take care of. I had a patient start bleeding from an arterial surgery site and was holding pressure while at the same time the bed alarm of a confused patient went off and no one was able to get into their room before she fell. All of us were taking patient loads beyond our usual staff grid.

This is what is odd with the whole ICU bed count and surge capacity stats. Not one word is mentioned about staffing and the ability to properly treat that many patients.

The major Houston hospital CEO's press conference last week (zoom) brought this up. It wasn't 100% clear but it seemed to me the messaging was they have plenty of physical space, equipment, etc....staffing was going to be the issue. I assume they are out in the contract nurse market actively.

Two nurse friends of mine who work in the TMC have said the same. Also starting to worry about people burning out.

My daughter is an ICU nurse at a hospital south of Austin. She's been picking up weekend shifts at a 'sister' hospital in Austin paying double time. The downside is that she's in the Covid unit. She said she looks like an astronaut when she attends to these patients.

When this mess is all done and over I wouldn't be too surprised if some who work the COVID wards walk away with a type of PTSD.

One friend, a nurse in the TMC, hasn't seen other people in real life outside of work since March and basically mirrors the situation described below at Parkland. Another nurse friend in Fort Worth had a 23 y/o co-worker die after a month-plus on ECMO. They think she got her PPP wrong and had a high viral exposure in the early days.

Irrespective of what the "right" thing to do is with closing restaurants/bars, balance the economy, etc -- I'd hope it can be agreed these care workers are really pretty incredible.

https://www.dallasnews.com/news/commentary/2020/07/01/inside-parkland-covid-unit-fatigue-and-mental-strain-grow-as-more-are-dying-than-ever/

Quote:

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Encased from head to toe in protective plastic, many of these women and men have been in this firefight for more than three months. As we walked the Tactical Care Unit on Saturday, they acknowledged the weariness and mental strain that I had seen in their only unmasked human feature.

Each wrestled with how to convey this deep distress, but fell back on some version of "people are just so very tired."

They don't have the time or energy to give it more thought than that.

"No matter how hard you work and how much you do, more people are sicker and more are dying than ever," nurse Perla Sanchez-Perez said. "It's been really, really difficult."

Like all of the 300 staffers who make up this team, Sanchez-Perez volunteered for this job and she's intent on pushing forward.

Samantha Rowley, senior vice president of nursing and surgical services, was blunt about what we saw Saturday: "People are exhausted. People are mentally drained. People are going through turmoil and distress.

"But they are managing to come back every day and fight through it because of that resilience and grit and their desire to be here."
...
"At some point in time, we are all going to collapse from pure emotional exhaustion and I have no clue what that tsunami looks like," Rowley said.
...
Chief medical officer Chang is confident of Parkland's ability to deal effectively with the virus at the heart of this pandemic. His big worry is the fatigue and mental strain on a staff that has fought for months while outsiders downplay or deny the disease.

What he'd like all of us to do along with wearing our masks, washing our hands and practicing social distancing is to go out of our way to thank anyone who works in a hospital.

"Let them know that what they are doing is seen and you know it matters," Chang said.

"We will eventually win. But we just want to be intact when we get there."

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It really makes me angry that hazard pay wasn't part of the CARES Act! I know money can't compensate for what they are dealing with, but I wish that their potential for exposure and mental stress would have been acknowledged earlier.

Continuing to lift up our doctors, nurses, and all staffs that are doing this work up in our daily prayers. God bless and cover them with His mercy and protection.

Didn't know exactly where to put this one: