Tag: #COVID-19

Dear Mayor DeBlasio, a response to your op-ed about drafting medical professionals…Truly yours, a nurse.
#COVID-19 · politics

Dear Mayor DeBlasio, a response to your op-ed about drafting medical professionals…Truly yours, a nurse.

lesbehonest2017Leave a comment

Having worked in the emergency department, which is essentially the red-headed stepchild of a hospital, I already know that people treat ED’s like crap until they need one. No one make massive donations to emergency departments like they do cancer centers.

We are unseen heroes.

Until COVID. Now all of the sudden people have taken an interest in our critical care skills. They are hard skills to learn. I felt like it took me a year to become a real nurse in the emergency department. Longer to master IV’s on a coding child with parents screaming in my ear. Longer to recognize the signs of a child who can wait five hours versus some one who can barely wait five minutes to be seen. I left the emergency department proficient.

I saved some kid’s lives along the way. I started a lot of IV’s. I pounded on chests with no heartbeat and I breathed air into lungs that could not breathe for themselves.

In six and a half years I was exposed to H1N1, Influenza B, Tuberculosis, Pertussis, Hepatitis C, and meningitis. More than once. I was kicked in the ribs the week of my wedding. I spent the week of my wedding dealing with bruised ribs and worker’s comp.

I carried with me the grief of parents and the sights of dying children.

I saw my co-worker’s brutally assaulted by patients.

Throughout those six and a half years I never had the support of management. I had to fight to get a Pertussis vaccine covered by the hospital after my third exposure. I had to send about ten e-mails and make multiple phone calls to get worker’s compensation to cover the emergency department bill that occupational health made me go to when I was kicked in the ribs. During H1N1 we had a shortage of masks and gowns and gloves. We were told to put up and shut up or be fired.

We never received raises consistently and we never got paid more during the H1N1 pandemic for risking our own health. Our hospital did not cover any costs incurred when one of our employees got sick with influenza or H1N1.

The day I left the ED I left my family, my co-workers, but I stepped into a new life as an advanced practice nurse where I could leave behind the crap that came with knowing some of the best people I’ve met in my life.

I’ve been reading the articles and watching the stories and hearing from my own friends of nurses shamed and scorned for speaking out when we don’t have protection or PPE and I know I made the right decision back in 2013 when I walked away from the emergency department. Hospital management did not have our back then and it does not have our backs now.

I’ve been approached by the hospital I work at per diem to put my critical care experience to use. My brain and my skills are valuable right now. But they don’t want to pay me adequately. My skills are desperately needed and I am deserving of pay equivalent to risking my life.

I unapologetically value my life at more than just 45$-65$ an hour with no hazard pay or differential. As should all nurses.

Mayor DeBlasio, you implore healthcare provider’s to come forward and just put their lives on the line. Yet we know that on a good day hospitals and management don’t have our backs. They have their own. You have offered no incentive for any nurse or MD to step forward and risk their life. Risk time away from their families. Risk infecting our families.

Pay us. Adequately. Forgive all loans for all medical professionals who respond. Partner with state colleges in NY, CT, NJ, MA and offer free master’s degrees or bachelor’s degrees once this is all over for nurses to advance their education.

Guarantee PPE. I’m sure you’re sick of hearing about PPE. But I said recently to a hospital employee if you could guarantee me a new N95, face shield, and full body PPE I’d sign up today. But they couldn’t. I have kids. I have a family. I am the sole financial provider right now. I’m not risking my life for hospital systems that haven’t risked anything for us.

I can tell you nurses and MD’s are not soldiers. We didn’t go into healthcare to risk our lives. But the longer you work in critical care the more you realize our lives are risked daily. Without a pandemic. And you see how little front line employees mean to the hospital system.

We are not flooding into the frontlines because you have not guaranteed us free healthcare should we contract COVID-19 while “volunteering” for you.

Most of us have deductible plans. Who is going to pay our six thousand dollar family deductible if I’m in the ICU unable to work because I heroically answered your call, worked the front lines without appropriate PPE, and contracted COVID-19? Are you Mayor DeBlasio going to guarantee free healthcare for acute COVID-19 cases in all your healthcare workers and also free mental healthcare long term for the PTSD that will inevitably ensue in all your front line workers watching people die? Because on your website and upon pressing by the media the response was “Well most of our volunteers have health insurance,” That is NOT good enough Mayor DeBlasio.

You say to draft healthcare providers. Soldiers receive college tuition, healthcare at top hospitals in the country, free housing, adequate pay, and many other benefits that should come with being a soldier. You are asking us to soldier up without offering us any reason to do so other than we just should because you are desperate.

Until hospitals and cities and governments start incentivizing healthcare providers by paying us adequately for risking our lives, providing long term financial ease by canceling all student debt for first responders, and guaranteeing free healthcare for any COVID related exposure illnesses that occur during employment and emergency response to a pandemic…then you can write all the op-ed’s you want trying to appeal to healthcare providers (especially those of us with critical care experience)…but no one is going to answer that call.

Many of us have been there. We’ve worked front lines before. We know the risks and we know hospitals and management don’t have our backs and in this case we also know there aren’t enough masks to have our front.

Prove me otherwise and then maybe you’ll get the people you need.

I’ll summarize for you- Pay me. Pay my loans. Offer free education afterward. Free housing and food during. Free healthcare during and after for anything related to COVID-19. Offer life insurance policies. And for God’s sake. Provide me with adequate PPE- not sterilized, not re-used- I’m talking full body suits. Look at some pictures from China.

Those are my conditions for re-entering the front lines. I hope every nurse demands the same.

 

 

Pandemic Journal#4…Waiting for the Hurricane.
#COVID-19

Pandemic Journal#4…Waiting for the Hurricane.

lesbehonest2017Leave a comment

I live in the Northeast and when we are hit with a hurricane we usually have plenty of warning. It’s both a blessing and a curse because there’s only just so much preparing one can do before a storm blows onto our shores.

That’s how this has felt. We’ve been seeing it everywhere, and in the past week it’s been slowly creeping into our state. Now it’s here. For sure. Some of my clients have it and some of their family members. I’m grateful I went to telehealth when I did. I’m grateful I have that option.

I read stories and hear from other nurses who are having to stay away from their families right now and as one of my son’s screams upstairs while I write this I think of that for an instant with some longing, then I snap back and repeat ‘I am grateful’ in my head.

After two weeks of almost no referrals this week my phone blew up. Thank God. But there’s an alarming trend in my new patients I’m booking. They are all healthcare providers. They all have no psychiatric history. They are all begging for emergent appointments.

While I am still doing telehealth and not on the front lines, I feel like I’m there because I’m hearing the stories all day long. They are bad. Nurses I’ve treated for years who work administration are being mandated to the bedside. No one has enough PPE. They fear refusal or questioning as they will be fired.

At least one hospital system in the state has now implemented new DNR policies. Two MD’s can make a patient (Even a patient without COVID) a DNR at any time based on their clinical judgment. To me it sounded like a way to prevent “Unnecessary” ICU admissions. Save the resources for the patient’s with the highest likelihood of survival.

That was hard to hear and hold. Most of my patient’s tend to like me. They at least know what to expect. I’m direct. I had a client call me hysterically sobbing recently to run a situation by me that they felt they needed feedback on and they knew I would be honest with them. They weren’t sure they were right. So they called me.

That felt like such a privilege to be that person’s lifeline. To hear such horrible crises on the front lines from the people working there- it calls for honest and raw reactions but not enough that I can truly show how horrified I am. Because I have to be the rock in the moment. It’s a lot as a psychiatric provider to hold right now.

I’m making masks in my spare time. I sew. I’ve mailed some to some of my healthcare provider clients. It feels like the least I can do.

I’m generally good at compartmentalizing. But COVID is truly challenging that ability. Not only is my work not separated from my home and family…enter telehealth in my home office…and my four year olds running in and out of the background of my sessions. I try and lock the door but I don’t always remember. Suddenly my many worlds are colliding every second of every minute of every day. I can’t compartmentalize out thinking about my cat recently diagnosed with lymphoma and CHF because she’s literally on my lap half of the day for most of my sessions.

One of my son’s is having some sort of sleep regression so he screams uncontrollably about whatever he decides he’s going to be upset about that night for an HOUR before bed. I never get an escape from them. I am never truly relaxed. I can’t go to hot yoga. I can’t go anywhere and if we do we are constantly worried about exposure.

It’s a story that is being replayed every day with all of my patient’s who do or do not work in healthcare. My patient’s all seem to understand the severity of COVID and they are singing the same song in every appointment I have. Tired. Anxious. Irritable. Sick of their kids. Sick of each other. Sick of worrying about getting sick. Sick of worrying about elderly relatives who won’t listen to stay at home orders. Sick of worrying about newborn babies. Sick of worrying about themselves or their partners working the front lines in healthcare.

The day to day is passing. This is the end of week three of COVID-19 stay at home orders. People are dying still. People are scared still. People are out of work. Worried about paying bills. Worried about homeschooling their kids. Healthcare providers are scared of speaking out for fear of being fired. They are scared to go to work but even more scared to be the whistleblower who gets blackballed from healthcare in the state.

I don’t have any uplifting message to leave you with today. As a true journal entry I will leave you with the true uneasiness and terror that we are living with. The outer edges of the storm have hit and we are now just expecting to be pummeled.

It’s like Book 5 of Harry Potter. Shit’s getting dark. People are already dying. More people will die. And we can only sit back and wait.

****TO any healthcare providers working front lines. Reach out for help. We are here. I see you and I know you are facing life or death every day. I know you didn’t expect this or ask for this. That you didn’t choose to face a pandemic with no PPE and an incompetent federal government. You have allies. Stay strong. You are my heroes. And if anything comes out of this I hope it will be organizing of healthcare providers and demanding improved compensation and improved access to resources.****

#45:

Jan. 22

“We have it totally under control. It’s one person coming in from China, and we have it under control. It’s going to be just fine.” CNBC interview

Feb. 24

“The Coronavirus is very much under control in the USA. … Stock Market starting to look very good to me!” Twitter

March 9

“The Fake News Media and their partner, the Democrat Party, is doing everything within its semi-considerable power … to inflame the CoronaVirus situation.” twitter

March 10

“We’re prepared, and we’re doing a great job with it. And it will go away. Just stay calm. It will go away.” Meeting with R. senators.

March 15

“This is a very contagious virus. It’s incredible. But it’s something that we have tremendous control over.” News Conference

March 18

“I always treated the Chinese Virus very seriously, and have done a very good job from the beginning, including my very early decision to close the ‘borders’ from China – against the wishes of almost all.” twitter

March 24

“I’d love to have the country opened up and just raring to go by Easter.” Fox News

March 26

“I don’t believe you need 40,000 or 30,000 ventilators. You know, you go into major hospitals sometimes they’ll have two ventilators, and now all of a sudden they’re saying, ‘Can we order 30,000 ventilators?” Fox News

 

Pandemic Journal Entry #2- But Where Did All the Yeast Go??
#COVID-19 · politics

Pandemic Journal Entry #2- But Where Did All the Yeast Go??

lesbehonest2017Leave a comment

In an ironic and rather cruel twist of fate I found a use for all the fabric I’ve saved for ten years. Most of which I used to make my own scrub tops back in my emergency department days. I started making fabric masks.

Apparently the United States of America supposedly, one of the most advanced countries in the world, doesn’t have enough masks and PPE (personal protective equipment) for a pandemic. We also outsourced all our manufacturing to China (They also were hit with the pandemic worse and first) so…yeah. Essentially the hospitals here are fucked.

The CDC and JACHO and DPH…all the most dreaded initials in healthcare…have now declared that wearing a bandana is “okay”. Let me put this in perspective. About three weeks ago these were the SAME initialed departments that were ding-ing hospitals nationwide for nurses keeping their water bottles “at the nurse’s station”.

I hope everyone wearing a bandana at work today eats a damn pizza at the nurse’s station.

The jury is out if cloth masks do anything. There are studies showing they don’t.

But of course because I’m smart and a nurse and have had to wear these masks for twelve hours on end I am a step ahead of the average “sewist” (someone who sews a lot? I dunno my Aunt used the term and it sounded official). I started sewing. Something I actually haven’t done much of since the boys were born.

I still got it though. After a first crappy mask. I got the hang of it. I make them three layers- cotton, thick fabric, cotton- with an opening at the top to slide in either a surgical mask or a HEPA filter. I’m using framing wire to make the nasal bridge part malleable and more snug.

I’ve also learned where to make a cinch (yes that’s a sewing term that I actually knew) in order to make it more snug to the nose and jaw. I also practice talking and breathing while wearing it. I can’t tell you the number of times I’ve tried to open my phone with face ID only to realize I have a damn mask on. They are comfortable. They are breathable and they are better than a bandana. I told my wife I should patent this shit.

But I won’t. I also saw some lady charging for them! Screw that noise. Any nurse I know can have as many as you want.

But while I’m making them I’m just thinking Fuck you CDC. Fuck you #45. No nurse on the front line should have to wear a fabric mask. Why don’t we have enough N95’s? Why are you risking the lives of the only people in the world who can save every one else?

Critical care nurses are not common. We have years of training and experience and most of us leave the game because on a good day it’s taxing. During a pandemic…yeah we don’t want to be near it.

But I would go near it if you had PPE. But you don’t. So you can’t pay me enough.

Yesterday the boys and I went for a 1.5 mile hike together. Only the state parks are open right now. No playgrounds. And there are talks of closing the parks. Please GOD NO! We literally would have no where to go with them. Maybe not literally. We have a yard. Try explaining to a 4 year old why we couldn’t go to a restaurant though. It was rough. He does not believe me when I tell him they are all closed.

We officially have no childcare this week because our baby-sitter’s told us they are abiding by the governor’s order to stay home which is totally valid and I’m not knocking at all. My wife and I had a pow-wow and made the decision that my wife will stay home from work (her store is still open as it is considered essential) so I can still see patients.

I’m worried all the time about everything.

Today was yeast. I bake bread or pizza dough every weekend. I used my last two packets of yeast today. Apparently every one decided that we will not have access to bread?! So there is no yeast anywhere. Not online not in stores. My wife went to over 8 stores before she found some. I know all y’all are not out there making homemade bread. Because every time I make it literally no one has ever even seen homemade bread before.

So where the hell is all the yeast going?! I don’t know. With the toilet paper I guess.

Anyway I made my cinnamon swirl bread today. My wife is stopping work this week so we will be down an income. I volunteered to provide telepsych services for the state of NY due to COVID-19. I also got an e-mail stating any one on a biologic should be excluded from direct patient care…I am on a biologic for my asthma (yes it’s that bad)  so that made me feel validated in doing remote work only. I don’t want to die. I probably would if I got this virus.

We are heading into the week where we will really feel the pandemic. Our numbers are growing. We are at the part of an exponential curve that is climbing with no end in sight to the top. It’s the scariest part to the curve. I tell people with panic symptoms that panic attacks always peak. There is always a time that is the worst after which they start to come back down. This isn’t a panic attack though. These are human lives.

Hang in there America. Shit’s about to get real.

 

 

******Also in case any future person is wondering politically what is going on during this pandemic…Our President sounds like an ass. So nothing new. The senate Republicans are idiots, got exposed, tested positive, and now they need the Democrats to agree with them for votes because too many are absent and they don’t have a 60 vote majority anymore. Can we get a new Supreme Court Justice NOW! In case you didn’t understand- The Republicans are acting and sounding like idiots and as a result are testing positive for COVID-19. The D’s are doing their thing. Squabbling and bitching that the R’s suck and not really getting anything accomplished.

 

Day…__…what day is it? Pandemic Journal Entry #1.
#COVID-19

Day…__…what day is it? Pandemic Journal Entry #1.

lesbehonest20171 Comment

I read somewhere to keep a journal during the pandemic. I’m thinking this week has sucked and I’d like to forget it. But if it helps someone else in the future trying to learn about the 2020 COVID-19 pandemic read on.
I’m all set with the pandemic situation. That could move on.

I never appreciated or craved my normal life as badly as I do now.

I transitioned all my clients to telehealth. For one week. Still working on next week and the week after.

All the major insurers actually stepped up to the plate and said they are accepting all claims for telehealth whether they’ve approved the provider or not (except for Anthem, shocker. Fuck Anthem). They recognize that there’s a damn pandemic and people are freaking out.

Add the panic e-mails from the hospital I work at assessing every one’s skillset as stories are coming out of Italy of eye doctor’s learning to use a ventilator.

This week I’ve ranged from calm to panic to despair back to calm again.

My therapist told me he has to close his practice for the time being due to the financial strain of COVID-19 causing half his caseload to cancel. I felt incredibly heartbroken for him to be in that situation, terrified that the same thing would happen to me and my practice, and also like wtf. It took me a year to find a therapist who was good and who I didn’t know professionally. Selfishly I was like now I have to find a new one?! During a freaking pandemic?!

Then much of my caseload canceled or rescheduled this week- some because I was waiting on Anthem BCBS to approve me for telehealth- others because they thought this would just pass and we could schedule out for two weeks.

I may have freaked out moderately. But then today I saw 16 patients, all remote, between the hospital in the first half of the day and my practice the second half of the day.

Me seeing inpatient psychiatric patients remotely was a first. It went well for me. The patient’s didn’t seem to mind. One was actually quite happy to see my cat who strutted in front of the camera at one point.

This week has been a new reality. So many unknowns. Lots of pressure to maintain my practice, an income, and support my colleagues working inpatient.

I don’t think my life will ever be the same which sounds dramatic but if anything, this week has shown the fragility of our every day existence and how interconnected we are and how dependent I am on others for my income.

There are too many proposals and not enough action. I’ve read many proposals about freezing student debt and credit card interest but not seen anything set in stone about it. I don’t want to fall behind in making payments to any one or anything but at the same time I’m worried that we won’t have a steady income.

Childcare is a freaking issue. They are with me all the time. ALL the time. We’ve had our neighbors and my mom helping out, but it’s not like I can leave when they are here. I see clients in my home office, and shut the door. I can still hear them. ALL the time.

I’m an introvert. I need my space. My office. My alone time. My time away from home and kids. I feel constantly overstimulated and I’m ready for a break from them.

The first week has been a blur of figuring out how to transition my practice to an entirely different platform and also work inpatient remotely. My wife and I are in constant fear that we will lose everything. I’m pretty sure every one in America in the middle class is feeling the same way as that topic takes up the majority of my sessions with patients.

The phone started ringing today for intakes. It was silent for a few days which also terrified me. But now people are realizing that this is the new normal, they are panicking worse than normal because of the pandemic, and they still need mental healthcare.

For now I’m lucky to have that job security and incredibly blessed and grateful to be able to transition my practice to remote health. I’m grateful I can be here with my kids even though I’m sticking them in front of Disney + for far too long while I see patients upstairs. It doesn’t feel sustainable. I hope it’s not. I hope life gets back to normal soon. But unfortunately I’m not stupid. I see the numbers and the timelines and I fear this is only the beginning.

There will be many more deaths. More illnesses. And many more days working remotely.

Some of my top pandemic moments weeks 1:

1- Rounds with an Attending, LCSW, nurse, nurse manager etc. I’m remote on the screen. Both my sons run in and poke their heads onto the screen. They then start chatting. I think I mute the screen. I hustle my kids out the door telling them to be good and I’ll get them a donut, and to go watch Spiderman, and yes I love them too, and No that wasn’t Mama’s patients, now please just stop talking, go downstairs, No donut if you say poopybutt again, I’m sick of it Declan, stop saying poopybutt and gross Jackson quit licking me, just come on….etc. I sit back down. All eyes are on me. I hadn’t pressed mute.

2- Patient clicks in to join the video session. “Hi! Uh, wait are you driving?!” “Yeah, don’t worry I’m getting off the exit, right…up…here….we can start though!” Literally started talking about their meds while driving.

3- Patient clicked in. In bed. Under covers. Just waking up. It’s 3 PM. “Well I made it to the session!” me- “You seriously couldn’t get out of bed and at least pretend you’ve been up for ten minutes?” them- “It’s a pandemic what do you want from me?!”

4- “Mama are you done seeing patients?” Me “No, just taking a quick break” he looks at my wife, “Yeah she does this at Gramma’s house too. Lots of breaks.” then he rolled his eyes! Freaking four year olds.

5. My business partner talking me off a ledge. Multiple times. Some of her words to me “Calm down.” “It’s the flu calm down” “Get a grip.” “Send yourself some Xanax” “You’ve lost your mind” “You’re a mess about nothing” me “It’s a PANDEMIC” Another frequent exchange between us- as in daily sometimes twice daily we just randomly text each other two words. “Fuck Anthem.” No explanations ever needed.

6. The best news of my week which I texted to my wife “Our liquor store is delivery only!!!”

7. At some point I drank wine and made double chocolate chip cookies. They were amazing.

These are light moments in dark times. Stick to the light to lead you through the dark.

 

 

 

 

Nurse to Nurse. Hang in There.
Nursing

Nurse to Nurse. Hang in There.

lesbehonest20171 Comment

I have been walking around with a ball of anxiety in my stomach for roughly two weeks. I knew last Friday would be a turning point. When I left my office that night I packed extra things I normally would leave there. I stopped going to hot yoga two weeks ago.

You know that was hard for me. But I knew from the stories coming out of Italy that after even only a handful of cases in our state the worst was yet to come.

I did a presentation once on mass casualties. The head of emergency response of our state was there. I presented on Hurricane Katrina. The largest barrier for them was helicopters. They didn’t have enough helicopters to rescue people, and they waited roughly 5-7 days to contract with private companies. By then many had died.

I asked the head of operations how many helicopters we have in our state. He said, “One”. You could hear a pin drop. He rushed to add that we “would never see flooding like in New Orleans,” to the roomful of 100+ people now freaking out that we were all going to die.

Two weeks ago I started to get a pit in my stomach because I am acutely aware of the estimated number of ventilators in our state. That was part of my presentation five years ago. I was also acutely aware that the numbers coming out of Italy were bad. Very bad. I started feeling like we were New Orleans being hit by Katrina with one helicopter.

A lot of people are going to die. We are going to be faced with tough decisions. I implored my Mom to stop yoga class and any other outings. I bought into social distancing far sooner than the rest of our country because being in healthcare is a double edged sword. We know the limitations of our system. We know how to interpret statistics and death rates and percentages. I knew two weeks ago we don’t have enough ventilators to save people in a pandemic.

I moved my practice to telehealth only. Of course so did the rest of the USA so it’s been a nightmare dealing with insurance companies. Many patients are still canceling though because they don’t have their own incomes and are worried about medical bills, even small co-pays can be detrimental when people are out of work.

In the midst of me worrying about keeping my practice afloat I received messages from the hospital I work at asking for me to work there in the coming weeks. I know the risks. I also know all the people who work there have their own risks.

I know the doctors with kids with cystic fibrosis, the doctors over 60 with cardiac disease, the nurses with respiratory diseases, the social workers…I know everyone’s story just like they know mine. I know they are risking their health and their families every time they go to work. It’s not a question for me. I have to help out. I didn’t go into nursing thinking there wouldn’t be any hard times.

None of us make enough money for the work we do. But we all take these risks to take care of strangers not just for the strangers, our patients, but for each other. The bonds of health care professionals are what keep us all going. Time and time again when I worked in the emergency department I didn’t show up for management or the money. I showed up for my co-workers. The same is true now.

I know how it feels to be short staffed. I know how it feels to be scared of going to work. I’m scared to go to work. But I’m going to go.

To all my nurses and doc’s and techs and hospital staff- hang in there. You are the true heroes in our society. You deserve the tests that the NBA team received. The disparity in our society that we laud celebrity and neglect our most valuable members of society- nurses and healthcare professionals- is despicable.

I know we are afraid. I know we don’t have enough supplies. I know we are all putting ourselves and our families at risk. From the bottom of my heart I thank you for all you do and I’m with you. I’m showing up at work. I’ll see you there. Tune out the noise and do what we do best. Heal. Tell dirty jokes. Make horrible coffee. Complain about management. And save some lives. We got this.