Last Post: 1:16:41am, 05/11/2020
Since the last week of March I have been working on a COVID unit as an RN. We basically took over half a floor of the hospital for people that are COVID positive or that potentially carry it. Its broken up into three different parts; an ICU, an intermediate care and then a "med-surg" unit that I am a part of, but it's not really any different than the intermediate care, we get patients that are just as ill and serious. Each unit has about 20 beds, and they have all only ever been completely full one time since this all started, otherwise it usually hovers around 60-75% capacity. I live in a city in Texas with a population of 100k people, but it's the biggest hospital between Dallas and Shreveport so it really caters to about a population 700-900k people.
When this COVID floor was first set up, they asked for volunteers and said that for 6 weeks it would be 7 days on of 12 hour shifts with 7 days off and then they would reevaluate from there. I went ahead and volunteered for it since I was already getting my hours cut or being floated all across the hospital to different units since the overall patient census had dropped pretty significantly, especially my original unit which mostly had elective surgery patients which weren't happening anymore. They didn't offer any bonus or hazard pay, the hospital was already losing more than $25 million a month from the drop in census.
At first it was just three of us nurses and they sent us to the unit and told us to set it up how we saw fit. We were going to be doing everything on our own; lab draws, EKGs, cleaning the patients, bring them their food, even cleaning the rooms when they left, which involved mopping the ceilings and walls twice over. Once we got onto the unit for the day, we couldn't go anywhere else in the hospital, so we were pretty much stuck in that fairly small unit all day. We could come in wearing regular clothes, change into surgical scrubs they provide, then take them off and at the end of the day. Since we couldn't leave, they did let us get free Starbucks coffee and meals from the cafeteria all day long, so we always got the fanciest drinks we could to take advantage of it. We spent most of the first day ordering supplies and setting up the rooms. The ICU and IMC had already been running for a week before our unit, but we basically had no guidance outside of just trying to emulate what they did. A nurse from one of the other units showed us how to properly put on our PPE and clean the rooms, and that was all the instruction we were left with. We got our first patient up near the end of the day and I was pretty nervous, as it would be my first potential known contact with someone who had the virus. They been coughing and running a fever for a few days, so the ER tested them and they sent them to us until the results came back. Before the rapid test was implemented, it took between 24-48 hours to get the test results back. I was going to be getting this first one so I gowned up, put on my N95 mask and got them settled. It was about time for shift change when I was finished, so I got out and explained to them what we were doing.
I came in the next morning at 0645 and the unit had gotten three more patients. Two of them were fairly young and could get up on their own to use the restroom and do whatever, but the other two were older and had alot of issues going on. We tried to limit how much we entered the rooms, so we did our best to bunch all their lab draws and meds, or whatever else they couldn't do themselves when their breakfast, lunch and dinner arrived. If the patient was incontinent, we would put in a Foley catheter without hesitation and throw on a brief, then wait for the results to come.
Myself and the two other nurses we had on day shift have only been a nurse for a year and a half at this point, so I wasn't a total noob, but I am not a seasoned vet that has been around the block a few times either. Like I has never drawn labs on my own before as nurse, we have lab techs for that, but I had been taught how to in school and had been drawing blood ever since I was in the Navy as a Corpsman. Regardless, it was still something I hadn't done in a long time and it took practice. Same with the 12-lead EKGs. If we couldn't get a blood draw or an IV on a patient that was a hard stick, the ICU would send someone over with an ultrasound machine,so we weren't completely screwed if we couldn't get it.
When a patients COVID-19 results would come back negative, they would get transferred to another floor in the hospital if they still needed further care. In that first week, everyone sent to the unit came back negative. Basically if someone displayed any symptoms that could possibly be COVID-19 and weren't well enough to try ans wait at home for the results to come back, they came to us. Had a cough or even mentioned you might have felt feverish at some point in the last few days, you got sent to my unit. Almost everyone single of them that tested negative has pneumonia, just a few others with something more serious (or less serious).
More to come, it gets much worse from here on out