I get it, y'all are irritated with us and everything that is going on in your bubble of a world....
Covid
Masks
Low staffed restaurants
Seriously...
we are doing our godamn bests...
so it makes no sense for people to be dicks to us or anyone in the medical field right now.
Zip...
Zero...
Nadda...
After 2.5 years you KNOW you need to don a mask...
and yes you can put your classy
"This mask does nothing"
mask on and I may shake my head...
but you know...
in your self centered head...
you need to put it on to get service...
here, at restaurants, hospitals, clinics, Target, Walmart
all of it...
and
If ya pull your mask down to sneeze or cough in my face,
Yes I am going to say something.
If you throw your ID and attitude at the young girl checking you in ....
You can be sure she is going to come back, tell me, and I'm gonna remember
yeah...I am
So, get your shit together and be nice to us.
You get to go home and take your mask off and cop an attitude at home and tell everyone what bitches us nurses are...
and we just keep smiling and reminding you to get a booster, wash your filthy hands, and wear a mask if you need to stand in line at the bottom of the Vail Chair Lift on a Saturday with 30k other people.
I have been back a couple of days and have been working on my FEMA tests to become a reservist...
because maybe that is why this all happened...
my mind keeps wandering to my last few days.
Demobilization was just that.
I had 24 hours to say good-bye, clean my room, and get a flight.
I did all three....
alone and with much thought.
My room was left just as I had entered it except for a box of chocolates, 20$ bill, and a thank you note to the cleaning staff that continued to work the "dirty floor" at the Sheraton for us.
it was the least I could do.
I shut the door at 450 am, just like I had been doing for the last 22 days but this time I was heading home.
My stomach rolling with anxiety, and maybe some fear of moving forward, when I really wanted to stay, or at the least move sideways.
{This may be a long post}
The last day at Jacobi Hospital was, as I said, bittersweet. I spent the day saying goodbye to nurses, residents, and doctors, who came around after hearing "Colorado" was leaving today. I teared up every time someone said, thank you....you brought a light that was desperately needed in this area.
I fought for my last 2 patients:
One, to discharge home so that I knew she was safe and also so that I could wheel her out, as I promised I would when she was on 80L of oxygen and I was questioning the sustainability of her life.
and the second: to stay alive ....just stay alive.
All the patients who were directly under my care lived, except for 2, that I am aware of. They were my ICU patients. They were only in my care for a couple of days.
The other ones,
even the one who kept asking if he was going to die....made it out.
Wait, except for Teresa....she is still in.
Mamacita....
she spoke no English and for 20 days we used hand signals and occasional yelling to communicate.
From ventilator to Hiflo oxygen to hopefully home...
here was my day
The two women shared a room, no private rooms in covid central. One a younger social worker who fought like hell everyday to get better, and my job was to keep telling her she was getting out alive.
the other a much older hispanic woman who was slowly giving up on life and everyday I begged her to breathe...to eat the horrible hospital food, and to to move her feet so that she didn't get blood clots and die of that.... opposed to Covid.
For 20 days straight, minus the one day I got floated to another area, I walked into the room and picked up and removed all the garbage ( housekeeping was swamped and short staffed), I emptied and cleaned all bedside commodes, wiped every surface with bleach wipes, made sure Jackie and Teresa got their teeth cleaned, gowns changed, and bed linens changed (even if it meant I had to go to different areas to find what I needed).
every morning...
and every evening before I left...
I did it again.
They came to know I was fighting for them...I wanted the area clean so that they could get well.
If they were able to get to the bedside commode it was required by me...
No one gets to sit in diapers,
they must move to keep the blood flowing and to facilitate breathing.
I "suggested" they prone, or Tummy Time as we called it, and actually made a time frame for when they should do it so that we could check to off our to "do list."
Proning is one of the most effective ways to open the lungs during Covid. It is a proven help.
I wrote my name, date, goals and Dr names on the white boards so that they knew what was going on.
And when I knew what type of food they liked, or would at least try to eat, I would trade other nurses one thing for another and even bring stuff from the hotel or my personal lunch so I knew that they at least got something in their bellies.
Jackie, the younger of the 2 was making wonderful progress, she became the voice for Teresa...updating me every morning to what the night had held and what bullshit might have happened, or setbacks and began to translate for Teresa through the curtain divider.
this became our needed norm.
Teresa at one point took a turn for the worse and oxygen needs went up quickly. I begged her to breathe, and to leave the mask on which she would pull off in her hypoxic state. I sat next to the bed and held the mask to her face and told her she needed to get better...
for her kids and grand kids...
I thought....
she is going to die today...
fuck
I finally pulled open the curtain which separated them and said, "Jackie help me talk to her, please"
and they saw each other for the first time...
I asked Jackie , " please tell her...tell her she needs to breathe, she needs to be on her tummy when I ask and she needs to live...not to give up"
Jackie barked at her in Spanish and something changed....
to me it looked as if being able to see each other they became fighters on the same team.
They were in the battle together.
It took a couple of days but Teresa began to get better.
I was able to get Jackie's Hi Flo machine when she no longer needed it...
I slid it over, got everything together, and set the settings as I had watched the therapists do for the past 2 weeks...then grabbed a respiratory therapist to double check the settings and I put it on Teresa.
This meant no full face mask....she was able to drink water and take a bite of food without her oxygen level dropping to 70%
She could talk on the phone....she could sleep.
I felt like a secret agent hero getting that machine to her without anyone's help.
There were so many doctors rounding I'm sure they just thought one of the other doctors ordered it. I just charted it and kept it maintained and no one asked where it came from .
The day I left,
the doctors were slow to get everything in place for Jackie to discharge to home. She needed an oxygen tank and for some reason they could not get the paper work together.
I called every dr I had come in contact with...
I begged them to send her home...she only needed 1L of oxygen for when she got home and needed to ambulate.
"There are no tanks."
I quietly suggested that she call the insurance and tell them she would purchase her own tank...go around the doctor orders and take care of it herself.
She did...
it worked...
they still wouldn't sign discharge orders so she left Against Medical Advice and I wheeled her out to her car and her husband she had not seen in more than a month.
When she got home she texted me pictures of her new Oxygen tank, an oximeter, and correspondence with her insurance that it would all be taken care of.
Yes! Home
(she changed my life)
Before she had left, Teresa realized she was going to be alone and begged for me to get her home too...before Mother's Day
She cried and cried and Jackie kept telling me she wants to go home for Mothers Day...it is a huge deal.
she can't...she is not ready.
I cried too...
I cried because it was my last day and I didn't get her out....
I went to my google app and translated to Spanish:
You will get better
You will see your family
You are strong
and You are my heart
so please, keep breathing...
today is my last day but you are going to be ok
I can promise you that
I asked Jackie to help me get her granddaughters phone number, which she did and I was able to find her on Face Book, contact her, and tell her who I was and that her Abuela needed them...and we would like to face time.
she said give me 5 minutes and call me back.
I took the letter I wrote to Teresa ...she read it, cried, grabbed me and hugged me so tight( which we are Not supposed to do) folded the letter up kissed it and put it where her bra would be if she was wearing something other than a hospital gown.
Then I showed her my phone
and hit the dial button.
Up popped her family...and the screaming and crying began.
She had not seen them in over 37 days
they cried and cried and we said hello and laughed and I gave her the phone with a battery charger from Nurse Chuck and told her to take her time...
2 hours later...she handed me the phone and kissed my hands.
before I left that evening,
Nurse Chuck and Nurse Ivey came in the quiet room where Teresa was, now without a roommate, and soon to be without her nurse...
and we promised she would get to FaceTime again on Mother's Day
That was Wednesday
Sunday afternoon I received texts from Ivey and Chuck that the FaceTime would start at 11 rain or shine.
people are good
I sent her a video to Ivey's phone saying
Feliz dia de la Madre
Mi Amore
Ivey said Teresa watched it about 10 times and kissed my face on her phone, held it to her heart and cried.
I'm going to miss her
I do miss her
and I actually ask about her every morning....
I send a text " what's the oxygen"
and they just answer with a number and a thumbs up.
When I got home the first random message I got was from a lady stating that they heard the nurses were killing patients....letting them die. That they weren't treating them with medication,
that no one gave a shit....
that the old and weary got left to die so that someone else could get the equipment....
that people were working above their knowledge base which in turn was for sure doing damage.
I cried when I got that text...
I cried because yes....everyone was working above their knowledge base...there is no treatment for Covid except ventilator, vitamin C, Zinc. proning, and luck...We did not do compressions when someone coded....because it spreads the virus everywhere and it wasn't safe...but that didn't mean we weren't trying. We all did are best and many are still there, still cleaning up and continuing to finish their job in NYC.
all I can say is, wear your mask...
take your vitamins,
and know that there will always be a nurse to care for you
I sat outside and texted a few people in hopes of being rescued from my own mind.
I was reminded that I was strong and that it wasn't much longer...
and I know that.
I know that
I know
I want to go home.
but then I think of how wonderful this has been
escaping the pain of my home life and troubles,
in an area where people do not know me,
but everyone appreciates me...
our jobs keep us so busy that there really is no time for heart hurting pain
or the fact that we are doing some crazy ass nursing shit
we just keep moving
the days are irrelevant and the biggest thing of the day is what you are ordering for dinner
and if someone will steal it from the food delivery area or not.
I got lost almost every day for a week at Jacobi...
These staff nurses made the days ok...
they were hard asses but I got used to the NY yelling and the weird sense of humor
they made us feel like family
How will I ever stop calling everyone Mommy and Papi
(it's a Bronx thing)
Take a minute.
smiling underneath
It's soooo hot in those stupid gowns.
Every room we walk into or come out of we have to don and doff...
every time.
all of that comes off and goes in garbage then you put it on again.
it takes a minute....
when someone is coding (dying) it seems to take 30 minutes to get it on properly
I look at this everyday and wonder what the theme was
These two...Jack and Jenna...
they aren't a couple but were inseparable ....
So weird to see them without masks.
They look awesome, never would have guessed
still empty. March 1, 2020
Lots of bridges and I couldn't figure out which was which but they were cool
every one in a while there were donuts from someone.
Covid donuts...
but the nurses we are, we ate them
He started filming the bus ride in slow mo....phone taped to the window.
He got left once at Jacobi , because his patient coded at shift change and we didn't all know each other yet....after that we always yelled " Is Brandon here?"
Chuck...
Southern as all get out and came from Pediatrics. He learned how to wipe adult ass and he successfully changed his first bedpan ever, We all cheered and wrote "I changed my first bedpan!" on the back of his gown
We tried to stay perky
renegade Flower Arrangements in the NYC garbage cans...
better than wasting all that beauty
Jordan
another Colorado nurse
I need to figure out that face...
I saw it all over
I can’t take as many pictures as I would like of the situation I find pertinent, although I have snapped a few. My feet hurt, my heart hurts , but not as much as these people losing life and loved ones. It seems for every celebration of an extubation, 3 will die.
But yet we still must celebrate .... we must.
We are working too hard to not. Everyday I go back to my hotel and shower like my life depends on it, sleep, and then do it all over again.
I will never hear this song and not think about Jacobi
and how it was played every time they successfully
got a patient off the ventilator
( with covid, 75% of the people die if they were intubated)
so when we hear this.
we cheer, no matter what
because we are cheering not just for the life,
but for the work we all did,
for the breath they breathe on their own,
and for their family who is not there to see that fight
I guess we all know that you never quite understand something until you see it first hand or you experience it.
After 9 hours of bullshit orientation...standard nurse stuff such as paperwork , pictures, and HIPPA...we were taken to tour the floors.
When we first arrived in NYC, they asked us our specialties. I had no reason to lie (although I heard that some people did so that they could get into different areas) so I just said PPU/post Cath, groin management, Telemetry and anything under...Because that is what I can do and sometimes , in my opinion....I'm not even that good at those.
Upon being hired they were very clear we could end up on any department, any specialty, and we needed to verify that it was understood. Well.... I understood,...What I didn't understand was the lack of resources, the real lack of any training, or help, and the severity of the illness.
I want to say that these hospitals have great nurses and doctors, but you can only imagine coming to work day after day, your co-workers are falling ill, or not showing up and the new influx of Covid patients have literally taken over the hospital.
These hospitals are 100% Covid + patients.
I don't know where the normal sick/stroke/heart attack/
patients go now...but these hospitals we are sent to are 100% covid hospitals...
even Mom and baby floor.
We were all grouped together and the team lead looked around and said,"what do you do...?"
I said ,"Tele and PPU/groin management stuff"
she smiled and said
"Great...ICU nurse....let's go"
and she took me to a wonderfully perfect older African American woman straight from Atlanta and dropped me in her lap.
"Show her the ropes, she's on her own tomorrow'
I had heard that this is what happens, but I just couldn't believe it.
The lady smiled and said "how are you with vents and Dialysis?"
The tears welled up, I kept it together and said...
"I have no idea, I have never done either, but I'll follow you and if you just explain stuff I may be of some help?"
"Well gown up little mamma and lets get to gettin"
In Covid rooms we must don and doff every single time you enter or exit and it is not only a pain in the ass it makes you so paranoid you can't think straight.
Is my gown on, oh shit is that a tear....I'm gonna get sick!
Every single time....
so if you get in the room and need a pen...you must follow the steps again....and you just can't rush it.
For 4 hours I did my best to watch her do dialysis (CRRT) run the ventilation, and make sure the medicines were all what he needed...she did all with a semi smile in her eyes and explained everything I asked....
she was so helpful...
I thanked her profusely as I left and thought....
there is no way I can do this they cannot put me in there
I will kill a patient....
I cried all the way home...
called all my icu nurse people
I cried myself to sleep,
prayed I would not end up there again....
got up the next morning....
and guess where I ended up?
Not the beach...
the ICU....
this time on my own.
And here is what I learned from a most fabulous Hospitalist, Dr. Anderson,...
It's ok...
scenario:
Me sweating bullets trying to suction the covid outta this intubated patients nose and mouth....Yall have no idea how much I hate snot and phlegm....covid snot is yellow green, so thick it looks like bubble gum, and comes from their mouth and nose...even though there is a tube in there.
so thick you can hardly move it.
As I struggled the Dr looked over and asked how I was...I laughed like the joker....
she said"you an ICU nurse?" I said , "do I look like a damn ICU nurse??"
She smiled and said, "guess what?....Everyone is an ICU nurse now! promotion"
Then this:
"no seriously, we are all so grateful you all came to help, every thing you do is going to help every person in this hospital. you will not hurt this patient....actually nothing you could do either way could make this patient worse.
You are amazing..."
***Nothing you can do can make this worse....this is the worst."***
Every person in this hospital is covid_19 +, even the babies.
I'm not sure what the exact % is that dies, but I believe it is most ,
