Message to Young Nurses Working With COVID-19 Patients

I saw the news of young nurses (those who graduated well after 2000)  impacted by the storm of COVID-19 patients. They never knew what it was like not to have Universal Precautions as part of daily ‘norms’ at work.  They’re scared and angry, and that is so very understandable.  In normal times, all of this would be absolutely unthinkable.  But these are not normal times.  This is a global situation that was not fully appreciated until it hit US. Many warnings had been issued over the last several decades.   Mistakes were made.   In the US, we tend to think that we’re immune to things that happen in other parts of the world.  While 9/11 erased a bit of that, it has never hit us in a medical battle like this, for the vast majority of people alive now.  Viruses don’t care about what country they’re in.  Every country on the planet is trying to get equipment, from PPE (gloves, gowns, masks, face shields, etc) to ventilators.  EVERY. COUNTRY.  There is little in the way of  inventory to purchase.  Add that the US government is outbidding states’ governors, and it’s a total cluster.  I’ve been an RN for 35 years, though have been disabled for many years now. I have the ‘luxury’ of watching this, but wish so much that I could be there helping. It goes against everything in me to not be of use during this time. So, I write. It’s all I have to offer.  My mom’s grandma died in the Spanish Flu of 1918. Pandemics influenced my family in how my mom’s mom did NOT cope with the death of her mom. Her father died a year later.  She stayed broken.  She raised kids as a broken mom. None of this is “just” the current situation… there will be collateral damage.  But we have to protect the caretakers AS BEST WE CAN with what PPE is available. Now. 

Time speeds up as you get older, so this may sound like ages ago, but it’s really not.  In the mid-80s, AIDS was still relatively new, not well understood, and another cause of fear and much discrimination. It was different, as there were higher risk groups. COVID-19 just needs a breathing body.  We didn’t have Universal Precautions until 1987. There was typically one box of gloves at the nurses’ station, and those were only for “Code Browns” (a poop situation beyond the ability of one person to deal with) or massive bleeding- and that was at the discretion of the nurse.  This is when I started nursing.  It’s just how things were.  We did have isolation carts for AIDS patients, with gowns and gloves.  Masks were only used for suctioning, and face shields weren’t even imagined. I don’t remember ever having protective eyewear.   We gave IM and IV meds with syringes that had needles. Not everybody had an IV pump… and Dial-a-Flows were rationed.   We were expected to be careful.  We also had up to 14 patients on an acute neurological/neurosurgical floor on the night shift PER NURSE.   It wasn’t until 1996 that Universal Precautions became “standard precautions”, and were considered part of basic care.  I taught infection control at a nursing home in the mid-90s.  Back then menstrual blood wasn’t considered a risk, and the guidelines were “if it has not saturated the pad to the point of dripping, it can be disposed of in regular trash cans”, which stunned me back then. Now, I can’t imagine putting any sort of blood in the regular trash.  Things change.

Governors are doing all they can to get enough PPE, but when it will arrive isn’t set in stone, especially with the “eBay” manner in which they are having to purchase supplies.  The feds aren’t  looking out for anybody on the frontlines. So it’s time for ingenuity and remembering that these are not normal situations.  Normal rules are out the window in a crisis.  This is more like M*A*S*H than 2020 hospitals.  Mentality has to adjust. Some conservation now may mean even more critical availability later.

It troubles me a lot that so many people who are dealing with this crisis are going to develop (if they haven’t already)  PTSD.  The repeated stress and life-altering/life-threatening situations does something to a person.  Please reach out to someone when (not if) you are overwhelmed.  Remember that this will not last forever.  The overall percentage  of people in the US who have this now is still statistically insignificant (a bit over 331,000 positive cases right now… with a population of 330M in the US, that is %0.001).  The folks who have this are not in any way insignificant, nor is their suffering or the loss felt by the family, friends, and coworkers of those who die from COVID-19… but from a pure numbers standpoint many, many more people are OK.  With that same 331,000, 9441 have died- that’s %0.03 of those who are positive. That’s 33 times less than %1.  Just of those who are positive.  The death rate is %0.0000000003 of the total population. I know you’re still swamped and getting slammed. But feeling like ‘everybody’ is sick can be another stressor.  For those in hotspots right now, I realize that how it feels is what is hard, because it seems so non-stop.  It will get better. Not today and not this week, or maybe not even this month… but it will get better.  We will know a time when this isn’t all over the news anymore.  And hopefully, we’re better for it.  This can’t happen in vain.

So, nurses who haven’t known a time without standard precautions, hang in there.  Bring your ideas to your managers about how to conserve PPE.  When all of the patients are positive for COVID-19, how many times do you need to change gowns?  I know reusing some things sounds absolutely counter-intuitive. I’ve seen some creative things on the news from the nurses in the thick of things.  You can change how this goes with your ideas.  Hoping for more PPE is fine- just don’t expect it on a timetable that is “normal”.  Nothing about this is normal.  Including what you have to do as a nurse or other caretaker.

Would I want to work with less PPE?  Absolutely not. But there IS no bounty of  PPE now- it’s all rationed, when it’s available.  And it’s because every corner of the country is going to see this virus hit close to home.  The hotspots need things now.  Until it gets there, what else can you use? How can you change the policies for a catastrophic influx of patients?  How do you stay safe?

Why…?

For quite a while, I’ve felt like I really don’t have a group of people that I can really call a core  ‘community’.   Yes, I’m a Christian, but I am tolerant of others’ choices for their own lives, even if I don’t understand them, or in some situations have any interest in hearing about them ( I don’t want to hear about anybody’s sexual interests… not. my. business.).  I refuse to shun the person.   Why do I have to believe the same as some other human?  Just because they’re a pastor or Bible teacher doesn’t mean they got it right (just watch late night TV preachers… they cast a shadow of doubt on a LOT of Bible teachers, no matter what level.)   I do believe that many are good pastors… but I won’t support any preacher who cherry picks which people are worth their compassion and attempts to understand.  I won’t support any preacher who promotes intolerance.  God made us all.  Period.  And we’re all flawed. Period.  Not one of us is better than the other.  Why do Christians tolerate intolerance?  I don’t have to agree with someone to understand that the choices based on the free will GOD gave them is their prerogative- and it doesn’t have to be mine.  I don’t have to shun them.   I feel like  an outcast most of the time.  I feel shunned by the ‘shunners’.    Add to that that the country is going down the tubes, and I really don’t like most people.     Why do people insist on continuing to prove that they are best avoided?   Or simply say they’re  one thing, and then never back it up?

I haven’t been a regular church goer for a long time (work hours when I was working, then  medical issues that make being away from home for more than a brief time logistically difficult).   Now the folks who went to the church I grew up in will take THAT statement as the reason for all of my frustrations… but my personal faith in God/Jesus is  stronger than ever.  God is the only constant and hope I have, and HE is more than enough.    I KNOW what it was like growing up in a  subculture of evangelicalism- and as a kid I loved going to church.  It was a great experience in the youth groups, choirs, teaching Vacation Bible School, working at the summer camp, and babysitting in the church nursery.  I truly loved it.  Since it was essentially my only source of social contact, there were no conflicts.  I was still ‘one of them’.  We all believed the same. For the most part.  My folks enjoyed a glass of wine now and then, and dad might have a beer (one) once in a while, where as many were convinced that even one drink was a sin (drunkeness is a sin… a social drink is not, imho).  But the ‘big stuff’ was all part of the church teaching.  Without any personal thought involved. Back then, it was just how things were.   I’m very thankful for a solid church upbringing (and the vast majority of my core beliefs are the same);  it was a consistent environment.  It just didn’t allow for exposure to the actual world as a whole. I had no idea that things could even BE all that different among other people.

As a kid, it really didn’t matter to me what or who was ‘in the real world’, since school and (figure) skating were my pretty much my only exposure to people who didn’t go to that church (there was the trip to Europe in the summer of 1977, where I first saw men openly holding hands while walking down the streets of Amsterdam, and hookers had storefront windows with literal red lights that glowed if they were ‘busy’).  It was a time period where society wasn’t as cruel as it is now, and the anonymity of the internet wasn’t even on the radar- so any criticizing, mocking, and name-calling was done in person, and ONLY among  very close friends- unless it was overt cruelty towards strangers.  Thankfully, I didn’t get subjected to that sort of “Christian”.  I was a kid, so not really expected to know any different.  People were simply more decent, in my opinion.  The ‘don’t ask, don’t tell’ philosophy had little to do with anything related to sexual orientation in my world,  but included politics, money,  and religion when being amongst folks whose views weren’t already known.   Why did people find it OK to reject others as ‘the enemy’ when they don’t even know them, most of the time based on assumptions from one comment?

Well, then I grew up.  After nursing school, I moved 1200 miles away on my own to start out my life out from under the shadow of being “the principal’s kid”.  I was not only in a different state and overall culture, but was in a city that had  a huge variety of people whose demographic groups I’d never encountered.  The first cross-dresser I ever saw was at a Walgreen’s checkout.  He was buying the make-up for himself, which I hadn’t even thought happened , until he turned around and smiled politely at me with full face make-up (foundation, mascara, eyeliner, blush, lipstick).  I was gobsmacked !  Where in the world had I landed? Why does the church exclude simply informing the high school kids (who are about to go out into the world, either in college, trade schools, or straight into the workforce? What about the various types of people in the world, and how best to show kindness?  Why don’t they teach about using one’s brain to determine if a situation is safe- and not just a blanket “help your neighbor”? (That omission almost got me killed in January 1987).  Though now, I guess evangelical churches have some exclusion clause to avoid anybody gay, who’s had an abortion, or is on food stamps.  Those issues seem to earn rejection without regard to the person who is struggling because of them. Why is avoidance the way to deal with the world when we’re commanded to go INTO the world and preach the Gospel- or at least show the love of Jesus.

https://www.biblestudytools.com/topical-verses/bible-verses-about-loving-others/

I was also a young nurse during the early years of the AIDS crisis.  I’d never known anybody who was gay.   Church hadn’t really mentioned homosexuality much, if at all.  It was a ‘given’ that men loved women, and women loved men.   Women wore makeup, men shaved their faces, and things were supposed to be all “Leave It To Beaver”.  I knew the terms- polite and otherwise – for homosexuality and what it meant- but that was it.   I had no clue that even in my own family, that there were those who were ‘different’ (neither of the two I knew back then were ‘out’ at that time, then two more became known when I was much older).   I wouldn’t trade them for anything.  All four (known) are/were (one is no longer alive) stand-up folks, and simply a joy to be around.  Why shun an entire demographic group?  Were they not also created by God? Why is it so hard to believe that there are gay Christians?  The Bible shouldn’t be used as a weapon to inflict pain? (I’m not talking about instruction and correction, but context and approach are everything…).

I have no idea how many gay men I took care of who had full-blown AIDS (“HIV positive” really didn’t happen without already being very ill… the disease wasn’t identified until various symptoms of full-blown AIDS had already developed; now, better testing and antiretroviral meds enable those with HIV to live much longer, and with a decent quality of life).  In the early years, HIV was an automatic death sentence.  There was no hope at all, like there is today.  Most of their families back then, and even their partners, had kicked them to the curb.  Families were ashamed, and partners were terrified to be associated with someone who had “it”.  But what I learned was that these human beings were going through horrific, long deaths, that left them just alive enough to realize they were never going to be OK, and that they’d been abandoned.  Why  shun those who need compassion?  Would Jesus do that?   I also learned about the dangers of stereotyping when an entire heterosexual and monogamous  family died from AIDS after the wife gave birth to the son, but needed a blood transfusion- with blood that wasn’t tested for the virus back then- then breastfed her son, and had normal sex with her husband.  All three died.  Nothing they did had them ‘in the closet’, or on anybody’s ‘judgement’ list.   I was beginning to understand that things weren’t always ‘this or that’, ‘black or white’, or even ‘because of’ assumptions.   All of these people had names and stories, and there simply wasn’t time or desire to judge or hate.  They needed compassion.  Why not just reach out to anybody who is hurting, without judging?

Why are LGBTQ and abortion the only issues that fire up evangelicals ?  Of course, life is precious. Yes, the Bible talks about homosexuality. But what about those babies who need healthcare throughout their life? Then it’s more like evangelicals are pro-birth. Not the church’s problem after that.  Why doesn’t everyone deserve healthcare?  Would Jesus turn away someone who was sick?  Who are we to ‘declare’ that some deserve healthcare, and some don’t?  What about equality among races? What about the issues with guns, prison reform, education reform, cleaning up the history books, etc?  What about OTHER issues and sins?  We all sin. We all will sin again. No sin is worse than others, except for one. We need to clean our own side of the street. We all need to confess our sins, and ask for the Holy Spirit to guide us. And it might take several times before we get some things under control- but we distract ourselves by looking at the faults of others when we have enough faults to sink our own ship.

https://bible.knowing-jesus.com/topics/Jesus-Healing

https://www.biblegateway.com/passage/?search=Matthew%205-7&version=NIV

Why the contempt for those who need help?   There is an assumption that the majority of those on welfare or food stamps are just bums who don’t want to work- which is cruel. Why  choose to believe the worst?   It takes a LOT of hassles to get help !  And even then, it’s a sub-poverty existence.  I’ve been on disability since 2004, and until I was eligible for Medicare 2 YEARS after getting Social Security Disability (not the same as the private employer-based disability insurance I paid for when I was working), I  would have had to spend $2000 per MONTH before I was eligible for Medicaid benefits. Each month.  That would have meant no apartment, utilities, medications, food, etc…  AND, you have to have an address, so if you live in the car, there’s no address, so no benefits.  So the government sets the income cut-offs for getting help  to exclude the majority of people who need help.    How does it make sense for someone who is medically disabled to not have access to medical care, including medications?    Why are only some people worth taking care of?   Would Christ look at someone who  is sick, hungry, naked, and/or homeless and kick them to the curb?   Not the Lord I learned about !  Remember the sheep and the goats?    There is some belief that people in this country are taken care of no matter what.  That is false !   People die here daily because they can’t afford medications or treatments.   And it’s not just cancer.   Why is that OK?  This was from 11 years ago- can you imagine what it is now during unemployment during the pandemic?

New study finds 45,000 deaths annually linked to lack of health coverage

Why can’t we just disagree, and not be told “Oh, it’s no big deal” (well, to me it might be !), or “get over it” (why should I, when the person who told me this is still complaining about Obama, and called Mrs. Obama the ‘n’ word repeatedly- from her evangelical tower?).   Why can’t we just understand that everybody views things in different ways EVEN when we all believe in God (for those who do) ?   There isn’t just one ‘flavor’ of Christian !!  It’s a little like the four gospels- each author had a different viewpoint, but that doesn’t make any of them wrong !    Matthew was a tax collector.  Mark never actually heard Jesus, but followed Peter, and interpreted for him when needed.  Luke was a doctor.  There is no consensus as to who specifically  wrote the Gospel of John- as well as 1 John, 2 John, 3 John, and Revelations.   But all four loved the Lord.  Why is it so hard for Christians to understand – and tolerate- that the belief in Christ is so much more important than the specific  issues that are argued about?

Why not believe in science?  Who do Christians think created EVERYTHING that scientists study?  What is wrong with using intelligence (God-given) to study things that God created, and then act on those discoveries?  If not, we’d still think leprosy was only good for a trip to a colony, a woman on her monthly cycle should be booted out of the common bed and any furniture for 7 days, be making our own candles for light, riding horses, and shrimp on the barbie would be taboo, among a bazillion other things. Those rules were given by God for the time period when there were no treatments for leprosy, no sanitary products, and no cure for hepatitis A, and the rest. Same with the kosher dietary laws- they are all health related.  You can ignore a tornado warning, and still get flattened. You can ignore science, and still have stuff happen.  The Bible didn’t say exactly HOW some of the things during End Times would happen… but I bet there will be some that are now able to be figured out through science- those who wrote the Bible only had their frame of reference.

Why has it all ended up like this?   And why does it seem like people would rather be nasty or “right”, or not understand that it’s OK not to agree on everything, even if we believe in the same God?   That one baffles me.  We are all PARTS of the same body.   I’m just glad that God knows my heart- and those who judge me are really judging themselves.   I might not tow the evangelical rope any longer (I prefer ‘non-denominational’)  but I still believe in the same God of my childhood… and miss those who were part of it. It saddens me that the toxicity definitely doesn’t seem to be even close to coming from God (my opinion- I get that, just as others get theirs)    Why is that so ‘bad’?   Why has it become so much more preferable to simply avoid humans who don’t agree, or not bother to get to know some of them?  The Great Commission would be a short assignment if all we do is preach to the choir.

Why do I never hear from folks who claimed to ask my dad about me, after I became disabled?  I tried calling a few, and reached out to the church when I was still able to leave home (this stay at home stuff has been my normal for 16 years). But out of sight, out of mind- and I’ve gotten used to it.  It’s OK now. I got tired of initiating everything… it was obvious I didn’t fit in anymore because I wasn’t just like them…those who had been church ‘family’.  Even something as non-threatening as being disabled is blown off. Fortunately, I grew up without siblings, so the dog and I get through the days just fine.  I thank God that He made me the way He did. In the long run, it really doesn’t matter what the excluders say.  God knows my heart, and feels my pain. And that  brings a lot of comfort.

I pray for all of the people I used to know. They were my frame of reference as a kid.   I wish them all the best in everything they do, and that God blesses them more than I can even begin to understand.  He is the author of love. He is the One who answers the ‘why’… though I may not get the answers as quickly as I’d like.  But I know He’s got all of it under control in His timing.

Updated for 2020.

Nobody ‘Deserves’ AIDS…

I was a young nurse in the late 80’s when AIDS was really exploding.  I’d hear some really snarky comments about ‘well, those guys deserve it’.  Really?  Looking back, with more years of experience and observation under my belt, I’ve got some questions about other people who may have deserved their ‘end’.

Look at the number of celebrities who have died from drug and alcohol abuse/addiction.  They must have ‘deserved’ it, eh?  John Kennedy, Jr.- risky flying conditions, he must have deserved to go down, too.  The guy who came up with the Atkins diet- he slipped on ice, fell and cracked his head a good one, and died as a result.  Must have deserved that.  You think they have nothing in common? Well, consider this:  all high risk actions have high risk consequences. Period. 

I grew up in an evangelical church, and know the stand on homosexuality from that arena.  There was no looking at the person aside from the actions that caused some to contract AIDS.  I got to know some of the AIDS victims (and yes- they were victims of a disease that is incredibly cruel).  Not everyone who got AIDS back then (and certainly not now) was gay. And even the gay guys deserved some compassion.  Hey, church- love others, right? Or just ‘some’ others?

I’ll never forget one guy; he’d been with us for several weeks, and was deteriorating.  The family wanted him to be ‘comfort care’, no heroics; the doctor wouldn’t write the order.  Now this guy was lucky to have anybody around at all. Most of them were alone after all of their ‘friends’ and ‘family’ bailed out on them after their diagnosis. The nurses were their only contact with other humans.  Anyway, one night this guy stroked.  It was bad. The doctor still wouldn’t write the ‘Do Not Resuscitate’ order, so if he had started going south (even more) we would have had to ‘code’ him.  I talked to the doctor, who was great with AIDS patients, and normally very realistic with prognoses. He still thought this guy would pull through, at least this time. The nurses knew he hadn’t had a seizure as the doc thought; the period of symptoms after the ‘seizure’ had lasted too long.  The night after the stroke, this patient started to look worse (hard to do).  His nurse that night was doing all she could to keep the guy from trying to take his last breath. There’s not much to do, really , but hope- and try nudging the bed now and then trying to stimulate a breath.  The family was pleading for us not to do anything, and the charge nurse was on the phone to the doc, letting him know that we were going to have to proceed with a code very shortly if he didn’t give us the order to let him go in peace.  Well, it got worse, and his nurse was to the point of putting a back board behind him (a hard, thick plastic board that provides a surface that allows chest compressions to ‘work’), and I was grabbing an oral airway (to keep his windpipe open until the code team got there and put a tube into his lungs)…we were literally seconds from starting a ‘Code Blue’.   As his nurse and I exchanged helpless glances, the charge nurse came in and said “We’re done.”, waving the written telephone order in one hand.   Everybody in the room exhaled a huge sigh of relief.  The patient was pronounced dead within a minute or two. And the family was the one around him instead of ‘strangers’ pounding on him when he took his last breath.  I still have a basket that the family had left full of candy…reminds me of him. That night was one that haunted me for a long time. I was 24 years old, and learning some really intense lessons.

Then there was the heterosexual guy who was in bad shape with AIDS.  He wasn’t going to live (as was the case with virtually %100 of AIDS patients in the early days).  His wife had contracted AIDS  from a blood transfusion after giving birth to their baby.  The wife and baby were already dead.  Blood supplies are tested now; they weren’t back then.  Her high risk behavior was to give birth. His high risk behavior was to love his wife in a faithful relationship.

The guy who was transferred up from ICU was really sad.  I was helping his nurse get him settled in the room. We were adjusting blankets, the TV, and making sure he had the urinal nearby. He couldn’t speak well, but nodded when he understood what we were saying.  Very pleasant guy, with considerable AIDS related brain damage.  Anyway, his nurse and I had finished getting him settled, and left the room. We had gotten about six feet down the hallway when we heard him cry out “Oh, no. Oh, no.”, so we immediately u-turned and went back in to the room.  The patient had wet the bed. He didn’t have the ability to react to the need to urinate and reach for the urinal anymore. When we got him up to the chair by the bed, so we could change the linen, he kept saying “I’m so bad. I’m so bad.”  It was heartbreaking.  He was so ashamed.

People can be all judgmental all over the place.  But be sure to include everyone on that list. Don’t just isolate one sin, and ignore the rest in your wrath and condescension.  We all needed Jesus to keep us from eternal damnation.  I don’t see anybody around me now who even comes close to having the right to damn someone for their actions.  If you do, there’s a preacher in Kansas you might enjoy.  He’s at a church with ‘Westboro’ in the name.  You know- the bunch that pickets military funerals?  For my fellow Christians, I’m not asking anybody to put blinders on and ignore the Bible. In fact, I’m asking you to live it.  Hate is a choice.  But so is love.  If Christians won’t step up and help those who really need the love of Christ, who will?  Nobody deserves to suffer, and everybody can be saved.  If the first thing you think of when you are reminded of a particular group of people is ‘sin’ and some form of judgement, then love isn’t the first thing on your heart.  I’ll pray for you.