So You Think That Bars Being Open Is More Important Than Following CDC Guidelines

I’m thinking about Texas since I lived there for 17 years, but goes for any state with morons.  So, you know, everywhere…  I worked as an RN in Austin, a town in The Hill Country, and know people all over the state.  But the principles are the same.

Has all of this COVID-19 stuff been a big wet rag on life as you knew it?   Probably. Are you too young to know that when you’re actually grown, a year is nothing? Likely.  It’s one set of holidays and work weeks (if you’re not still living in your parents’ basement).  Are you old enough to know that this isn’t how you want life to be?  Yup. But here’s the thing… if you don’t follow the guidelines, the only thing in your future that people will think of is your funeral. And they’ll talk about how you wasted your life over a mask. A 50cent mask.  That’s the price you put on your own life. I’d have said at least a buck.

Do you know what happens when someone is sick in a hospital whose capacity has been exploded beyond what they can deal with like they normally would?  If you’re lucky, you get a new oxygen mask/cannula every week like normal- but with shortages, you may have the same snotty one for many weeks. Someone will pick the boogers out now and then with a needle.  If you end up on a ventilator (vent, from here on out), you will be knocked out. You won’t have a clue- until they run out of the medications used to make being on a vent tolerable (vents hurt, and the more pressure needed as your lungs stiffen up from damage caused by COVID-19,  the more it hurts- so you are knocked out for comfort reasons).  Then you’ll have a big clue- because you will be tied to the bed so you can’t remove the tube going down your throat  into your ratty, stiff lungs. You’ll know everything that’s going on, and each time the vent gives you a breath, you will want to scream.  But that can’t happen when there’s a tube between your vocal cords. You won’t have any family or friends around during this, unless they’re dying in the next bed- and they’re no good to you then.  The patients in this video are so quiet- because they don’t have the the ability to get a good enough breath to speak…

SO, are ya having fun yet?   Excruciating pain, tied to the bed, with a tube the size of your little finger ramming air every 3 seconds or so, into your restricted lungs ?  Sounds like a party to me!   You’ll have a catheter going into your bladder to drain urine (which, if you’re not familiar with catheters, is put in the same hole you’re used to urine coming out of), until your kidneys fail- and then dialysis until it quits working, after which you’ll die over a week or two max. It won’t be fast, but long enough to wish every second that you’d made different choices since they ran out of the good drugs a week before you started circling the drain. . You’ll also feel every time they have to stick a needle into your wrist, so they can see if you have enough oxygen in your blood- not just the little painless oxygen saturation monitor. You. Will. Hurt. Like. Hell.    But, go ahead, make plans to be in close proximity to those not wearing masks- and you could bring it home to your family.  Any one of those you’re eager to get rid of?  No guarantee the ones you like won’t get it instead.  And no guarantee the refrigerated truck will have enough juice to keep all of the bodies cool enough to get to the funeral home, who only has time to stick you in a box and put you in a public grave- to be sorted out later.  The bodies are piling up too fast for proper identification by family, and families aren’t allowed in the trucks.  SO, you end up in a mass grave. Until someone fishes your soggy boxed body out of the dirt in several months. Think this is too dramatic?  These guys got the only trucks they could find- unrefrigerated.  They did the best they could.  And you could end up in a truck like this… your body decomposing so that fluids drip out of the truck.

Maybe you could ask the state to let you hang out in one place to drink and party.  Those ICE Detention Centers should be empty soon. In theory, they could be used for people who don’t think the rules should apply to them.   Cages sound appropriate for you. Here’s the thing, though.  Nobody leaves until everybody tests negative, which doesn’t start until after the initial 14 day quarantine. If you get sick during the time nobody can leave, you get no care at  all (which is fair no matter where you are- why should the ones bucking the guidelines who get sick get the last vent over someone who has followed every CDC guideline, and was made sick by a jerk like you?).  If you get sick in the detention center, you might skate through with something that feels like a bad flu- or you could end up dying after days of gasping for air.  Your body will begin to decompose, and the smell of putrification will sting the nose of anybody still alert enough to notice.  It will be like a hot August afternoon on a Texas backroad where 3 adult deer were hit by a truck three days earlier. Times however many people have croaked at the center who are also rotting.

Maybe you’re one of those ‘spiritual’ sorts who gets wasted on Friday night, so the hangover is gone by Sunday morning and you can pass muster at church- which is also blowing off public health.  I’m a Christian; I grew up in a church I loved going to several times a week. If your faith isn’t strong enough to go without being in a particular building once a week (minimum), then the virus guidelines aren’t the biggest issue in your church career.  Church isn’t a building. It’s the people in it. You can come up with some creative ways to worship and still live. Is ‘fellowship’ important?  Yup. But would God give you a  brain to understand scientists who study the things He created?  I think He’d be mortified He gave you a brain at all.

What about what happens after you test negative?  Well, the full story isn’t really known since this isn’t a virus anybody has seen before all of this started.  Lung damage is likely from what is known. And more is coming out about brain damage. That could mean seizures (so medication and no booze for the rest of your life), or worse- as in staring off into space, wearing diapers that your friend from high school that you hated is changing, because she went to nursing school while you were boozing it up at the bar during a pandemic.  Sound fun?  Your petty dislike of that high school adversary changing your drawers, wiping crap off of your butt, and then putting moisture barrier cream on your nether regions , to prevent you from getting DIAPER RASH?  At age 21 ?    Your. Life. Will. Be. Over. As. You. Know. It.

Or, you could wear the mask for however long it takes to protect yourself, AND those around you, and live long enough to celebrate at the bar when the virus is less of a risk than falling off of the barstool.  If you’re still wanting to do what you want when you want (because you’re a selfish brat that acts like you’re still 3 years old), then you could speed things up and go sit in a low-water crossing during a gully-washer.  None of those who drown thought it would happen to them, either- and how many of you (in TX for sure) know someone, or know someone who knew someone who was swept away during a flash flood?   People will still talk about how stupid you were at your funeral (if they find your body), but at least there will be people you didn’t contaminate, still alive, to pay their respects.

Grow up – or become the poster child for birth control.

What happens to a body when the morgues and funeral homes are overrun? Search for “Farm of Rotting Bodies in Tennessee”.   Warning – it’s very graphic.

 

What You Do IS Enough- COVID-19 Has Tied Your Hands

To all of the essential workers- 

You can only do what  you can do.

You are making a huge difference .

You are helping keep things from getting worse.

You were not given any choice in how this virus works.

You can’t control how it impacts a specific person.

Even what feels like a small kindness might be the last kindness someone knows- and THAT is huge.  

This will not last forever, but your work will. Every time you hold a hand, or wipe a tear, every time you give someone news – good or bad- the way you do that will be what someone remembers about such a horrific time.  You make the ultimate difference in the healing of a family who wasn’t able to be with their loved one.  For those who are working in non-medical areas, your work keeps those at home safe. You keep more people from getting sick.

That is one incredible legacy.    This one ratty, disabled RN would be proud to stand with you any day of the week. YOU are redefining the industry where you work.  And you are not forgotten.

“What lies behind us and what lies before us are tiny matters compared to what lies within us.”
– Ralph Waldo Emerson

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?