Healthcare worker check in November 18, 2020 11:00 PM   Subscribe

Hey Metafilter healthcare workers, how you hanging in? You managing to look after yourself and stay safe? What’s been lifting your spirits and keeping you going? Alternatively what’s been absolute shit and can diaf?(besides the good sis covid of course.)
posted by supercrayon to MetaFilter-Related at 11:00 PM (24 comments total) 13 users marked this as a favorite

I have a job duty of trying identifying emergency contacts when we can't find an emergency contact for whatever reason, and more often than not I'm coming up empty. It usually gets resolved eventually, but in the moment it's such an important thing and i haven't been able to find anyone and i feel really bad about that.

I've spent alot of time taking with my social worker peers about COVID positive discharges. We are the primary way to help people apply for the public health provided services that assist with isolation /quarantine issues, were trained in the referral processes, know resources. We know that our population is primarily renters, low income, and many of them live in multi-generational households. We also have people who are homeless etc living in congregate settings or find shelter via public transit, bus stops, encampments, etc.

The number of referrals we are getting on the ER side is low. Our physicians and nurses are our eyes and ears on these things, but they are so overburdened and things are moving so fast that what happens after someone who is medically stable and COVID positive just isn't on their minds. So they go, and if they are in need maybe getting addressed, maybe not. Also reviews of referrals for these services isn't possible 24 hours a day, and keeping people on site when we need the beds is a balance, and these are tough decisions. Anyway, the question is there a way for us to increase awareness of these programs when people need to know about them? Is there a way to get fliers available? Is there a way to distribute that doesn't overburden staff? Is this even a thing we can handle if the referrals go up?

I'm also involved with child abuse cases, community and domestic violence resources , substance abuse stuff, and various other things like getting people home, homelessness resources, some emotional support things, just so much stuff. None of that stuff has stopped.

Anyway, I'm a mess. Personally I'm seeing alot of things, i want so hard to be able to be more involved and at the same time I'm like a witness who has zero control and it's just happening around me. I can't do anything particularly useful- nothing i do will change the course of the disease, I can't get more help for anyone, i can't do a job I'm simply not trained to do.

In addition my spouse needs alot of in home support right now, our daughter is 2.5 and she's a handful and very upset about changes and routines and pretty much anything that isn't exactly what she wants to do right now, and it's taking its toll on the both of us. We are fighting more. My ability to be emotionally present is compromised. Our families live states away in so that's out for support.

The annoying cherry on top is my PTSD from my life is revved really high, and it's a highly distracting to have intrusive thoughts about it pretty much all the time and just have to keep powering through them to do what i need to do. It's like this whole seperate world of emotional processing I'm doing, I'm pretty sure it's the helplessness of it all. Least i have therapy for that.

One day I'm going to have a good cry about this.

Thanks for asking. I really haven't been talking, and I'm sorry to just dump, but i didn't realize I've been just waiting for someone to ask.

Thanks to everyone and all that you do, i super appreciate the work, and the time you took to read if you read this.
posted by AlexiaSky at 12:27 AM on November 19, 2020 [94 favorites]

I'm happy that my clinical work is in-person. I think there's more depth to shared appreciation of colleagues, more cohesion among varied team members. I'm not a very social person, but it's nice to see people I don't live with sometimes.

I am angry at the ridiculous mix of restrictions and permissions for various activities and gatherings outside of work. Some very dangerous venues remain open for what seem to be political reasons.

I'm worried about the winter, and COVID surges in hospital, and about my own health. COVID could easily make me very, very sick based on my history. But I don't find it helpful to worry about that much, so I try to do my job, use PPE properly, and avoid potential community exposure.

The thread on the blue about the Atlantic article helped me appreciate how many of you have much more challenging situations, and it really seems to bring out the best in all of you. (I lurked.) Thanks for your work, including whatever you've had to do to take care of yourself and your loved ones. We live in some very strange times.

AlexiaSky, you are dealing with a lot, and I hope you can find some peace. I think your work is especially important even when it seems all jumbled from what you might usually do. Here, social work has similar challenges, and I think you and and your peers are particularly skilled at adapting to these strange times, even if it doesn't feel that way.
posted by sillyman at 5:23 AM on November 19, 2020 [21 favorites]

AlexiaSky, I'm glad you dumped, glad you got a chance to talk about that a bit. I'm sending great big hugs to you if you want them.

supercrayon, thank you so much for posting this, so we can offer a listening ear to MeFites who could use one right now.
posted by kristi at 8:37 AM on November 19, 2020 [12 favorites]

posted by dismas at 9:00 AM on November 19, 2020 [9 favorites]

I have two cousins, in another state, who are both nurses (and one is married to a respiratory therapist). I think about them a lot.

They're working so hard to take care of people who are so sick, and it makes me mad that some of their energy is going to people who denied that COVID was real, or who refused to take simple precautions like wearing a mask. I know that's part of the job, but it still feels like an insult.

I don't know what I can do to help besides keep my family home and wear a mask, so that's what I do.

Take care, y'all, and WEAR YOUR MASK & STAY HOME.
posted by wenestvedt at 10:07 AM on November 20, 2020 [5 favorites]

I'm a dentist, which, on the face of things, would be a pretty risky occupation, what with creating aerosol from the mouth with pretty much everything we do. Had I still been in my private practice, just up the road from Boeing in Mukilteo Wa., I might not have made it through last spring.

As chance and no small amount of foresight (for the climate around boeing at least, not coronavirus) might have it, I sold my practice fall of 2019 to work in public health with the Kalispel Tribe in Pend Oreille county washington, near the idaho border.

I saw the first reports out of China last January, and we had a team meeting about ordering a goodly supply of PPE -- thinking gloves and gowns not anticipating the N95 mask angle.

April and May were interesting, but we did manage our supply of PPE pretty well, and the Tribe and various grant agencies were super supportive in getting us air filtration units and allowing us to engineer both our work space and our patient load to maximize the safety of both the staff and our patient population.

I would say that my clinic is second only to my own home in being the safest place I spend time. We have a good mask protocol, and we spend at least 30 minutes every work day reviewing the latest info on covid19, from the increasing outbreak in our county, to the possibility of vaccines in the mid-future.

We share a building with a medical clinic, who test for, but do not treat covid19 patients. We have had 2 fatalities in our immediate area, but cases are continuing to rise because of our proximity to Idaho, where they are denying that covid is a thing (our county is also pretty rural, but also older, and these folks are pretty good about compliance).

The Native American community gets covid at 3x the national average, and die at 5x. We are all working very hard to keep them informed, safe and healthy, while protecting ourselves.
posted by OHenryPacey at 12:42 PM on November 20, 2020 [34 favorites]

Thanks for the updates, everyone. I’m not a health worker, I’m just somebody who is grateful that there are health workers. I can’t imagine how hard this is for all of you. Please hang in there!
posted by Bella Donna at 1:28 PM on November 20, 2020 [4 favorites]

One day I'm going to have a good cry about this.

Hello, it me. Except the crying won't come out. I think if it ever did, I would explode.

I'm a nurse, I work in a hospital, but not directly with Covid patients (my job is sort of case-management-adjacent). My hospital got through the spring wave of Covid mostly all right, but multiple staff members did get sick and some were out for a month or longer. We've had several major floods in our building due to the plumbing reaching its end of life, so now they're shutting down rooms in batches to work on that, which is at least better than the day there was 4 inches of standing water in the ICU ...

I live alone, so in a way I'm glad that I have to go to work, because at least I see other people there. However, some maniac decided that last week was a good time to starting playing Christmas music in the cafeteria! Now every day I try to find someplace to sit and eat where I can't hear that stuff, because [redacted for excessively violent thoughts].

My cats are mostly lovely, except I can't clip their back claws without another person to help, so my belly and legs are covered with little punctures.

I'm tired of all this. There's no one to get a hug from. And I can't cry.
posted by shiny blue object at 7:25 PM on November 21, 2020 [13 favorites]

Thank you for this post, it really means a lot. I also appreciate seeing all the posts on AskMeFi, where posters ask if they can travel or socialize with others, and people kindly discourage them and point out the risks. This site has been a great distraction and source of community and support, even though I'm not a very active poster, so thank you, MeFites. As to the original question of how I am doing...

I am an MD in the US. I do not work in an inpatient setting. I am not working in a specialty that would directly treat patients for COVID (though both staff and patients in my organization have had exposures/cases). I am able to work remotely through telehealth part of the time (though still going in at least one day a week). That is to say, in terms of being a healthcare provider, I'm several ranks removed from "front line", and I am still more stressed out than I have ever been in my life. I'm constantly worried that one of our staff is going to get sick, we'll all have been exposed, and we won't be able to operate and provide care for folks who need it. Many of my friends from medical school are working in healthcare settings and states with much higher risk circumstances than mine, and the general themes I am seeing on social media are that all of us are scared and heartbroken and trying to sound the alarm that the situation we were all fearing in March is happening now, and begging our family and friends to not gather over Thanksgiving. So, I am doing "anxious". With a large side of "guilty" about being this anxious, because I still have a job, and that's only one way I am more privileged and/or fortunate than a lot of other folks these days.

Again, thank you for this post, and like AlexiaSky, sorry to dump. Masked, distanced, figurative air-hugs to you all. Stay safe out there.
posted by alygator at 9:09 PM on November 21, 2020 [12 favorites]

I'm tired of all this. There's no one to get a hug from. And I can't cry.

Flagged as fantastic. It sums up what I have been feeling and haven't been able to articulate. Thank you, shiny blue object.

I'm tech support, so have minimal contact with patients, but am in and out of clinics and hospitals (and the morgue) daily.

This is not easy.

Yet, we're getting through it.

HCWs, generally speaking are compassionate by nature. I have only seen more compassion for other staff as well as for those we care for in this time. I don't know where everyone is getting their emotional battery recharged.

Nevertheless, we persist.
posted by a non mouse, a cow herd at 6:09 AM on November 22, 2020 [4 favorites]

I am a doc in Poland.

The first wave in the spring was treated very seriously by both the health authorities/government and society. We had a short lock-down and a universal mask mandate (initially outdoors as well as indoors, then indoors only) in March/April. I literally never saw a single COVID patient in my hospital (that I knew of).

Then the summer was a trickle of cases but people just went back to life as usual. Right at the beginning of summer, the PM said there was no need to fear the virus any more and he was GLAD to see so many people not wearing masks. People truly felt we had beaten the pandemic. Yeah, no.

It all went downhill after school started in September. Like, we went from hardly remembering there was a pandemic to almost everyone personally knowing several people who died and dozens who were/had been sick.

Now it's bad. Ambulances being refused in the ERs bad. Go somewhere else with your crashing patient, we have no ICU beds bad. Smaller hospitals running out of oxygen bad.

I am working in a non-COVID unit but since my hospital needs to open two more COVID units I am just waiting until I get transferred. I am stressed since it will be a brand new unit staffed by a very small staff of people pulled from different units, with complete staff change every week.
The COVID units are two buildings away from the ICU and we won't have anesthetists on staff so I'm worried about having enough support. I think I wouldn't worry half as much if I knew I would be working with people I know and trust since we pretty much have to hit the floor running. My heart goes out to all the healthcare workers in the hardest hit areas.

Hugs to all of you.
posted by M. at 1:02 PM on November 22, 2020 [16 favorites]

I’m an OR nurse at a county-run Level I trauma center.

Our community prevalence is among the lowest in the nation, a fact for which I am deeply grateful and which I suspect is the only thing that’s kept me and my colleagues safe so far.

Our traumas, the constant parade of GSWs and stabbings and pedestrian-versus-auto and jumpers, aren’t tested—there’s no time. Our urgent cases are tested in the ED using a rapid antigen test known to have a high false-negative rate. Our scheduled cases are tested as outpatients some time during the seven days prior to their surgery. They spend the time between their test and their surgery at home, where they’re told to follow the same mask and social distancing protocols as the rest of the public. So of course that means they’re just as likely as anyone else these days to be contracting the virus. They aren’t tested again, but we’re supposed to choose our PPE based on their test result, which is every bit as absurd as it sounds.

One of my roles in the OR is to assist the anesthesia providers during intubation and extubation. During those processes, which are the very definition of an aerosolizing procedure, I’m inches from the patient’s airway.

That’s not to say that everyone on the unit isn’t, to a lesser extent, because the air in each OR is positive pressure relative to the surrounding hallways and rooms. Any time an OR door opens, air flows outward, directly into the face of the person walking into the room. When we mentioned this to infection control, they told us just to open and close the doors quickly and we should be OK.

It took the contact tracers ten days to tell me that the mother of one of my pediatric patients had covid. Normally we don’t allow visitors in the preoperative area but we made an exception for her. She and I were both wearing ear loop isolation masks during our encounter, but we were closer than 6’ for longer than 15 minutes, talking the whole time. Because we were both masked, occupational health said it didn’t actually constitute an occupational exposure and told me I didn’t need a test.

I am so fucking terrified of what it’s going to be like two weeks after Thanksgiving.
posted by jesourie at 6:18 PM on November 23, 2020 [14 favorites]

I, like alygator, am an outpatient specialist and several degrees removed from the frontlines. I am in NC, in one of the few parts of the state that has been okayish about masks, but we had to hire bouncers this spring for our clinic. (All the bars were closed anyway.)

I almost certainly had covid. I had been on vacation (in Spain!) in late February/early March, and flew home on a Sunday, developed a horrible sore throat on Wednesday, followed by several days of, um, GI distress. No fever; I'd been self monitoring since the night I got home.

I started quarantine on Thursday of that week; got pushback from administration about canceling clinics, but within days, as the rest of the country shut down, they lay off me. My social worker dropped off a care package, because social workers are awesome. 😊

Despite being a health care worker and recent travel to a hot-spot, I could not get a test; I couldn't even get a call back from employee health. I looked into getting antibody testing, but as it wouldn't change masking protocol I decided it wasn't worth the cost.

If that was my bout with covid, I'll count myself lucky. But I'm hearing so many reports of reinfection that I don't even know if we can pin our hopes on vaccines.

While I was quarantined, I tried to be productive and relearn ICU care, which I hated as a resident and still hate. I feel guilty admitting that I would be a disaster if redeployed. I don't know if I'd quit over it. But this is increasingly feeling like trench warfare, in that there are a bunch of administrative man-babies* working from home, and the rest of us are cannon fodder.

* Notable exception for Dr Anthony Fauci. He may be an administrator but he is also a national treasure.
posted by basalganglia at 3:09 AM on November 25, 2020 [12 favorites]

OK this morning's covid debrief email included a link to a snazzy cartoon about how the staffing shortages are our fault for daring to get sick through occupational exposures.

Who else would like to join me in burning it all down?
posted by basalganglia at 4:27 AM on November 25, 2020 [19 favorites]

I'm too far away to join you in burning it all down but I'd like to see that cartoon. I find anger to be a useful distraction from anxiety.
posted by M. at 5:22 AM on November 25, 2020 [1 favorite]

...I mean, at least they're acknowledging that occupational transmissions happen? In my place, they're keeping the numbers artificially low by claiming that as long as you were wearing an N95 and eye protection, you must have gotten it in the community. Even if you were, say, putting a trach in a covid+ patient.

Speaking of trachs, when we do them on covid+ patients the anesthesia team and the surgeons wear PAPRs, but the nursing team (circulator AND scrub!) just get N95s, because according to nursing management we aren't trained to use PAPRs, nursing doesn't have their own supply of PAPRs, and it isn't our policy.

Our anesthesia providers, who were visibly shaken and upset by the idea that the scrub nurse should get less protection than the rest of the people scrubbed in for the procedure, immediately offered to let us use theirs and help us don and doff them correctly, because of course that's the correct solution, but nursing management shut them down.
posted by jesourie at 9:07 AM on November 26, 2020 [15 favorites]

That’s fucking awful jesourie. I’ve run across similar experiences internationally, where nurses are afforded a lower level of protection and then if they try to ameliorate this they’re reprimanded. Clinicians on the frontline should be the ones making decisions anout their safety and bodily autonomy, not some bureaucrat riding a desk eight layers up the food chain.

Btw thanks to anyone working today, I hope you are staying safe and that Americans stay the fuck at home.
posted by supercrayon at 9:16 AM on November 26, 2020 [3 favorites]

Fellow nurses and healthcare workers: I mentioned this in the healthcare threads but I'll say it here too. If anyone here thinks talking to coworkers and working together to pressure our employers to provide adequate protections, leave and pay is a good idea, I can help connect you to a network of other nurses who are doing the same. Please message me!
posted by latkes at 9:23 AM on November 26, 2020 [9 favorites]

So, at the same time the CFO of the hospital system where I work is sending out emails talking about how well the company is weathering the COVID crises, so much so that they are returning some of the federal bailout money provided by the government, they are also using stalling tactics in negotiating with the union on our new contract, offering a 1 percent wage increase per year for the next three years (compared to the 3 percent in the current contract,) threatening to increase healthcare premiums, and to discontinue weekend shift differentials. At the height of the pandemic panic in March/April/May, the hospital was covered with signs praising nurses as super heros. Now we see how much we super heros are worth, apparently.
posted by WhenInGnome at 2:56 PM on November 26, 2020 [12 favorites]

I've been avoiding dropping into this thread because I have survivor's guilt, but goddamn did I pick the right year to step back from meatball primary care in the safety net to go and get my master's degree in health administration. I was pretty quickly fired (or pressured to resign some would say) after I told my administrators that they were failing at their jobs and I was going to learn how to do it myself. I spent most of the last year doing my school and the kids' home school while managing to find time to staff the county health department's COVID hotline from home and continue to staff heroin treatment at a homeless service center. But like 3 months before the pandemic broke I was attending on the wards at the largest hospital in downtown Seattle and I know what it's like there now

I have posted a million times about my semi-famous wife who is head of infectious disease at the county hospital and she has been doing amazing work, from running clinical trials to allocating remdesivir to now helping determine vaccine allocation. My family has seen so much less of her this year, and so much more of each other, and she has become this bitter, easily annoyed husk of health care provider. She would deny it, but it's obvious, especially since she's the kind of person whose personability and good cheer have carried her far in her career. Because she's critical leadership, she didn't have the mandatory 2 week furlough everyone at the hospital got over the summer, but she did get the pay cut. As others have pointed out, this is how we treat health care heroes.

The incompetent ninnies at my old place of employ, the largest primary care safety net in Seattle, never did get it together enough to offer COVID testing, and there have been lay-offs. The most notable of which was the CEO who, late into the pandemic was canned in the worst way. Like employees got an email saying "effective immediately, so and so won't be coming to work any more."

Meanwhile, I wasn't even looking for a job, because our two kids in home school have developed panic attacks and serious depression. But somewhat out of the blue, someone called me up and said "Hey, here's a boatload of money, we read some of your ideas about health care, and we want you to design, build, and run a primary care clinic designed to meet the needs of the seriously mentally ill, chemically dependent, and unstably housed people our agency serves." I tried really hard to figure out what the catch was, but there wasn't one. I still feel like I am dreaming.

So now I am a dreaded administrator, although my job is theoretically 70% clinical. By necessity, we are emphasizing telemedicine and screening out people who might have COVID to testing off site. The kind of crazy thing, we expected COVID to hit the marginalized and homeless really hard, but the reality is we are seeing little of it. Because the rest of society wants to socially distance from them. That, and the fact that they don't travel, go to work, or gather in large numbers. Also, THEY ALL WEAR THEIR GODDAMN MASKS LIKE THEY ARE TOLD BECAUSE THEY AREN'T IDIOT PRIVILEGED FUCKS WHO ASSUME THEY'LL BE FINE when the worst happens.

But there I was at work on Tuesday, kind of slogging through COVID related staffing shortages and trying to hire people into the most unpopular and hazardous industry in the country right now when I received a phone call from our in house pharmacy supplier. They are receiving a shipment of the COVID 19 vaccine in mid-December and they wanted to know how many doses we thought we would need. It was like a splash of cold water in the face. It's really happening, and it's happening soon. The reality is, that I looked at WA state's allocation numbers and did some quick math and I don't we will be (nor should be) in the first allocation, but still. First piece of not-awful news yet about this fucking thing.
posted by Slarty Bartfast at 5:26 PM on November 27, 2020 [25 favorites]

It’s hard to make non-healthcare people understand, but that Blue Angels flyover Trump
gave us is starting to wear off.
posted by Slarty Bartfast at 9:05 PM on November 27, 2020 [1 favorite]

I have a friend who is a nurse at what used to be a retirement age assisted living facility. Now it is an overflow whatever facility. He's the only person with a medical degree most nights he works and he's had six nights off since April. 70 beds.

The facility has yet to have a covid case but they started having fentanyl overdoses so I volunteered to sit in the woods behind the place and help figure out how it was getting in. Nobody drops their blinds on that side of the building at night and I could see my friend moving room to room and he never stopped for each of the five nights it took to catch the fentanyl people.

He is continent and wears diapers and is not embarassed about it. He is too tired to cook or do laundry so he just kept buying clothes. Sometimes he sleeps in the lot there cause he is too tired to drive home. He has expired tags on his car because emissions and no time to look into it so he gets tickets.

I had no idea until I sat in those woods those nights. I used his car to warm up and snooped. He takes samples to the lab when he gets off work. There was a new box of scrubs in the back seat and he eats drive thru.

I do his laundry now. He resisted at first but I like him and I have his spare keys and one more person's laundry is nothing to me. His pockets are full of gloves and masks and pills so I have to be thorough or it makes a mess in the dryer.

So there is a laundry here that will wash and fold and they sell gift certificates. I didn't get one for him cause if I do his laundry I actually get to talk to him every week but that's what I would get him otherwise.

When covid hit, the nurses at Mission were trying to unionize and late night I was ridesharing HCA execs sent here specifically to thwart that and they would be on their way from the good restaurants to the good hotels talking strategy on the phone and at one point they were actually debating whether the nurses should be allowed to wear masks in public areas of the hospital. That was April/May and I was also driving the commie nurses early morning and I had dashcam audio to share with them.

So laundry and healthy food and volunteer security and corporate espionage are pretty popular with nurses these days. Sounds wrong to me too.
posted by Mr. Yuck at 6:05 PM on November 28, 2020 [13 favorites]

I can't think too much about the vaccine. Like, the idea crosses my mind and I just... blank it out. It feels too dangerous to get my hopes up.

And it probably won't help me, personally, anyway. I take Rituxan twice a year to manage my MS, and it works great for me. My MRIs are stable, I have no new symptoms, the whole shebang. It's the best possible outcome and I actively look forward to my twice yearly appointments.

Thing is, one of the known side effects of Rituxan is a poor response to vaccines since Rituxan destroys all circulating B cells that express CD20. The recommendation is that any vaccines be given four weeks before getting a Rituxan infusion.

My most recent infusion was just about a month ago, so in terms of efficacy it's probably the worst possible time for me to be vaccinated against anything.

I keep vacillating back and forth between getting vaccinated now anyway, because even an attenuated response seems better than nothing, and deferring until four weeks before before my next infusion (the middle of April). I don't want to get vaccinated mid-December if I'm unlikely to have a meaningful response--it feels wasteful and selfish when doses are still in limited supply. But I also don't want to miss my chance entirely--who knows what supply might be like in April?

It seems like lots of people have been thinking about early access to a vaccine as their reward, their pot of gold at the end of this ridiculously shitty pandemic rainbow, and while I'm genuinely, breathtakingly relieved for my colleagues who stand to benefit from a vaccine, it does suck a whole lot to be denied the same feeling of relief for myself.
posted by jesourie at 12:31 PM on November 29, 2020 [2 favorites]

I’m an end of life/palliative RN, my office is in the covid unit. Coworkers I care about deeply are in our icu or transferred out for ecmo because not many places do that in Vegas. I was in the vaccine trial and got antibody tested on my own a month after my lady injection; I have antibodies. So now I’m not scared for me but the grind of so many prolonged and awful deaths is getting to me. My usual caseload is around 20 patients, yesterday it was 45. I’m angry mostly. I’m not sure I can do this all winter.
posted by yodelingisfun at 7:40 AM on December 1, 2020 [3 favorites]

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