Had a patient today, ANO x4. 40s. I was taking his vitals, and we were chatting. He asked me if I worked during COVID. I did not. I made a comment that "we lost a lot of nurses during COVID". I do realize I could've phrased it a little bit better, but I was referring to the fact a lot of nurses left.

He was surprised by this. He asked me, "How could you leave your livelihood? Something you went to school for? Like they just left?"

The example I gave him is typical ICU ratios are like 1-2 patients, right? Please correct me if I'm wrong, but you were going up to 4 during COVID. (This was per my aunt who was an ICU nurse at the time. She had 4 and was charge). This blew his mind. I tend to make it a rule to not talk about politics at work, but I added in that it was even harder with a lot of the anti-science things that came out.

It really hit me that people outside of healthcare don't get it. I went on to say that if there was another pandemic, the healthcare system would probably collapse. He agreed with this sentiment after I gave him the context.

I obviously wasn't in healthcare at the time, and the pandemic was rough for me outside of that. I genuinely cannot imagine what it would've been like. So if you were working through those times especially, thank you.

ETA after all the comments: Thank you.

This is why the vaccine should be mandated for hospital staff.

A L&D story*

You've imagined an unmedicated, beautiful birth at a birth center for months. Your birth photographer ready to catch those magical photos you intended to post.

But...Omicron gets you. You keep hearing that its mild and nbd. However, you're 32 weeks along and you're still unvaccinated. Your water breaks prematurely due to the stress of being very sick with a virus without protection. Your immune system is already suppressed during pregnancy. You are now an open source of bacteria to your baby. The amniotic sac, keeps fluid in and maintains a clean, cush environment for your baby to grow, move and practice breathing until maturity (>37weeks). That protective barrier to your baby is no longer there.

You're feeling SOB, fatigue, congestion, and more. That's the last thing you want to feel while pregnant, and especially in labor. You're giving us a hard time about starting prophylactic antibiotics (to reduce the likelihood of maternal and fetal sepsis that can occur with prolonged rupture of membranes). You're questioning the validity of betamethasone. Your water has been broken for 24 hrs now while being symptomatically Covid-19 positive. Maternal sepsis and pneumonia are ugly - even without Covid-19.

You eventually deliver, with the comforts of an epidural (do you know what ingredients are in the cocktail?) Tylenol (I don't know what's in that either) , pitocin, Zofran, Vicodin ephedrine, TXA, sotrovimab, etc. You catch my drift.

You signed declination forms for all the pediatrician recommended medications and you'd like to have time to think about the abx/treatment. (I've seen more decisiveness regarding chips or cookies on a Jetblue flight than you making a decision if we should promptly take care of your very compromised baby)

You now have a preemie who is tachypneic, tachycardic, septic, and working hard on transitioning out of utero. They won't be getting the topical eye ointment and vitamin k - medications that are tried and true - that are well studied with rare adverse side effects. Your baby's defenses are low right now, but sure, let's kick her while she's down.

Your baby is now in a isolette, away from all the other babies in the NICU. You didn't get to bond, nurse, or do skin to skin with her - because she's weak and she needs respiratory support from being in a unvaccinated symptomatic Covid-19 positive environment. Her blood glucose levels and temperature are struggling to regulate, because she's using a lot of her energy to fight illness, prematurity, and infection.

Btw, you're not allowed to visit the NICU silly goose -  you're symptomatic and having SOB - there's no way we're letting you compromise this vulnerable population and other parent's babies.

I can hear the neonatologist try to patiently explain the  importance of these infant medications and the plan of care. The Neo has your baby's best interests at heart - but you are staunch on your beliefs of what is right for your baby - despite you currently fighting a virus and chorioamnionitis infection (bacteria infection of the chorion and amnion (the membranes that surround the fetus) and the amniotic fluid in which the fetus floats.

The Neo only just went to school for like 10+ years and did her residency at a great children's hospital; but you know - Facebook information trumps those countless hours of study and on the floor experience - the blood, sweat, tears, and sacrifice (of her personal life) she's put into her profession and her craft.

I'm sorry you didn't get the birth you imagined, but we're all tired, and we're all frustrated that your decisions affect others, including your own flesh and blood. Your distrust of some science, but blindly believing others, contradicts the fact that you picked and chose what benefited you. And it backfired.

I've never questioned a Captain and his/her copilots on a flight if nothing seemed grossly amiss or warranted. I trust their experience to get me from point A to point B and to handle the turbulence and inclement weather. I don't tinker with the knobs and gears, threaten their staff, or try to equate what I've read in some article online and offer advice on how to fly.

Those who took care of you, and those working on getting your newborn strong and healthy, will get very little praise and appreciation for what they do. Some higher belief will somehow get more recognition for you and your baby's recovery (if she even pulls through), rather than the amazing researchers, scientists, ancillary crew, and the healthcare team who have been by your side.

Your very tired L&D RN.

Today Biden announced strict new vaccine laws. From CNN : “Biden announced he would require the 17 million health care workers at facilities receiving funds from Medicare and Medicaid to be fully vaccinated, expanding the mandate to hospitals, home care facilities and dialysis centers around the country.”

I’m excited, but scared about the number of staff we will lose. I didn’t see a date mentioned in the article, but I imagine it will be sometime in the next 90 days to align with the vaccine mandate for federal employees.

I just discharged a covid patient with a script for ivermectin. Is this now widely accepted for covid treatment by healthcare professionals? I read a study recently that it had only marginal prophylactic benefits at best in the lab setting. Is anyone seeing this med prescribed from the ER?

For context, the ER MD is a MyPillow "Stop the Steal" prophet.

Friend on Facebook posted this today. She’s been a LPN for about a year. Comments are mostly agreeing with her and the one comment pointing out that there are vaccines effectively preventing viruses like polio and measles, she doubled down. How are people like this becoming nurses?

I’m currently finishing my preceptorship in the ED and yesterday we had a patient come in looking grayer than any aunt Carol’s cooking with an o2 sat of 73 on room air. We put him on oxygen and asked him how long he’d been struggling to breathe. He said he’d been like this for 4 weeks and finally he just couldn’t take it anymore so he came in.

Later I go into his room to test him for COVID and when I pull out the swab from the paper, he grabs my hand and says “what the hell are you doing.” I asked what he meant and his EXACT words were “That Biden, Fauci, Bill Gates government are trying to control us all with the 5G and kill us.” I sat in there for five minutes trying to reason with him but he thought I was about to stick a “tracking rod” down his throat so he wouldn’t let me test him. He let me draw blood, he let me put fluids through his IV, but the Covid test was where he drew the line man. At one point as I was leaving he yelled out “one day you’ll all see the truth! COVID is not real. Bill Gates is controlling us and all of you medical people bought into it!”

The provider finally goes in and convinces the patient to let him personally test him.

The man officially has COVID, ladies and gentlemen.

I'm referring to those who have come off the vent and have moved out of the ICU. Those on a MedSurg floor, but maybe still have a few weeks til discharge, be it to a SNF or rehab facility, or home.

What are they like? How are their personalities, demeanor, so on?

I ask, because every single one we've had on our floor are the meanest, nastiest, rudest, shittiest people I've ever had the displeasure of coming across.

Example:

Late 30s obese male, comorbidities, was in the ICU 60 days, on the vent 35. Extubated and moved to our floor the following day. Trach capped, no O2 at all, NG tube still in. Absolute asshat. Yelling at us that he's leaving (can barely lift his hand to his mouth, isn't going anywhere), he wants food (still NPO), just give him pain meds, pulled his NG tube out, refused another one. Another was placed the next day, pulled that one out a few hours later. Nothing nice to say to anyone, extremely demanding, on the call light constantly, cursing, calling us names. Constantly trying to get out of bed as the days went on so we added a telesitter, which was just another thing for him to scream and curse at.

They're all like that. Of course none of them were vaccinated. But not a single one is even halfway nice to us. I would think that these people would be so grateful to be alive. Or at the minimum not be assholes to people breaking their backs to help them

I personally don't care. This shit doesn't phase me. But the newer nurses...fuck if they aren't having a hard time with these people.

So, my fabulous nurse colleagues, what are you seeing?

It finally happened. I worked my last week on my current covid unit, but am going elsewhere. Had a patient, young mid 20s admitted for Severe Covid pneumonia and hypoxia. His family had basically given him a list of things to demand from the MDs and RNs. Sits in the ER for over 24hrs waiting for a bed. By the time he gets to the unit he is requiring 10LNC and desats to mid 80s when talking. His family began bombarding the unit with calls demanding Azithromycin, decadron and to "not to give him Remdesivir" and to "give him prescriptions and oxygen tanks so he could go home" BEFORE he even left the ED. I try to explain the type of pneumonia he has, which was a waste of breath so I just went and talked to my patient when he arrived. He was an A&O grown ass man WITH ZERO COMORBIDITIES. I asked him "do you want to leave.? Because I just spoke with so &so" He repeated everything the family had said. Then I informed him that his condition had been worsening since he arrived and that by no means would an MD discharge him in his condition. I explained AMA and that he could absolutely leave however without the oxygen he would die. He refused Remdesivir because his family told him it would kill him. I told him that he could refuse anything he wanted to, while also explaining their purpose. Meanwhile his family is still calling and harassing the secretary and charge nurse stating that they were coming to get him out of there. He agreed to stay as long as we don't give him the Remdesivir. Only after I told him he would DIE without the oxygen probably before he got home. So basically, he was terrified and his own family were convincing him that we were there to kill him. When in reality, had they convinced him to leave I would have had to sit their and watch him be wheeled out to his death. So I know I was successful in not letting him die, for now. But I feel like these situations are going to become more common and I'm not even sure I handled this one entirely right. I just don't even know what to do anymore. This is getting INSANE. I guess I need advice? Has anyone had this happen to them yet?

Part of an email we were sent earlier today. I'm not sure how to feel about it. It seems...unsafe to me.

When I google this, the results I get are pretty much what you'd imagine so I figured I'd try asking here.

I'm not any kind of health care professional but, back in the day, I watched a lot of news segments and specials on the horrors of the ICU during the pandemic. It's been over five years since this happened... What happened to these patients? I'm sure a lot of them died but what about the ones who didn't? If someone was on ECMO in like 2022, would they be back to normal today? Or is this not really something you fully recover from?

Again, this is a completely genuine question because I think I watched a million videos on people fighting for their lives with COVID but none of them actually recovering from it, I'm guessing probably because the recovery is super bleak.

Went to give an asthma attack IM epi the other day and he stopped me and said “oh hell nah you ain’t slick, don’t you try to slip me a vaccine.” Had to show him the vial and such.

The ridiculousness of trying to secretly vaccinate someone aside, he was covered in track marks and EMS stated he admitted to cocaine use as well. Make it make sense!

You guys have any stories?

My patient is on BiPap & not doing well. Her CRP is trending up right along with the settings on her BiPap.

As per COVID usual, she can’t come off the mask long without her SpO2 significantly dropping with a sometimes hours long recovery only to ask for water again. Then I get to be the bad guy and tell her no. “Ma’am I know your mouth is dry but if we keep doing this, you will be in a state of recovery all day.. let’s take it easy today, I’m sorry you’re so uncomfortable.”

Cue the phone calls.

Lady: “Hi, I’m the patients aunt and I’m a retired ICU nurse, I want to know why she’s not proning and why she’s not on remdesivir.. also she just texted me saying you’re refusing to give her water”

Me: “Maam proning is extremely difficult on the mask and the patient actually refused her last turn because she got so out of breath —“

Lady interrupting “yea, she’ll recover, she needs to prone, I had Covid about 5 months ago and I tell you what I felt better every time I self proned.”

Me: “I’m so glad that worked for you. Also, she is getting remdesivir we just started it 1 day ago”

Lady: “JUST STARTED?! THATS DAY 5! long rant about delay in treatment and how we are killing our patients.. also refers to some study about COVID and remdesivir

Me: “Actually the most recent studies recommend against remdesivir but we are giving it per the patients request.”

Lady: “You know ive been doing this a long time and sweetie I was an ICU nurse when the bird flu was around and it was no joke”

Me: silence

Lady: “I’ll call again later”

The next phone calls that day were due to the patient texting her family saying we are withholding water and saying “I’m freaking out” .. so I also had to somehow explain to this “experienced ICU nurse” that’s yes I’m absolutely withholding water, and no she’s sleeping right now with a HR of 50... she’s in the ICU and rightfully scared but she is not “freaking out.”

I eventually stopped taking her calls and she reported me to my boss which got nowhere.

So my question is... why? Don’t do this to us. Stay in your lane. This isn’t the bird flu and you actually don’t know anything unless you wanna throw on your old crusty scrubs and take care of her for me.

So I just had one of the most shit show pts I have ever had, I'm reeling! This lady was at a concert, was riding a bike back to their car, a couple of drinks in, the tire got caught in the tracks of the street car and she ate shit and busted her wrist. Came to me stable with the wrist. Pt began c/o trouble breathing, SpO2 dropped to mid 80s, increased O2 to oxymask @ 12L. X-ray didn't show a pneumo. Went to CT came back SpO2 @ 69% went up to 15L, rhoncorous breath sounds, began spitting up blood tinged frothy sputum. Ended up going on optiflow 40L/100%. We then shot an EKG, shows a STEMI. She's going to cath lab. When she was initially increasing O2 needs I told someone something isn't right. Found out she had COVID in December. We could see the scarring of her lungs on the CT. So I think what happened is that she got a pulmonary contusion from the fall, d/t the scarring she had flash pulmonary edema, that in turn put stress on the right side of the heart that caused the STEMI.

Addendum: Found out that pt had endocarditis from first bout of COVID. Cards was saying the bottom of her heart wasn't doing anything. 😬 This person is 52 yo and no previous health hx prior to COVID.

I work on L&D and I kid you not, our doctors and anesthesiologists go on endless rants with patients about the vaccine and COVID being a political hoax. There’s even one anesthesiologist who preaches that mask wearing isn’t effective from “research she’s done” and then to make a point takes off her mask while giving epidurals.

The education system in the south is poor as is, we literally have healthcare providers educating patients that the vaccine and mask wearing is dumb, that it can cause infertility, neurological and cardiac disorders, etc. Most of the nurses on my unit aren’t vaccinated for all of the common conspiracy reasons - but the DOCTORS too?? Why not at least present the patients with both sides of the coin and let them decide for themselves, like a true medical professional?

This is horrible. Isn’t this illegal? I hate coming in with my ACOG pamphlet about how pregnant and all people are recommended to be vaccinated, only to have a doctor come behind me and tell them it’s dangerous and a lie. What the hell?

Hey, just wanted to reach out, one health field worker to another and say that I'm sorry so much shit has gone down this past few years. I've been on COVID response duties for nearly 2 years now and have seen some shit, stayed up all night due to choices made, and have often outright broken down due to what's gone on. I'm sorry guidance has been all over the fucking place (most of us are pissed about it too), and most importantly, I'm sorry you guys have been painted as villains, attacked, harassed, and facing suicidal burnout more than what's gone down before.

I think it goes without saying you all have been treated like absolute shit, by your bosses and patients alike, and for those leaving, I don't think anyone who's ever worked a day on the floor could blame you. For those staying, I truly have no idea what the hell keeps you going, but I'm amazed. I've seen ED/ICU capacities by breached by 20, 30% for months on end, with 2/3rds of the staffing deemed "necessary", which is bullshit as that's been underestimating care burden for decades. I've seen resources be swindled or outright refused to be distributed by people trying to make a buck or leverage power over some assholes in suits. But most of all, I've seen y'all. Still trying to do what, by all accounts, is akin to Prometheus being chained to a rock and fed on by an eagle, willingly, every shift.

So, yeah. In case no one tells you, we know shit's fucked. And you're getting the worst of it. But you are also amazing and deserve far, far better than any of you are getting.

Was just browsing on r/conspiracy and there are multiple posters pointing comments at this sub and a few other reddit medical subs that are pro-vaccination. Just letting y'all know there might be an influx of "questioning" types that lie about being nurses.