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Old 04-08-2020, 11:55 AM
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Default COVID Nursing...Ask Me Anything

I am a 56 y/o nurse, now working on a Medical/Surgical floor at a local Metro Detroit hospital. My hospital is 100% COVID positive, by design. We are importing COVID patients from the other 7 hospitals in my system as well as many area systems, as well.

I thought I could avail myself, if anyone had questions on how the hospitals work in this kind of crisis. Please don't trash me, if you are not interested, you don't have to read or participate. In the ever changing craziness, I thought people might be curious at to what is happening inside the protected walls of medical facilities.

Talking about it also is pretty good for me. With golf out of the question, I have fewer coping mechanisms. *Self serving disclaimer.

There may be stuff I am not able to answer, I will be upfront about what I do not know, and things that would be inappropriate for me to discuss.

Lastly, if you know or know of anyone working in hospitals...try to support them. I am here to tell you they need it. The nurses, doctors, respiratory therapists, unit clerks, nursing assistants, housekeepers, security, .....ARE putting their lives on the line.
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Old 04-08-2020, 12:36 PM
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Is Covid all that it's cracked up to be? If you had to give us the top five most common symptoms, what are they? Have all of your patients also been tested for the flu?

Thank you for what you're doing, by the way. When I said that you had been drafted, several days ago, I had no idea that you were gong to an all Covid hospital. I have faith that PPE will start to become more plentiful, as production has greatly increased. You should find some relief in that very soon. In the meantime, take care of yourself as best as possible.

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Old 04-08-2020, 12:59 PM
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Originally Posted by Halcón View Post
Is Covid all that it's cracked up to be? If you had to give us the top five most common symptoms, what are they? Have all of your patients also been tested for the flu?

Thank you for what you're doing, by the way. When I said that you had been drafted, several days ago, I had no idea that you were gong to an all Covid hospital. I have faith that PPE will start to become more plentiful, as production has greatly increased. You should find some relief in that very soon. In the meantime, take care of yourself as best as possible.
Thank you for the well wishes.

The symptoms I see are the commonly broadcasted symptoms. Fever, cough, difficulty breathing, decrease oxygen exchange by the lungs, weakness. Several of the younger patients report a loss of smell/taste. This often results in a decrease in appetite. Another bad thing, given all sick patient's need for good nutrition to heal.

We initially tested for both flu and COVID, resulting the flu portion first. If the patient tested positive for influenza, they would not test for COVID and save the test. If flu positive, they were sent home. We are no longer testing patients for the flu, but we are coming out of the flu season now.

COVID is indeed as bad as advertised. Since going back to work on the floor, we have successfully discharged 5 patients and have had 4 patients expire. That is not a great ratio. Damn frustrating part is the lack of a clear and effective treatment plan.
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Old 04-08-2020, 01:03 PM
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Thank you for the work you're doing.

Do the other professionals you're working with have any speculation/guesses on the commonality between patients who are severely affected that are otherwise healthy... no obvious underlying conditions, etc.?
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Old 04-08-2020, 01:16 PM
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Thank you for the work you're doing.

Do the other professionals you're working with have any speculation/guesses on the commonality between patients who are severely affected that are otherwise healthy... no obvious underlying conditions, etc.?
It sounds like severity in younger patients is thought to be driven by the severity of the immune response to the virus. This severe response is really moving the mortality needle on health young folks, without significant co morbidity's. Some of these folks go downhill very quickly. They develop Acute Respiratory Distress Syndrome. (A lung condition where organs have inadequate oxygen supply due to fluid buildup in the lungs.) This forces our hand. We are doing everything we can to keep patients off vents. Both to save the vents for people that would not survive without them and because they seem to be a point of little return. We are more inclined to use a high flow O2, humidified and sometimes heated, to help the younger patients.

Where this severe immune response comes from and why some experience it and some don't, I don't know the answer.
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Old 04-08-2020, 01:32 PM
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Are you taking any special precautions to not infect anyone at home now that you're constantly exposed? Segregating inside your own home?
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Old 04-08-2020, 01:34 PM
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Of those who have had severe cases and/or expired, can you comment on age range, nursing home location, race and/or gender? Reports today are indicating higher rates for the older black population likely due to pre-existing conditions like diabetes, high blood pressure, smoking, etc. Detroit area already has higher black population than many other major cities potentially skewing stats even more.
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Old 04-08-2020, 01:39 PM
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Thanks, ru4por.

When someone is sick enough to be hospitalized, but not severe enough to be put on a ventilator, what's being done for them? There's no cure, we can take fluids and food and NSAIDs for fever at home. What is the treatment for those in this middle range, that makes hospitalization a good idea?
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Old 04-08-2020, 01:51 PM
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Do you have enough PPE?

How many Canadian nurses do you work with?

Cheers mate. I'm praying for you. Hopefully we can throw a round together sometime this fall or next spring!
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Old 04-08-2020, 02:14 PM
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Quote:
Originally Posted by DavidSauls View Post
When someone is sick enough to be hospitalized, but not severe enough to be put on a ventilator, what's being done for them? There's no cure, we can take fluids and food and NSAIDs for fever at home. What is the treatment for those in this middle range, that makes hospitalization a good idea?
I was kind of wondering this too. Obviously when true ARDS sets in, then ICU physicians and respiratory therapists become particularly important. You mentioned that you're on a med-surg floor, so I'm guessing you don't have much ICU exposure currently, but are many of your patients in "stepdown" or a similar level of care? As far as monitoring those patients, is it mainly watching vital signs like respiration rate, heart rate, and oxygenation? Or are there other things to watch out for that other nurses or physicians might not think to look for?

Thanks, and best.
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