[00:00:00] Hey, and welcome back. My name’s Mandy and I’m Hehe. Hehe, how are you? 

[00:00:03] I’m doing well. How are you? 

[00:00:07] Great, great. So today is a really exciting episode. I’m so glad you’re listening today. You’re gonna hear a shift in perspective, a shift in perspective on being a nurse, their perspective has shifted on, uh, COVID deniers and anti-vaxers.

[00:00:29] We haven’t talked about this yet. And some troubling realizations that this COVID charge nurse made this year. And to tell you what happened and her incredible story and perspective our guest today is COVID charge nurse EMA from Illinois. Hi, EMA. 

[00:00:49] Hi guys. Thanks so much for having me on. I’ll just kind of launch into my story of kind of from the beginning.

[00:00:56] Um, I, uh, got out of college there. I graduated in May, 2019. I applied to a job on a respiratory medical surgical unit. Um, I myself have asthma, so I thought that was a field that I was familiar with. Something I was passionate about. I started on that unit in August of 2019 coming off orientation in about October and you know, it was called in flu season.

[00:01:24] So still a little bit busy on that floor. A little bit rough, to be honest. Um, we were a 28 bed unit, so we had every bed filled there, cold in flu season, and then coming out of the, and then January 20, 20. We started hearing kind of news about the coronavirus coming and how it was the respiratory born illness that kind of made me nervous, but we didn’t really have to deal with it.

[00:01:47] Actually, our unit moved, um, away from the ICU where we were originally positioned down to a rehab floor. So it took. Kind of protect our respiratory patients from the disease was the idea to keep them very separate. And after that initial, like first wave as we’ll call it, it wasn’t actually hit very hard in where I am central Illinois.

[00:02:08] So they ended up moving us back up to our original floor. Um, things were normal there for a second. And then the summer happened, we had, um, our people going outside contracting COVID. We were then a mixed floor. So we would have patients with COVID and patients non COVID mixed on the same floor, obviously not in the same rooms, but it still was a little bit of a change to know that we have this infectious disease right across the street or right across the next door.

[00:02:34] And of course not allowed to talk about it, but we all kind of knew and, um, It’s a little bit stressful there. And then I would say my, actually, my first night as lead on the floor was in September, I believe September, 2020. And that was the night we got the, um, note from the help supervisor saying, you’re gonna be admitting only COVID patients now.

[00:02:57] And you’re gonna be moving all your non COVID patients off the floor at the same time. You’re trying to admit all these COVID patients. So we started doubling beds that. Um, I’m not sure if we got all the way filled up to 20 beds, but, um, that was our first all COVID floor, all unit COVID. That was my first night as lead.

[00:03:17] And it was a little bit intimidating. I was lucky to be trained by some great nurses, um, that kind of. You know, let me know how to, you know, accept appropriate patient assignments, but then, you know, with COVID everything changed the rules and regulations for our floor. The criteria changed almost every shift.

[00:03:35] So you’d have to ask the incoming day shift, you know, what are the oxygen requirements today? And, um, that sort of thing, like what is the ICU about availability today? You just have to go day by day and keep it very flexible. And that was a little bit, a lot for me. I, at that point was what, 23 years old.

[00:03:55] um, so I was just learning as I go, trying to, you know, the most important thing is lead is to stay calm . So that was a good test of how calm can I remain in situations, um, that are pretty intense for people. And at that point we had a no visitor policy. So all these patients were just with us, especially at night, it was, it felt a little bit isolating for them.

[00:04:17] So we were trying our best to seek communicative with what we were allowed to do. Um, you know, setting up FaceTime with them, um, that sort of thing I’m trying to remember. It’s kind hard to think on that years ago, it was just,

[00:04:36] um, one of scenario. I don’t, we were that point. So, um, moving in that’s the fall now we had, um, that was a very busy time on our floor. I think every shift we had. Um, a death either like a planned deaf people going on hospice eventually, or we had an RT, which is a rapid response, meaning someone’s declining rapidly and means in media intervention or code cardiac arrest, meaning you’re gonna be doing CPR on a patient.

[00:05:05] Um, so that was one, one of those, every shift I felt like, and it kept us on our toes for sure. um, one important thing to note that we are just a med surg floor. So back before COVID we had certain criteria that they could not, if they couldn’t meet that, or if they were above that, they had to go to, um, intermediate or ICU in the particular place that I worked.

[00:05:27] We had two ICUs. Um, so that’s a total of 24 beds between the two ICUs. And then we had a, just a part of our cardiac floor was intermediately had about eight intermediate beds. We really only had. 30 something beds to send our patients to beyond us. So once those beds were filled, we were stuck. And, um, for a time their manager was telling us, okay, we’re gonna be accepting intermediate patients.

[00:05:53] Um, but our ratios are only gonna be three to one, which even as she said it, I had to roll my eyes and just, uh, we can literally keep ourselves staffed as we are six to one. So, um, I already knew that was gonna be an issue. They were gonna try to keep the buts. We only had. Um, six rooms, not even that were close to the desk with windows that we could see into the room without having to open the door.

[00:06:17] Um, so we’re targeting those beds, but it was really difficult to keep beds open as given there were such a shortage. So it was really. Just, um, timing of, if someone needs a bed, they’re gonna take it. Even if they’re not intermediate, we cannot hold beds for anybody. Um, so we’d end up with intermediate level patients in any room in our floor.

[00:06:37] And, um, how our floors laid out is that you cannot see every room. There’s not monitors in every room in any of our rooms. We have telemetry monitors, but they’re red from the cardiac floor. So we would have to physically enter a room to find out where the beeping is coming from and the beeps. Um, as I remember, we’re constant, if it was not a call alarm, which we did see from the desk, we could see who’s calling, but, um, you guys are familiar with pulse OMES.

[00:07:05] Um, it’s the little finger clip guy that kind of reads their oxygen stats and your heart rate. Um, and they would just put those, every code patient was supposed to who was on more than room. I was supposed to have a Paul sack, um, reading and so took capital. Um, and we could kind of fiddle with them a little bit.

[00:07:21] With respiratory therapist approval fi with it. So we could set the setting lower. So about 90%, it would start beeping if we go below 90. Um, so we just have to kind of find the beeps and the beep could be the probe is just a little bit off their finger. Um, it could be totally off. They could be out of bed, um, or they could be desaturating.

[00:07:42] Um, and you know, you can walk in someone siding at 48% and then you have to almost treat every alarm like someone is desat critically. So that was one of the most exhausting parts of working on a med surg floor turned COVID was just that, um, alarm fatigue. And, um, just kind of the stress response that you get, you kind of starts to fade after a while.

[00:08:04] Like you’ve been hearing alarms for 12 hours or 10 hours at that point. And, but you still have to respond to everything. Like it could be an emergency. and that was going on. You know, we have surges of COVID. I mean, especially, I just remember around the holidays, each holiday, you know, people would gather and stuff.

[00:08:23] Well, it was a little hard to deal with. Cause I was on the COVID unit every holiday last year, not with my family. So I understand people wanting to gather after being, you know, quarantined and social distancing, then the. We would see about seven to 12 days after a holiday, we’d see a surge, um, of people getting COVID we’d have whole families get COVID.

[00:08:44] We had, at one point we had a mom and a dad and a disabled son all on our floor with COVID and I think this father ended up passing away and Amazon ended up passing away. Um, so it was just really hard to deal with, um, just seeing families of people, um, and also having to communicate with patients, families for them, because.

[00:09:07] With lots amount of oxygen on people. It’s really hard to communicate. We would have, um, before COVID our, our criteria was, if you’re over 10 liters of oxygen, you need to go to intermediate or ICU. And then with COVID, um, it kind of crept up. It was okay. 15 liters. Okay. 15 liters on your breather. And they ntroduce these, um, machines called Opti flaws.

[00:09:29] If anyone’s not familiar, it’s basically like a tube. A nasal tube with the prongs in the nose, um, that they could, we could technically crank them up to 80 liters of oxygen. And then we could also titrate FIO two up to a hundred percent FIO two, which is like pure oxygen lasting into their face. And of course we were working with respiratory therapists.

[00:09:51] We weren’t technically allowed to touch the machines, but just given the vast number of people on them, we would have to, you know, replace, they had, uh, Cline beds attached for humidity. So people wouldn’t dry out too so fast, but it was still, you know, it was difficult time communicating, uh, with full code patients.

[00:10:09] We would bring ’em up to 65 liters and see how long we could keep them on there until an ICU bed opens up or until a event opens up on the ICU floor. Um, so we would have full code patients on 65 liters of oxygen for days, and definitely not what is good practice. It was normal practice, but we really just didn’t have anywhere to put.

[00:10:30] Um, and so it became an emergency, which you never know with those Paul Fox going off all the time. Like, I don’t know who he was having emergency or who just got up to go to the bathroom, that sort of thing. . Um, but yeah, so it was kind of those patients. We would try to keep an eye on a little bit closer.

[00:10:45] Um, oftentimes we would have to double those patients together, um, just because they would require more frequent monitoring. If we. And so just being in the room with another Opti flow patient, we could just keep an eye on both of them, even if they weren’t your patient, you know, of course you respond to any alarm as a nurse on the floor.

[00:11:03] Um, so that was the fall in the winter, um, dealing with that, um, that was seller no visitor policy and definitely hard. Dealing with end of life care for people. Um, generally it was expected in, in terms of, okay, we have had to talk about code status. We have a physician talk about code status to family members saying, you know, they’re not gonna make it or, and, or we don’t have the resources to help them make it.

[00:11:33] And if they’re generally over like 65, Or if they’re obese, they have worse outcomes than a younger patient. And so we had to kind of prioritize patients, unfortunately. And, um, you know, that was difficult to have to say. We don’t have anywhere for them to go for your mom to go or for your grandma to go.

[00:11:53] So unfortunately, they’re gonna have to stay here, but you still can’t come. So we will be with them up until the end. And, um, yeah, that was definitely one of the most difficult parts was having still six patients and having someone, you know, is on the way out, but like, you can’t stay in the room with them for very long other people, you know, calling and stuff and.

[00:12:15] Um, the thing about is it’s pneumonia, right? So it’s basically filling your lungs up with fluid and gun and you become hypoxic and you become confused as well. So people get very confused at the end. They get agitated, they can get aggressive. Um, the oxygen that we put on them is painful. It starts digging into your face.

[00:12:36] And if they’re already a DNR, we can, um, go again, scoot practice and layer a non on top of those, those, uh, 65 to 80 liters of oxygen to apply another additional 15 liters on top of them. Um, so that’s just a lot of pressure on their face and it’s uncomfortable and it’s painful. They would start to get sores.

[00:12:56] Or, you know, redness, or we try to pad them as much as we could, but we still needed to ensure like a good seal on their face. Um, so it was uncomfortable and people would often try to remove out this thing you’re killing me is I’m dying cause of this. I’m like, I know it feels like that. I’m sorry. Um, but of course they’re usually not in their right mind at that time.

[00:13:16] So you just try to explain it the best you can and just keep monitoring them and making sure they’re not pulling their oxygen off. That was definitely hard. And when you have to make the call to a family member saying, okay, they can’t really consent to things anymore. They’re disoriented. They don’t know where they are.

[00:13:31] What’s going on the day. Those are kind of indicators that you have to find someone else that can become power of attorney and can consent for them. And just trying to explain the situation to non-medical, people can be difficult, you know, in the middle of your shift, you’re trying to do other things you’re saying, well, I need to apply like risk restraints to your mom.

[00:13:48] So she doesn’t. Pull off our oxygen and pass away tonight. So it’s kind of those nitty gritty things that you kind of have to get to with people that you’d like to be a little bit more delicate and a little bit more gentle with them, but it’s, um, you know, I guess it’s a crisis scenario that that was going on for months so you kind of get good at, um, trying to explain to family members the best you can.

[00:14:09] um, and being concise with what you’re chatting them, because sometimes doctors don’t wanna hit the nitty gritty with them. You know, they only see a patient for five to 10 minutes in the morning when they do their rounds. And, um, they don’t always, you know, see the 12 hours of a shift of people declining or people getting better.

[00:14:26] They can’t really give an accurate description of exactly how their night went type of thing. Um, so yeah, having people in risk restraints with so much oxygen on them and still trying to do cares for them and giving meds with someone with on so much oxygen is, can be very troublesome. They’re swallow can start to go.

[00:14:46] If they’re being blasted with so much oxygen, um, You can literally feel if you put your hand up in front of someone’s mouth, like the oxygen just bursting out of their mouth. And that brought up concerns with infection protocol. As we were told that it was contact droplet eye protection, which is, you know, the gown, the face shield or goggles and just a regular hospital mask and gloves, of course.

[00:15:12] Um, so that’s what we were being told was appropriate. And I said to my manager, I said, I can feel the air. Rushing out of their mouths as I’m taking care of them. And I, of course was given one N 95 for the year. And my first shift that I had been floated in the spring to a COVID unit, I had a patient on event.

[00:15:34] So I. Thought that the N 90 fives, you know, disposable supposed to be one time you. So I had thrown my N 95 away after my first shift on a COVID unit. back when my floor wasn’t particularly a COVID filled, I had been floated to the ICU. So I had thrown away my N 95, a little early on in the, in the pandemic for myself, kind of screwed myself there.

[00:15:57] I guess I just didn’t realize that we were really actually not gonna be getting anymore. So I went through most of. The summer in the fall without 95, as we were being told our patients on our floor do not need one because they’re not on BI or C a P or event 

[00:16:13] you on unit refused to supply you another in 95.

[00:16:19] So I had 

[00:16:19] asked my manager about three times. I said, I have asthma. I’m not comfortable. I feel like I should be getting another, another mask. And she’s like, well, we gave you one or happened to it. I, I thought they were disposable. I 

[00:16:34] am just, I’m so sorry that I interrupted Youma you have been telling such a powerful story and I’m on the edge of my sea, our faces.

[00:16:44] I can see hehe. We are like jaw dropped and I wanna hear more. And I’m just taking, giving you a minute, taking a minute. I’m I am grateful that we can have this conversation with you today because that’s some. Fucked up dangerous, dangerous shit. All of the shit. You’ve all of this story has its own pieces of, I just like could, we could dig into all of it.

[00:17:17] Any of it, any piece is an example of gosh, your year and we, what have we hit? Have we even hit a year? We’ve hit one year into your career. One year. And you’re telling me that for this year that we’ve been listening to this, we’ve, we’ve heard your, this story. And there are only, this is only parts of your story and the parts that we’ve heard, you didn’t get a N 95 mask because you threw it away because they are disposable.

[00:17:51] Right. That was the idea they were supposed to be disposed. They 

[00:17:56] are still, I, uh, like if this is the thing that I die on, they are still disposable. The fact that you are forced to

[00:18:18] wear a dirty mask is illegal in every other situation and it’s inappropriate and it’s harmful and it’s di causing direct. Lives to be lost. And so I am just sitting here grateful for you today 

[00:18:23] of all my coworkers, one of, maybe four that did not get COVID. Now that 

[00:18:27] you’re on this podcast, they’re gonna like reach out to you for a study of like, how do we, we are gonna test your blood because something is going on.

[00:18:34] You’re obviously immune to COVID because yeah, you’re giving forceful air through someone’s nose, nasal passages where we know COVID lives and then forcing it out of their mouth, into your. Basically and those, right. Like, because you’re in there all the time and you’re caring for them and it’s been a.

[00:18:55] Right. And we all have theories, like, um, I had gotten really sick in December and January, December, 2019, and January, 2020 kind of before COVID was on the us radar. So I was kind of like, Hmm. Hmm. I wonder if that was it. Cause I was really sick back to back, like almost only four weeks apart, I gotten really sick.

[00:19:14] So I was kind of wondering, I wonder if I’d gone early, you know, my dad actually does a lot of business in China and I don’t think he’d been there recently, but you never know. There was that little sick contact, I suppose. Um, but I don’t know. I, I really don’t know. I’m really thankful for it. Um, I honestly was something I had to think about a lot, cause I have asthma and I’m not like the most petite person.

[00:19:34] So we know that people heavier people don’t do as well. So I had a whole contingency plan planned at, I said, I have. Know a garbage bag. I’m gonna put myself in a garbage bag. My friend’s gonna drive me to the hospital in their trunks and I don’t get them sick, but I don’t want, I can’t afford like the hospital bill of the ambulance ride, that sort of thing.

[00:19:51] Um, and we were kind of joke. I’m like, oh, I want Brooke. I, you know, she’s like one of my good friends on the floor. She’s a CNA. I said, Brooke, I want you to come over. If I have to be in the ICU and gimme a wax before they put the catheter in, I don’t want any of my coworkers seeing me being any mustiness.

[00:20:06] And just keep me clean. Um, I don’t want a G2, I’d rather not have a Gub or a tra and P, but I know I didn’t have those legally right now, beforehand, that that would happen. Cause I’m pretty, um, contingency plan kind in my head of like, what if I were to get? Cause when I got sick, I got pretty sick. Um, so I was kind of fearful of that, but also at the same time, um, you know, being young, I know I had a better chance of survival.

[00:20:33] If I were to get sick. So that’s kind of how I justified it. I I’ll be OK. You have to 

[00:20:42] IMO. What kind of like trauma do you think came from being so young and having to plan out what might happen if you got sick with a deadly disease? 

[00:20:56] Trauma. That’s a good question. It’s something I haven’t had to think about.

[00:21:01] Um, but now that I, I quit my job about three weeks ago, I’ve actually had time to set and think about things and it’s kind of messed me up a bit just recently. I haven’t had to think about it until recently just going about my daily life. And I’m like, gosh, what did I just have to do? Like, what was I doing?

[00:21:16] Was that really me? I always forget. Like, I feel like I. I’m not 24. I feel like I’m much, much older. I feel like my maturity is out. I like 30, 40 something year old just given the things I had to deal with. And I just, yes, I feel very different from my friends now, too. Like people my own age. I’m like, I can relate to you guys still, but you guys can’t really relate to me.

[00:21:40] And it’s definitely something I need to be thinking about going to therapy and just talking about it because the only people I feel comfortable talking about is my actual coworkers who did it with me. And we do have some good conversations, um, about the topic. So I’m thankful that at least I have my support of people who literally know exactly what we were doing.

[00:21:59] Cause they were on the floor with me. We were doing it together. Um, I have my two other night shift leads, um, who, one who trained me and the one who left for the ISU, um, earlier this year. And then I became more of a, um, the full-time lead. So it has been interesting kind of talking to them about, and they’re young too.

[00:22:20] I. 25 26, the other two night shift leads, um, on the COVID unit and kind of how they’re dealing with it. I have my one that I’ve talked about, like, Hey, like, do you have any like stress response anymore? Like, do you get anxious? Where like, do you feel stressed? He’s like, no, I’m like, okay, is that a bad thing?

[00:22:39] He’s like, no, we’re just nurses. Like, this is how we do it. I’m like, um, oh, I dunno, Andrew. Like, I really dunno. Cause he is like, we’re just getting better at it. And we’re just more used to it. I’m like, yeah. I guess, I guess that’s one way to think about it. Um, which is kind of sad. I have a night shift friend, uh, We do get to talk about it quite a bit.

[00:23:00] Now she’s in the ICU and she sees it even more ventilated. Patients are even more intense to take care of it. So, um, she’s definitely talked about maybe herself feeling some PTSD and she’s been telling me, she’s like, oh, if you find a good therapist, let me know. like a support group. Let me know. Um, so definitely just talking to my peers around me.

[00:23:18] I’m like, okay, I guess. Is a thing. I haven’t really had to think about it until recently. And it’s probably something I’ll care with me for a while, but hopefully not in a way that will like negatively affect my life, hopefully, or like relationships or how I think about myself. Um, that would be the hope.

[00:23:40] What you’re describing sounds like, um, combat veteran. Yes. 

[00:23:44] And I’ve gotten that comment a lot. I had made a TikTok video, um, about it, and a lot of the comments were either like, thank you for your service. Wow. You have PTSD. Really guys do I . 

[00:23:56] I mean, no, one’s here to make that diagnosis for you. I mean, join us on our next episode.

[00:24:04] We need to give the links for. Support groups like this because that in, in the research and in the journals and books about combat vets often help can come in the form of one on one counseling, like you alluded to and mentioned, and also group, um, you know, your, your. People that get it. The people that are the only ones maybe who get it being facilitated by a professional so that, uh, if someone has an idea about what’s normal, it can be CRA cross referenced, like fact checked quickly because one person’s numbing is another person’s overreaction is another person’s rage.

[00:24:50] Like they’re normal, but it’s actually. Healthy. It’s a response and that can be kind of clarified by a facilitator. So you’re bringing up a lot of points that we’re totally 100% behind you and want you to find help if you’re feeling that. And if this is part of that, like sharing your story might be really powerful or it might have the opposite or, you know, both effects.

[00:25:16] Oh, my gosh, I have to face this or 

[00:25:19] right, exactly. And that’s where right now I’m kind of, um, toing with the idea of either making more videos about my experience. Um, but also that attention kind of on, especially social media control, negative comments. And unfortunately, of course, I’m still a little sensitive about that.

[00:25:38] I don’t wanna read negative comments. I don’t wanna, um, have to kind of defend my. Experience to people who don’t have the same experience. Um, and so that’s why I have not posted since my first video, when I, right after I quit my job’s three weeks, I’ve just been struggling with like, what do I say? Do I say more?

[00:25:59] Um, that sort of thing, um, is definitely, but yeah, definitely support group sounds nice. and reaching an audience that, I mean is a little bit, we’d be more understanding and empathetic towards at least my experience. 

[00:26:14] Yeah, for sure. Yeah. Strangers on the internet are not that type though. You know, sharing your story can be powerful.

[00:26:21] If you turn off the comments or don’t read the comments. 

[00:26:24] Hey, there’s an idea 

[00:26:26] I will say. And this is the last thing I’ll say about. I’ll say in my trauma informed work trauma sensitive work, I’m not a therapist, right. I don’t give diagnoses either, but I do know at least in the realm of birth and what I’ve heard about combat vets, and what I’ve heard about PTSD is the sooner you get professional help and look into it with a professional.

[00:26:50] Um, hopefully someone’s specifically trained in trauma and I think. And I think we have options online. I know for a fact that it’s possible to find a trauma counselor online and it can help. And it’s weird and you have to turn yourself video off cause it’s super weird to go to therapy and see yourself.

[00:27:10] It’s like having a mirror in a therapist’s office. It’s like, um, this is inappropriate. Can you turn this around? but I know it can happen for some folks that works and the sooner you can heal, start to heal. Yeah, maybe have faster results and more positive 

[00:27:28] results. Sure. And that’s definitely something I am seriously considering.

[00:27:32] I was even joking about eating therapy. I went through a bad breakup last year, too. of course. Oh gosh. I’ve had my, had to take my partner out of our house and move and that sort of thing. So that’s been something I’ve been thinking about. It’s just the point of like, well, I’m still functioning. Like I’m still getting my stuff done.

[00:27:48] I’m still paying my bills and having friendships. So it’s just the point of like, I just need to do it for myself, even if I’m not struggling to do it before I start to drive out, it’s actually important. Um, but yeah, anyways, I can, um, you had mentioned, um, the N 95 mask, and I just wanted to bring up a point of how we dealt with the, um, the mass shortage.

[00:28:08] So, um, back when we were on, we had been moved down to like the rehab floor away from COVID. We were given, you know, the surgical mask and still told you need to wear these until they’re visibly soiled, visibly soiled. So, um, you know, keeping a mask on, um, Two three weeks at a time. That sort of thing, you could just feel them getting a fusy afraid.

[00:28:30] Um, and we would have to kind of hide them on the unit because, uh, people would kind of enter the hospital, looking for masks. They would take mask out the walls, that sort of thing. We couldn’t have them in the PPE dispensers on next to the rooms cause people would take them. And even just having that for.

[00:28:46] Like employees we’d have to kind of like if a respiratory therapist wants a new master’s like, you really need one, that sort of thing. It was just kind of bad hoarding situation. And then you see like the providers come in for their five to 10 minute visit with like the. The very nice PA um, helmets that we didn’t have.

[00:29:04] We had these old cap hoods that we used for, you know, TB, other airborne disease that were like the whole hood with the tube going out. And it’s attached to the belt around you, um, with a big battery pack in it that you cannot hear anything. The patient is saying at all. Um, so we had two of those for the unit that they even told us.

[00:29:23] You don’t need to wear those. It’s not air. Oh my gosh. But some people do, some people do. I had a couple with my other nurse that actually didn’t get that I know of. He were at the, in every single room, but I mean, his life was miserable trying to, um, do his work in a full PA hood. Um, and every patient COVID patient was, um, I don’t know how he did it, but he has four little kids at home.

[00:29:47] So he did it for them. Um, I, at that time was like living by myself and I was like, you know, what, if I get COVID, it’s really just me. Um, I can isolate myself better than he can. I expect his choice, of course. Um, but then once we were getting, you know, full COVID unit, again, the N 95 mask, we were layering.

[00:30:08] Surgical mask. I, I below it and then you find and another one, uh, over it. So you’d have about three masks on, um, which, you know, sucked it was hot. It was sweaty. You can’t, they can barely hear you, especially with all the oxygen that they can’t even hear you anyway. So you’re trying to yell at them. You know, three layers of a mask.

[00:30:33] And that was just to keep, um, the first layer was, you know, keep the, your mouth humidity off the mask. It doesn’t keep moist. And then the other layer is to protect from the COVID particles on your mask. So you can touch it after and put it in your little paper bag that gave us paper bag in one mask. Oh five, excuse me, which are 

[00:30:51] all appropriate inappropriate uses of those masks.

[00:30:53] Right? Right. No, that’s not. No, no. The manufacturer. Pretty much crossed out all of the recommendations because we just decided not. Abide by them anymore. So in a perfect world, we would, in normal times we would, but right now it’s not normal time. So it was a lot of COVID kind of changing rules for things.

[00:31:13] And me as a new nurse, I was just learning like those rules and stuff. So it was kind of hard to be like, oh, we are allowed to do this now. Like this isn’t exactly my scope. This isn’t exactly a good practice, but it was just kind of, you know, I keep telling us it’s a crisis. I’m like, well, it’s been, it’s been a crisis.

[00:31:29] It has been a crisis. So. I was actually lucky enough to, um, my uncle is a pulmonologist critical care doc in Cleveland. So he was able to send me about eight and 90 fives. Um, so I like personally had to have a contact who was a physician who was a critical care pulmonologist, send me masks. Um, so that I could use them.

[00:31:53] And he even like sent me tips on how to keep them sterile. Like you be lamp boxes, which of course I didn’t have that. It was nice that he was trying to look out for me. And, um, you know, my, then his wife is my aunt. Is a infectious disease nurse practitioner. So she was of course fiber acids, not knowing or knowing that I did not have an file wearing into these patients with oxygen and coughing.

[00:32:16] She says, you need to wear one in every room. Someone’s coughing. I said, I, I wish that would be great if I could. Um, so yeah, they made a special effort to send me those. And I did give them out to the other nurses on my unit who had some loved ones or stuff like that. So I still have some, I still have some just in case, but we were supplied here not too long ago.

[00:32:37] Um, let’s see, March. April, we got more N 90 fives on the four and, um, those K and 95 is what we call the duck. Bill mask, uh, is not as thick as N 95, but they, I think they just ran out or they got too expensive for a hospital to supply. Yeah.

[00:32:58] We do have mass now. And I appreciate, uh, everyone’s concerned like, oh, I have some, let me send them. I think we got the supply now in most hospitals, it was just more so like last year, the rationing and everything, we ran out of the plastic gowns. Um, we had used, it was more like a paper material, which they still worked.

[00:33:16] I guess they still worked. They were still like got them wet and they weren’t damp, they would repel water, but it was just interesting going from, it was actually nice. Cause the plastic gals, they heat you up and you’re just sweating. You immediately start to sweat, especially in a room with hum oxygen.

[00:33:32] It’s hot in there. And just any, any tasks you come out dripping and sweat. And it would be disgusting. he’d smell so bad at the end of 12 hours. It was really gross. And God forbid you have to do an RT or a code and a plastic gown and in 95. Oh my gosh. I tell you that was a workout for sure. that was definitely a workout.

[00:33:54] And I’m glad we kind of got the paper ones, even though we kind of ran out the good ones. So it was at least more breathable and it was a little bit more doable for us. And. We were allowed to wear gowns room to room with some, you know, rules about how close to the desk and how far you can travel in a, in a dirty gown, that sort of thing.

[00:34:11] But yeah, I was, um, you’re kind of stuck in a patient room if you’re all, um, gown up with your PPE. If you need to go grab something like, oftentimes patients will ask you for, you know, I want crackers, okay. Now I want ice. You know what? I actually need some lip balm. So it’s like every single request is a separate trip out of the room, which, you know, you’re still gonna.

[00:34:30] Get the stuff for them, but you need to kind of wait, pick your head out the hallway, see if anyone’s walking by and say, Hey, can you, uh, can you grab me some stuff right quick? Cause I don’t have to, you know, waste this PPE and then put more on, cause you know, you don’t want go in any clean utility or nutrition with a dirty, Ugh, dirty PPE.

[00:34:47] You know, that’s a nightmare. So we actually did get some deployed staff. Um, from some like clinics, offices, that sort of thing, surgery of people, this was back. This was in December. They, they finally got some deployed staff just to be on the unit, just to help us get gather supplies and to respond to alarms.

[00:35:06] Cause there was too much to do. Um, given you have five to six patients, it’s just a lot to do. So they deployed some staff to help us, which we greatly appreciated any help just being at the desk to answer a phone, say this is a family member or a physician. We need to be on the phone. ASAP. And so that, that took a while to get some help on the floor, but then we did and it was great and they really appreciate those people that did not volunteer.

[00:35:33] They did not volunteer to go to the COVID unit. They were reassigned. And very rarely we would have people refuse to go on the COVID floor and they would be reassigned. Um, if they didn’t want to be there, they can’t force anyone. So they would just have to go home or go to a different floor. Cause you know, short, everywhere.

[00:35:52] So healthcare professionals could refuse to work on a COVID floor. And if that was their reassignment from their home unit, then they would be sent home. Was there any discussion of, um, healthcare professionals that didn’t have the COVID vaccine being assigned or not assigned to the COVID unit? 

[00:36:14] Um, not so much.

[00:36:18] Um, Not so much in my experience, if they did not wanna work on the COVID unit, they generally were said, okay, well, you’re gonna miss the day of work then. And I’ve only had worked with that two nurses that chose not to be vaccinated and they still came to work and chose to work around COVID. So not so much in my experience saying, oh, I’m not vaccinated.

[00:36:42] I can’t work here. It’s it was more of a. I’m still gonna work here. I’m not gonna get vaccinated type of thing. I’ll take my chances, um, which was kinda phrase it to me, but it’s their, their opinion, I suppose. Um, but yeah. Um, going back to, I guess when the co the vaccine came out, um, we, it came out kind of like late December, early January and.

[00:37:10] I was actually given, I was able to go see my family right after Christmas. I worked Christmas and I got to see them after Christmas. I did delay getting my vaccine by two, two or three days. And I just remember getting my first dose and being so happy. I like cried tears of joy in my car. I like had even like made a little bit longer of a Snapchat story to post.

[00:37:32] Then I ended up deleting it. Cause I thought it was covered up me crying in my car, getting a vaccine, but I was really excited and I was really, um, I was like, oh finally, I don’t feel like. This disease could kill me every day that I work around it and I was very happy and it was just kind of, um, it’s not a shame to be knowing that they were asking people to get their vaccine and saying, it’s gonna expire if we don’t give it out.

[00:37:55] So people please get a vaccinated. I was like, what really? I would think people would be lining up. You would think it’d be like a crisis trying to just get it out to everybody. And not the other way around. So that was a little bit, um, drawing to me. And of course I have to think about it. My perspective, I work around COVID all the time.

[00:38:14] I know exactly how bad it does, not news articles and stuff. And people’s. Little random stories about having COVID and not being bad, blah, blah, blah. So 

[00:38:26] how did that change the way that you looked at people who were COVID deniers or anti-vaxers through this because you had worked around it, but also you have that emotional response to getting yours.

[00:38:43] Yeah. So definitely changed my perspective on people. Um, I was just like, wow, I wish I could be that ignorant. you know, I wish I didn’t know what I knew and it shouldn’t have to take you being a charge nurse or a nurse to understand that this disease kills people and it’s preventable at this point. And I mean, I’ve never been an anti I respected science in the medical community and, you know, evidence based practice for forever.

[00:39:14] So it’s just kind of like, well, I guess you just don’t understand, or I guess you just have a different perspective that I’m expected to respect and, you know, we have to treat every patient equally and I always pride to myself. I’m not generally trying to look at vaccination status on my COVID patients.

[00:39:32] Um, I mean, that would kind of. Only reason I would look to see if, to just kind of guess how severe their symptoms are gonna be, if they’re vaccinated versus UN vaccinated, that sort of thing. Um, but that didn’t really an issue up until recently. Not, not a lot of people are getting vaccinated at first. Um, yeah, it’s important to try to stay.

[00:39:54] Um, what is it? Stay in the middle and not try to like express my political opinions to anybody. I mean, I encourage the vaccine, not my friends. So, you know, I got it. I’m okay. Even my coworkers were hesitant you. I was like, oh, I’m gonna wait for Soandso to get it before I get it. That sort of thing. And I mean, I guess I understand it’s a new thing.

[00:40:14] It seemed very fast, but I mean, going through was a whole, you know, was eight months then of COVID then to get a vaccine. I was like, yeah, well, this is, we were looking for an answer and this is the answer guys. Like I know I wish we had more. Um, but this is, this is it. This is what we came up with. And, um, Yeah.

[00:40:33] So definitely of course they made it like a political thing. It’s already near like my family members who are maybe more right leaning. I was not gonna be getting along with some of them. I had not spoken to in a while. Um, no real confrontation about anything. I just don’t have energy to, you know, I don’t have the energy.

[00:40:49] It’s not my job to be educating the public. About public health. I mean, I guess in part it is my job at that point, I was like, I’m too busy. I’m too exhausted. I’m too busy. I’m just trying to get through my each week. And I don’t have time for people that are gonna be, um, disrespectful about it. Especially 

[00:41:09] your capacity is overwhelmed by the need to do your job professionally into how many times do we hold our tongue as the nurse and that.

[00:41:21] You know, that’s because we have biases and it’s because we have questions and it’s because, you know, our patients have different choices than us, but you have experienced some what sounds like to me, you know, correct me if I’m wrong or don’t, but you know, I don’t wanna label something that is part of your story, but it, it sounds.

[00:41:44] You’ve also heard a lot of misinformation, wrong information, lies, gas, lighting, manipulation, and a little bit of, um, I don’t, I don’t know what I would call like refusing. A safe work environment. What is, is there a word for that abuse abuse? I was thinking of like torture abuse, um, and then to turn around and say, this is your job.

[00:42:09] This is what nurses do, stuff. It in a place that doesn’t affect your work, come to work or don’t come to like, this is your choice kind of thing. Like you either work in the COVID unit or you, they chose to 

[00:42:21] be a nurse. You 

[00:42:22] chose your daughters. So these harmful, repetitive. Stories that you’re hearing from your, the people that are training you possibly from the nurses that have been there longer than you from your administrators and your managers from the people at the highest level.

[00:42:40] In your healthcare and the CDC changing recommendations on aerosolized, you know, transmission to support hospital choice, to not purchase masks and be ready for a crisis situation because they are, as we have alluded to the front lines, right. Of a, a healthcare crisis. Without those proper, like it’s a nurse shortage.

[00:43:05] It’s a mask shortage. No, no, no, no, no, no. Those are all stories that make everyone feel better and, you know, right. 

[00:43:12] I get people kinda ask me like, so why haven’t they used like hydro whatever the president at the time was pushing Orin. Why haven’t they been using that? I’m like, well, I don’t know. I don’t get to make those decisions of physicians or meds.

[00:43:25] Follow up orders and we would get emails about bandaids and stuff like that, but things would change so rapidly that it was all word of mouth mm-hmm it was all word of mouth. What are we doing today? 

[00:43:36] If nurses are hearing that if healthcare professionals are hearing that, which is screwed up, we know because if some.

[00:43:42] Doctors are going into a room with a full headgear piece, covering Avi for aerosolized, deadly virus, easy to contract deadly virus in that room. But then everyone else is like, oh no, you’re totally disposable. More disposable than our fucking disposable masks. You go right on in and you call us and we’ll start your PTO when you get COVID and die.

[00:44:06] And we won’t save a bed for you, if you do. And that. Gruesome way for me to say that, but it’s true and it’s confusing and it’s straight up. What you are telling us is straight up. What other folks are telling us on the daily it’s confusing. So if the public is supposed to decipher, you know, the story that’s out there is it’s normal and we can fight this.

[00:44:29] It’s, it’s actually, it’s actually really difficult to fight it with, you know, in that system. It’s really difficult to fight it with all this misinformation. It’s really difficult to fight it. The majority of folks getting 

[00:44:40] vaccines, being such a new, I mean, not that coronavirus is new. They’ve they’ve been coronaviruses.

[00:44:47] Um, before I remember in January getting a coronavirus HKU patient, I was like, wow, you mean coronavirus? Like the one I’ve been hearing about on the news, I’m like, no, no, it’s a different one. I’m like, okay. So it’s just a different mutation strain, that sort of thing. Um, it is confusing and we were treating patients with, um, VIR.

[00:45:06] Antiviral medication through the IV. Um, basically I need COVID patient. If their renal function or liver function was healthy enough to support that, or they weren’t critical. Like if they were on more than, you know, 35 liters of oxygen, they could get VIR. And they were also starting the convalescent plasma treatment of recovered COVID patients.

[00:45:30] Um, which plasma is, uh, Hard to come by. It’s expensive. Um, not everyone qualified for it. And, um, I’m trying to remember which one they decided was not actually effective, but I think it was the last one they decided was actually, you know what, we’ve been doing this now for a year, year and a half, it’s not actually working.

[00:45:52] I was like, great. Ah, great. If we had had studies, if we had time to do studies, that sort of thing, we would know that before we had to do it, um, So it is kind of frustrating, cuz it is a lot of work to run plasma. It’s a blood product requires more frequent monitoring, that sort of thing. Um, just adding that on top of all of our responsibilities before I was like, gosh, another thing we were doing.

[00:46:16] That was like a waste, not a waste of time, but, you know, we were trying at that point, we’re trying anything. Um, but yeah, it is confusing and I just wish that we had, you know, more data to back stuff up. And I’m really, really excited to see how research goes in the next couple years and to find out what, what really was going on or how to treat stuff better and what we were doing.

[00:46:37] Um, I’m really interested to see kind of studies that happen and Theto, that comes out to show like what the heck was going on. What are we doing? 

[00:46:45] Yeah, for sure. Emma, I have two questions. Um, before we close out, you can always say, um, no, Mandy, I’m not, I’m not here for that. Uh, in your, um, kind of at the top of this at the top of this episode, we talked about your shifting your shift in perspective and, and I’m so grateful for what you have shared in.

[00:47:08] And your unique perspective as a new grad. Oh my gosh. You had a brand new idea of what a nurse did coming out of school and then did you you could never have imagined, but you know, you’re, you’re in, you’re in meetings, prioritizing who survives and who dies first. Um, what’s. What’s changed in what a nurse is for you to you now, or, or are you wanting to be a nurse or has that, has that changed for you?

[00:47:47] Yeah, definitely as a new grad, you know, I was learning kind of the basic stuff and, you know, following my lead or following my managers, um, whatever they were telling me that becoming the charge nurse, we had a lot more autonomy than we did before. COVID, um, You know, we were the ones who had to identify patients who needed the ICU beds, that sort of thing.

[00:48:07] My nurse would come to me and say, okay, they’re oxygen requirements, whatnot. They said, okay, we need to get them off the floor. Um, but then it would come down to how fast are they actually deteriorating? And the one that’s going faster needs to go first. Um, so these are all kind of decisions that we would have to bring up.

[00:48:21] To the doctors and stuff. And at night, I don’t know, not every hospital does this, but we were changed to tele hospitalists. So these were physicians over the phone and over webcam that did not work for our hospital system. Normally they were like contracted and employers, uh, providers, excuse me. Um, and of course we’ve had ones from like all over, have one in Hawaii, one in Israel, that sort of thing.

[00:48:45] So it was kind of like having to explain to them what our criteria are at. General moment and what we can do. Um, and we were, you know, responsible for checking ICU for beds and. We wouldn’t even bring it up. If there wasn’t a bed, we say, yeah, they need that. I see. But there’s no bed, so they’d have to stay here.

[00:49:01] So what can we do for them here on our floor? Um, so it was a bit of a struggle trying to work with these physicians that are not the, you know, the general hospitalist that see these patients every day. It was just kind of like the night watch over people that we would have to explain what’s going on, who this person is, what they need and ask for that ourselves.

[00:49:20] So there’s a lot of responsibility in having to be charged nurse and kind of having to talk my nurses through that. I’m saying you need to like ask for exactly what you want because you know, this physician is not covering and not watching or chart. They’re not looking at these numbers all the time.

[00:49:35] You to hundred 50 patients they’re watching out for. So it’s, you need to be the one, um, implementing a, like needing to raise level of care. And that sort of thing. So that was different for COVID. I think we had a lot more responsibility to our patients to be watching a lot out for them. Um, given that our physicians, even the ones that would follow the patients during the hospital stay in house, they see them for five in go in the room.

[00:50:02] That sort of thing. So it was a lot more, you need to be keeping track of how this patient’s doing very, very closely, um, because no one else is gonna be checking up on them really until the morning. So that changed my perspective a lot. I did not realize, um, the scope of our practice, I guess. And I don’t know if it was in a, in a actually like legal way, blah, blah, blah.

[00:50:25] But, um, definitely I still do wanna be a nurse. I actually am. Had an interview with ambulatory surgery here. I just moved up to the city. Um, from where I was in central Illinois, up to Chicago. So I’d be looking at, at doing something different, something, not at the bedside so much with some patients that generally are more healthy and, um, not COVID, I definitely need a break from COVID for a little while.

[00:50:54] Um, but the thought didn’t really cross my mind not to be a nurse anymore. Cause that’s what, you know, I have a master’s degree in nursing, like what I need to do nursing things and. I still have to pay rent and pay bills and I need to start working as soon as I can really, I’ve been able to take three weeks off and that’s just because I have a savings account and not a lot of people have that, at least at my age too.

[00:51:18] It’s be able to like, just depend on that for don’t have to be getting back into the field here pretty soon. Um, so yeah, I definitely still wanna be a nurse. Um, no comfortable in a charge position where I don’t have to be making these really, really hard decisions about people. I think that was a little bit too much for me to have to keep doing that.

[00:51:38] Um, and it’s hard to, it’s hard to conceive that you’re making can be making life or death decisions for people that are two, three, almost four times my age. You know, we did it, those couple really old patients that are like, I wanna respect all your decisions and I wanna respect your wishes and what you want, but we just can’t provide that.

[00:51:57] And to be having to say that it was really hard. 

[00:52:01] Oh, wow. Emma, congratulations for quitting. It’s for being on your third week of not doing shit for nobody. I am thrilled for you. I am thrilled to see, oh, to hear about all those lucky patients in your future. You know, I had a little card stock in my pocket with soap notes for maybe the first three years.

[00:52:28] So the fact that you were like soap notes, we come up with the plan of fucking care for these folks and we call and get the order that, and that’s not like the plan of care. Like I’m gonna tell the doctor that they need a Tums because it’s the middle of the night. And they just kind of wanna be told, like those little things, no, No, no, no, not.

[00:52:47] This is like the most grandest, most important, most biggest piece type of plan of care. And you were doing that as a nurse. And to question that and to say, you know, I wasn’t able to handle that. Here’s a little also insider secret. No one handles that in a way that they tell us is the right, right. Like no one handles that without the it affecting them.

[00:53:15] In other ways and you handle it, meaning you do it, but it is not easy and it should not be, um, that should not be one person’s job that should not, oh my gosh. It should not have fallen like that. So you did it. So check the box, you handled it. And then , 

[00:53:36] it was too much. And we had actually gotten a new nurse manager here in the spring.

[00:53:42] Um, our nurse manager left and they had opened up a, like an emergency COVID ICU. That was a nursing simulation floor. So I had not actually had real patients. So she went up there. To, um, manage that for them. So we got a new nurse manager who was a, um, an OB provider. She was an OB nurse practitioner. So her coming in with very, very limited med-surge knowledge, and of course it’s hard to get COVID experience.

[00:54:07] And that at that point being almost totally new to like med-surge nursing and stuff, she was just kind of going with whatever her superiors would say. So that was kind of maybe more where my departure started getting this new manager who just wasn’t. Um, you know, on the floor, she was not taking care of these patients.

[00:54:26] Um, she, you know, it was just different. And I had asked for a raise, I was making the same amount that I had made as a new grad with the, you know, two extra dollars an hour as charge. And that was not enough for me to want to. Stay and keep doing that type of work. I felt like I was doing a little bit too much for what I was getting paid to do, and I have even trained the travel nurses we would get, and they were making two to three times.

[00:54:53] We making. Um, so it was just at the point where I’m like, I could be making more money doing the same thing and not have to be lead and get to travel to do it. And while I’m not really considering travel at the moment, that was a big reason why I left just knowing there’s other opportunities out there that would compensate me better for my work.

[00:55:12] And yeah, just asking for a reason, getting just flat out denied, um, did hurt a little bit. Cause I felt like I. Worth more than what I was making. So that was a big indicator of me wanting to leave as well, to be honest, 

[00:55:28] huh? Absolutely. That’s, that’s totally inappropriate. And out of line that you, that that was your pay and no hazard pay and they didn’t do anything when you responded.

[00:55:39] Um, my last question and I don’t wanna say goodbye. We could talk forever. If you could leave your fellow colleagues that are listening in medicine with a few words of advice, what would they. 

[00:55:49] Well, first of all, I’d say, thank you. You guys are amazing. Um, um, just to look out for yourself and for your coworkers, as much as you can, because at the end of the day, it is your professional license that you need to be worried about and who knows what type of lawsuits are gonna be coming around because of COVID.

[00:56:07] Um, and just to be strong and just think about yourself and what you really want and what you can handle, because I got to a point where I. Didn’t think that was gonna be giving the best care. So I had to get outta there before that happened. So just to be mindful of yourself and take care of yourself.

[00:56:23] Ah, that’s really powerful. Thank you so much. 

[00:56:26] Thank you guys. I appreciate guys having me on. 

[00:56:28] Absolutely. Thanks for being on here. Powerful story. Thank you so much for sharing. 

[00:56:33] And if anyone that’s listening, um, is going through and can relate to Emo’s story or any has any information on how you are handling your trauma and your experiences.

[00:56:48] Now, either in a group setting or an individual setting, we are here for it, let us know and fill out the application so you can share your story here on the pulse check podcast. We really are grateful for you listening. Thank you, Ima. And we will see you guys next week. Bye. 

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