Covid-19

April 8, 2020

These days work has been interesting.  I never know what I will walk into.  Mostly we have been staffed appropriately because we have stopped the elective surgeries in order to prepare for what we might need the beds for as well as to protect patients that don’t need to be in the hospital, which could potentially expose them to this virus.

April 8th: the new protocol put in place last week was to wear a surgical mask at all times while in the hospital as well as get ‘screened’ upon entrance of the building. The screening process is as follows: People with scanners, scan our name badge, take our temperature and ask if we have any new respiratory symptoms.  For the most part this is a streamline process that only takes a moment.  There have only been a handful of days I have had to wait in a line for this process. Today was no different. I waved at Travis through the window signing “I love you” as he drove away. He drops me off when he can and we enjoy the extra moments we have together in the morning and evening. Anyway, there were a couple people in front of me and soon I was on my way up to my unit, Orthopedic/Neuroscience. Today I had three patients which is a wonderful feeling from having four or five on day shift.  We were fully staffed, even with CNAs. The day progressed nicely until about one.  Prior to one o’clock, I had one discharge and there were multiple other discharges on the floor as well, reducing our patient population meaning we would probably have to reduce our staff as well.  Yet, we needed to take a look at what the emergency room had in it in case we were to receive any of those ER patients to our unit.  There were three strokes, a spine injury and a couple limb pain which could turn into a break or a potential surgical patient. So, a possible 5-6 patients could be heading to our unit.  The charge nurse was stating to me how it would be so empty up here because we will have two nurses, a charge nurse and one CNA.  I looked at him and asked, “Have you looked at the emergency room lately? There are a number of very likely patients for us. Be careful how you staff.”  He blew it off as no big deal and repeated how it would be so empty with just two nurses, a charge nurse and one CNA. Sure enough, he sent home nurses and within a short 2 hours we went from slightly over staffed (with the discharges) to understaffed and stressed.  So unnecessary! (one nurse even said to me, “how was it I was on a fully staffed floor and ended up on this understaffed floor?” I responded with, “I know, right?!”) There was one CNA for the entire floor and the charge nurse’s response was, “well what has she been doing all day? She has complained since she got here this morning, she would like to go home.” In her defense I responded: “She has had admits back to back.” “Two in one hour is not bad.” I said, “yes, but my patient also came back from dialysis and my other patient is a one to one feed, all time-consuming patients”. (not to mention the additional patients on the unit that have to use the bathroom, meals ordered, vitals taken etc.) He seemed to calm down a bit, but that didn’t alleviate the understaffed situation we were in, unnecessarily. Then, of all things, one of the patients on the floor, through a great nurse assessing and educating a certain patient, this patient went from no isolation to complete FULL isolation of a Covid-19 rule out waiting to be placed on another floor in a negative air flow room. (another frustration of the day, the nurse that had this patient previously is one that does only the minimum, so it isn’t a surprise this wasn’t found out until a resource nurse arrived on the floor and took over her patients) WHAT?!  Again?  This happened again?! Another Covid patient on our unit, where we have the elderly and immune-compromised patients? Frustration! I praise the Lord, this patient wasn’t mine this time, and I KNOW the Lord worked out the details for a reason.  Yet, this is another part of how this day hit the gutter. I have put in two separate Safety Nets (a link where we as staff share about situations that arise that were unsafe, and a team reviews them and attempts to prevent the situation from arising again) And yet I have never heard back from the team, I just get an automated email that says CLOSED.  That doesn’t tell me if they are working on it or anything. And the fact these keep happening on our floor, which is Level 5, meaning we aren’t supposed to get Covid patients until way down the road is unnerving and frustrating.  We are not set up to take these patients, yet. 

So, as we are all running around attempting to do our best to get ready for shift change, understaffed and dealing with a Covid crisis my heart hurts.  I admit I want to hide in a corner.

As my heart was hurting, running about finishing my shift, I silently reflected on why I became a nurse in the first place. I knew I would have tough days.  I knew there would be unnerving situations.  I knew the potential danger I might be in.  Yet, my love for people and my desire to care for people in times of need is why I became a nurse.  I want to be the light of Jesus to these people in a dark place in their life.  This time is now.  Caring for patients today is no different than when I became a nurse.  So why was today so frustrating? Why did I feel like I wanted to turn in my two-week notice? Because people aren’t thinking about the ‘we’.  The charge nurse was excited to say we only had two nurses and a charge with one CNA.  He was too focused on how he would feel, sharing that with bed board.  He wasn’t looking out for the best interest of the unit. (Just the other day when he asked for updates regarding my patients, which he wants to know how many discharges I might have, I told him I had a potential discharge.  He looked at me and said, “well I haven’t heard that, so I am going to say none since I haven’t ever been able to say that at bed board.”  The thoughts in my head: Really?  You aren’t going to share information with bed board, just because you haven’t ever done that before? That is the wrong reason my friend. It’s not about you, its about the needs of the unit.) Ugh. Anyway, in addition, the lack of response from the safety net team seems they don’t care about the ‘we’ either.  Not communicating they are working on the issues brought before them. Do they even hear what we are saying? The masks they force people to put on at the door, with the studies showing the lack of protection to those who are healthy, appears the reason they have us wear them is so they (Billings Clinic) can cover their hides if one of us gets this virus.  They can say “we gave them protection”.  Well, this protection is the wrong kind to protect against the virus.  Surgical masks don’t keep this virus out. So, from the publics eye, this all looks good. Not from the inside.

So then, I get frustrated. Who has my back? The charge nurse is about looking good at bed board.  The facility I work for is about looking good to the public.  Management on my unit pops their head out of their office once in a while to say, “Keep up the good work” and then go back to their protected office. Even the emergency department is only, sometimes, asking the written questions without further investigation on a patient’s exposure to Covid. (There is a script that asks “if you have been out of the state in the last 30 days, and if you have been exposed to an infectious person”. Let’s be real and ask the direct question: “Have you been exposed to someone or potentially been exposed to someone with Covid-19?”) And so, patients are getting to our unit without the proper screening and then we don’t have the proper protection. I have had two of these patients. (another post) I remind myself frequently of WHO is in control.  I know NONE of this goes unnoticed by the Lord. He is in control.  He is watching, He is not surprised by any of this.  He is my Protector, Shield, Comforter, Shepherd, and Peace.  Which is encouraging and a wonderful promise.  That calms me down. As I press on in my day, tears brim my eyes and I hold them in.  “Pull it together, finish this shift strong,” I tell myself. God has given me the ability to care for my patients, to make it through one moment at a time. Press on. Report given to the oncoming nurses. Badge out.

Travis picks me up. It is so good to see his face. I go through the motions.  I take my face mask off and put it in a paper bag on the floor behind the passenger seat, place my lunch box and bag on the seat, climb in the front seat trying to touch as little as possible on our short drive home.  He asks about my day. I keep it short so the tears won’t fall just yet, turn to look out the window and ask about his day. He knows.  He senses I’m trying to hold it together. He answers the question and we finish the ride in silence.  Upon arrival at home, I go through my ritual again, leaving shoes outside, and leaving all scrubs, badges, etc. at the door.  As I do this, Travis tells me of a co-worker of his that has said to say thank you to me for being a nurse. The tears can’t be held back anymore, I whisper thank you and quickly head to the shower.  I just want him to hold me and to let the tears fall, but I can’t, not yet. I have to scrub hard to try to ensure I didn’t bring this virus home. As the water showered down on my face, the tears began to fall. So many tears with so many reasons.  Guilty tears: for wanting to give two weeks and be done with the nonsense of the hospital. Sad tears: that I actually feel this way. Angry tears: that leadership/management and this facility don’t respond to show WE, the staff are their best interest in decisions. Envious tears: that other people get to work from home. Understanding tears: This is the first pandemic for most people and they are doing the best they can, to their ability. Tears of confusion: why do I feel this way? I don’t even have the virus.  Grateful tears: for the protection I have from the Almighty God. Tears of comfort: knowing God is in control.  Tears of blessing: to have Travis as my husband for such a time as this. Fearful tears: what does the future hold, what is the outcome of this virus. Love tears: I get to love patients, Travis loves me and God loves me even more.  Many tears fall. Finally, Travis is able to hold me and when the timing is right asks, “do you want to talk about it”.  I nod. 

When I am able to hold the tears back I begin to share with Travis about my day and how frustrating it is to go to work.  How sad I am to have lost the desire to work because I feel the staff of the hospital are not being protected to the best of the facilities abilities. And then I hear myself.  I say, with tears and great conviction: “I am willing to give my life for people, in order they would see and know Jesus. That is part of why I wanted to be a nurse.  I am willing to put myself out there for others, BUT it sure gets hard to do this for foolish and stupid people.”  I stopped. The words. What I just said resonated in my head for a moment.  Those are the very people Jesus gave his life for.  The foolish and stupid.  Me. I was foolish and stupid until the Lord opened my eyes to my need for Him.  He has changed me.  Changed my heart.  I am now a new creation. I still make mistakes, yet I desire to be more reflective of Him.  Praying for wisdom and discernment. To not be stupid and foolish anymore. This week. Of all the weeks to be having this moment of frustration, tears and mixed emotions, was the week Jesus paid it all. Jesus didn’t go to the cross to die for those that already seem to ‘get it’ or ‘have understanding’. No, He went to the cross for the undeserving, the ones with wool over their eyes. He went to the cross for those who spit in His face, slapped His face, mocked Him and for even those that physically nailed his wrists and feet to the cross while speaking derogatory words to Him. Wow.

My tears turned to those of brokenness. Brokenness for the lost.  The very people I am surrounded with day in and day out at the hospital. How could I get frustrated with the blind? They can’t see.  God sent His Son to come, to die, to raise again, with the HOPE.  He has opened my eyes, I am no longer blind. And He has prepared me for such a time as this. The Light of Jesus fills me and I should be overflowing with my every word, action and deed.  How selfish of me to expect such great things from my co-workers and employer, especially during this season of Covid-19, the unknown. My tears turned to tears of grace.  I need to have more grace for those around me. I can still be frustrated with the current situation and things taking place that shouldn’t be, but I am responsible for me and my reaction and response.  How do I gear up to enter the hospital where so many things seem to be wrong these days?  How do I tangibly shine Jesus light to make a difference in the sphere in which the Lord has placed me? Filling up on God’s word, His truths, His promises, continuing to seek His wisdom, His discernment and guidance. Prayer.  Expressing all of these emotions and concerns to the Lord Himself.  He wants to hear from me.  He has placed each of my tears: the guilty, angry, envious, understanding, confused, grateful, comforting, fearful, blessed, loving, brokenness and grace tears in a jar.  He sees them.  He knows me.  He knows my heart.

For me this looks like: putting on the full armor of God daily, to be able to stand against the flaming arrows that come my way, continuing to be an advocate, using my voice for my unit by requesting the proper safety equipment and protocol to be in place.  To continue to care for all patients with love from the Lord.  To speak up with respect, love and kindness when needed.  God has placed me on this unit, at this time, for a reason. And similar to Esther, who was placed for such a time as this (4:14) I too, am placed here and now, for such a time as this. The tears will fall, but JOY comes in the morning.