whithou

Update from the lawyers representing the cyclists https://www.bikelaw.com/2021/10/waller-bike-crash/

Wow, I hope I don't encounter some of y'all on the road when I'm biking to work. Bike lanes are basically non existent in Houston so I take the lane when I'm on a two lane road (I don't bike on roads with just one lane). The speed limit will never be what I pedal so I guess y'all will have to slow down for a few minutes until you can safely pass. F me for trying to do a good thing for the environment and stay healthy. Most bikers I see around my area are just trying to get from point A to B and not decked all out in spandex. I do rock the spandex once a week but that's when I'm getting miles in on the bayous.

I leave at 6AM when it's still dark out and go at a leisurely pace so I'm not too sweaty when I get to the hospital. Wearing breathable scrubs helps too. My husband on the other hand is a sweaty mess when he gets to work but they have showers that he's able to use.

I know of one of them testing positive and having respiratory distress. I'm not sure if it was from COVID or from the fact that the baby was premature (30 weeker).

Things are still grim at my ICU in Houston. The one thing I'm struggling with the most this time around is taking care of pregnant patients. I was pregnant the last wave and was terrified of getting COVID even though we didn't have any pregnant COVID patients. I don't know how I would be able to keep it together if I was still pregnant this time around. We have a handful of them now and all of them had to have emergency C-sections once their oxygen saturations dropped. The silver lining is that the babies are doing well down in the neonatal ICU but the moms are still intubated with no signs of improvement. Even with the additional ICU that opened up we are still full with no open ICU beds. One perk is that our administration is pretty much throwing money at us to stay in our current roles. I currently get four times my salary to just show up at work so I have been thinking of using that extra cash for a trip once this nightmare is (hopefully) over.

Things we've done as a family: - We are a one car household. I bike the kids to daycare on our electric cargo bike (Tern GSD). My husband and I also bike to work. We chose to live in the loop in Houston so we can walk to the grocery store and restaurants. - I take all of our veggie and fruit scraps/used coffee beans to a nearby park that has a compost bin. - We buy most of our produce from the farmer's market. I try not to cook too many beef and pork based meals and instead use chicken as the main protein. The next step is to do vegetarian meals but it's been hard for me to get creative in that area. - I shop at consignment shops to get used clothes

Yep, it's wild here at my Houston ICU as well. My cardiac ICU has no cardiac patients. Instead, they are all replaced with COVID ones and we are a COVID ICU now. So hopefully no one has a heart attack right now as there are no beds for them at my hospital. We do have one intubated patient who had the first shot in July (no second shot). I'd say there's a 50/50 chance he'll make it.

My hospital system in Houston is drowning right now with this recent wave. It seemed like overnight last week that my ICU unit got overwhelmed with COVID. So far all of our patients in the ICU have been unvaccinated. Our CEO sent out an email yesterday saying that since the beginning of the year our hospital system has had around 220 COVID deaths and all of those were unvaccinated individuals. My patient that I had the other day got it at their own birthday party and we intubated them yesterday after I noticed them starting to act a little odd (a change in mental status is a quick ticket to intubation with COVID patients). From my view, this variant has been more deadly and we are intubating more frequently this time around. We are out of ICU beds and COVID patients that need an ICU bed are once again waiting down in the Emergency Center. To top it off, we are short staffed as most nurses have taken travel assignments or have left bedside all together. Because if a nurse has to deal with this mess again, might as well be making $120/hr on a travel assignment.

We're back to the surge status that we saw last spring at my hospital in Houston. We have been on full diversion for a couple of days now with COVID patients waiting for days in the emergency center due to no bed availability. Our hospital has been bleeding nurses to travel assignments, where they can make $120/hr, so we have been working with poor staffing in our ICUs. We had a neonatal nurse sent to my ICU to help us the last shift I worked. A COVID patient on the verge of intubation was convinced that he wanted to leave against medical advice because he thought he take care of himself better at home. He was tired of being told to lay on his stomach and to keep his Bipap mask on. It took our head doctor of the ICU to go talk to him and have him watch his vital signs monitor to see his oxygen levels drop from 88% on the Bipap to 70% with no supplemental oxygen to scare him enough that he stated he would stay one more day. Our doctor also offered to give him a tour of our ICU before he left so that the patient could see what the next step would be for him if he decided to leave our unit. That next step being sedated, paralyzed, and having a breathing tube down your throat.

Has she gotten an antibody test to see if she has had it? I feel like I and most of the nurses have likely gotten it but testing is only offered if we have had symptoms. We have had a couple of patients that have gotten COVID while hospitalized so even with us all wearing masks it is still being spread around.

It's only for those that work at my hospital.

Reasons from being "I don't want to be a guinea pig" to "Bill Gates wants to know where I am". I wish I was kidding. When I ask if they have read more about the vaccine most haven't done their own research.

I signed up to help administer the COVID vaccine to medical staff starting next week. Most of the ICU nurses that I work with have passed on getting it. I would have eagerly gotten it if it wasn't for a disqualifying factor (pregnancy).

At my Houston hospital we are now opening up a third COVID ICU overflow and a third medical/surgical and stepdown COVID overflow. We also now have travelers on our units as more nurses are calling off due to having COVID. I came onto shift the other day and saw an oxygen tank in our break room. I thought that was odd, and found out that one of the nurses couldn't breathe during her shift and she had to take a time out and get supplemental oxygen. A few days later she ended up testing positive for COVID. We have access to IPads now for our patients which brings about some heartbreaking conversations. A daughter was pleading for her dad to show some sign of life while he sat motionless on the ventilator. He's been off sedation for days but he is still unresponsive. One of our long stay COVID patients passed the other day. Her oxygen saturation read 1% on the ventilator. The lowest I have ever seen is in the 60s with a good oxygen saturation being between 90-100%. While I was watching one of my unstable COVID patients through the window yesterday an IT contractor came up to me and told me that I should try to get COVID. I laughed and then stopped once I realized he was actually being serious. He said that we need herd immunity and that he had already gotten COVID to protect himself. I told him I'll pass on that on the off chance that I myself end up where my patient currently is.

They did cross train nurses in anticipation of our surge staffing. I had nurses from the OR, PACU, and downgrade units shadow me. The cross training is really just for nurses from other units to get a feel for how it is in the ICU as under their scope they still cannot do ICU tasks. Currently I take care of 1-2 ICU patients. When we do switch to surge staffing I will be taking care of 3-6 ICU patients and have 1-3 nurses under me to do non-ICU tasks. Which isn't that helpful as the nurses assisting me will not be able to manage the ventilator or titrate medications which is a big part of COVID patient care.

Update from my hospital in Houston. We are opening up another ICU and downgrade unit for COVID patients. Currently our four ICUs are full. For the patients that are in our emergency center I've heard from nurses there that they are reaching out to hospitals in places like College Station and Huntsville to take our COVID ICU patients since we are out of space. I worked overtime this week to make up for how short staffed we are as nurses are starting to have symptoms of COVID and calling in. We are pulling nurses from downgrade floors to take our patients, which is super unsafe since they don't have ICU experience. We did stop elective procedures this week on my unit but I'm worried that these patients that aren't able to get cardiac caths done will eventually come in emergently after having a heart attack. We had several of these the first time we shut down elective procedures.

It has been a disheartening journey and it is only starting. I did not realize how there really is no definitive treatment for the illness until we got COVID patients. When they first come on our unit they are not intubated yet and are on maximum supplemental oxygen. They are all agitated and keep pulling off their oxygen devices so we are constantly running into the room to hold the oxygen device onto their face. The doctors don't like intubating as it is hard to extubate/take them off the breathing tube. Eventually though the patients need to be intubated as their oxygenation numbers aren't so hot. After they are intubated the patients usually have to be paralyzed so they can tolerate the breathing tube. Then starts the waiting game of hoping they'll start to improve on the various trial medications and proning them. Meanwhile, COVID wrecks havoc on all of the other organs in these patients. We have only have a few success stories and those patients were the younger ones. Everyone I work with is emotionally drained and the last shift we had two COVID patients that coded. I have family members calling around the clock and I never have anything positive to tell them. We still don't have enough PPE and I rewear my N95 until is breaks. I know that I'll eventually get COVID if I haven't already but at least I'm young and healthy. The older nurses are very nervous and one kept saying "I don't feel safe/I'm scared" the last shift I worked. This is probably more information than you wanted to know but it was therapeutic to type this out. Thanks for reaching out on what it has been like.

Long time lurker but decided to bite the bullet and register since I can offer some perspective on this. I'm an ICU RN in Houston and the ICUs at my hospital are definitely overwhelmed. Elective procedures had started back up at my hospital that required ICU admission afterwards but I have a feeling that will come to a halt now with us having no empty beds. My ICU became a COVID overflow unit in March but we are now at capacity with the majority of our patients with COVID and intubated. The main ICU where COVID patients go has been full for awhile now but they have been able to always downgrade a patient just in time for them to take another sick one. That is not the case anymore as the intubated COVID patients are not getting better and stay for several weeks. The last shift I worked they had intubated patients just chilling in the EC because we were out of beds. Texas Children's and MD Anderson are going to start taking patients from at capacity hospitals since certain hospitals are out of space.