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Mrs Whiggins

By Mrs Whiggins
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I'd just like to point out that neither myself nor any of my fellow nurses, fellow advanced nurse practitioners, and other healthcare providers ever swore an oath that we would lay down our lives for

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Welp, it finally happened. I snapped in public today. I went into work for a bit this morning because I’m trying to figure out the safest way to host physicians we are recruiting given our CV-19 sit

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I don't really know what to say anymore tbh. What happened last night is hard to put into words for anyone who hasn't worked in a hospital healthcare setting. Just unreal. Everyone is getting fucked.

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Anastasis

Anastasis 23469

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1 hour ago, Neonmoon said:

I agree. What is the explanation for waiting to Dec 10th or 11th to review this?

My understanding is that there is a statutory requirement for a two week notice period to hold an Advisory Committee Meeting.  But the FDA is not mandated to hold an AdComm meeting.  There is nothing that stops them from acting without it. They are more than capable of throwing all their reviewers at the application, making a determination wrt the EUA, and moving forward.  It is prudent to hold the AdComm, but imo that could be done afterwards and if warranted pull the EUA (which would be a total shit show granted). Or just say fuck the notice period and move. Everybody knows what the outcome here is going to be.  Everybody knows the limitations that exist with the trial data, everybody knows what the acute reactions and safety profile are, everyone knows that we don't have much safety data beyond that and we are just going to have to fuck around find out. That isn't going to change until we roll it out, so lets get fucking going.  Meanwhile we drop 150k+ new cases per day running out a fucking notice period. 

https://www.fda.gov/advisory-committees/about-advisory-committees/common-questions-and-answers-about-fda-advisory-committee-meetings

https://www.fda.gov/patients/about-patient-affairs-staff/learn-about-fda-advisory-committees

 

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Brisketexan

Brisketexan 105110

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20 minutes ago, Anastasis said:

My understanding is that there is a statutory requirement for a two week notice period to hold an Advisory Committee Meeting.  But the FDA is not mandated to hold an AdComm meeting.  There is nothing that stops them from acting without it. They are more than capable of throwing all their reviewers at the application, making a determination wrt the EUA, and moving forward.  It is prudent to hold the AdComm, but imo that could be done afterwards and if warranted pull the EUA (which would be a total shit show granted). Or just say fuck the notice period and move. Everybody knows what the outcome here is going to be.  Everybody knows the limitations that exist with the trial data, everybody knows what the acute reactions and safety profile are, everyone knows that we don't have much safety data beyond that and we are just going to have to fuck around find out. That isn't going to change until we roll it out, so lets get fucking going.  Meanwhile we drop 150k+ new cases per day running out a fucking notice period. 

https://www.fda.gov/advisory-committees/about-advisory-committees/common-questions-and-answers-about-fda-advisory-committee-meetings

https://www.fda.gov/patients/about-patient-affairs-staff/learn-about-fda-advisory-committees

 

Yeah, I agree -- even if it took some sort of court action to enjoin the operation of the timing rules in this instance, that could cut it short by a few days.

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LurkingHorn

LurkingHorn 1066

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Agreed with others about the wait being unnecessary at this point. I think I brought this up in the other thread, but it seems like if they were doing a rolling review of the data then the approval should already be granted and people should be receiving vaccines right now. Two weeks can make a big difference in the number of lives saved. Very frustrating. 

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bolverk

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2 hours ago, yoladu said:

actually if there is one President of those 4 who can be credited for the vaccine it is George W. Bush. Read up on it.

https://georgewbush-whitehouse.archives.gov/homeland/pandemic-influenza-implementation.html

The NIAID made a ton of advances in new medical countermeasures in the last 15 years, shortening the time between virus identification and countermeasure development (vaccine).

without that forethought, Operation Warp Speed, or whatever you want to call it, would not have been possible. Their was already a ton of legwork and research done that made the formula/vaccine for this specific virus relatively easy to concoct - mass production/distribution is the difficult part.

 

 

 

Right. As far as I can recall, this was in response to either the SARS or MERS (both?) outbreaks and got the ball rolling, taking it quite far. The Bush administration handed off everything over to the Obama administration, which then built on it to develop the pandemic response plan that the Trump administration subsequently trashed.

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The terrifying thing to me is the fact that "resources" aren't just limited to beds, PPE, ventilators, etc.  Healthcare workers might become the most scarce resource of all.  It doesn't matter how many beds are available if there aren't enough people to treat current capacity.
Our COVID ICU just had a significant number of nurses (4 ≥ x ≥ 10) leave within a two week period. That is crippling to a unit. Guess who gets to pick up the slack??

[mention=2008]BradInATX[/mention] There is definitely a higher bar for getting admitted to the hospital, but at least here in Austin we still have enough ICU beds for frivolous admissions to my (non-COVID) ICU. So we've got that going for us.

JCAHO coming in the next two weeks, despite being utterly useless and harming nurses with their pandemic response earlier in the year. Better not have a snack out on our desks!
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Anastasis

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3 minutes ago, trauma babe said:

I don't understand why Tapa always fucks up inserting a user @mention 

And I got my fucking comparison signs backwards. 💀

Why did they leave? Issues related to current situation or unrelated reasons?

would also be interest trauma in your perspective as front line hcp on vax roll out. Some of the survey data suggest up to 30%+ or so of nurses may not do the vax initially. What is the perspective you are hearing among your coworkers, if you don’t mind sharing?

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2 minutes ago, Anastasis said:

Why did they leave? Issues related to current situation or unrelated reasons?

would also be interest trauma in your perspective as front line hcp on vax roll out. Some of the survey data suggest up to 30%+ or so of nurses may not do the vax initially. What is the perspective you are hearing among your coworkers, if you don’t mind sharing?

I can't say this with direct personal knowledge of each nurse's situation, but I've spoken with several of them plus heard some hospital gossip—ours is typically more truthful than not—and most, if not all, of the COVID ICU nurses that left did so in order to take COVID ICU travel assignments in other cities, where they will make absurd amounts of money for ICU RNs (esp Austin-based ICU RNs). They'll have to pull 5-6 shifts a week, which is rough, but when the pay is right you can deal with it. When you know that if you can tough it out for a month or two or longer—you can basically write your own contract length after 2 weeks—you can have the financial security to take all the time you need to find a hospital to practice within that does more than pay lip service to how much they care about your wellbeing and how important you are to the hospital, your coworkers, and your patients; how much you deserve to be paid more but the money just isn't there (one of the largest healthcare systems in the world); how this shitty system or protocol or whatever has to stay the way it is because it just does... Or hell, you can easily pay off your student debt, or downpayment on a house, or whatever, and get a gig at one of the other joints in town. My ICU has lost a handful over the last few months for the same reasons. Really, really good, talented, compassionate, smart, hardworking, motivated, experienced critical care nurses. Sure, they won't be able to work within our hospital system again, but why would they want to?

I'd be lying if I said I haven't run through some mental scenarios myself. Rent is expensive and only getting worse. We are locked out of any type of raise for the next two years at least, and are already among the worst paid critical care RNs in Texas when adjusted for cost of living. I've missed out on two internal advancement opportunities just this year alone for dubious reasons. I'm looking to be in anesthesia school in about a year, and that is six figures at literally any school worth going to in the country. The majority of people on my shifts now have less than two years of ICU experience and I barely recognize any of them. They are just still too naive to fully recognize what is going on. It's hard to come up with a reason to stay, tbh.

As to a vaccine, we actually just received a survey from management about our feelings on it, and we were given the chance to reply that we would be willing and available on two upcoming dates to be vaccinated, followed by the second dose two weeks later. I said fuck yes. Charge nurse at huddle mentioned earlier surveys estimated that we as staff were split about 50/50 on it. Sadly there are a number of anti-vax Karen RNs, dudebros, and people who just don't wanna get cancer first. Idgaf how thick or cold this shit is, stick it right in my delt and slam it. Or booty. Wherever it needs to go.

One of the most important roles a nurse plays is being a voice of critical education and informed, conscientious action.  

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Mrs Whiggins

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My heart hurts. It really hurts. Do you remember back in March when the task force and the President (the same man whose last 75 tweets have been about election stuff and nothing about COVID suffering) talked about 100,000 to 200,000 fatalities? Or when I posted each of the states as they reached the 100 death milestone during the Easter prediction thread? It ended on April 10 with 19 states having at least 100, Texas was at 223 and stands now at 22,000.

This is us. This is our country. Whether born here or arrived here, it is ours and we need each other more than ever. In the highest elected office there sits a man who is so extremely pathologically narcissistic that he cannot feel any empathy or concern for any of this suffering. He is physically incapable of it. The complicit officials who have stood by and watched this suffering occur and have said nothing. Or those that profited off of it financially or electorally. And the leaders that decided that rules and mandates were for others while they celebrated their weddings, or getaway trips, or meeting up at The French Laundry just for fun, giving plenty of ammo to the already callous officials who didn't care in the first place that could now crow about the hypocrisy. Or those that have ignored that their own health care, provided by the very same people working and dying in these conditions, costs them pennies compared to the regular taxpayers. All of them stand in the Hall of Shame and should never be forgotten that the final tally should forever be aligned with their names.

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...Just a few weeks ago, a man in his 30s with no medical problems arrived in Doerschug’s unit with a severe case of COVID-19. After a week on a ventilator, the man’s health had greatly improved. Nurses removed his breathing tube, and his vitals were stable. But just a few hours later, the man was dead. “Our whole team just sat down on the ground and cried,” Doerschug told me outside the hospital, his voice muffled by his mask and the sound of the heating vent. Trauma like that compounds when a hospital fills up with critically ill patients. “The sheer enormity of it—it’s just endless,” Doerschug said.

 

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Brisketexan

Brisketexan 105110

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7 minutes ago, Mrs Whiggins said:

My heart hurts. It really hurts. Do you remember back in March when the task force and the President (the same man whose last 75 tweets have been about election stuff and nothing about COVID suffering) talked about 100,000 to 200,000 fatalities? Or when I posted each of the states as they reached the 100 death milestone during the Easter prediction thread? It ended on April 10 with 19 states having at least 100, Texas was at 223 and stands now at 22,000.

This is us. This is our country. Whether born here or arrived here, it is ours and we need each other more than ever. In the highest elected office there sits a man who is so extremely pathologically narcissistic that he cannot feel any empathy or concern for any of this suffering. He is physically incapable of it. The complicit officials who have stood by and watched this suffering occur and have said nothing. Or those that profited off of it financially or electorally. And the leaders that decided that rules and mandates were for others while they celebrated their weddings, or getaway trips, or meeting up at The French Laundry just for fun, giving plenty of ammo to the already callous officials who didn't care in the first place that could now crow about the hypocrisy. Or those that have ignored that their own health care, provided by the very same people working and dying in these conditions, costs them pennies compared to the regular taxpayers. All of them stand in the Hall of Shame and should never be forgotten that the final tally should forever be aligned with their names.

 

Well, they shouldn't be libtards helping fake a hoax for extra coronavirus payments to their hospitals.

Did I get that right?

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Mrs Whiggins

Mrs Whiggins 13050

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1 minute ago, Brisketexan said:

Well, they shouldn't be libtards helping fake a hoax for extra coronavirus payments to their hospitals.

Did I get that right?

Sadly, you did. Just watching and reading how the medical staff are wearing themselves to the bone, hour after hour. People dying, hour after hour. And smug ass Mitch just sitting there with that creepy little giggle and grin like nothing is wrong. I suppose in his world, nothing IS wrong. But it is so very very wrong.

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Mach 1

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We're lucky to have Dr. Fauci in this country.  He's a rock of factual information.  No bullshit, not intimidated, communicates very effectively.

Someone like this needs the Medal of Freedom.  Might take the stain off of someone like Limbaugh getting one.  

Ah, who am I kidding.  Nothing will take the stain out of that, barring a new MOF Commission demanding he return it or shove it up his ass.

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Anastasis

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6 minutes ago, Mach 1 said:

We're lucky to have Dr. Fauci in this country.  He's a rock of factual information.  No bullshit, not intimidated, communicates very effectively.

Someone like this needs the Medal of Freedom.  Might take the stain off of someone like Limbaugh getting one.  

Ah, who am I kidding.  Nothing will take the stain out of that, barring a new MOF Commission demanding he return it or shove it up his ass.

Fauci is great.  But he also played a role in the miscommunication about mask wearing very early on in the pandemic. I don't think that anchor should hang too heavy around the neck, but it's part of the assessment. 

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Brisketexan

Brisketexan 105110

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1 minute ago, Anastasis said:

Fauci is great.  But he also played a role in the miscommunication about mask wearing very early on in the pandemic. I don't think that anchor should hang too heavy around the neck, but it's part of the assessment. 

He did -- it was a miscalculation.  The purpose was to avoid a run on super-scarce PPE as medical providers needed it, and if the public wanted it, there would have been an even worse run on it.  Honestly, there really wasn't a good play at that point in time.  Tell the public that they need to mask up, and all the PPE gets snatched up so docs and nurses die?  Tell the public they don't need masks so medical providers can have them....and then have a problem with people not believe your changed tune later?  All the options at that time were bad.

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Mach 1

Mach 1 1677

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2 minutes ago, Anastasis said:

Fauci is great.  But he also played a role in the miscommunication about mask wearing very early on in the pandemic. I don't think that anchor should hang too heavy around the neck, but it's part of the assessment. 

A reasonable person might conclude he was pressured by his boss to downplay mask wearing early on. Bad look for him, if so. Nevertheless he's been the only adult in the room for some time.

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Anastasis

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1 minute ago, Brisketexan said:

He did -- it was a miscalculation.  The purpose was to avoid a run on super-scarce PPE as medical providers needed it, and if the public wanted it, there would have been an even worse run on it.  Honestly, there really wasn't a good play at that point in time.  Tell the public that they need to mask up, and all the PPE gets snatched up so docs and nurses die?  Tell the public they don't need masks so medical providers can have them....and then have a problem with people not believe your changed tune later?  All the options at that time were bad.

I don't really agree, other than the fact that it was a miscalculation.  If the calculus was "we don't want to create a run on PPE" fine.  Just say that.  The N95s on the market were already getting snatched up and gone in early march. I mean, it's all monday morning QB'ing, but why not just be up front. "Face coverings can make a difference.  We need to reserve the most sophisticated masks for our hcps. But for the rest of us, simple cloth masks, gators, etc. can make a difference.  Get use to it guys, cause we are going to need to do it for the long haul." The inconsistency in messaging is more problematic from a public health perspective imo. 

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Mach 1

Mach 1 1677

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1 minute ago, Anastasis said:

I don't really agree, other than the fact that it was a miscalculation.  If the calculus was "we don't want to create a run on PPE" fine.  Just say that.  The N95s on the market were already getting snatched up and gone in early march. I mean, it's all monday morning QB'ing, but why not just be up front. "Face coverings can make a difference.  We need to reserve the most sophisticated masks for our hcps. But for the rest of us, simple cloth masks, gators, etc. can make a difference.  Get use to it guys, cause we are going to need to do it for the long haul." The inconsistency in messaging is more problematic from a public health perspective imo. 

Ok let's agree he fucked up early on.  Who else beside Fauci can we trust to give us the truth NOW.

crickets

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Brisketexan

Brisketexan 105110

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4 minutes ago, Anastasis said:

"Face coverings can make a difference.  We need to reserve the most sophisticated masks for our hcps. But for the rest of us, simple cloth masks, gators, etc. can make a difference.  Get use to it guys, cause we are going to need to do it for the long haul."

Have you met America?  That would have been an epic failure, and you know it -- and importantly, he and the public health people knew it, too.

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Anastasis

Anastasis 23469

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Just now, Brisketexan said:

Have you met America?  That would have been an epic failure, and you know it -- and importantly, he and the public health people knew it, too.

More than the epic fail that has resulted?

Disagree. 

Public health people know that consistency in messaging is important. 

We are all over the place.  Fauci isn't the root cause of the vast majority of the problem, orange man far more influential. 

But Fauci hasn't quite earned his hagiography, imo.  It's mostly a reflection off the scum covered pond.  

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Brisketexan

Brisketexan 105110

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4 minutes ago, Anastasis said:

More than the epic fail that has resulted?

Disagree. 

Public health people know that consistency in messaging is important. 

We are all over the place.  Fauci isn't the root cause of the vast majority of the problem, orange man far more influential. 

But Fauci hasn't quite earned his hagiography, imo.  It's mostly a reflection off the scum covered pond.  

Hindsight, 2020, all that shit.  I can definitely buy the argument that he should have messaged your way....but I can also buy the argument for the way he messaged.  Novel situation, very limited information, doing the best you can.  I have a hard time criticizing that kind of decisionmaking.  It was motivated by the right goal, and periodically involved miscalculations.  Chaos/fog of war does that shit.

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Brisketexan

Brisketexan 105110

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Just now, Anastasis said:

Also. Can we just nuke 2020. 

Dude, it's building to a crescendo.  Body count skyrocketing, complete political collapse, potential civil war......it's just getting GOOD!

giphy.gif

 

I mean, except for the thing where we're IN the show, and we're gonna die a gruesome on-screen death.  But hey.....THINK OF THE RATINGS.

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