COVID-19 2nd wave - Texas only - Stats and such

[Guest Lobo]

Johnny sack---the testing/hospitalization spike just hit its most recent/record apex a few days ago. 

What color is the sky in your world?  

Edited June 22, 2020 by Lobo

[atomheartbevo 89416]

2 hours ago, justhookit said:

Obviously Abbott is going to get talked about some on this thread, but for the love of god can we leave Trump and national policy out of this?

If you're talking about my post, I never mentioned Trump or even "the President" - you're the one injecting him into the conversation.  As far as I know, he hasn't even said anything recently about a stimulus round.  Policy folks in the administration who were silent in previous weeks or firmly against another round, are all of the sudden talking about it, because Texas and other states flaring up.

And by the way, I apologize if you think I was trying to create a political discussion on whether there should be another round of stimulus - I wasn't.    Next time I will phrase it as "given the business and covid climate in Texas, the policy folks in DC are talking about another round of stimulus, which could help those Texans who need it."  

Regardless of what we think, it's going to be needed in Texas.   Not everybody can afford to pump coconut water through their bidet.  Or even have a bidet - judging by the TP shelves in HEB, a lot of people still rely on rubbing shit off of themselves with paper. 

We are probably headed back down to 25% levels.  We won't shut all the way down, but I think we are at 25% sometime in July and will end up stuck there for a good month at least, just in time for school to start back up and drive the numbers up again.  A shitload of businesses in Texas cannot survive even 25% for an extended period without some kind of assistance.  Especially the hospitality folks who are getting hammered with lowered revenue from Spring Break, Memorial Day, probably July 4th, summer travel/spending in general.

 

Edited June 22, 2020 by atomheartbevo

[Johnny Sack 8397]

1 minute ago, Lobo said:

Johnny sack---the testing/hospitalization spike just hit its most recent/record apex a few days ago. 

What color is the sky in your world?  

So, ballgame in two weeks?

 

[dcar00 14035]

1 minute ago, Johnny Sack said:

So, ballgame in two weeks?

 

1.5 weeks to ballgame. the countdown it has begun.

[Johnny Sack 8397]

Just now, dcar00 said:

1.5 weeks to ballgame. the countdown it has begun.

I’ll take whatever bet anyone wants to make that by 12/31/20 Texas’ per capita death rate won’t be 1/4 of New York’s.  

[Guest Lobo]

Ballgame?  I don't know anything about that.  Maybe death rates will fall because younger people have a lower fatality rate.  I dunno.  

What is ever apparent is more people in Texas are getting it because some people are being stupid.  That's all.  

Per capita death rate 1/4 of New York's?  You sure you got that betting line correct?  

Edited June 22, 2020 by Lobo

[atomheartbevo 89416]

5 minutes ago, Johnny Sack said:

How many deaths today?

Guessing not many since no one is mentioning them.  

Deaths free up hospital beds.  I'm more concerned about those hospitals themselves.  I happen to have half a dozen hospitals in my little neck of the woods, and so I'm surrounded by neighbors who work at them (and drive up prices in the neighborhood but that's for the real estate thread).  Many of them are acting/talking like we are headed back down to previous months.

The good news, they are improving care for those in ICU it seems, hence fewer deaths.  Or lesser.

[justhookit 4179]

5 minutes ago, atomheartbevo said:

If you're talking about my post, I never mentioned Trump or even "the President" - you're the one injecting him into the conversation.  As far as I know, he hasn't even said anything recently about a stimulus round.  Policy folks in the administration who were silent in previous weeks or firmly against another round, are all of the sudden talking about it, because Texas and other states flaring up.

And by the way, I apologize if you think I was trying to create a political discussion on whether there should be another round of stimulus - I wasn't.    Next time I will phrase it as "given the business and covid climate in Texas, the policy folks in DC are talking about another round of stimulus, which could help those Texans who need it."  

Regardless of what we think, it's going to be needed in Texas.   Not everybody can afford to pump coconut water through their bidet.  Or even have a bidet - judging by the TP shelves in HEB, a lot of people still rely on rubbing shit off of themselves with paper. 

We are probably headed back down to 25% levels.  We won't shut all the way down, but I think we are at 25% sometime in July and will end up stuck there for a good month at least, just in time for school to start back up and drive the numbers up again.  A shitload of businesses in Texas cannot survive even 25% for an extended period without some kind of assistance.  Especially the hospitality folks who are getting hammered with lowered revenue from Spring Break, Memorial Day, probably July 4th, summer travel/spending in general.

 

I’ve got things to do, but no I wasn’t responding to you. It was the quote directly above mine. He edited it.

i started this thread and specifically asked, again, that we kept the politics out of it. I’ll get back to the rest of it soon.

Edited June 22, 2020 by justhookit
And as I said, I realize we are going to discuss Abbott

[dcar00 14035]

Just now, Lobo said:

Ballgame?  I don't know anything about that.  Maybe death rates will fall because younger people have a lower fatality rate.  I dunno.  

What is ever apparent is more people in Texas are getting it because some people are being stupid.  That's all.  

well how about that.  we could quite possibly /thread....nah this is surl, get back to it boys.

[dcar00 14035]

1 minute ago, atomheartbevo said:

Deaths free up hospital beds.  I'm more concerned about those hospitals themselves.  I happen to have half a dozen hospitals in my little neck of the woods, and so I'm surrounded by neighbors who work at them (and drive up prices in the neighborhood but that's for the real estate thread).  Many of them are acting/talking like we are headed back down to previous months.

The good news, they are improving care for those in ICU it seems, hence fewer deaths.  Or lesser.

I propose "not as many" as a way through the fewer/lesser fog of grammar war.

[Johnny Sack 8397]

2 minutes ago, atomheartbevo said:

Deaths free up hospital beds.  I'm more concerned about those hospitals themselves.  I happen to have half a dozen hospitals in my little neck of the woods, and so I'm surrounded by neighbors who work at them (and drive up prices in the neighborhood but that's for the real estate thread).  Many of them are acting/talking like we are headed back down to previous months.

The good news, they are improving care for those in ICU it seems, hence fewer deaths.  Or lesser.

If it has to happen, they can set up offsite hospitals promptly.  More so in July than what could have been done in April.  
 

There is plenty of surge capacity.  And we have more vents than we will ever need. 
 

A lot of what is happening now in Texas is younger people getting this.  I don’t anticipate having massive deaths like NY did.  Young people getting it isn’t the worst thing.  We should be protecting nursing homes and olds.  
 

I wear a mask indoors.  Have since mid March.  Because there are vulnerable people in public places.  What should be happening is the vulnerables stay at home and the ones who don’t have family help should have neighbors help deliver groceries and such.  The rest should get on with life. 

[Llano Estacado 1257]

I propose "not as many" as a way through the fewer/lesser fog of grammar war.

Are deaths countable / quantifiable?

Yes.

Fewer.

Less suffering. Fewer deaths. Fewer masks. Less dumb-assery. Etc. etc.

[MNLonghornFUKM 8799]

If it has to happen, they can set up offsite hospitals promptly.  More so in July than what could have been done in April.  
 
There is plenty of surge capacity.  And we have more vents than we will ever need. 
 
A lot of what is happening now in Texas is younger people getting this.  I don’t anticipate having massive deaths like NY did.  Young people getting it isn’t the worst thing.  We should be protecting nursing homes and olds.  
 
I wear a mask indoors.  Have since mid March.  Because there are vulnerable people in public places.  What should be happening is the vulnerables stay at home and the ones who don’t have family help should have neighbors help deliver groceries and such.  The rest should get on with life. 

Just got back from my grocery store and it’s sad that the old hunched over folk are probably 50% mask wearers up here. Many more young’s wearing masks but i just assume we’re more chance of being asymptomatic

[dcar00 14035]

1 minute ago, Llano Estacado said:

 

Are deaths countable / quantifiable?

Yes.

Fewer.

Less suffering. Fewer deaths. Fewer masks. Less dumb-assery. Etc. etc.

 

uh oh, the teacher showed up...and I thought I was going to get to apply the 15 minute rule.

[BradInATX 9208]

16 minutes ago, Johnny Sack said:

If it has to happen, they can set up offsite hospitals promptly.  More so in July than what could have been done in April.  
 

There is plenty of surge capacity.  And we have more vents than we will ever need. 

And we'll just go pluck doctors and nurses from the magical Nurse Tree and Doctor Bush down in the Gumdrop Forest to staff all of these wonderful overflow hospitals! 

Edited June 22, 2020 by BradInATX

[dcar00 14035]

28 minutes ago, Johnny Sack said:

How many deaths today?

Guessing not many since no one is mentioning them.  

hey wait a minute, I posted 16 deaths up thread(per 1point3).   how about, you know, a little somethin' for the effort?

[dcar00 14035]

1 minute ago, BradInATX said:

And we'll just go pluck doctors and nurses from the magical Nurse Tree and Doctor Bush down in the Gumdrop Forest to staff all of these wonderful overflow hospitals in a surge scenario! 

admit it you were going to type Magical Nurse Bush and Doctor Tree and pussed out.

[BradInATX 9208]

36 minutes ago, utee94 said:

Exactly my thoughts.  Anyone that's ever been to Mardi Gras in New Orleans, and had to stand in line for a bathroom in one of the bars, knows exactly where the extremely close physical contact was occurring.  It's crowded on the streets for sure, but it's a GD moshpit inside the bars and clubs.

 

That's why I wasn't surprised at all when the Texas and Florida beaches didn't turn into NY or LA 2.0

 

My cousin's husband who owns a bunch of porn stores down in New Orleans told me the trick was always to get in on a balcony party in the quarter. Where you pay a flat rate for open bar and food (the last one I was at was $200 I think). He was definitely on point. Worth every penny.

[BradInATX 9208]

2 minutes ago, dcar00 said:

admit it you were going to type Magical Nurse Bush and Doctor Tree and pussed out.

I'm actually more ashamed that I didn't think of it than had I wussed out

. 

Edited June 22, 2020 by BradInATX

[gmr548 16504]

For reference, here is a screengrab I pulled 06/10 compared to today's.
 


 
 

It's like watching the drought monitor over the summer.

[utee94 15745]

8 minutes ago, BradInATX said:

My cousin's husband who owns a bunch of porn stores down in New Orleans told me the trick was always to get in on a balcony party in the quarter. Where you pay a flat rate for open bar and food (the last one I was at was $200 I think). He was definitely on point. Worth every penny.

Ha!  The last time I went to New Orleans for Mardi Gras was just after college, and I'm pretty sure our entire 5-day trip there cost me less than $200.  Now that I can afford the finer things, I'm definitely not spending money on Mardi Gras in New Orleans.  The Coronas aren't even close to the top of the list of things I'd worry about catching there.

 

Edited June 22, 2020 by utee94

[Johnny Sack 8397]

12 minutes ago, BradInATX said:

And we'll just go pluck doctors and nurses from the magical Nurse Tree and Doctor Bush down in the Gumdrop Forest to staff all of these wonderful overflow hospitals! 

We have plenty of Texas doctors and nurses.  A whole bunch had nothing to do in March and April.   They are tanned, rested and ready.  
 

[Buzzrock 14870]

We can always use more Nurse Bush

[gmr548 16504]

Our biggest problem is that no one in charge will act proactively.  We're blindly groping forwards stepping on one landmine after another.

Yep.  We are seeing a massive spike, but we've lost the mentality we had 6 weeks ago.
This just feels we were up by 4 touchdowns at the half, but even though the other team just scored 14 on us in the first few minutes of the third quarter, we are still going to try and run the clock out.

Both of these really hit home on a Texas football board

[bolverk 29399]

2 hours ago, Parliament said:

5 hours ago, bolverk said:

Oh, hey, Amarillo, Canyon, and Dumas are looking better!

Perhaps. But it's still Amarillo, Canyon and Dumas.

The Panhandle might be a bland, sterile landscape but it still beats the shit out of all the broken down rust piles strewn across Ohio.

[BradInATX 9208]

19 minutes ago, Johnny Sack said:

We have plenty of Texas doctors and nurses.  A whole bunch had nothing to do in March and April.   They are tanned, rested and ready.  
 

No, we don't. Hospitals had staffing issues with nurses, doctors, and techs even before Covid. The reason we had doctors and nurses doing nothing in March/April is because we shut down elective surgeries in anticipation of a Covid surge that didn't really come. But you already knew that. 

There are a finite amount of ICU nurses. You can flex nurses over from the OR and ER, but they're not going to provide the same quality of care that an experienced ICU nurse would. They also don't grow on your magical Nurse Bush, and you'd eventually run out of them as well. In a scenario where we're building temporary hospitals in parking lots or stadiums, the staffing is going to be extraordinarily stretched and suboptimal and eventually you're putting the health of the healthcare workers at risk, which would create its own problems.

I know you're a "10 word or less" sound bite/talking point guy and not one to get wrapped up in minutia like facts or details, but this is a stupid statement even for you. It's obvious you have zero knowledge of the healthcare industry when you say things like "we have plenty of Texas doctors and nurses". Even prior to Covid, this wasn't even remotely true.  Go ask any nurse in Texas how many recruiting calls they get every month and come back and tell me your results. You're showing your ass here.

Edited June 23, 2020 by BradInATX

[atomheartbevo 89416]

52 minutes ago, justhookit said:

I’ve got things to do, but no I wasn’t responding to you. It was the quote directly above mine. He edited it.

i started this thread and specifically asked, again, that we kept the politics out of it. I’ll get back to the rest of it soon.

Sorry, didn't see his edit.      I should not have mentioned the WH though, just leave it at the policy folks are driving for another round of stimulus.

I do think we will be back at 25% in July.  Too many stubborn people refusing to wear masks.

Edited June 23, 2020 by atomheartbevo

[atomheartbevo 89416]

There is one silver lining to things, even if we don't have a statewide policy on masks - there are a lot more chains, Walmart, HEB, etc. that are going back to mask required statewide, regardless of local policies.  

Hey, wait, it's all chains that happen to sell masks.

[Js1 85104]

Say nurse bush again 

[Captainant 27447]

23 minutes ago, Johnny Sack said:

We have plenty of Texas doctors and nurses.  A whole bunch had nothing to do in March and April.   They are tanned, rested and ready.  
 

Paging @trauma babe and @ChiTownDoc I hear things have been real peachy

[JBJ 3649]

5 hours ago, Anastasis said:

For reference, here is a screengrab I pulled 06/10 compared to today's.

 

 

 

The Alamo looks like a problem area.  /nyt

[ChiTownDoc 21098]

17 minutes ago, Captainant said:

Paging @trauma babe and @ChiTownDoc I hear things have been real peachy

Honestly hospitals for the most part did have a lot of capacity open in March and April.  Some were busy and overwhelmed but very few in Texas or IL.  A metric shitton of people skipped routine care and electives were at zero.  There was a PPE problem but we have pretty good PPE just about everywhere we are at now.  And we have some last in line dumps we cover too.  

[safe sex 11678]

As @ChiTownDoc said, we did have capacity in March and April due to the cancellation of elective procedures, the lockdown, and people's general fear of catching the virus by coming to the hospital. This also coincided with a severe drought in appropriate PPE.

Both are no longer the case.

I don't have any statistics to show you to back this up, but from my years in trauma, I can tell you that traumatic surgical patients tend to come in waves. There is nothing obvious connecting them; there no reason for why they should all be happening at the same time, but they come and go in clusters with some staying longer than others. Elective procedures are generally a steady stream of patients for us: we always have a few. So when we're in the middle of a trauma peak, we're either close or at capacity (thirty beds in my home unit). Our medical ICU, where non-traumatic head bleeds, DKA, sepsis, drownings, people swimming in comorbidities, et al go, is also thirty beds. When COVID started, they designated half of those to be the COVID ICU. We were able to make it through April and May with just those fifteen beds because Austinites did an excellent job in flattening the curve compared to many other places in the country. Bit by bit, we got better, though still not wholly acceptable, PPE. (Example: when I was last in the COVID ICU a few weeks ago for a stretch of shifts, I brought my personal respirator from home so as to not have to reuse N95s, which is what got me my first confirmed exposure to SARS-CoV-2 on the first time I was sent to the COVID ICU. And to further clarify the ridiculousness, if a manager had caught me doing that, I probably would have been sent home without pay for violating their policy against using personal PPE. Another reason I work nights)

Sounds like things are/were well in hand, right? Wellllll...Austinites are no longer doing a good job at wearing masks, socially distancing, or socially isolating among ourselves. We are in a trauma peak. We have elective surgeries occurring. Our COVID ICU has expanded to past twenty of the thirty beds in the medical ICU, which means that the trauma ICU now has to take the standard MICU patient population that overflows due to a lack of beds on that floor. We. Are. Full. Our med/surg COVID floor, once kept to a single floor, has expanded to a floor and a half now. We have hemorrhaged ICU nursing staff since the middle of April, and the nurses that have stayed are burnt out with incredibly low morale. The gallows humor that exists among ICU nurses, especially on nights, is a lot more gallows than it is humor now. There is a mental health crisis occurring among nurses and the response of administration is buy boxes of doughnuts, hand out t-shirts, encourage us to do yoga, and then to make sure the public knows that they [the administration] consider us heroes.  

To anyone who says we've got plenty of doctors and nurses ready to jump in...uh what? There has been a nationwide nursing shortage for the past thirty-plus years, and Texas is no exception. Furthermore, cross-training to a new specialty of nursing takes a lot time plus supervised experience. You can't just jump into it.

• An OR nurse cannot just start taking ICU-level patients. OR nurses barely do any patient care. That is not a knock on them; it's just the reality of that type of nursing.
• A PACU nurse cannot just start taking ICU-level patients or med/surg patients. They see patients for thirty minutes-to-an-hour, tops, and their patients are always stable, hence why the patient went to PACU from the OR to begin with.
• An ED nurse cannot just start taking ICU-level patients. They have the skills to stabilize and acutely manage critically-ill patients, but they don't have the research skills, practical skills, or intuition an ICU nurse has. Not to mention, I'm not sure I've ever met an ED nurse that knows how to actually document care.. (I kid, a little)
• A med/surg nurse cannot just start taking ICU-level patients. They do not have the knowledge or experience to titrate critical vasoactive, inotropic, paralytic, or sedating medications (all of which are currently used on ICU-level COVIDs). They can't assist with line placement or intubation. They can't make more than a couple of critical decisions in a life-threatening moment because they are never really in those situations. When a code happens, you what occurs? An ICU nurse runs up to the floor to manage the code until doctors can get there because we know what the fuck we're doing in a code and they don't. Like OR nurses, this is not a knock on them. It's just a different type of nursing.
• A med/surg nurse cannot just start taking an even heavier assignment. M/S nurses at night already have five-to-six patients every shift, which isn't exactly super safe (but safe enough for the state of Texas, I guess). That is a struggle, even for very experienced RNs. Can we really ask them to start taking eight-to-ten patients per shift? And if they're COVID+ on top of everything else?
• An outpatient dialysis nurse (tons of them here in Texas/the south) can't just start taking hospitalized patients. It's entirely different! I don't know what the fuck they do, but it certainly isn't hospital patient care.

And before you just think I'm jerking off to myself about how awesome, smart, talented, beautiful, and fabulous my fellow ICU nurses and I are—though it's true, we are all of those things—no ICU nurse could just flip a switch become a med/surg nurse. On rare occasions when we are floated to help on a M/S floor, they are only allowed to give us three patients in a shift because our brains are educated and wired to handle two (three max) critical patients at a time, not five-to-six not very sick patients, and not very sick patients require a different type of care. A type of care we don't really know how to provide very well. Nor could we do any of the other types of nursing right away. It's literally impossible. If things get truly desperate, people will die due to nursing shortages.

I can't speak to or for doctors, but if there are any that want to start training to help out in the ICU as ancillary nursing staff, we haven't been told about it. 

Stay at home as much as you can. Wash your hands as often as you can. When you do go out, wear a fucking mask and stay the fuck away from other people and don't bitch about it. 

One more fun anecdote: so we are testing everyone who is admitted to the hospital now (with bullshit exceptions for external tests, even ones a week old). We had two elective surgical patients come in a bit ago, and both were swabbed when they came in. Both negative. A few days later, some suspicious symptoms, and they were retested and came back positive. Oops! Did they have it when they came in and we had a bum first test? Did they get it from us? Did they spread it to any of us while we were doing our jobs and being all up in their business? We'll never know because administration won't tell us shit. Nevermind the fact that we are starting to have nurses test positive as well, and admin's response is that we probably got it at the grocery store, so we can't blame them. Lol okay.

 

Edited June 23, 2020 by trauma babe
words

[Iceman 2639]

 

10 hours ago, atomheartbevo said:

There is one silver lining to things, even if we don't have a statewide policy on masks - there are a lot more chains, Walmart, HEB, etc. that are going back to mask required statewide, regardless of local policies.  

Hey, wait, it's all chains that happen to sell masks.

WalMart did not have a requirement for masks, not at the state or national level at least.   I do believe Costco was a national chain that did.

Edited June 23, 2020 by Iceman

[BradInATX 9208]

As [mention=2289]ChiTownDoc[/mention] said, we did have capacity in March and April due to the cancellation of elective procedures, the lockdown, and people's general fear of catching the virus by coming to the hospital. This also coincided with a severe drought in appropriate PPE.
Both are no longer the case.
I don't have any statistics to show you to back this up, but from my years in trauma, I can tell you that traumatic surgical patients tend to come in waves. There is nothing obvious connecting them; there no reason for why they should all be happening at the same time, but they come and go in clusters with some staying longer than others. Elective procedures are generally a steady stream of patients for us: we always have a few. So when we're in the middle of a trauma peak, we're either close or at capacity (thirty beds in my home unit). Our medical ICU, where non-traumatic head bleeds, DKA, sepsis, drownings, people swimming in comorbidities, et al go, is also thirty beds. When COVID started, they designated half of those to be the COVID ICU. We were able to make it through April and May with just those fifteen beds because Austinites did an excellent job in flattening the curve compared to many other places in the country. Bit by bit, we got better, though still not wholly acceptable, PPE. (Example: when I was last in the COVID ICU a few weeks ago for a stretch of shifts, I brought my personal respirator from home so as to not have to reuse N95s, which is what got me my first confirmed exposure to SARS-CoV-2 on the first time I was sent to the COVID ICU. And to further clarify the ridiculousness, if a manager had caught me doing that, I probably would have been sent home without pay for violating their policy against using personal PPE. Another reason I work nights)
Sounds like things are/were well in hand, right? Wellllll...Austinites are no longer doing a good job at wearing masks, socially distancing, or socially isolating among ourselves. We are in a trauma peak. We have elective surgeries occurring. Our COVID ICU has expanded to past twenty of the thirty beds in the medical ICU, which means that the trauma ICU now has to take the standard MICU patient population that overflows due to a lack of beds on that floor. We. Are. Full. Our med/surg COVID floor, once kept to a single floor, has expanded to a floor and a half now. We have hemorrhaged ICU nursing staff since the middle of April, and the nurses that have stayed are burnt out with incredibly low morale. The gallows humor that exists among ICU nurses, especially on nights, is a lot more gallows than it is humor now. There is a mental health crisis occurring among nurses and the response of administration is buy boxes of doughnuts, hand out t-shirts, encourage us to do yoga, and then to make sure the public knows that they [the administration] consider us heroes.  
To anyone who says we've got plenty of doctors and nurses ready to jump in...uh what? There has been a nationwide nursing shortage for the past thirty-plus years, and Texas is no exception. Furthermore, cross-training to a new specialty of nursing takes a lot time plus supervised experience. You can't just jump into it.

• An OR nurse cannot just start taking ICU-level patients. OR nurses barely do any patient care. That is not a knock on them; it's just the reality of that type of nursing.
• A PACU nurse cannot just start taking ICU-level patients or med/surg patients. They see patients for thirty minutes-to-an-hour, tops, and their patients are always stable, hence why the patient went to PACU from the OR to begin with.
• An ED nurse cannot just start taking ICU-level patients. They have the skills to stabilize and acutely manage critically-ill patients, but they don't have the research skills, practical skills, or intuition an ICU nurse has. Not to mention, I'm not sure I've ever met an ED nurse that knows how to actually document care.. (I kid, a little)
• A med/surg nurse cannot just start taking ICU-level patients. They do not have the knowledge or experience to titrate critical vasoactive, inotropic, paralytic, or sedating medications (all of which are currently used on ICU-level COVIDs). They can't assist with line placement or intubation. They can't make more than a couple of critical decisions in a life-threatening moment because they are never really in those situations. When a code happens, you what occurs? An ICU nurse runs up to the floor to manage the code until doctors can get there because we know what the fuck we're doing in a code and they don't. Like OR nurses, this is not a knock on them. It's just a different type of nursing.
• A med/surg nurse cannot just start taking an even heavier assignment. M/S nurses at night already have five-to-six patients every shift, which isn't exactly super safe (but safe enough for the state of Texas, I guess). That is a struggle, even for very experienced RNs. Can we really ask them to start taking eight-to-ten patients per shift? And if they're COVID+ on top of everything else?
• An outpatient dialysis nurse (tons of them here in Texas/the south) can't just start taking hospitalized patients. It's entirely different! I don't know what the fuck they do, but it certainly isn't hospital patient care.

And before you just think I'm jerking off to myself about how awesome, smart, talented, beautiful, and fabulous my fellow ICU nurses and I are—though it's true, we are all of those things—no ICU nurse could just flip a switch become a med/surg nurse. On rare occasions when we are floated to help on a M/S floor, they are only allowed to give us three patients in a shift because our brains are educated and wired to handle two (three max) critical patients at a time, not five-to-six not very sick patients, and not very sick patients require a different type of care. A type of care we don't really know how to provide very well. Nor could we do any of the other types of nursing right away. It's literally impossible. If things get truly desperate, people will die due to nursing shortages.
I can't speak to or for doctors, but if there are any that want to start training to help out in the ICU as ancillary nursing staff, we haven't been told about it. 
Stay at home as much as you can. Wash your hands as often as you can. When you do go out, wear a fucking mask and stay the fuck away from other people and don't bitch about it. 
One more fun anecdote: so we are testing everyone who is admitted to the hospital now (with bullshit exceptions for external tests, even ones a week old). We had two elective surgical patients come in a bit ago, and both were swabbed when they came in. Both negative. A few days later, some suspicious symptoms, and they were retested and came back positive. Oops! Did they have it when they came in and we had a bum first test? Did they get it from us? Did they spread it to any of us while we were doing our jobs and being all up in their business? We'll never know because administration won't tell us shit. Nevermind the fact that we are starting to have nurses test positive as well, and admin's response is that we probably got it at the grocery store, so we can't blame them. Lol okay.
 

That's nice but have you heard of the Nurse bush?

[NotActuallyALonghorn 4968]

17 minutes ago, BurntEyes said:

I can't speak for ChiTwon but not only have I heard nurse bush, I've seen it and even played with it.

I'll warn you though, if you do find one, it's a crazy bush. Wild if you will. It can be fun but also, trouble. You've been warned.

 

[TXSG8R 3360]

12 hours ago, Johnny Sack said:

If it has to happen, they can set up offsite hospitals promptly.  More so in July than what could have been done in April.  
 

There is plenty of surge capacity.  And we have more vents than we will ever need. 
 

A lot of what is happening now in Texas is younger people getting this.  I don’t anticipate having massive deaths like NY did.  Young people getting it isn’t the worst thing.  We should be protecting nursing homes and olds.  
 

I wear a mask indoors.  Have since mid March.  Because there are vulnerable people in public places.  What should be happening is the vulnerables stay at home and the ones who don’t have family help should have neighbors help deliver groceries and such.  The rest should get on with life. 

Why are some of you acting like death is the only outcome to worry about here?  This thing fucks up the lungs of most of the people that get it.  Even young people are showing pulmonary fibrosis and long term lung damage.  They had to perform a double lung transplant on a 20 year old.  Just because you don't have to go on a vent doesn't mean you're going to come out of this without any problems.  

[Iceman 2639]

Meh.  so do cigarettes.

We don't shut down the world for them...

Joking but not joking.  If this health and "guarantees from death" are the new normal, why the fuck do cigarettes exist?

 

Edited June 23, 2020 by Iceman

[Murfdogg21 4412]

5 hours ago, trauma babe said:

As @ChiTownDoc said, we did have capacity in March and April due to the cancellation of elective procedures, the lockdown, and people's general fear of catching the virus by coming to the hospital. This also coincided with a severe drought in appropriate PPE.

Both are no longer the case.

I don't have any statistics to show you to back this up, but from my years in trauma, I can tell you that traumatic surgical patients tend to come in waves. There is nothing obvious connecting them; there no reason for why they should all be happening at the same time, but they come and go in clusters with some staying longer than others. Elective procedures are generally a steady stream of patients for us: we always have a few. So when we're in the middle of a trauma peak, we're either close or at capacity (thirty beds in my home unit). Our medical ICU, where non-traumatic head bleeds, DKA, sepsis, drownings, people swimming in comorbidities, et al go, is also thirty beds. When COVID started, they designated half of those to be the COVID ICU. We were able to make it through April and May with just those fifteen beds because Austinites did an excellent job in flattening the curve compared to many other places in the country. Bit by bit, we got better, though still not wholly acceptable, PPE. (Example: when I was last in the COVID ICU a few weeks ago for a stretch of shifts, I brought my personal respirator from home so as to not have to reuse N95s, which is what got me my first confirmed exposure to SARS-CoV-2 on the first time I was sent to the COVID ICU. And to further clarify the ridiculousness, if a manager had caught me doing that, I probably would have been sent home without pay for violating their policy against using personal PPE. Another reason I work nights)

Sounds like things are/were well in hand, right? Wellllll...Austinites are no longer doing a good job at wearing masks, socially distancing, or socially isolating among ourselves. We are in a trauma peak. We have elective surgeries occurring. Our COVID ICU has expanded to past twenty of the thirty beds in the medical ICU, which means that the trauma ICU now has to take the standard MICU patient population that overflows due to a lack of beds on that floor. We. Are. Full. Our med/surg COVID floor, once kept to a single floor, has expanded to a floor and a half now. We have hemorrhaged ICU nursing staff since the middle of April, and the nurses that have stayed are burnt out with incredibly low morale. The gallows humor that exists among ICU nurses, especially on nights, is a lot more gallows than it is humor now. There is a mental health crisis occurring among nurses and the response of administration is buy boxes of doughnuts, hand out t-shirts, encourage us to do yoga, and then to make sure the public knows that they [the administration] consider us heroes.  

To anyone who says we've got plenty of doctors and nurses ready to jump in...uh what? There has been a nationwide nursing shortage for the past thirty-plus years, and Texas is no exception. Furthermore, cross-training to a new specialty of nursing takes a lot time plus supervised experience. You can't just jump into it.

• An OR nurse cannot just start taking ICU-level patients. OR nurses barely do any patient care. That is not a knock on them; it's just the reality of that type of nursing.
• A PACU nurse cannot just start taking ICU-level patients or med/surg patients. They see patients for thirty minutes-to-an-hour, tops, and their patients are always stable, hence why the patient went to PACU from the OR to begin with.
• An ED nurse cannot just start taking ICU-level patients. They have the skills to stabilize and acutely manage critically-ill patients, but they don't have the research skills, practical skills, or intuition an ICU nurse has. Not to mention, I'm not sure I've ever met an ED nurse that knows how to actually document care.. (I kid, a little)
• A med/surg nurse cannot just start taking ICU-level patients. They do not have the knowledge or experience to titrate critical vasoactive, inotropic, paralytic, or sedating medications (all of which are currently used on ICU-level COVIDs). They can't assist with line placement or intubation. They can't make more than a couple of critical decisions in a life-threatening moment because they are never really in those situations. When a code happens, you what occurs? An ICU nurse runs up to the floor to manage the code until doctors can get there because we know what the fuck we're doing in a code and they don't. Like OR nurses, this is not a knock on them. It's just a different type of nursing.
• A med/surg nurse cannot just start taking an even heavier assignment. M/S nurses at night already have five-to-six patients every shift, which isn't exactly super safe (but safe enough for the state of Texas, I guess). That is a struggle, even for very experienced RNs. Can we really ask them to start taking eight-to-ten patients per shift? And if they're COVID+ on top of everything else?
• An outpatient dialysis nurse (tons of them here in Texas/the south) can't just start taking hospitalized patients. It's entirely different! I don't know what the fuck they do, but it certainly isn't hospital patient care.

And before you just think I'm jerking off to myself about how awesome, smart, talented, beautiful, and fabulous my fellow ICU nurses and I are—though it's true, we are all of those things—no ICU nurse could just flip a switch become a med/surg nurse. On rare occasions when we are floated to help on a M/S floor, they are only allowed to give us three patients in a shift because our brains are educated and wired to handle two (three max) critical patients at a time, not five-to-six not very sick patients, and not very sick patients require a different type of care. A type of care we don't really know how to provide very well. Nor could we do any of the other types of nursing right away. It's literally impossible. If things get truly desperate, people will die due to nursing shortages.

I can't speak to or for doctors, but if there are any that want to start training to help out in the ICU as ancillary nursing staff, we haven't been told about it. 

Stay at home as much as you can. Wash your hands as often as you can. When you do go out, wear a fucking mask and stay the fuck away from other people and don't bitch about it. 

One more fun anecdote: so we are testing everyone who is admitted to the hospital now (with bullshit exceptions for external tests, even ones a week old). We had two elective surgical patients come in a bit ago, and both were swabbed when they came in. Both negative. A few days later, some suspicious symptoms, and they were retested and came back positive. Oops! Did they have it when they came in and we had a bum first test? Did they get it from us? Did they spread it to any of us while we were doing our jobs and being all up in their business? We'll never know because administration won't tell us shit. Nevermind the fact that we are starting to have nurses test positive as well, and admin's response is that we probably got it at the grocery store, so we can't blame them. Lol okay.

 

But how is your bush?

[B00M 6280]

Glad to hear Austin area hospitals are full and the nurses are depressed. Abbot didn't mention this yesterday, weird.

Edited June 23, 2020 by B00M

[BradInATX 9208]

5 hours ago, trauma babe said:

As @ChiTownDoc said, we did have capacity in March and April due to the cancellation of elective procedures, the lockdown, and people's general fear of catching the virus by coming to the hospital. This also coincided with a severe drought in appropriate PPE.

Both are no longer the case.

I don't have any statistics to show you to back this up, but from my years in trauma, I can tell you that traumatic surgical patients tend to come in waves. There is nothing obvious connecting them; there no reason for why they should all be happening at the same time, but they come and go in clusters with some staying longer than others. Elective procedures are generally a steady stream of patients for us: we always have a few. So when we're in the middle of a trauma peak, we're either close or at capacity (thirty beds in my home unit). Our medical ICU, where non-traumatic head bleeds, DKA, sepsis, drownings, people swimming in comorbidities, et al go, is also thirty beds. When COVID started, they designated half of those to be the COVID ICU. We were able to make it through April and May with just those fifteen beds because Austinites did an excellent job in flattening the curve compared to many other places in the country. Bit by bit, we got better, though still not wholly acceptable, PPE. (Example: when I was last in the COVID ICU a few weeks ago for a stretch of shifts, I brought my personal respirator from home so as to not have to reuse N95s, which is what got me my first confirmed exposure to SARS-CoV-2 on the first time I was sent to the COVID ICU. And to further clarify the ridiculousness, if a manager had caught me doing that, I probably would have been sent home without pay for violating their policy against using personal PPE. Another reason I work nights)

Sounds like things are/were well in hand, right? Wellllll...Austinites are no longer doing a good job at wearing masks, socially distancing, or socially isolating among ourselves. We are in a trauma peak. We have elective surgeries occurring. Our COVID ICU has expanded to past twenty of the thirty beds in the medical ICU, which means that the trauma ICU now has to take the standard MICU patient population that overflows due to a lack of beds on that floor. We. Are. Full. Our med/surg COVID floor, once kept to a single floor, has expanded to a floor and a half now. We have hemorrhaged ICU nursing staff since the middle of April, and the nurses that have stayed are burnt out with incredibly low morale. The gallows humor that exists among ICU nurses, especially on nights, is a lot more gallows than it is humor now. There is a mental health crisis occurring among nurses and the response of administration is buy boxes of doughnuts, hand out t-shirts, encourage us to do yoga, and then to make sure the public knows that they [the administration] consider us heroes.  

To anyone who says we've got plenty of doctors and nurses ready to jump in...uh what? There has been a nationwide nursing shortage for the past thirty-plus years, and Texas is no exception. Furthermore, cross-training to a new specialty of nursing takes a lot time plus supervised experience. You can't just jump into it.

• An OR nurse cannot just start taking ICU-level patients. OR nurses barely do any patient care. That is not a knock on them; it's just the reality of that type of nursing.
• A PACU nurse cannot just start taking ICU-level patients or med/surg patients. They see patients for thirty minutes-to-an-hour, tops, and their patients are always stable, hence why the patient went to PACU from the OR to begin with.
• An ED nurse cannot just start taking ICU-level patients. They have the skills to stabilize and acutely manage critically-ill patients, but they don't have the research skills, practical skills, or intuition an ICU nurse has. Not to mention, I'm not sure I've ever met an ED nurse that knows how to actually document care.. (I kid, a little)
• A med/surg nurse cannot just start taking ICU-level patients. They do not have the knowledge or experience to titrate critical vasoactive, inotropic, paralytic, or sedating medications (all of which are currently used on ICU-level COVIDs). They can't assist with line placement or intubation. They can't make more than a couple of critical decisions in a life-threatening moment because they are never really in those situations. When a code happens, you what occurs? An ICU nurse runs up to the floor to manage the code until doctors can get there because we know what the fuck we're doing in a code and they don't. Like OR nurses, this is not a knock on them. It's just a different type of nursing.
• A med/surg nurse cannot just start taking an even heavier assignment. M/S nurses at night already have five-to-six patients every shift, which isn't exactly super safe (but safe enough for the state of Texas, I guess). That is a struggle, even for very experienced RNs. Can we really ask them to start taking eight-to-ten patients per shift? And if they're COVID+ on top of everything else?
• An outpatient dialysis nurse (tons of them here in Texas/the south) can't just start taking hospitalized patients. It's entirely different! I don't know what the fuck they do, but it certainly isn't hospital patient care.

And before you just think I'm jerking off to myself about how awesome, smart, talented, beautiful, and fabulous my fellow ICU nurses and I are—though it's true, we are all of those things—no ICU nurse could just flip a switch become a med/surg nurse. On rare occasions when we are floated to help on a M/S floor, they are only allowed to give us three patients in a shift because our brains are educated and wired to handle two (three max) critical patients at a time, not five-to-six not very sick patients, and not very sick patients require a different type of care. A type of care we don't really know how to provide very well. Nor could we do any of the other types of nursing right away. It's literally impossible. If things get truly desperate, people will die due to nursing shortages.

I can't speak to or for doctors, but if there are any that want to start training to help out in the ICU as ancillary nursing staff, we haven't been told about it. 

Stay at home as much as you can. Wash your hands as often as you can. When you do go out, wear a fucking mask and stay the fuck away from other people and don't bitch about it. 

One more fun anecdote: so we are testing everyone who is admitted to the hospital now (with bullshit exceptions for external tests, even ones a week old). We had two elective surgical patients come in a bit ago, and both were swabbed when they came in. Both negative. A few days later, some suspicious symptoms, and they were retested and came back positive. Oops! Did they have it when they came in and we had a bum first test? Did they get it from us? Did they spread it to any of us while we were doing our jobs and being all up in their business? We'll never know because administration won't tell us shit. Nevermind the fact that we are starting to have nurses test positive as well, and admin's response is that we probably got it at the grocery store, so we can't blame them. Lol okay.

 

 

@Johnny Sack

Are you going to come and address this? Or just continue to drive-by post with absolutely no substance and then run away like the giant pussy you are every time someone calls you on your bullshit?

[BradInATX 9208]

26 minutes ago, B00M said:

Glad to hear Austin area hospitals are full and the nurses are depressed. Abbot didn't mention this yesterday, weird.

 

Ascension is also back to a no-visitor policy. Like for the entire hospital, not just the ICU. At least so I hear about a couple of the smaller ones (don't know about Dell/Main). I think there's still the exception that dad can be in Labor and Delivery, but that's it. So if you're in there dying of cancer, you get to say goodbye to your loved ones via Zoom. A small price to pay for slorch's freedom to walk around Walmart without a thin piece of fabric on his face.

Edited June 23, 2020 by BradInATX

[BradInATX 9208]

31 minutes ago, Iceman said:

Meh.  so do cigarettes.

We don't shut down the world for them...

Joking but not joking.  If this health and "guarantees from death" are the new normal, why the fuck do cigarettes exist?

 

 

You're legitimately asking what the difference between cigarette smoking, a voluntary activity that isn't contagious, and a highly-contagious viral global pandemic is? You made that equivocation in your mind and thought "hey, what a great point I've just made! let me post it for the world to see. Good one slorch!"?

Edited June 23, 2020 by BradInATX

[TXSG8R 3360]

20 minutes ago, Iceman said:

Meh.  so do cigarettes.

We don't shut down the world for them...

Joking but not joking.  If this health and "guarantees from death" are the new normal, why the fuck do cigarettes exist?

 

One is a lifestyle choice, one is a virus.  When the medical community realized the impacts of secondhand smoke, the government took steps to reduce the chances of being exposed to it by banning its use indoors, forcing smokers into designated spots that non-smokers can avoid, etc.  We are doing less for a virus that kills people within a month of exposure by not making masks mandatory (at a minimum), unlike smoking that can take years/decades to impact the person that, again, is doing it by choice.  Your take is fucking dumb.  

[Smax 3800]

It's not about enforcement. If there is a rule that says wear a mask, all the good people have ammo against the selfish cunts not wearing a mask who say "you can't tell me what to do". Yes, some will stay say that, but more won't. 

Yet those idiots have no problem with
No shirt
No shoes
No service

[Js1 85104]

4 minutes ago, BradInATX said:

 

You're legitimately asking what the difference between cigarette smoking, a voluntary activity that isn't contagious, and a highly-contagious viral global pandemic are? You made that equivocation in your mind and thought "hey, what a great point I've just made! let me post it for the world to see. Good one slorch!"?

Some people like to show off their 7th grade education

[Js1 85104]

Dp. Just how nurse bush likes it 

Edited June 23, 2020 by Js1

[Iceman 2639]

27 minutes ago, BradInATX said:

 

You're legitimately asking what the difference between cigarette smoking, a voluntary activity that isn't contagious, and a highly-contagious viral global pandemic is? You made that equivocation in your mind and thought "hey, what a great point I've just made! let me post it for the world to see. Good one slorch!"?

And you are ignoring an example the health hazard we have accepted in society for generations. If I go to a bar or nightclub or a casino I’m going to breath smoke. It isn’t necessarily voluntary. The point stands, all the sudden with Covid; you and your fucking moronic friends find the need to set the bar at “nobody is endangered in public.”
 

and stop being a fucking bitch and nagging every post that you disagree with.  CR is that way>>>>>>>

Edited June 23, 2020 by Iceman

[Iceman 2639]

28 minutes ago, TXSG8R said:

One is a lifestyle choice, one is a virus.  When the medical community realized the impacts of secondhand smoke, the government took steps to reduce the chances of being exposed to it by banning its use indoors, forcing smokers into designated spots that non-smokers can avoid, etc.  We are doing less for a virus that kills people within a month of exposure by not making masks mandatory (at a minimum), unlike smoking that can take years/decades to impact the person that, again, is doing it by choice.  Your take is fucking dumb.  

I don’t smoke.  I am exposed to second hand smoke in public. 
 

it isn’t a stretch, by any means.

[kevwun 15643]

Have you been out in the last 5 years?  There are almost no bars or clubs you can still smoke in.

Edited June 23, 2020 by kevwun