For Laura S, an Emergency Room (ER) nurse at a major hospital in Indianapolis, the pandemic has engulfed her hospital and her life. She is no stranger to the days when the ER became swamped with patients, nor the occasional scramble for monitors and beds. Nurses are use to multitasking. It's called a normal day in an ER.
But the changes since the good old days of February 2020 have been dizzying. With the sudden arrival of the coronavirus into the city the ER has been swamped.
Among the most difficult changes has been the new rule that no visitors are allowed in the emergency department. The implications are profound. Since COVID patients often decline quickly, families may drop off their loved ones while they are talking and breathing on their own, then have to learn over the phone that they are possibly on a ventilator, or have died. It is an understatement to say that this is traumatic for both the families and the hospital staff.
Another change is that all patients must now be treated as potentially infected, and it is mandatory to wear surgical masks at all times - from before entering the building, until leaving to go home.
Nor is home life the same. Laura leaves for work in the morning extra early so she can change into work shoes and apply her mask before entering the building. When she finishes her shift she changes into sweats and a T-shirt in the locker room, then changes into non-hospital shoes before the drive home.
When she arrives at her house she changes out of the sweats/T-shirt, puts a robe on in the garage, then sanitizes the interior of her car, as well as the outside door handles. Then she cleans the door to the garage, sanitizes her hands, puts her clothes directly into her prepped washing machine, showers, and THEN eats dinner and greets her family -- whom she has not seen since the day prior. Quality time with family has become scare.
As if the interruptions to work/home balance weren't enough, a new flow at the hospital had to be improvised. The ER admitting area has been transformed, most of the units in the hospital have been turned into ICUs, and the hospital has opened new areas in the ER. There are now three triage areas: Ambulance triage, non-COVID triage, and hot (COVID) triage.
The hospital has even set up tents in front of the hospital for the possibility that all ER capacity will become exhausted. Staff has been increased for each of the areas. Teams for the areas are comprised of one ICU nurse along with various nurses from around the city who have been displaced from their regular nursing positions.
All trauma patients are now seen in negative air flow rooms, and patients designated for the operating room are intubated in the ER first, so it can be done in a negative airflow room. This reduces the risk of infection from aerosolization (the spread of the virus through normal breathing) during these procedures.
All staff wear N95 masks which are stored in a brown paper bag after use so they can be reused. There is still a shortage of N95 masks at the hospital.
Thank you Laura S for being one of the FrontLine Heroes in Indianapolis, and for gracefully accepting the interruptions to your life, and for all you and your team are doing for the people of the city.
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