The Cost of Covid

Hello, today I want to talk about a difficult topic for me, and one that is political. I want to talk about COVID. I want to talk about some of the effects that it’s been having on my life personally, the effects that it’s having on our medical system, and the consequences that the nurses and other health care staff are dealing with because of individual choices that are being made.

The Delta variant is brutal, and is having a heavy toll on our medical system. The ICU beds in Maine are pretty much full. That means, if you have a heart attack or get in a car accident, or go into organ failure, you are not getting an ICU bed. That means that the step down beds are taking those ICU patients because it’s the next highest acuity and their normal patients are being shunted to the medical surgical units. Many patients that should be on medical surgical units don’t have beds so they’re sitting in ED, waiting to be admitted somewhere. This means that the staff at all levels are taking care of patients, much more acute than they are normally used to caring for, in a setting that isn’t set up for that level of acuity.

I’m going to talk about this in context of just nursing because that’s what I do, and that’s the perspective that I can offer you. But it’s important to understand that the implications are for all people who work in healthcare and it isn’t just affecting nursing staff.

While all nurses have the same license, we don’t have the same training and experience. When you work in the ICU or you work in med surge or you work geriatrics your skill set changes. You do continuing education and you do annual trainings. You have a skill set that you build and you maintain working in that specialty. So that being said, when you end up taking ICU patients in lower level acuity units, you have direct care staff taking care of these patients that don’t have the training or experience to take care of those patients. They don’t have the skill set that is normally built up in order to take care of that level of acuity. This is putting our patients at risk, because they are not getting the level of expertise that those patients deserve to have. Then on top of that they’re on units that are designed to take care of lower level of acuity patient, which means that the resources simply aren’t there. The stuff to take care of these patients is not readily available for the staff to take care of them with.

It’s scary. And it’s demanding beyond my ability to explain. We’ll do the best that we can with what we have, but the result has been that COVID is claiming the lives of people that aren’t even infected with the virus. People who don’t have COVID are dying because they don’t get access to the health care they need. Because COVID is filling the beds. It’s insanity.

Choosing not to be vaccinated is not just choosing to put your own health at risk. As the number of cases rise staying unvaccinated and unmasked is choosing to put everyone with any kind of medical problem at risk. This is crushing our healthcare system. It will be a long and difficult road for our healthcare system to recover from all COVID has already cost us. And that’s not just in the system. That’s not just in the infrastructure. It’s also the burden, psychologically and emotionally, for the staff that are caring for these patients.

As a nurse: our goal and our overwhelming drive, every day is to provide our patients with the best care that we possibly can, because we want to save lives, and we want people to live well. When we’re put into a situation where we don’t have the resources and the training that we need in order to give our patients the high quality care that they deserve? That comes with an emotional burden. We have to stand by and watch your patients die because they don’t have the resources that they need. That comes with an emotional price. Every day that we clock in, it’s a price that we have to pay. And it’s an emotional price that isn’t going to go away once COVID goes away. It is going to take us time to emotionally recover from the things that we’ve seen and the things that we’ve had to do during this era of the COVID pandemic. And it’s been going on for two years; day after day after day after day… We are watching people die. People who we can normally save.

And we’re just sitting here thinking, “why are people not getting vaccinated? Why are people not wearing masks? and why aren’t we protecting each other in our community and taking care of each other so that we don’t want to have to watch our loved ones die?” It’s a really difficult thing to have to tell a family member; that there’s no bed, that your loved one needs some medical service, but there’s no bed. We can’t even transfer people out to another state because hospitals are not accepting patients from other states because they’re so overwhelmed with their own number of cases. So it’s not just a matter of shunting them to other hospitals. There are no beds. Nationally, there are no more beds.

The only way that we can open these beds back up is to bring down the number of COVID cases that are happening, and the only ways that we can do that is if more people get vaccinated, more people continue to vigilantly mask, and we start following the recommendations for social distancing the way that we should be in a very responsible way.

As demands on these units continue to rise. Hospitals will be facing difficult decisions. One of the things that they will be looking at is what services they provide and they will begin to triage those services. They will start looking at what services are truly essential for maintaining the life of individuals and which services are about maintaining quality of life. Because in a time of crisis and in a time of high demand of resource we have to put life saving services prior to those that look at the quality of life. Hospitals, and many of the peripheral facilities associated with hospitals, provide a lot of different services and those services are being provided by healthcare staff that will have a demand to be on the units where the patient load is overwhelming the staff that’s available on those units. So oftentimes you’re looking at: “Can we close a primary care office? Can we close an outpatient OB office? Can we close a Urgent Care Clinic?” in order to pull that health care staff from those facilities and bring it back into the hospital that they’re affiliated with to put them on the units where these high patient case loads are accumulating so that we can better care for the higher acuity workload that the hospitals are facing.

And this means that patients with long term chronic illnesses are going to not be able to get the care that they need and the maintenance of their conditions that they need. This is going to put them at risk for going into flares and going into an exacerbation of their condition which can then shift them from being a chronic patient into an acute patient that we’re seeing in the ED. All because our ICU beds are being filled up. That has a trickle down effect through the whole system and it has a very, very heavy price.

We need to start looking at what we can do as individuals to stem the tide, and to reduce the number of cases, so that we can reduce the number of patients that are in the hospitals.

We’ve got to do it.

We’ve got to do it, or the system is going to collapse. Because we can’t keep going at this pace forever. It’s not sustainable. It’s not sustainable on a system level. It’s not sustainable on a financial level. It’s not sustainable on an emotional level. The health care staff is burning out. We’re just going to stop being capable of doing this job, which is just going to lead to a further health care shortage. We’ve got to stem the tide.

So if you are not vaccinated; please reconsider, and get vaccinated if it is medically possible for you to do so. If you have not been masking, please start wearing masks when you’re out and around other people. Please, start social distancing if you have not been doing so. Stay home when you can and mask when you can’t. This is how we’re going to make this stop. This is how we keep people from dying.

It’s our only option.

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