Category: Observe & Report

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So Long and Soooo Long

WARNING

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Extremely LONG Post

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(Don’t say I didn’t warn you)

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AN ESSAY FOR MY MOTHERSHIP FAMILY

I have always believed that certain elements in life have a purpose. When I found myself at odds with my personal beliefs in my previous position, I was unable to search for employment within the healthcare insurance business. I had signed a non-compete clause preventing me from finding employment at a competitor within a 50 mile radius of this particular company.

I had no idea what I would do next. I had worked as an RN Case Manager within the Healthcare Industry for more than 15 years. I had also been away from bedside nursing for close to 20 years. My only recourse (other than moving 50 miles away) was to look for Care Management positions in an office setting or return to the hospital setting.

When I saw a posting for Care Management positions at The Mothership as well as our oldest Legacy Sister, I knew I had to try for both. I felt good about the Legacy interview, but I was secretly hoping I would get a chance to interview at The Mothership.

After all, I had started my nursing career at this place some 25 years ago. I formed lifelong bonds with many of those that worked alongside me either at the bedside on the unit or as a Case Manager. They were my “family,” everyone throughout the Mothership knew or knew of each other. Despite the size at that time, going to work mostly felt as if I was going over to a friend’s house to work on a project.

The only reason I left was because I had the opportunity to work for Big Blue’s Younger Sister. It was a Monday thru Friday gig with no weekends or holidays or working odd hours. A welcomed relief from rotating days and afternoons and making sure that I worked at least 3 of the 6 holidays of the year.

Imagine my surprise when I arrived at The Mothership and the interviewer was the Case Manager (CM) I worked with as a staff nurse. In fact, I credit this person with steering me into a career in Case Management. I consider this person to be one of my Touchstones; showing up (even after I left the hospital) during those times I needed an ear to listen or a hug to tell me that things would be okay. Knowing that I was interviewing with her (now in a leadership position) was the moment I realized that the purpose for leaving my previous job was to return to the hospital setting.

It was like coming home that first week at Beaumont. Besides Touchstone, I ran into several members of my Mothership “family” who remained at the Mothership for all those years. I was happy that they remembered me; from the transporters that brought up our post-op patients to the unit. To those RN’s who worked side-by-side with me during some of the toughest days as a brand new (and even seasoned) nurse. I was even caught off guard when I ran into my former Nurse Manager (another Touchstone who had graduated from the floors to become a high-ranking RN at The Mothership). At first walked passed me, but stopped in her tracks, turned around, and called out my name, genuinely happy to see me back at The Mothership.

I also found out that many of the Case Managers I worked with during my first stint at the Mothership were still in the same department. In fact, when given the opportunity to choose my assigned unit, I chose the one where I knew two of the CMs in that office. Best. Decision. Ever.Seeing many familiar faces at The Mothership was a testament that these long-standing employees were valued and respected. Sure, there had been a few changes (holy huge new tower, Batman!) to The Mothership since I was last there; but overall, there was still that element of pride for working at an established well-known hospital. These employees were proud to say where they worked, because The Mothership only hired the best.

Flash forward to The Mothership today, seven years later. So much had changed in that amount of time, including Headquarters (HQ) attitude towards patient care and employee satisfaction. Within those 7 years, The System changed CEO’s and expanded their reach to the south-/south-western part of the Metro Area. Suddenly The System was obsessed with the merger; streamlining processes so that ALL Ships were doing the same thing.

The new CEO, though he tried to sound down-to-earth (Folks, anyone?), was somehow never visible at The Mothership. In fact I only recall him showing up at The Mothership ONCE for a Town Hall Meeting with the employees. I’m sure CEO – who, BTW is an accountant – had been to The Mothership several times, probably for other executive level meetings; however, in the 5 years that CEO has been with The System, I had never seen or met him in person.

This was a departure from past CEOs who made a point to sit with employees to take The System’s pulse, ask us how we felt and what we think should change. I just felt I couldn’t trust someone who didn’t make an effort to understand how The Mothership’s engine worked and how The Mothership remained afloat.That was the first inkling of concern I had about the direction of The System. CEO would “advertise” that he was “rounding” with multiple departments and units throughout The System. There would be videos of CEO at all the other Ships, but I had never (to this day) seen CEO do the same for The Mothership. While boasting about being transparent on his weekly email blasts, many of his decisions were made without the input of any of the “worker bee” employees. Many times The Mothership employees felt as if the wind had been knocked out of them, because changes that CEO helped implement were never clearly communicated. I quickly realized that CEO could talk the talk, but could never walk the walk. Or rather WANT to walk the walk.

What cemented my concern was two-fold. The first event was when they moved the entire Care Mgmt Dept from under Nursing’s umbrella to Finance’s umbrella. It was certainly a shift when we were used to having support from Nursing leaders. Now it felt that Finance didn’t understand (or care to realize) the importance having clinically experienced nurses and MSWs to assist in coordinating patient care during and after leaving in the hospital.

In fact The Mothership’s new CFO asked to shadow a CM to see what our day was like. I was apparently one of the CM’s who was chosen. Of course the day she sat down with me, there was none of the constant interruptions by multiple healthcare disciplines including outside vendors & insurance companies. There was no irate patient or family member who was insistent that they needed to remain in this step-down unit.

CFO lasted for less than 1.5 hours that day; often telling me that the “issues” we were experiencing were “normal” because she saw the same exact issues as the former CFO of another Out-of-State hospital. It was clear that this CFO had never spent time at the bedside; nor did CFO care to understand how many facets of Case Management there was.

CFO likely never had to explain to a patient or family member why he/she didn’t meet the “criteria” to go to Inpatient Rehab and therefore, his/her insurance wouldn’t pay for an IP Rehab stay. All while simultaneously encouraging family to choose from a list of Subacute Rehabs, which any lay person may see as a putting their loved one in a “Nursing Home.” (FYI, it’s not. There are multiple “levels” of care at any Nursing Facility.)

Better yet, I’m sure CFO had never had to participate in a Multidisciplinary Meeting with the family of a patient — who could no longer breathe on his/her own and was unable to communicate his/her wishes — to discuss goals of care for their loved one, even when every discipline & specialty consultants agreed that the current course of treatment was futile in nature. More often than none, these family meetings would turn into a WWE-like match; family members uncontrollably sobbing. Parents & Siblings screaming expletive words at one another or — better yet — throwing things at one another.

Sometimes just being in the vicinity, that flying object would veer off track and hit you instead. Sometimes meetings ended with a family member grabbing you and begging you to pull out my “magic bag” and “fix things.” Tell me that, while still trying to maintain professional composure, you wouldn’t feel some sort of responsibility to help that family … even if it is to assure them that we’ve exhausted all possibilities.

Instead what was often seen by CEO and CFO was the “number of days” (or “Length of Stay” in healthcare terms) that the patient had accumulated while in the hospital. Or the cost that The Mothership was incurring because of a complication that occurred during a patient’s hospital stay. In short, HQ and The Mothership had no experience in having those face-to-face conversations. They had never had to explain, in person, why the patient’s insurance won’t cover his / her IV antibiotic and was unable to find the right resources for any type of medication assistance. Or sat next to a patient to tell him / her that there were no other places that they can go (other than home) from the hospital because his insurance terminated, or the benefit wasn’t available. Or speak with families who insists they can no longer take care of their loved one at home but aren’t financially able to afford personal caregiver services or an apartment on an Assisted Living Campus.

The Mothership suddenly felt like a “fantasy football league.” It was all about statistics, what the “player” can bring to the table, and the resulting money they would save / make on this particular activity. Patients no longer were human in their eyes; instead, they became numbers & stats in the literal Game of Life. And us employees were just pawns (or “players”) in helping them achieve a championship title. Which would then result in vast improvements for their chances of success (aka the ability to increase The System’s revenue … or their pockets).

The second concern presented when they hired an “Interim” Director of Care Mgmt for The Mothership to “overhaul” the way that us “players” approached every single activity / responsibility assigned to our department.

Nicknamed Hurricane, she tore through The Mothership, many times treating us as second graders. The best description I could come up with was that she reminded me of Professor Dolores Umbridge in the HP series — she talks all sugary and sweet; all while demeaning you and relishing the power that she had been given.

Hurricane destroyed the Care Mgmt Dept’s confidence; often pushing activities that may work at the The System’s smaller Ships onto The Mothership, who had double (sometimes triple) the number of licensed beds. The Mothership was where the other Ships tended to transfer their complex patients. The Mothership had world-renown physicians in pretty much every specialty of care.

I don’t disagree that a hospital of this size can be difficult to “manage” and HQ often has to reel in departments where their activities may have pushed things too far. However, the one thing that had always (previously?) been true is that The Mothership was able to quickly adjust to the needs of the community, sometimes finding ways to achieve outcomes that would best serve the patient. Often times, The Mothership’s various departments would try their best and work *together* to achieve the desired results.

This didn’t matter to Hurricane. She forced her beliefs onto the Care Mgmt Dept, often threatening that we needed to “get on the bus” and get with the program. (Seriously. we were actually given a “ticket” to get on the damn bus.) If we didn’t then we should stay off “the bus” because there were other people “standing in line” willing to “get with all the changes.”

In other words, we were replaceable.

Hurricane stayed on until a new permanent Director of Care Mgmt was hired; she was to “mentor” this New Director (to “continue the work” that she had started). Unfortunately, our hopes of having someone that could understand the nuances of The Mothership while confidently, yet calmly assist us through change and adjust course as needed (as we had multiple times), were dashed. After our experience with Hurricane we were hoping that our New Director (ND) would advocate for our department.

ND often had a way of making decisions without thoroughly understanding what the results of her actions would be down the road. It didn’t help that ND was (like most of leadership after current CEO took the reins) came from outside The System. They often failed to get any input from other seasoned CM’s or Leadership on what has / hasn’t worked in the past. Once she made her decision, ND typically stood her ground; never acknowledging that her “change du jour” wasn’t achieving the outcome she wanted. As a result, she would try out another change (again without others’ input), which would result in yet another change in process. Wash. Rinse. Repeat.

If Hurricane didn’t completely destroy our self-confidence, the snap-decisions that ND made certainly did. More than often, no one could remember what the “latest process” was for an activity. Everyone felt as if ND+Minions were trying break us; aiming to pit us against one another. CM’s felt as if the Auth Coordinators (we won’t even get into THAT role) and the MSWs were out to “get them,” and vice versa. ND in essence, silo’d each of our roles; shifting responsibilities to and fro, all while adding new non-essential tasks that didn’t require an RN or an MSW to perform. Hurricane and ND’s actions ultimately had their employees questioning all the smart, talented, dedicated, and hardworking employees were even marginally “good” at our job.

They turned those employees who used to be proud that they worked for The Mothership into employees who were embarrassed to say where they worked. This type of behavior ultimately resulted in the employees resenting both The Mothership and The System.

Between Hurricane and ND’s actions (or lack thereof), the Care Mgmt Dept has lost (at the very minimum) 20 or so highly experienced CM’s, MSW’s, Auth Coord’s, and clerical staff. Many of those who had years of experience working at The Mothership.

Our department was already stretched thin when COVID-19 hit. Rather than showing support for the frontline employees, The System’s CEO (an accountant; likely with no bedside experience), had already began to complain about the loss of revenue that would occur because of this pandemic. CEO talked about how canceled surgeries and cardiac procedures, which are the main bread & butter (for The Mothership, anyway) and the payroll for the Frontline workers would result a major net loss for The System.

Let that sink in: While the community-at-large was showing appreciation for us frontline workers, The System’s CEO was complaining about having to pay them.

Bravery at that time, apparently became a detriment to The System’s (already) Deep Pockets, which ultimately led to many positions being terminated or placed on furlough in the “April Sweeps.”

Unfortunately, The Mothership’s Care Mgmt Dept seemed to turn into a microcosmic version of HQ; of what was going on systemically at The System’s Executive Level. Just like the other employees throughout The Mothership (and likely throughout the other Ships), there was an overall feeling of oppression; of feeling that you weren’t allowed to make any decisions without leadership’s approval.

And if the Head Cheese acted in such a manner, then this allowed other leaders below CEO to act in the same way to their peers under them. And so forth and so on, until it reaches those frontline workers, who have no recourse but to remain silent.

The frustration most of us felt throughout The Mothership was *never* about appreciation. It was (and still is) about feeling respected and valued. Of what we could bring to the table. It was about The System voicing that they were being transparent and honest with all their activities when they really weren’t.

In the Mothership’s Care Mgmt Dept, this ultimately lead to the lack of trust in our department’s leadership. Often times, we felt as if there was Game of Thrones-type scheming behind our backs; leading us to feel as if our jobs were in peril.

As most of us (especially the RN’s) went into the healthcare industry to *help* our patients & family members during a time wrought with uncertainty, the tendency was to make sure that we were providing the best care possible while in the hospital. In short, we practice empathy; constantly working hard for our patients & families, often at the expense of our own family and personal lives.

Things get difficult when what Management deems that their “priority” is more important than what should be best for the patient. (I’ll let you decide what our priority is: Making sure The Mothership gets paid? Or making sure the patient is discharged safely? Hint: it’s all about the Benjamins.)

Never mind that some of these “priority” tasks do not require an RN or an MSW to complete. Yes, some of those tasks are driven by the government (IMM letters, anyone?) but it doesn’t require assigning an RN (who sometimes has the clinical knowledge that could sometimes rival a first-year resident) to perform them.

If ND+Minions could understand that taking these non-essential tasks off our plates will result in improvement in The System & The Mothership’s outcomes. By doing this, it would allow us to perform more value-added tasks in addition to addressing all activities that the CFO & ND deemed as priorities which would ultimately improve our “stats.”

Unfortunately, our current Administration (at both The System & The Mothership) are too short-sighted to realize that what they consider a priority now will only hurt them financially in the long run. Fast Cash followed by Free Fall.

Long-winded, I know … but these are the reasons why, despite absolutely *loving* what I do, I feel I can no longer work for The Mothership and The System. For those that know me, I’m extremely passionate about everything I do; especially with Care Management. Unfortunately, right now there is way too much on our plates that I feel that I’m unable to give the 100% I typically do. As it is, I am OCD enough where I need to make sure that things are done in the correct manner. To do that, I would find myself working 12 hours a day, but only get paid for 8 hours. Anything to help the patient and the healthcare team.

Quite frankly, going in to work (especially of late) had been a struggle. I often felt defeated by the end of the day because I couldn’t do the necessary tasks that were needed before I left. This had affected my confidence to the point that I felt I was always angry at what was going on … not only at The Mothership level, but The System level as well. I knew I needed to get out of that toxic environment (which instilled fear and mistrust in CEO, CFO, ND as well as among ourselves) not only for my own sanity, but my Dear Husband’s (DH) sanity as well.

It breaks my heart that I’m leaving my family once again. For the past 7 years I’ve had the pleasure of working with incredible nurses, physicians, APPs, Physical & Occupational therapists (PT/OT), and other ancillary healthcare staff. From the pharmacy & their techs to nutritional support dietitians. From the cashiers in the cafeteria & concourse (who pretty much know my breakfast order) to the environmental service staff that always pop their heads into our office to see if we need our trash emptied. (We always said ” No, thank you,” only in part because it was cathartic hearing the trash bags clank down the chute. It was like throwing out all the negative juju we experienced that day.)

The people who I will miss the most are those that have been in the trenches with me … The RNs (including their management team) that work bedside us on the Medical Purgatory – I mean Progressive Care Unit I was assigned to. The PT/OT staff who was always available to do a session for patients whose insurance required their notes to determine what the most appropriate level of rehab the insurance deems most appropriate for the patient. The Respiratory Therapists who put up with all my questions about Vent / BiPAP settings and trach sizes & types; especially because I’m constantly pestering them to perform home O2 evals.

I will miss the incredible Liaisons from all the different facilities, agencies, companies; especially my favorite LTACH girl (who gets things DONE) and the Home & Hospice agency who always reminds me that the tasks I perform do not “succ.” I will certainly miss those physicians / residents and APPs who were always ready & willing to be participating team players in coordinating post-discharge care needs.

Most of all, I will miss the ladies that have sat side-by-side pretty much every day; my office sisters. They have been a constant influence in my life and have gotten me through some pretty rough patches. I will also miss all the other CM’s, MSW’s, Docs, APPs, and staff RNs who knew that our office door was always (figuratively) open for those that needed a place to decompress, vent, or even swear or cry. They knew that what happened in office stayed in our office.

I will miss those Touchstones, old and new. I will miss my Mothership Touchstones I had as a staff nurse. I will miss the Touchstone who fueled my passion for Care Management.

In fact, I relish all of my Touchstones. Though we no longer work together, I appreciate the lessons my Manager at Younger Sister taught me when I decided to try my hand at leadership. The Number One lesson was the first lesson this Touchstone ever taught me; and I continue to carry this lesson today even if I’m no longer in a leadership role. This Touchstone taught me that the most important thing about being a good leader was not to mess with people’s time (both as it relates to time-off AND length of time of any interaction/task) & pay.

Though they may no longer be my boss, these Touchstones have provided me with the confidence I needed to remember; that I am ten times better than what I think I am.

Yesterday was my last day at The Mothership. On Monday I start a new position at The School. It had always been a dream for me to work at The School. When the opportunity came up, my confidence was so shaken that I didn’t think I would get the job. At the persistence (and blessings) from my office sisters, I went for it and was genuinely surprised when I was offered this position.

I believe that going though the past seven years has lead me to this new path in my career. Despite what HQ and the leaders at The Mothership have put me through, I believe that my stint here had *purpose.* You have all lifted me up at one time or another. You are the people that gave me my courage and confidence.

I am truly sorry to those I haven’t been able to see before I left. The last two weeks have been a whirlwind of activity and — in true Mothership fashion — my last day was fraught with issues requiring my immediate attention. Please know that, despite my current feelings for The Mothership, I will miss what She used to be.

I will miss every one of you. I will miss my Mothership Family

PS. For those wondering why I kept the d*mn ticket. This is why:

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Perspective on Racism

Long rant below. Scroll past this post if you don’t want to be annoyed by my opinions
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Turn away now
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Last chance
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If you are at all interested in Civil War American history, take a looky-see at this awesome half-hour documentary about statues honoring the Confederate States and the context of how these statues are memorialized.

Two things about it:

  1. Listen closely to how Mr. Cotton describes his name, and
  2. I will *never* forget being in Charleston for work-related training.

Let me just tell you the story of my Clinical Instructor. She grew up close to Charleston and was part of the United Daughters of the Confederacy. During that week of training, we somehow got on the topic of the Civil War. That instructor pointedly stated, “It wasn’t a war about slavery” and “We don’t call it the Civil War. We call it The War of Northern Aggression.” Now imagine this person saying it in a southern drawl.” I was left speechless.

I get honoring your ancestors to remember your past, but you should also see it in the eyes of someone whose family were destroyed because of it. So yes, burn them down! But … I believe that art is art and these statues should be appreciated for what they are: An important part of our country’s history. But provide context as to why it was built and the part of *American* History it honors, for Pete’s sake!

With that said, please ALSO watch the this other video before reading the rest of this rant. It’s a great lecture about “heritage.” I’ve learned something new in the wee hours of the morning (Thanks A LOT, Kurt! 😏)

And now the rest of my rant.

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What a GREAT video that outlines what use those statues / monuments served during that time in history. It recognizes that – when they were built, they serviced that town or city’s need to feel “superior” to others. It celebrates their “Heritage,” so to speak, at a time when these cities and towns felt threatened by someone else that didn’t look like them or sound like them.

THAT’S the narrative and context I was talking about up above. This is why I believe that, rather than defacing a monument / statue, they should be “displayed” somewhere else where it can be observed and discussed of American History.

That said, I truly believe that statues of “Southern Pride” (including that d*mn Confederate flag) do NOT belong in ANY public space. Because yes, they are a symbol of White Supremacy. Rather than destroy or deface these statues or monuments, some of them (not all) should be displayed in a place where people WANT to learn about why many of the other statues / monuments were torn down during our period in time.

Clearly I am a #BlackLivesMatter person. I’m just saying that those “symbols” are part of our history, whether we like it or not. Seeing them on display (at a history or art museum) could serve as a talking point to discuss racism both now and then. It could serve as an explanation of how we got to where we are right now; the Tipping point, as is mentioned in that second video.

This person is spot on in saying that at this moment in time, there has been more support and understanding of racism. And more of an understanding of what it’s like to be judged by the color of your skin, or what you look like from the outside.

Take me, for example. I can name *several* instances growing up in a relatively blue collar neighborhood of experiencing little micro-aggression because I was Asian:

How the manager of my first job called me Connie Chung, implying that because I’m Asian, I was smart like “All Asians” are. (Psst …Not true. I came very close to failing chemistry and microbiology at Oakland University.)

Or how I’ve been called an “Oriental Doll” or, better yet – a “Shogun Princess. ” By a classmate’s dad, nonetheless.

I’m ashamed of myself for not being brave enough to correct them, but I was only a kid. How do you tell a grown adult that you are NOT Chinese OR Japanese when you’re 9 or 10?

Then there was the time when I was 16, I was referred to (by a teacher, nonetheless, as “Oriental.” It’s as if I were just an object on display or a particular design style (Oriental rug, vase, painting, etc). To me, that term is one of the most, if not the number one thing that gets to this 1st generation Filipino-American.

I now tell people that I hate the term “Oriental” because it sounds like I’m being lumped into ALL Asian ethnicities, as if we were all one in the same.

Now that I’m assertive enough to say something, it’s surprising how people react: angry for being called out, remorse for not realizing how “Oriental” is considered offensive by most Asian-Americans.

I use my experiences as a talking point for those who might not realize that there’s more to being Asian than the “Model Minority” we’ve been labeled as.

  • No, we’re NOT automatically smart.
  • No, not all of us become doctors, nurses, engineers, or accountants.
  • No, we’re NOT automatically smart. No, not all of us become doctors, nurses, or accountants.
  • Yes, I can speak perfectly clear English, so stop telling me you don’t understand what I’m saying because of my “accent.”

My point is that we shouldn’t forget how we got here. And having CLEAR examples of racism can help more people to understand why it’s horrible and sickening.

Okay. Off soapbox for now.

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Getting Things Straight

If you don’t want to read a political rant, just scroll past my post

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Another chance to change your mind

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Okay, don’t say that I didn’t warn you!

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So … let me get this straight.

  • He had our own military tear-gas static, non-violent protesters which included the media
  • He wants to invoke the Insurrection Act so he can have the power to do the same amongst the rest of the States (without permission from the governors)
  • He states he wants to DOMINATE these THUGS
  • He incites those 2nd Amendment hardbodies (and let’s face it, the NRA) to take up arms to defend themselves

So … NO to peaceful protest, but YES to violence against them so we can dominate those that may or may NOT be part of the rioters & looters?

And NO to the Federal Government interfering in State matters (-ie management of the current COVID pandemic, meaning absolutely NO leadership in working with the appropriate persons), but YES to having the ability to deploy our own military “manage” the crowds in ALL States?

Does anyone else see similarities from history on how dictatorships begin?

  1. Fear-mongering
  2. Demonizing the opposition
  3. Systematic efforts to intimidate the media and anyone that doesn’t agree with them
  4. Politicizing the civil service, military, National Guard, or the domestic security agencies

For my Filipino and Filipino-American friends & family: Doesn’t it sound similar to how Marcos implemented martial law? And then subsequently revamped the constitution, silenced the media, and used violence and oppression against the political opposition and ordinary citizens?

Do you want this to happen to the US? Because it’s already happening.

You may like him and/or agree with him on one or all of what he has done, or what he purports to be his stance about certain issues. You may like what he has “done for the economy.”

You may NOT like who he ultimately runs against for re-election.

But I implore you to think long and hard on who you want to lead our country.

And I implore you to VOTE.

Off soapbox … for now.

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News from the Hospital Front: When You Wish Upon A Star, Part Deux

So no biggie … I’ve received a few comments about my previous post, questioning why we still need to #ShelterInPlace (or #StayHomeStaySafe or any variety of similar hashtags) if the number of reported COVID-19 cases are decreasing in some areas.

First of all … just because the virus IS showing signs of slowing down in some areas, it doesn’t mean that it’s not ramping up in other areas.

Think of it this way … if you’re unaware that you have COVID-19 and are asymptomatic, then once your community “opens” you would be free to go about town without restrictions (common sense, people!). This means you can travel to other cities or communities and spread the virus into an area that otherwise did not have any (or had very few) reported COVID-19 cases. You have now put that community at risk.

Second, despite what has been told by your local, state or federal government, #ShelterInPlace was NOT meant for the sole purpose of keeping hospitals from overflowing and overwhelmed. Yes, that is ONE aspect of it, but so is trying to keep your cooties to yourself or your household. #ShelterInPlace was to help STOP the spread of COVID-19 and to keep the communities SAFE from this highly contagious virus.

Yes, the hospitals are NOT at capacity; however, that is because the otherwise money-making elective surgeries would have pushed the hospitals over capacity and therefore limiting the number of resources available to that hospital (-ie- staffing, PPE, ventilators, oxygen delivery equipment, etc).

And honestly, unless it’s an emergent situation … would you want to have surgery at a hospital at this time? Where you know COVID-19-stricken patients are also being treated? #ShelterInPlace was to PROTECT the PUBLIC from COVID-19. This virus is extremely contagious to the point where health care professionals and researchers are still unable to determine why the virus affects each person uniquely.

Yes, there are those common symptoms (extremely high fevers, chills & unrelenting head- and muscle aches) and manifestations of contracting the virus, but the short-term effects vary from person to person. Some may never have any symptoms, while others go into acute respiratory distress, kidney and/or heart failure. They can develop bleeding disorders in which blood clots develop and spread into your legs, lungs, heart, brain. Can you imagine having a stroke and/or a heart attack from these blood clots?

Yes these are horrible things that occur to those who develop these issues from COVID-19. It doesn’t happen to everyone … but It. CAN. And just because you don’t feel like you’ve contracted the virus, doesn’t mean you don’t have it and are capable of spreading it to at least 5 to 6 other people, who can each spread it to another 5 to 6 people. Any number of those people will likely develop these complications. How would YOU feel if you gave it to someone you love? I can tell you from experience that IT. SUCKS.

Anyway, those are just the some of the immediate (acute) complications that can develop. We haven’t even been to break the surface on any long-term complications.

There are multiple medical journals out there reporting how COVID-19 “survivors” requiring oxygen (or worse, a ventilator) during the acute phase of the virus are still having difficulty maintaining their lung function, even after being successfully weaned off of oxygen treatments. My Dear Husband (DH), for example … He has been home now for three weeks and yet his oxygen saturation (O2 sat) levels range only from 88-94%. A “normal” saturation for otherwise healthy people should typically be anywhere from 97-100%. “Bad” is anything less than 89%.

My cousin, also a Registered Nurse working on a COVID-19 ICU unit, has also had COVID-19. More than a month later, she is still having difficulty breathing (despite having normal O2 sat levels) and has had ongoing intermittent chest pain / pressure. There have been reports of COVID-19 “survivors” developing cardiomyopathy (weakening of the heart muscles) and heart failure; however, her PCP and her specialty physicians (a pulmonologist and a neurologist) haven’t even considered doing any cardiac working her up because all her cardiac blood tests and her EKGs have been normal.

Did I mention she’s under 30 years old and that the multiple times she’s been to the ER, she’s been told that all her symptoms are likely “just anxiety” since her immediate diagnostic tests were negative. So instead, she’s “living with it” and still going to work.

As for me, there are other journal articles out there that talk about short term memory loss for those affected by COVID-19. Besides the unrelenting dizziness I have whenever I change positions from standing-sitting-lying (NOT caused by blood pressure changes, BTW), I do believe that COVID-19 has affected my memory. I don’t know, maybe it’s because it’s overwhelming at work with the frequent changes in policy, procedure, etc; but I find myself (more so post-COVID, than prior) losing track of my keys, phone, wallet. I also have had issues forgetting about certain tasks or items that routinely (and already on one) to be added to lists. And from talking to other COVID-19 “survivors,” I’ve found that I’m not the only one that this has happened to. We have officially named this condition as “COVID Brain.”

Just so you know, I am able see it from the side of those individuals and families that aren’t healthcare professionals. For the most part, my DH and his parents are not as versed in the Health Care World as both I and DH’s sister am. It’s a LOT of information to take in and there is NO simple way of explaining how much of a toll this has taken on every single person in the world, let alone how much COVID-19 has and will continue to affect how we live our lives on a daily basis.

We might as well face it now that there will be no returning back to normal. And that we will all have to adjust to a new normal.

I also get that the longer that our nation remains “closed,” more people will be unable to maintain employment (myself, as a Registered Nurse included). I understand how this can lead to financial ruin (DH has the hospital bills to prove it) and therefore, the inability to provide for yourself and/or your family. But please let me implore you to consider that this will ONLY CONTINUE until there is a way to stop the spread of COVID-19.

And since a vaccine for COVID-19 is a long way off (despite what you hear in the news) AND we currently don’t even have a consistent and adequate treatment guideline in place for treatment of COVID-19, the ONLY way to #SlowTheSpread is to continue practicing social distancing and wearing a face mask when outside your home.

And, in my own humble opinion, the only way to gain the “upper hand” (so to speak) on COVID-19 is to #ShelterInPlace.

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News from the Hospital Front: When You Wish Upon A Star

I hear you, people. I understand how hard it is to work from home or to provide some sort of semblance of school to your children. I also know how difficult it is to be unemployed (believe me, I found myself unexpectedly unemployed during the summer of 2010) and yet still have bills to pay.

I am also bored as h*ll staying at home (although, my cooking may have improved a bit) and am chomping at the bit to go out. As it is, DH, Kirby Krackel, and I were scheduled to be on vacation this past week and the upcoming week. Two whole weeks off to make a road trip out to the Utah National Parks. Sadly, it wasn’t meant to be. Due to this stupid COVID-19 crisis.

But what I don’t understand is why other states are loosening up the restrictions on staying at home and are beginning to open non-essential businesses in the wake of this crisis … which is FAR from over, despite what you may be reading and/or hearing in the news. For those that disagree with me, I invite you to tour the ER and spend a 12-hour shift in the ICU.

I don’t wish it upon you or any of your loved ones, but I wish you could understand what it’s like to have experienced having COVID-19; the feeling of isolation and helplessness that comes from keeping your distance from loved ones so that you don’t give COVID-19 to them.

I don’t wish it upon anyone to experience the extreme chills despite high temps, the worse muscle aches in the world. And yet, as a Registered Nurse, knowing that you NEED your body to react this way because it’s your body’s way of trying to fight off the virus on its own. And in the same vein, fearing that your body may overreact and cause severe respiratory distress that you need to be admitted to the hospital.

I don’t wish it upon you, but I wish you could feel what it’s like to watch via FaceTime the panic in your spouse’s face as you see him struggling to breathe with a mask blowing 100% pure oxygen directly through his mouth & nose … while he barely is able to tell me that he still feels like he can’t take a breath. Or the panic you feel that, as a wife and as a Registered Nurse:

  1. You can’t be there to physically hold his hand to help calm him down
  2. You know his assigned RN is busy with her other patient that is being intubated, and
  3. You fear that he’ll be the next one they’ll place on a vent.

I don’t wish it upon you, but I wish you could experience the red taped bureaucracy involved in trying to seek appropriate treatment, while also trying to follow the guidelines put in place … Only to have those guidelines change from day to day, hour to hour.

Or the fact that, as an essential worker, how difficult it has been to even get tested for COVID-19, knowing that your positive test result can be added to the data being collected during this pandemic.

I don’t wish it upon you, but I wish you knew what it’s like to love your career and be good at it, yet are hesitant to go into work each day for fear of what might happen on your shift.

Or what it’s like to force yourself to take a few deep, calming breaths before pushing back your unit’s door, labeled with a temporary sign that reads “Isolation Unit. Keep Doors Closed.”

Or how every day you greet your co-workers with, “Wonder what fresh hell we’ll get ourselves into today.”

Or how much of a struggle it is to remember what the latest protocol is for each specific task you have on your daily assignment. And what it’s like to worry that if you don’t follow these ever-changing guidelines, then you’d miss something life-threateningly important.

Most importantly, I don’t wish it upon you, but I wish you could recognize that what is happening at the patient’s bedside and on these units are occurring at a lightning fast pace. So fast in fact, that the *actual* news reported on a daily basis is often times a week or two behind.

  • Lack of testing? Called it.
  • Lack of PPE not just for the hospital, but other care facilities including nursing homes? Called that, too. Hydroxychloroquine ousted as “The Miracle Drug”? Uh huh … and I’m waiting for the news to report on how Remdesivir is only effective within 1-4 days of when the patient actually developed symptoms.

I don’t expect you to *understand* what my experiences have been like with COVID-19. However, I am simply asking you to see the reasons why Michigan’s government placed these “Stay At Home” restrictions in place.

While COVID-19 may not have affected you or your loved ones directly, it HAS affected the 50K Michiganders who tested positive for COVID-19 (which is significantly less that the actual, as many people were denied testing … myself included).

Or the families of the 5K Michiganders who DIED from COVID-19 related complications.

What I DO wish upon you is this: I implore you to consider the reasons why I believe it’s too early to “reopen” the country.

How can we reopen when we don’t have adequate testing to confirm exactly how many people have COVID-19?

How can we #SlowTheSpread when we aren’t even sure who has the virus or not … especially when there are countless of people that are NOT showing any symptoms? Those countless people would then unknowingly spread COVID-19 to at least 5 to 6 other individuals that can also remain asymptomatic.

How can we allow businesses, restaurants, retail shops to open when we don’t even have the appropriate leadership in place to set realistic guidelines on how to control the spread of this highly contagious virus?

How can we “reopen” when we don’t have a secure plan in place to keep the curve flattened?

How do we not learn from other countries that have reopened “too soon” and now have shown a resurgence in COVID-19 cases? Like South Korea, who loosen some social distancing restrictions early this month; or the Wuhan Province of China, where new cases popped up after at least 35 days without any new ones.

How can we believe that with “common sense” we can “go back to life as it was” … when “as it was” WAS. NOT. ENOUGH. to control this COVID-19 Pandemic? And that the thought of “we could catch the virus or any other virus” is merely considered a risk?

Sure we take risks every day, but that’s a CHOICE that each individual makes … of which that risk, if you use “common sense,” should then be limited to your own outcomes. “Common sense” would dictate that any risk taken should avoid endangering others. Unfortunately, if you CHOOSE to take the risk of going out into public without applying social-distancing and without wearing a protective face mask … you certainly are NOT using “common sense.” In fact you would be putting an entire community at risk.

It’s unhealthy to think that by staying “closed,” our economy will crumble. It’s also egotistical to think that if the US Economy collapses, then every other economy will collapse worldwide. How can we think that the economy … the “almighty dollar” (or in this case “liquid assets”) is worth more than a life?

Let me clarify by saying that I DO want the country to reopen. I DO want our economy to be stable. I DO want those unemployed by this crisis to be be able to go back to work. I would certainly love to go out to restaurants again. And take that Road Trip we had planned for the beginning of this month.

What I DON’T want is to see an increase in hospitalizations for COVID-19 related issues. Because the more COVID-19 cases seen in the hospital means that the more resources will be reallocated to treating these patients.

This means that elective surgeries (the money maker for any hospital system) will be placed on hold (again), resulting in less revenue. Then the (non-frontline) Hospital Executives will continue to believe that they have “too many employee salaries to pay”, which would then lead to more furloughs and job eliminations.

This ultimately means less staff to take care of these COVID-19 patients (or any sick patients requiring hospitalization, for that matter). And since there will ultimately be those individual who DO NOT use their common sense when the economy reopens, this mean that we may ultimately never gain control over COVID-19. That’s why *I* believe that we need to maintain these #StayHomeStaySafe and #ShelterAtHome restrictions for now; at least until we are able to control the spread of COVID-19 … If not to save more lives (we just surpassed 90K deaths today), but to protect the lives of those still walking this earth.

After all, what good is an economy if we don’t have people to spend it on?

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PS. Thanks to the research study I participated in, I can officially say that I did have COVID-19. And I have the antibodies to prove it!