TEACHING THE NEW NURSES, OUT OF ET TUBES, LOTS OF CLOTS

Things seem to be better (in the sense that it’s better to be hit by a bus than a train), but the lack of resources is still pronounced. The department is now staffed by about 30% regular ED staff and 70% contractors like me, but most people are still getting a feel for the department, and many of the agency nurses here don’t have ED experience. Medical and surgical wards are completely different from ICU and ED settings. You can’t even attempt to plan your day when you work in an ED, but the contractors seem to be holding up despite the comparative chaos. Most are happy to learn, and now that things have calmed down a bit more, I’m happy to teach what I know. A number of contractors have stayed only for a few hours or days and left because the stress is so high. I don’t blame them; there’s almost nothing that can prepare you for a situation like this.

I ended my last shift in this stretch of 11 shifts in a row with a wake-up resuscitation one hour before the end of shift. I mentioned to a couple of friends (and in a previous journal article) that obtaining vascular access by drilling a hole and placing a tube in someone’s bone marrow (in lieu of an IV) was the only trick up my sleeve I hadn’t had to use yet. I should have kept that thought to myself because that “wish” got granted tonight — we had two patients with CPR in progress and difficult vascular access, so I got the drill out twice tonight. It’s been at least five years since the last time I’ve had to use that skill, but I’ve still got it, apparently.

Once I got back to my hotel room, I had to hustle to bag up my contaminated scrubs and white coat (the coat is so gross I’m not even sure it’s garbage-worthy), shower, and gather my belongings to hop on my first flight home. I got off shift at 7:30am and my flight left at 9:30am. Under normal circumstances that would be a near-impossible itinerary, but luckily for me, there’s a pandemic going on and the airport is basically empty. I made it to the airport by about 8:45, was through LaGuardia security in <15 minutes, and made my flight without a problem. This time, I don’t have a functional private jet. There are about 12 people on the flight in total, though I may get the Detroit to Madison airplane to myself.

I don’t have a definitive contract to fly back out yet, but I expect to go back on April 16th and spend another two weeks on the Eastern front. I’m excited to see my family but a little apprehensive. I don’t want to be a Typhoid Mary to them, but we talked about the return plans before I went out. Everyone in my household is low-risk; I live with three men (one husband and two long-time roommates) who are between 30 and 35 years old and my five-year-old daughter. I looked into the illness odds before I flew out and learned that we adults each have a 0.3% chance of hospitalization and a 0.1% chance of critical illness if we catch it, and the odds are even lower for my daughter. About 85% of people who end up on ventilators die, so my back-of-the-napkin math says the adults individually have a 0.085% chance of death from catching it. Despite knowing the odds are markedly in our favor if I do infect the house, a 0.3% chance of hospitalization and <0.1% chance of death is still not 0%.