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Coronavirus prep

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  • corinasue1143
    corinasue1143 Posts: 7,464 Member
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    I’m really struck by the general tone of this thread. I don’t think people realize how hospitals and ICUs are run in general. I worked as an RN in a telemetry unit, which is a step down from ICU. Every single year during the flu season, the hospital filled up, as did the ICU. It was not unusual to people to come into the ER, and either have to wait 12-24 hours because there were no beds available or even the hospital would direct ambulances away, because they were full. There were many times when the ICU was full and so they would send the patient who needed to be in the ICU onto the telemetry unit with a ICU nurse to take care of them.
    This was a normal occurrence in a city with a large number of hospitals.
    They didn’t just send patients out on their own and say “Oh well!”.
    I do get annoyed when I hear non medical people really freaking out about full hospitals and ICUs, as though this just shows this is the end of the world. This always happens every year. COVID is just highlighting the real problems with the system. Hospitals operate to maximize their profits. They don’t want empty beds sitting around. If there are too many for too long, they either cut staff or offer new services.
    A real part of this problem is the way hospitals are run. They are operating on a knife’s edge for profit. Not once have I heard this being addressed. Even in normal times, RNs have a burnout time of about 2 years because they are so overworked. So when I hear people freaking out about how nurses are overworked, it’s nothing new.
    Full hospitals and overworked nurses are not shocking things. Of course it’s worse than normal, but but definitely not shocking.

    Thanks for saying it so well
  • Dnarules
    Dnarules Posts: 2,081 Member
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    I’m really struck by the general tone of this thread. I don’t think people realize how hospitals and ICUs are run in general. I worked as an RN in a telemetry unit, which is a step down from ICU. Every single year during the flu season, the hospital filled up, as did the ICU. It was not unusual to people to come into the ER, and either have to wait 12-24 hours because there were no beds available or even the hospital would direct ambulances away, because they were full. There were many times when the ICU was full and so they would send the patient who needed to be in the ICU onto the telemetry unit with a ICU nurse to take care of them.
    This was a normal occurrence in a city with a large number of hospitals.
    They didn’t just send patients out on their own and say “Oh well!”.
    I do get annoyed when I hear non medical people really freaking out about full hospitals and ICUs, as though this just shows this is the end of the world. This always happens every year. COVID is just highlighting the real problems with the system. Hospitals operate to maximize their profits. They don’t want empty beds sitting around. If there are too many for too long, they either cut staff or offer new services.
    A real part of this problem is the way hospitals are run. They are operating on a knife’s edge for profit. Not once have I heard this being addressed. Even in normal times, RNs have a burnout time of about 2 years because they are so overworked. So when I hear people freaking out about how nurses are overworked, it’s nothing new.
    Full hospitals and overworked nurses are not shocking things. Of course it’s worse than normal, but but definitely not shocking.

    Thanks for that input. I think the fact that the flu season is just getting started in the US makes this especially worrisome, for both patients and healthcare workers. I have a number of students who work in healthcare, and I know the demands can be overwhelming.
  • SummerSkier
    SummerSkier Posts: 4,933 Member
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    So for a while we were saying that the death rates were declining because we were understanding how to treat this better. The death rates seem to be climbing like crazy. Why are the treatments not working or are there just that many more people that are sick?
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
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    AnnPT77 wrote: »
    I read your initial post (rather casually, probably, I admit), and thought you were saying "this is no big deal, it happens regularly", which is something a lot of non-medical people around me seem to be saying to minimize the seriousness of the situation. From replies, I suspect some others read it the same way.

    Yes, I did, especially since I recalled some earlier posts about how we were overreacting to covid with the shutdowns (long after pretty much everything seemed to have reopened, for the most part), so read it in that light.

    Glad I was wrong.
    Since you've clarified, it sounds more like "our health system was already bursting at the seams during local peaks, so that's not a new thing". That makes sense.

    Agreed, although what I've read suggests things are significantly worse and patients who otherwise would get care are potentially not going to be able to get it in a new way, some places, so I do think that aspect is a new or different thing from how it normally is.
    I'm not an expert, but one current thing that does seem somewhat novel to me is that so many hospitals in so many places are simultaneously peaking capacity with Covid patients, so that some of the usual-times safety valves (inter-hospital transfers, deferring non-crisis procedures, etc.) aren't working. I have read about specific hospitals/systems sending people home with oxygen, people whom they'd normally admit, though I have no direct personal knowledge to confirm the reports.

    Yes, this.
  • SModa61
    SModa61 Posts: 2,895 Member
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    I've seen plenty of articles about the questions healthcare workers must consider when they decide which patients they don't treat... which patients they are going to send home to die. That's not something I've seen before from any flu season.

    Curious. Do we know that those patients being sent home are being triaged in such a way that they are being sent home to die? Or could it be that they are the most mild cases? Or that it is just bad luck that they are arriving when no beds are available?
  • janejellyroll
    janejellyroll Posts: 25,763 Member
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    SModa61 wrote: »
    I've seen plenty of articles about the questions healthcare workers must consider when they decide which patients they don't treat... which patients they are going to send home to die. That's not something I've seen before from any flu season.

    Curious. Do we know that those patients being sent home are being triaged in such a way that they are being sent home to die? Or could it be that they are the most mild cases? Or that it is just bad luck that they are arriving when no beds are available?

    If you're being sent home and dying of Covid, it seems reasonable to assume that you are not one of the "most mild" cases unless "mild case" has taken on a whole new meaning of which I'm unaware.

  • SModa61
    SModa61 Posts: 2,895 Member
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    SModa61 wrote: »
    I've seen plenty of articles about the questions healthcare workers must consider when they decide which patients they don't treat... which patients they are going to send home to die. That's not something I've seen before from any flu season.

    Curious. Do we know that those patients being sent home are being triaged in such a way that they are being sent home to die? Or could it be that they are the most mild cases? Or that it is just bad luck that they are arriving when no beds are available?

    If you're being sent home and dying of Covid, it seems reasonable to assume that you are not one of the "most mild" cases unless "mild case" has taken on a whole new meaning of which I'm unaware.

    @janejellyroll My comment was referencing the specific phrase of "send home to die". My interpretation of that phrase is an intentional act like the person is being deemed too much work to warrant the effort and therefore being sent home where they are expected to die. Your comment is along the alternate interpretation of "send them home where they happen to die" and of course the subset of people sent home that end up dying are of course not the mild cases but it could be that they were sent home because they were not expected to die, but did. I was trying to find our from @T1DCarnivoreRunner whether his phrasing was the intentional act, as it reads, and that hopeless cases are being triaged to be sent home to die, or are they mild cases with unexpected deaths.