Disclaimer: There’s been a lot of political nonsense regarding Covid coming from both sides. This is not that. I’ve been working in healthcare for five years, and I’ve been experiencing how Covid has affected us all for the past two. This is what I personally experienced, with no political commentary or opinions. Just a simple tracking of what ultimately turned into a horrendous mess. Mistakes where made, and lessons were learned by some, but ignored by others. Ultimately, I believe that in spite of this catastrophic disaster, too few protocols will be implemented to minimize the risk of this happening again.
A quick side note: while Covid has a pretty high survival rate, any time there is a large scale outbreak of disease, there are severe and fatal cases. A 99% survival rate doesn’t discount the fact that we still had to treat all the people who were suffering from their standard medical conditions as well. It seems that some people forget that we had to treat all the other medical emergencies in addition to all the people coming in sick from Covid. While some aspects of Covid where vastly overblown, the effects of it on healthcare cannot be ignored.
The Quiet Days
Where to start? The Quiet Days where the very beginning of this whole mess, and they were strange. It’s important to note that at the beginning, everyone seemed to avoid the hospital, even if it is the one place they needed to be. The hospital administration, attempting to manage assets, closed down our outpatient department and cancelled all non elective surgeries. As you can imagine, this reduced the hospitals financial influx quite significantly. For a time, the eerie silence and closed down floors seemed almost relaxing. But the time wasn’t managed properly, and things only became worse from there.
The mental health epidemic was already bad before this. Leaving a bunch of psychologically traumatized people at home with nothing to do did not make things better. The same thing applies for everyone who was ignoring weird aches and pains that would normally have been treated by a primary care physician or urgent care facility. That weird pain in your side might be nothing serious now, but if you don’t treat it for months, it can quickly end up being worse. This created a veritable backlog of health conditions of many shapes and varieties, which I believe has cost a significant group of people their lives.
The Quiet Days were also not used to prepare a proper area of care for our Covid patients. A project was started to create a “Covid Unit” in an old Emergency Department wing, but the project was quickly abandoned, which I never understood. It seems like separating the highly contagious patients from the rest of the population seems like a good idea. This did not happen, and patients were often mixed together, which put people at risk of catching the infection in the hospital setting. In addition, the creation of stockpiles was not implemented during these slow days, which could have been extremely beneficial.
The Supply Chain
The supply chains for healthcare have always been precarious. Supplies are used, restocked, and then the facilities stores are replenished by our suppliers. The facility keeps enough on hand to last until the trucks arrive. This becomes a problem when your supply use goes up by a significant level, as was the case at our facility. So things like masks, gowns, gloves, and even more simple supplies that we were using every day like gauze and urinals were running out faster than we could resupply. And did the facility have any emergency stores? No. It’s a logistical nightmare.
In the five years I’ve worked in healthcare, and after consultation with other coworkers in healthcare for even longer than me, some ranging up to twenty years, there has been no such stockpile in the building. No emergency reserves of any kind, or plan for the need of excess resources. This was a massive failing of the healthcare system as a whole, and of the government as well to ensure that we would have the supplies necessary for a significant outbreak.
The catastrophic result of this was that employees were being asked to reuse PPE products that weren’t designed to be reused, and that limits were placed on our usage of certain equipment. Things live ventilator circuits which would normally be disposed of where being assigned to a single patient to be reused any time they needed to be transferred to a different ventilator for radiology imaging or procedures. I’m unaware of the full effects of this, but I can imagine there were probably some cross contamination issues associated. I am also aware that for a time there were shortages of contrast media used for CT scans, blankets, sheets, sanitizing chemicals, and various other products that we use every day, and which are needed for the safe performance of various procedures.
The Staffing Shortage (No One is Coming, We’re on Our Own)
When you think of the Emergency Room, or ICU, you probably think of bustling rooms filled with nurses and doctors and techs of all kinds scurrying around checking vitals, administering medications, and keeping track of all the ins and outs of patient safety. What you don’t see behind the curtain is that a large number of people have been working between 12-16 hour shifts for five or more days straight, just to keep departments staffed to a level that can handle patient influx.
There are no laws on the books (That I am aware of) regarding what is known as a safe staffing ratio (The acceptable number of patients assigned to a particular nurse), outside of California. What this means is that a single nurse may be spread out between a large group of people, and that should never be the case. It also means that entire floors may be shut down, while you sit out in the waiting room with dozens of other sick people.
But where did all the staff go? Well, most of them quit. Healthcare is a frustrating, mentally stressful tightrope act, and the rope is only getting thinner the longer you stay on board. Hundreds of people where forced out of the business for refusing vaccination, when they were needed most. Some have left after encountering violent outbursts from patients, which I have personally witnessed. For some, the stress was too much. And for many, the pay simply isn’t worth the risks to their health, as some nurses and techs worked well past the standard retirement age.
Inflation has been on the rise, as most of us are aware, and hospitals aren’t able to compensate their staff at competitive rates compared to non healthcare fields. I recently found that our lowest payed staff members would make an average of five dollars more per hour working for the local grocery stores than they will working in their field of healthcare. This has lead to all of us having to adapt our skillsets well beyond the limits of what is safe, let alone comfortable. Multitasking has always been a part of healthcare, but we’re testing the limits more and more as we go along.
This is combined with the terrible policy of hiring travelling employees, often hiring large groups from out of state and offering extensive rates instead of pouring funding into the nurses we had. This bred a sense of contention, and lead nurses to chase ephemeral travel positions in an attempt to move up in the world. The problem is that you put all that funding into staff, only to have those contracts dry up within months, and the short staffing becomes even worse.
The Busy Days
When you combine the shortages of staffing, the lack of supplies and reasonable supply lines, the violent outbursts, and the massive influx of severe cases of sickness due to both Covid and delayed care for preexisting conditions, you get the Busy Days.
These days are pretty frequent now, and it’s not hard to understand why. They’re days where people sit out in the waiting room seeking treatment for ten hours, where people can’t get room assignments on the floor because rooms have all been shut down, and where improvising with a lack of supplies is necessary. It is the culmination of lack of planning, preparedness, and most of all, people willing to serve.
You may be wondering why a preparedness blog is talking about this topic, but I think it highlights an important aspect for anyone trying to reach a high level of preparedness, to always make sure your health is taken care of. It reduces the strain on your body, your finances, and the system that takes care of you when you can’t. I cannot stress enough that the system is broken, but that it can be fixed. We all have to do our part to ensure our health by treating illnesses and injuries when they are minor, so they don’t become major.
It’s also important to understand what a fragile system we are operating under, and how outside instigators like politicians and striking truck drivers can absolutely crash the system under the right circumstances. This is the kind of stuff that happens every day in different parts of the world and on different levels, and could signal a significant emergency under the right circumstances.
modernsurvivalarkansas.com 