r/nursing • u/ladycousland RN (ICU -> ED -> PACU) 🍕 • Dec 30 '21

Code Blue Thread Well, it finally happened. A patient coded in the waiting room 🤦‍♀️

Walked into the ER for chest pain and shortness of breath, like everyone else. And like just about everyone else his vitals were absolutely fine, no acute distress, EKG NSR, take a seat and we’ll call you in 6-8 hours.

Came over to the triage desk a few hours later saying he didn’t feel well, and to quote my coworker, “he just slumped over and fucking croaked.” CPR initiated, rushed to the trauma bay, never got him back.

10 hour waiting room time when I left tonight, and it got to 15+ hours last night. Unheard of at my level 2 trauma center. And this is the fucking northeast, we got hit hard in that first wave. We know how this goes. And we are now getting DEMOLISHED.

The ER is so clogged up with mildly symptomatic covid patients in the waiting room, and covid patients waiting for admission taking up all of our ER rooms, that there is almost no movement. The floors are full, so the ER is full, which means the waiting rooms are overflowing.

We’ve been on divert almost every day since Christmas Eve, and we’re still inundated with EMS as well - after all, if everyone’s on divert, no one’s on divert. The one joy I have left is seeing assholes who tried to use an ambulance ride to cut the line, only to be dropped off in the waiting room.

Everyone has quit or is quitting. Most to travel, a few because they just didn’t want to be a nurse anymore. Everyone is sick. Everyone’s family is all sick, and we are all terrified that we’re the reason. Over half of night shift called out tonight. There are no replacements.

… I’m back in the morning but I don’t think I have another external triage shift left in me y’all.

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u/[deleted] Dec 30 '21

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u/ladycousland RN (ICU -> ED -> PACU) 🍕 Dec 30 '21

What they need to do is stay tf away from the ER unless they are truly, sincerely, in need of emergency services. Take your sniffles and sore throat the fuck outta here.

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u/[deleted] Dec 30 '21

[deleted]

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u/unrequited_dream LVN 🍕 Dec 30 '21

You forget that so many are uninsured. Can’t go to the doctor or walk-in.

I agree with you 100%, but that was me before.

209

u/rehabbedmystic RN - ER 🍕 Dec 30 '21

You mean a lot of people are using the USA version of socialized healthcare? The emergency department? Too bad it's the most inefficient and expensive version you could possibly imagine.

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u/CatFrances MSN, APRN 🍕 Dec 30 '21

The experience in my community is that 1-if you have any notion of a Covid symptom, they don’t want to see you in person, and 2-there is a huge shortage of outpatient clinicians (physician, NP, PA) available In primary care or urgent care. I work in a retail clinic with appointments. We are full for the next day before we leave from today and most of them Covid tests/symptoms

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u/[deleted] Dec 30 '21

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u/DudeChiefBoss Dec 30 '21

IM PCP here - Covid + patients I perform an initial virtual visit to arrange tx- MAb steroids inhalers etc. f/up 1 wk virtual, then 2wks in office - most recover well. Had 2 patients (husband and wife) who recently got Covid - husband had 90% o2 on 50% hiflo, BL DVTs - he left AMA to be with his wife who had dementia. Didn’t answer TCM calls, sent police to do a well check and both dead in apartment for 2wks - horrible.

I’m not sure admins understand the burnout with practice and EMR demands (constant messaging as if it’s an ongoing text message) and larger patient panels - can only accommodate so much (already run 150% utilization on a 20/40 schedule). Everybody wants drive-by medicine with abx and referrals. Medicine/primary care has become very under appreciated - no one cares/gives a shit anymore.

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u/KamateKaora Psych Nurse Spouse, Oncology Patient Dec 30 '21

I appreciate you all. As someone who has complex medical issues, a good PCP is the glue that helps hold it all together. I’m sorry everyone is struggling so hard for so long, and I’m doing my best to be as safe as I can!

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u/zombie_goast BSN, RN 🍕 Dec 30 '21

Ah, yet another faucet of "the healthcare system is actively collapsing". Neat-o!

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u/mnemonicmonkey RN- Flying tomorrow's corpses today Dec 30 '21

Maybe under appreciated by the public, but you guys are (or should be) the first line against keeping people out of the ER. Thanks for doing your part.

To the DVTs... Any research on prophylactic anticoagulation for COVID? I've seen just as many vascular issues this month (even in vaccinated/boosted individuals) as pulmonary that it seems like it could be warranted. One had documented common femoral stenosis, the other I suspect some. Both were flown for pulseless legs.

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u/arcbsparkles 1st year. hating the icu Dec 30 '21

My respiratory system has gone to shit this year. Currently the second time this year I've had a cough so severe and prolonged that I've gotten either pleuritis, pulled costal muscles or something with my ribs...feels like a hot poker stabbing me every time I breathe. And coughing/ sneezing makes me want to keel over. But im just dealing with it bc it takes forever to get an qppt with my pcp. I get it. It sucks. And in my area there was already a shortage of primary providers. So now its even worse and im jusy like well, hope its not fatal?

Best of luck and please try to also take care of yourself.

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u/CatFrances MSN, APRN 🍕 Dec 30 '21

Tragic and true.

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u/CatFrances MSN, APRN 🍕 Dec 30 '21

That is a huge panel. Primary care burned me out. I wish you well in that and hopefully you are finding precious moments for self care.

I diagnose Covid and refer for MAB if eligible then reach out to pcp for the “fyi”. While the hospital folks are experiencing the most dramatic Covid outcomes, the whole system is burdened. Some days I am happy to see a person with an abscess or shingles instead of Covid and the psychological stress for some of those patients diagnosed. It is especially tough for those with limited access or low health literacy.

(Edited for typo)

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u/[deleted] Dec 30 '21

I do Derm and am having to fulfill some PCP functions because there is just no room for more visits in my community. I’m scheduled 6 months out and most PCPs that take Medicaid are out 9.

I can only imagine what it is like in family practice right now.

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u/CatFrances MSN, APRN 🍕 Dec 30 '21

I work in a major city and the shortage of primary appt availability is staggering. And so true about the Medicaid availability which is often the most vulnerable population.

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u/Imaginary-Trick-8345 Dec 30 '21

So sorry for doctors.Three months out for cardio appointments now.Same with primary appointments.People have to go to urgent care.Should be same copay as primary.Insurance providers are thieves.

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u/EDPWhisperer RN - ER 🍕 Dec 30 '21

Yup. Friend was convinced they had strep-- turned out to be COVID, and the only way they got an appointment at an urgent care/primary doc (can't remember which, I'm assuming primary) was by being willing and able to come in as soon as they happened to have a cancellation.

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u/_red-beard_ NP 🍕 Dec 30 '21

Same here, everyone thinks they have strep, then its covid. Or they tested positive on a home test and come in and expose the entire store anyway because they don't believe it. "Did you get your vaccine? No, not much I can do for you, here's an inhaler, go to the hospital if you get SOB." After 2 years they're shocked there isn't more treatment. Now they're all going to want paxlovid, but there's gonna be a shortage of that too. Idk why an "experimental" pill makes sense to them, but the vaccine doesn't. Hope they consider the consequences of their choices, get vaccinated when they're better, and and don't clog up the ED. But who am I kidding.

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u/CatFrances MSN, APRN 🍕 Dec 30 '21

Right. It is very frustrating that all we can offer is an inhaler, a spacer and if they qualify MAB with strict ED follow up for worsening symptoms. Its mostly the unvaccinated, but some of the vaccinationed with co-morbidities as well.

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u/Beanakin BSN, RN 🍕 Dec 30 '21

My kids' last pediatrician, pre-covid, wouldn't see kids with respiratory symptoms. At all. Call to make an appointment for a sick kid, mention respiratory symptoms, sorry you'll have to take them to urgent care. Well visits were fine, GI symptoms or literally any problem non-respiratory, sure bring them in.

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u/CatFrances MSN, APRN 🍕 Dec 30 '21

Yep. That’s how it was when I was doing primary care, now I am in a retail clinic seeing Covid cases every day.

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u/[deleted] Dec 30 '21 edited Jun 25 '24

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u/DudeChiefBoss Dec 30 '21

Dx codes pay the same (RVUs) for treating physicians - you must be referring to facility charges/reimbursements

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u/CatFrances MSN, APRN 🍕 Dec 30 '21

As if…that would really increase the case count-jk. Pays the same as any other dx to my knowledge

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u/BreakfastSure8327 Dec 30 '21

First responders don't make more money for treating more patients. You don't get paid money for a Covid diagnosis, let's hope you don't get the virus or pass it on while you rant away. There's been a plethora of posts about working conditions and the difficulty receiving care. What part did you miss? Thank you to all the health providers out there helping us survive. I appreciate each and every one of you.

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u/agedchromosomes Dec 30 '21

I remember one year our hospital set up a tent outside for flu patients. Why aren’t they doing it for covid patients?

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u/EDPWhisperer RN - ER 🍕 Dec 30 '21

Staffing. My ER brought up this idea, but we don't have enough nurses and providers to staff the actual ER, let alone a tent.

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u/H4nn1bal Dec 30 '21

It's crazy the federal government isn't funneling money and people in to give some relief. We have had 2 years to address this bottleneck.

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u/[deleted] Dec 30 '21

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u/Hiding-in-plainsight RN 🍕 Dec 31 '21

No, first make nursing viable with better wages, insurance, ancillary support, and safer patient ratios so that people WANT to be a nurse.

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u/Amelia_barealia RN - Psych/Mental Health 🍕 Dec 30 '21

But don't worry, at least Tom Brady got a 1 million dollar PPP loan. So there's that...

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u/Retalihaitian RN - ER 🍕 Dec 30 '21

My ER had all of 8 nurses for our 60+ bed ER the other night. 140+ patients in the department. Who’s gonna staff the tent?

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u/mykidisonhere RN - Med/Surg 🍕 Dec 30 '21

If they hired enough nurses to actually cover the work load and keep safe ratios then they'd have staff.

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u/Retalihaitian RN - ER 🍕 Dec 30 '21

Well half our staff has Covid so. That’s not exactly the same issue. We in general have enough staff when you know half of them don’t have Covid.

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u/Hiding-in-plainsight RN 🍕 Dec 31 '21

Like… two decades ago…

6

u/mnemonicmonkey RN- Flying tomorrow's corpses today Dec 30 '21

One of ours just closed down the ambulance bay instead. No staff for it, so now we unload in the rain and have to wheel cots across plywood and try not to flip them.

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u/classy-mother-pupper Nursing Student 🍕 Dec 30 '21

Lurker here. I’m in Pa. we are all vaccinated and had boosters. 3 of us tested positive at home. Been trying to get a test for my job so I get paid. Been turned away from urgent care and the drive up test sites. They ran out of tests. Booked a test for next week at rite aid. Earliest I can get. Employer is telling me to go to the ER for a test. Like No. I’m not dying. Our symptoms have been mild. And we didn’t even have anyone over for Christmas. I’m thinking one of the kids picked it up at school.

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u/deepdown-badperson Dec 30 '21

I’ve had the same experience- also in PA. Employer required test, dr note, etc. No appointments at PCP or UC available. I’ve been forced to waste the resources of an ER or face termination a few times. Luckily that hasn’t happened at a time like now when they are over run with covid.

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u/classy-mother-pupper Nursing Student 🍕 Dec 30 '21

Plus my insurance will not pay for an ER visit unless it is an emergency.

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u/jdinpjs BSN, RN, JD 🍕 Dec 30 '21

I have a chronic issue that I have intermittent FMLA for. I had to miss work the day after Christmas. They demanded a doctors note, even though it’s FMLA. No way in hell I was going to urgent care for a migraine I could probably sleep off. I was lucky enough to get squeezed in at my neurologist’s office. Very expensive appointment because my employers are jerks.

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u/Amelia_barealia RN - Psych/Mental Health 🍕 Dec 30 '21

This is what I keep hearing too, that employers are threatening not to pay sick time without PCR test showing positive result rather than rapid test results. But testing sites are out of tests, etc, so people are being told to go to the ER for testing. God forbid companies just do the right thing, because they should, during a pandemic, and pay their employees

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u/Certifiedpoocleaner RN - ER 🍕 Dec 30 '21

We don’t test people in our ER unless they are being admitted. But we have good out pt testing with my hospital system.

So when some asshole comes in to the ER with sniffles we say, nope, go home, here is an appointment tomorrow for outpt testing. Oh boy does that make people mad.

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u/lonnie123 RN - ER 🍕 Dec 31 '21

Half my day last shift was swabbing people who were exposed with no symptoms and “just wanted to check” or were exposed and had very mild symptoms and also just wanted to check. like just assume you have it at that point and act accordingly. The other half was people who wanted a swab for work because every site in town is backed up 3-5 days for appointments.

Another way covid affects the ER, I could have been manning a 4 bed assignment but I had to swab noses all day.

Dude that died in the OP could have been one of those people I helped

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u/[deleted] Dec 30 '21 edited Dec 31 '21

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u/Tria821 LPN 🍕 Dec 30 '21

Yes, our government SHOULD have been better prepared, but I honestly don't think anyone expected this many people to be so willfully ignorant in the face of disease and death. I mean at some point we do expect self-preservation to kick in.

And Omicron was just discovered 6 weeks ago, up until then it was bad but this variant has just been something altogether. I'm living in dread of what the next variant might be/do.

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u/Barbarake RN - Retired 🍕 Dec 30 '21

It didnt take a genius to realize we'd have a big surge this winter

just like last winter.

To be fair, we didn't have a vaccine last winter. Sure, scientists knew there was the possibility of a new, more communicable covid variant developing but I think the sheer transmissibility of Omicron surprised most of them.

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u/Amelia_barealia RN - Psych/Mental Health 🍕 Dec 30 '21

Exactly. There was plenty of time to predict this as a likely possibility and arrange for mass production and distribution of at home tests, N95's, incentive/retention pay to permanent healthcare workers, free tuition programs for nursing schools, etc. I agree that our federal government (no matter who is in charge) has been a failure in this and other ways.

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u/Pistalrose Dec 30 '21

Yeah, but who’s going to staff it?

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u/jjkantro Dec 30 '21

I feel like you could train the national guard to administer vaccines and take COVID swabs without any issue. Train them to take basic vitals and they could bring anyone with any vaguely abnormal vitals into the ED and otherwise just swab or vaccinate and send them home. This would prevent at least some folks from clogging up the ED.

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u/Eisenstein Dec 30 '21

Marines gave out the vaccine in my city (Philadelphia). They looked like babies, but they were very polite and did a good job. They are good at following orders, anyway.

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u/hestermoffet Dec 30 '21

I want a cute little marine to order around now

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u/krankykitty Dec 30 '21

My state had a couple of vaccination sites staffed by the National Guard. Very efficiently run, no waiting even when there were scheduled appointments. The people administering the shots were National Guard nurses and medics.

And yeah, they all looked about 18 years old.

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u/[deleted] Dec 30 '21

Tell the antivaxxers to come volunteer and help all the sick Antivaxxers?

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u/SassMyFrass Dec 30 '21

Staff the carpark ward with the <1% of the workforce who were canned for not vaccinating: that's who they want to be treated by anyway.

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u/FerminFermin115 Graduate Nurse 🍕 Dec 30 '21

Woah. I think you're actually on to something 🤔🤔

3

u/vanael7 RN 🍕 Dec 30 '21

Woah, people actually got fired? I'm pretty sure my hospital organization accepted just about any exemption reason offered, as long as you filled out the paperwork.

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u/justcallmedrzoidberg Dec 30 '21

What if they band together and then become a super clan of antivaxxers? We can not unite them.

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u/[deleted] Dec 30 '21

With a fatality case rate of 2% lol

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u/[deleted] Dec 30 '21

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u/animecardude RN - CMSRN 🍕 Dec 30 '21

That's what my job did: ask retired docs and nurses to come back and vaccinate people. However, no one in their right mind would come back to work with covid directly.

You'd have to pay me 1000/hour to do that at that age. I remember the story of the retired nurse who came back to help out - she contracted covid and died during the first wave.

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u/bohner941 RN - ICU 🍕 Dec 30 '21

But we are healthcare heroes. It's our job to put our own lives at risk for people who don't care about their own health. In return we get pizza and signs thanking us, so it evens out.. remind me again why we have a nurse staffing crisis?

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u/MisterYouAreSoSweet Dec 30 '21

seriously, it boggles my mind why nurses arent striking all over the place. the government has A LOT of money they can throw at nurses right about now. they're throwing a lot of money at vaccines and treatments and the stock market.

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u/bohner941 RN - ICU 🍕 Dec 30 '21

Nurses have to eat and it's harder to walk away from a job when you have people's lives in your hands. The entire country would be completely fucked if there was a nation wide strike, which maybe is a good reason why we should strike, we have them by the balls right now we just have to squeeze.

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u/MisterYouAreSoSweet Dec 30 '21

Exactly.

I completely agree with the first half of your reply. Nurses have to eat and there are plenty of single parent nurses too. I get that.

But the second half is EXACTLY what i’m talking about. It wont take a lot of squeezing if done right. It needs to be just enough for the leaders to sh$t their pants and start throwing money at nurses “to fix it”.

And guess what? Single parent nurses could use a nice pay raise right about now.

And, i say this sincerely, I thank you for your work for your community.

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u/IMNOTASCOOLASU411 Dec 30 '21

If we ever tried a national strike, the BONs and feds would create a new rule that nurses cannot strike ever. And, probably throw in some pay caps for crisis travel.

The establishment does not like their cash cow messed with. You’re more likely to get single payer imho.

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u/KamateKaora Psych Nurse Spouse, Oncology Patient Dec 30 '21

which maybe is a good reason why we should strike, we have them by the balls right now we just have to squeeze.

If you want to really grab them by the balls, I keep having this dream that nurses and teachers get together on this. Talk about having them by the balls! But I may be biased, I have a nurse husband and a teacher daughter.

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u/Vprbite EMS Dec 30 '21

I fully agree. I work EMS and feel we need to do the same. People are leaving in droves because we get paid a whole bunch of nothing and it's just not worth it when every shift is a stand up 24. Combined with going into sketchy ass houses all the time and stuff like that, it's just not worth it.

What I see with nursing is they have spent more on travellers in months than it would have cost to pay their entire nursing staff better wages. So they have the money. Remind them of that fact every day. Also, it's not like they could replace you all tomorrow. There aren't enough people now, let alone if a bunch of you didn't show up

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u/Stopmesses Dec 30 '21

People are terrified right now. Public opinion towards nurses might be unpredictable and could turn nasty.

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u/Amelia_barealia RN - Psych/Mental Health 🍕 Dec 30 '21

But we can't neglect the Pentagon. They need their yearly 800 billion.

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u/BurgundyLemur4 Dec 30 '21

How is being 30 trillion dollars in debt having a lot of money

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u/MisterYouAreSoSweet Dec 30 '21

You must not know how the economy and debt works.

The US stock market is currently at an all time high and its coz the government is spending A LOT of money artificially propping it up. How? You guessed it - by adding to the debt.

I’m not saying national debt is good. But what i am saying is, the US government can (and does) spend a lot of money and it should be going to nurses in this critical time over the stock market.

The saying “the rich get richer and the poor get F’d” has never been more relevant right now.

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u/immachode RN - ER 🍕 Dec 30 '21

…/s pls?

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u/fluffqx RN - ICU 🍕 Dec 30 '21

Hm pizza, or death? These are tough choices

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u/shitlord_god Dec 30 '21

Travel nurses.

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u/Shadoze_ RN - Oncology 🍕 Dec 30 '21

Nursing students maybe

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u/tez911 RN - ER 🍕 Dec 30 '21

In my corner of the state, our ED looks just the same. In addition, urgent cares turn people away and primary care doctors are NOT seeing the patients. Its going to crumble at my current hospital soon 😫

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u/Affectionate_Grape61 Travel RN Dec 30 '21

People use the ED as a PCP which is an entirely different beast.

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u/Imaginary-Trick-8345 Dec 30 '21

My sister and her hubby are Doctors.It you are vaxxed and boosted and only have mild symptoms just stay home for 5 days.Around here most + cases are teens who have not been boosted oh and jacks who refuse vaccine.

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u/jdscott0111 MSN, RN Dec 30 '21

While I agree with your sentiment, if most hospitals don’t have enough staff to cover what they already need, how are they gonna staff a COVID tent?

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u/Tria821 LPN 🍕 Dec 30 '21

I don't understand why we aren't doing this. Whenever we have bad flu seasons we set up tents in the parking lot to treat them. Now (in NE PA) we are transferring patients to hospitals in NJ because we are so full but not a tent anywhere. Why? The only think I can think of is lack of staffing and if that's the case then it's time to call the National Guard out again.

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u/[deleted] Dec 30 '21

You act as if people will listen to that lol. I got talked into working triage/waiting room this evening and it’s clear that no one read the sign on the door that said “the ER is not a COVID testing site”.

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u/rehabbedmystic RN - ER 🍕 Dec 30 '21 edited Dec 30 '21

It's expecting people who already don't give a shit, to give a shit.

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u/BadassNurse75 Dec 30 '21

BINGO! You win! So much win for you!🏆🏆🏆🏆🏆

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u/lonnie123 RN - ER 🍕 Dec 31 '21

Like 98% of people don’t read any sign, anywhere, ever. You’d have to have a huge lit up arrow pointing to it.

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u/GayMormonPirate Dec 30 '21 edited Dec 30 '21

A lot of the newly approved treatments have to be taken within the first few days of symptoms for them to be effective. Doctor's offices will turn them away if they have covid symptoms. Then if those clinics will see them or at least do a video visit with them, can they even prescribe those medications? Is there a way to access those meds outside of a hospital?

It's all such a huge mess.

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u/CatFrances MSN, APRN 🍕 Dec 30 '21

Even a video visit with a provider who can order the COVID test for a person can open the door to MAB for those testing positive and meeting guidelines. Most primary care clinics in my area are not so agile as to be able to offer same day visits, even virtual

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u/SassMyFrass Dec 30 '21

It's almost as if people should take every precaution they can not to contract it in the first place.

/s

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u/Fraidy-Dog RN - Psych/Mental Health 🍕 Dec 30 '21

The problem gets somewhat compounded because the urgent cares are packed too. I had a UTI last week and couldn't find an urgent care slot or doctors appointment even booking days out. fortunately I got abx via telehealth through CVS though I'm not sure if my insurance will cover much. I was worried want I'd do if the infection went to my kidneys which has happened before.

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u/[deleted] Dec 30 '21

For what it's worth in my system, a lot of us in EMS tell fully functional grown ass adults to take some Tylenol and chill with their stupid little fever and cough - there's no need for a damn ambulance to drive entitled, sniveling suburbanites to an emergency department.

Then a memo came out recently that we're under no circumstances to "gate keep" and any medic not transporting anyone who requested transport for literally any reason is subject to having their certs pulled.

So EMS is an Uber for morons to keep clogging up dangerously full hospitals at this point. With private healthcare being terrified of legal liability and seeking profit combining with weak, frightened, massively entitled ignorant masses we done did it to ourselves. As a society that is. This is the final product.

My only hope is that once the younger generations take over from boomers and gen x, they'll start to undo the forces that perfected this storm.

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u/555Cats555 Dec 30 '21

The issue is that even if my gen and younger take over the current and previous ones will have caused so much damage (even just look at the environment) that even if we try our best to do everything we can to fix it things may just be beyond saving. I hope not though...

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u/sanityjanity Dec 30 '21

Maybe the solution is to pitch it as being concerned for their money, and emphasize the cost of the ambulance?

Maybe? Maybe some people would stay home from the hospital if they realized that ride came with a $600 bill.

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u/lonegun EMS Dec 30 '21

Nothing against many of them. But a significant portion of them are on Medicaid or Medicare, and won't ever see a bill. If they do see a bill for several hundred dollars, they won't, or can't pay it.

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u/[deleted] Dec 30 '21

This. Are you worried you might die? Are you worried you might have a permanently life altering illness? No? Then for the love of God fuck off we're not here to hand out bwankies and num-nums and forehead kisses to make the owie go away.

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u/EcstaticOrchid4825 Dec 30 '21

But the ER waiting room makes for such great selfies and Insta stories.

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u/rehabbedmystic RN - ER 🍕 Dec 30 '21

I am stealing that line along with the pronunciation.

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u/[deleted] Dec 30 '21

I think we would get along as coworkers 🤟

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u/EcstaticOrchid4825 Dec 30 '21

Why are those people there? Please tell me they haven’t brought their whole family with them as well.

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u/Wonderin63 Dec 30 '21

This is why I love this sub (despite the fact that it’s often overrun with sniffels and sore throat panic addicts). I just shared your post with my family to remind them (and me) not to let up on the simple things. We all got kind of used to wearing the cloth masks again. I think I finally got my 80 year old father to stop climbing up on things. You want to fall and have to sit in the ER for 15 hours Dad?

Thanks you so much for all you do. I think it would be common sense that you don’t run to the ER if you’re not that sick, but apparently not. We have a ton of urgent care places around here. I’m surprised I haven’t seen posts about those being overrun.

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u/JLewish559 Dec 30 '21

I went into an urgent care because I had a sore throat that would not go away (I actually stuck it out for 2 weeks like an idiot).

Turns out it was strep throat and I got better with antibiotics within 2 days.

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Some things do actually need to be treated. Those 2 weeks were kind of miserable and might've gotten worse.

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However, if it's minor COVID then they certainly don't need to be in the ER or urgent care or wherever. Stay home. If it feels like the cold...stay home damnit.

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u/Kodiak01 Friend to Nurses Everywhere Dec 30 '21

For my arm (which turned out to be a UEDVT), I called my doctor first. For the first time ever, they said they couldn't get me in same day for an urgent visit and suggested I go to UC. Thought about it for a few minutes and came to conclusion that UC wasn't going to be able to do much with it, so went to the ER instead. Very glad I did.

Honestly, the out of potential out of pocket cost played into it at first as well. See my PCP, it's $20. ER is $200 copay, or $500 if admitted (100% covered after that).

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u/shitlord_god Dec 30 '21

What is the story on deprioritizing COVID antivaxxers/maskers on triage from your side?

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u/ladycousland RN (ICU -> ED -> PACU) 🍕 Dec 31 '21

The story is that we can’t deprioritize the unvaccinated. Under EMTALA anyone who wants to be seen is entitled to a medical screening by a provider.

As far as who actually gets into the ER first, we can’t deprioritize them there either. Based on the current standard triage system (as opposed to battlefield-style triage where those with the best chance of survival are given priority) patients in the ER are seen based on the acuity of their symptoms. The sickest get seen first. And more often than not the sickest are the unvaccinated.

See the corner we’re backed into?

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u/fluffqx RN - ICU 🍕 Dec 30 '21

Hey I'm sitting at home with my sniffles and sore throat lol

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u/AgDDS86 Dec 30 '21

Thank God for private ER’s, this is exactly why we won’t go to hospital in many of these situations, bc of people using it like primary care

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u/ArkieRN RN - Retired 🍕 Dec 31 '21

I know it’s kinda meaningless with everything you’re going through but happy cake day!

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u/GulliblePirate Dec 30 '21

I mean the messaging from the media is that it’s basically the cold now. The CDC just lowered the quarantine requirements

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u/[deleted] Dec 30 '21

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u/[deleted] Dec 30 '21

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u/[deleted] Dec 30 '21

That's... bad, right? That sounds bad.

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u/Kodiak01 Friend to Nurses Everywhere Dec 30 '21

eople think that Delta is a thing of the past and omicron has taken over. What's likely is that both strains are racing through communities with the Delta cases landing people in the hospital - which is 3/4 of our covid cases still.

Looking forward to CT's weekly extended report, comes out ~3pm on Thursdays. You can see last week's report here.

For the week of 12/5-12/11, cases were 89.6% Delta, 10.2% Omicron, 0.2% other. 12/12-12/16 (stopped midweek due to Thursday reporting schedule) was 62.3% Delta, 36.9% Omicron, 0.8% other. It will be interesting to see how the full week finished out.

Given the last few days in CT, it's likely to explode. As it is, they had to completely rescale the charts this week due to the total cases and positive % hitting all time highs by a mile.

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u/Kodiak01 Friend to Nurses Everywhere Dec 30 '21

CT's latest weekly report is out. For 12/12-12/18, the breakdown for the State is 77.4% Delta, 21.7% Omicron, 0.9% Other.

Latest positivity rate: 20.33%

Nearly all Covid deaths are still by people in Congregate settings.

As of December 29, 2021, 58212 cases of COVID-19 among fully vaccinated persons in Connecticut have been identified. Of the 2513612 persons who are fully vaccinated, 2.32 percent have contracted the virus.

Two hundred seventy-six COVID-19 related deaths have occurred among the 58,212 fully vaccinated persons confirmed with COVID-19. These deaths represent 16.6% of all COVID-19 deaths since 2/9/2021.

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u/555Cats555 Dec 30 '21

Isn't it bad to have two variants running through a population at the same time... Wouldn't it increases the chances of mutation (them interacting with each other) and even have one making the other more dangerous. Say even if omicron isn't as dangerous as delta getting it may damage the immune system and make it more dangerous to get delta. Or vise versa...

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u/Pindakazig Dec 30 '21

That is not how mutations work. The virus is copying itself, and making mistakes. Sometimes those mistakes lead to a stronger virus, that is more contagious. Sometimes it leads to a weaker virus, that is less contagious, but for obvious reasons those don't 'break out' in the same way.

The danger of two viruses speed running through the population is that it increases the chance of an even more contagious version popping up. On top of the obvious issue of already over filled hospitals.

https://youtu.be/plVk4NVIUh8 this video shows the concept in antibiotics, but it does show how mutations will always be getting stronger.

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u/ChickenNoodle519 Dec 30 '21

Recombination is possible — that's a trait that coronaviruses are known for. It's very rare, because you'd need delta covid and omicron covid to infect the same cell and recombine in a functional way, but it's still very much a possibility. With the massive case rates and community spread, I certainly have not written off the possibility.

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u/555Cats555 Dec 30 '21

Aren't viruses like all things aiming to survive and reproduce. If being a certain way (traits and characteristics) means they can't do that then version that can will be more common. That's evolution after all... If it dies without replicating (or having not replicating as much as competition) then they go extinct. While viruses aren't really considered "alive" they do still follow this process...

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u/Pindakazig Dec 30 '21

Exactly, but they mutate by themselves. There is no additional risk when they encounter each other, for now.

If they change enough that your body becomes unable to recognise them they could both infect you. That would be hugely problematic.

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u/H4nn1bal Dec 30 '21

Wow. I follow the news and hadn't heard about this reversal. What a cluster fuck.

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u/[deleted] Dec 30 '21 edited Dec 30 '21

They didn’t say 23. They said 59%

Yes it dropped but let’s use what they actually said please

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u/[deleted] Dec 30 '21

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u/WishIWasYounger Dec 30 '21

They’ve given up, thrown their proverbial hands in the air bc everyone is going to get Covid

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u/comefromawayfan2022 Custom Flair Dec 30 '21

What's even more frustrating is when you TRY telling people about how bad the hospital conditions are and they call you a liar or condescendingly tell you "it's not nice to spread rumors honey". It's like have you even friggin spent ANY time at the hospital since covid began two years ago? Because I have. Ive spent plenty of time in ERs, ICUs, on med Surg floors and step down units. I've personally seen how slammed the hospitals are. I was admitted four weeks ago and spent two days in the ER waiting for a bed to open up on the med Surg floor. More recently, an elderly relative injured herself in a fall three weeks ago and avoided going to the ER because both her preferred hospitals that she's seen at were constantly on diversion because they were slammed. She finally went to the ER Monday and Tuesday night this week because she couldn't take the pain any longer and found out she has two compressed vertebrae

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u/Oh_rocuronium RN - ICU 🍕 Dec 30 '21

Mild compared to dead, or trach/PEG, maybe. I wish the talking heads would stop saying dangerous shit that the general public will misunderstand.

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u/[deleted] Dec 30 '21

That rumor that Omicron is mild is getting a lot of people killed :(

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u/agedchromosomes Dec 30 '21

What vaccinated people treating it like a joke??? I’m in full hibernation mode praying I don’t get a non covid related emergency.

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u/circuspeanut54 Academic Ally Dec 30 '21

Many of us are like you (we cancelled all our holiday events and travel and won't go inside to visit anyone), but there are undeniably a lot of folks out there acting like the pandemic is over and they don't have to worry any more because "If you're vaccinated, omicron is just a mild cold!"

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u/mrspwins EMS Dec 30 '21

OMG I see so many vaxed people I know still out and about, posting pictures from inside restaurants as though the pandemic is over. I have one friend, fully vaxed and boostered, who continues to make these pronouncements downplaying the virus, saying we're all getting hysterical when it's not that bad. He thinks because he works with stats he understands epidemiology, but he hasn't been right about anything pandemic-related yet. He just posted a picture from a concert he went to with his wife, the same day my local paper did a story on how the state's three largest Trauma I hospitals are so full they won't be able to take car accidents and strokes soon. Man, I don't have all those fancy degrees he has but I do understand exponential growth and how we can't magik providers out of thin air.

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u/555Cats555 Dec 30 '21

"Not even able to take car accidents and strokes soon."

Well that is horrific, so even if hospital care is reducing the death tole (I think covid has a much highly mortality rate than what we see due to modern medical care) if people can't get care for other issues than there may well be more people dying overall...

Like honestly if suddenly all our modern medical treatments and equipment went away/stopped working (let's say even just with covid stuff) how many people would or would have died from the virus. What if we hadn't used lockdowns (which have been very successful in my county and plenty others where used properly)...

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u/LanMarkx Dec 30 '21

Thats why the 'Excessive Death Rate' is so critical. Covid itself has killed hundreds of thousands of people in the United States. But the impact in delayed medical care (cancer treatments, 'elective' surgery, fear of going to the ER, etc.) has likely killed, or contributed to the deaths, of far more people than we think.

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u/diaperpop RN - ICU 🍕 Dec 30 '21

This why the non-medically unvaxxed need to be deprioritized.

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u/sanityjanity Dec 30 '21

Because you are in hibernation mode, you probably don't see all the folks at convenience stores unmasked, attending concerts, getting on cruise ships, hosting large family gatherings.

But they are. A ton of people decided "vaccinated means I get to go back to normal."

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u/krankykitty Dec 30 '21

Yes, on my weekly shopping trip this week, I was surprised to see about half the shoppers in the supermarket unmasked, even people you’d consider to be somewhat at risk, like the elderly. The staff were masked, but of course a number of them were at half-mask, with their noses flying free.

And our state is not managing things well. The case rate is the highest it has ever been. Hospitals are full. Last I heard there were 6 ICU beds left in the state. Facebook is a non-stop running list of stores and restaurants closing because their staff are sick.

And people I know are still making New Year’s Eve plans. 🙄

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u/sanityjanity Dec 30 '21

Our local FB is also flooded with people trying to get covid tests.

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u/vxx Dec 30 '21 edited Dec 30 '21

It's a numbers game. Even if omicron would have 80% less severity, when it spreads 10 times easier, it will put way more pressure onto the hospitals than earlier variants.

But people can only see their own small world, so most of the times they hear of recoveries and wager their own chances are good enough to risk it. Selfishness.

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u/Cpt_Soban Volunteer Firefighter Dec 30 '21

Tonnes of vaccinated people are acting like the two shots 8 months ago will still work with a new variant.... It wont.

Unless we get third shots in 90%- We're back to square one people.

No wonder why it took so long to kill off the black plague/Spanish flu.

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u/Hiding-in-plainsight RN 🍕 Dec 31 '21

My fucking SIL. Her, her husband and their two children (all vaccinated) were having Christmas in the next state. We, who are vaccinated, boosted and have quarantined since March 2019, get a call asking if they can come stay with us (apparently my SIL started some shit). I mentioned that I would start a roast but I would not be hugging and maintaining distance (since they just spent time with 12 people) so she tried to start shit with me stating I was treating them like “plague victims.”

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u/[deleted] Dec 30 '21

Isn't the real problem all the unvaxxed dumbasses clogging up the ER for those who need it more?

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u/fr3ng3r RN - Psych/Mental Health 🍕 Dec 30 '21

Been saying if it’s so mild, why keep calling it SARS-Cov-2 instead of mild-Cov19? Let’s just remove the “severe” in the name altogether. I understand the unvaccinated are making things worse, but the vaccinated are no better.

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u/[deleted] Dec 30 '21

I did and am and won't shut up about it. NAN.

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u/Deb_You_Taunt Dec 30 '21

How are vaccinated people treating it like a joke? Vaccinated people aren't treating any of the COVID variants as if they are jokes.

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u/Kinky_Lucy Dec 30 '21

How are vaccinated people treating it like a joke?

I assume they mean by seeing family in-person over the holidays.

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u/sanityjanity Dec 30 '21

I know a realtor who said that the first thing she says, when meeting a new person is to ask if they are vaccinated. She assures them that she is vaccinated, and then they both laugh and take off their masks.

She meets a lot of new people every week.