I read recently that Wisconsin had become the state with the 6th highest number of Covid patients. Not a great number, considering the total population of Wisconsin compared to other states on either coast.
Last night, I was floated to work on the units where all of our Covid patients are being admitted. Every patient is in Contact, Droplet and Airborne isolation. So that requires a disposable gown, the use of an N95 mask and a pair of goggles, every time we enter the room for any reason. I had been told we would be limited to a ratio of three patients per nurse, but by the end of the night I had five patients. Three had been diagnosed with the Covid virus. The other two were awaiting test results to determine if they had the Covid virus.
Of my five patients, only one was seriously sick, but she was very old with a long history of pulmonary problems and a host of other co-morbidities, and while the Covid virus certainly isn't helping, I don't think it will be the cause of her demise. Unless she takes a rapid turn, I think she will end up being discharged from the hospital.
Another patient was pretty sick, but was having more problems from C. dificile. While he was pretty sick with diarrhea, I'm pretty sure he will end up being discharged.
The other three patients basically looked like they had fairly bad cold symptoms. Again, pretty sure they will eventually be discharged from the hospital. Their path is far from certain, as many Covid patients seem to be doing fine right up until they develop serious complications, and some become severely ill over the course of a few hours, and a few have died with very little warning. That could certainly still happen before they are discharged. But for now, they look like they are going to make it out of the hospital.
So acuity is manageable at this point, at least where I am a nurse (an urban hospital in downtown Milwaukee). But these lower acuity levels are not going to last long. As the virus becomes more prevalent in society, more and more patients will suffer more serious consequences of the infection, and with hospital beds already in short supply, that means the patients that are admitted will be more sick patients. So my busy but manageable night will become much less manageable as this process moves along.
Along with the increasing incidence of Covid infection, more and more healthcare professionals will be exposed. It will be inevitable that more and more of them will be diagnosed with Covid, and many of them will have serious symptoms. Nurses will become too sick to work. Plus as the Covid patients become more and more sick, it is inevitable that some healthcare workers will believe that going into work could possibly cause their deaths, and so they will stop coming to work. Within the next few weeks, our patient ratios could go from 5 patients per nurse to as many as 10 patients per nurse, with many of them seriously sick from Covid. Nurses in New York, the epicenter of the disease outbreak, already describe situations where multiple patients will suffer cardiopulmonary arrest per shift. With limited resources, including PPE, the infection rate will get much worse, and everything I've described above will get much worse.
I hope I'm wrong. But I sense I'm right about the situation.
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