Daisys and Diamonds
Super_Ideal_Rock
- Joined
- Apr 30, 2019
- Messages
- 24,193
@dizzyakira prayers for your family
Thank you for sharing. I do feel like your account of what's happening is more realistic/fair than her account. At the end of the day, it's an experience of a single nurse from a single hospital. It's still terrifying but I'm inclined to believe that most people are doing the best they can under the worst of situations, choosing to make bad choices over worse ones. Whole thing is truly gut wrenching and personally, I have to choose to put my trust into the medical personnel to make the best decision possible under the circumstances. Knowledge is good, but fear and mistrust will not help us right now.I've been spending a GREAT DEAL of time - as in several hours a day - on Reddit on a couple of subreddits that are populated mainly by health care practitioners and researchers, reading research as well as the dialogue between practitioners, so I think I can perhaps offer a little insight for being a medical "civilian".
Based on what I've been reading for weeks......most of what she is saying has kernels of truth. She is describing what is occurring and decisions being made fairly accurately. What's misleading here is the ascribing of motive and reasoning and an attitude of blame of medical personnel. She is describing a large amount of gross neglicence and "not caring" and "people left to rot", and that is not an accurate picture of the motives, reasoning, or attitude of the large majority of these men and women in an untenable situation and risking their lives. They DO care; they are terrified; they are exhausted; they are beyond overwhelmed; they are having to make decisions without good information or good options, or often are having to treat based on guidelines being set by administrators that are NOT on the front lines. If they defy those guidelines or speak out about them, they are fired. And may lose licensing. They are in a brutal situation.
Yes, some people are not being resuscitated or only receive token resuscitation when they code, but there are reasons for that. These are very elderly, very frail patients that have no chance of surviving. These doctors and nurses know it because they are doing this all day, day in and day out. None of the patients like that were surviving even the most heroic efforts - not one - once they coded, and they were subjected to incredibly painful rib and sternum fractures and other severe discomfort in their final moments, while at the same time aerosolizing potentially large amounts of virus to infect all the personnel that are necessary to have in the room for the code procedures. Eventually, medical personnel had to make the decision to, in those most severe cases, not subject them to utterly pointless efforts that would cause severe pain and discomfort to patients with no benefit and make caregivers ill. It's a wrenching decision that is emotionally wrecking them, but it is utterly rational in the situation. Patients who are a little younger, a little stronger, might have a faint chance at surviving resuscitation, still are receiving full efforts. ETA: Even this utterly varies within the same hospital, depending upon who is the person in charge in any given room during any given code. It happens rarely that even the most hopeless patient without a DNR is not given full efforts, and those who are higher ranking and making these calls are constantly debating the ethics with each other and administrators, trying to make the best decision they can.
Up until very recently, it's true that hospitals were avoiding high-flow nasal cannulas and/or CPAP/BiPAP and going straight from normal-flow nasal cannulas to ventilators if patients decompensated for multiple reasons, but mainly due to concerns of aerosolizing viral particles being much higher for high-flow cannulas and CPAP/BiPAP. It was not known yet how damaging the ventilators can be to COVID-19 patients in a way that differs from the usual presentation of severe acute respiratory distress. Word is now spreading that most patients seem to do better on the high-flow oxygen support or at most very gentle settings on ventilators. Some hospitals have not gotten word of this yet, so have not changed protocol. Some hospitals are getting word and are changing protocol to reflect this new knowledge. Still others have gotten word, but refuse to change protocol because they are prioritizing using no aerosolizing procedures over patient outcomes, as they feel the risk to personnel is too great. Therefore, yes, patients and their loved ones need to know that low- and high-flow non-invasive oxygen and time to heal should be used if at all possible. Ventilation and ECMO are absolute last resorts. Ventilation may have actually caused some deaths due to barotrauma that would not have occurred on high-flow non-invasive support.
Yes, PPE is not getting changed from patient to patient in many places. That's not the fault of medical personnel. There isn't enough PPE - not even close. It's a shitshow. It's either keep on what they had on with the previous patient or not have any on at all.
Yes, medical personnel who speak out about disagreement with decisions about protocol, leave, compensation, disagreement with administration, or the whole PPE debacle are in some cases being fired.
Yes, there is a lot of chaos. In NYC, they've been overwhelmed. It's a novel, highly contagious virus. Chaos is a natural consequence. That is not the fault of these personnel. That is not murder.
The medications she's describing as not being given in that hospital may not be there, but that means nothing about what other hospitals even in NYC are giving. In some cases, different hospitals are giving different regimens because they are different arms of research trials of these medications, as that is sometimes the only way to be able to get them at all. No medication so far has been a silver bullet, and most that are being trialed are hard to get. As far as the more widely-available hydroxyquloriquine that she mentioned, several trials as well as the overwhelming majority of anecdotal experience of those on the front lines show no real benefit in moderate to severe disease, which makes sense based on the presumed mechanism of action. It might have some benefit very early in the course, and that will hopefully be trialed, but that is irrelevant for the patients to which she is referring. At the same time, it has very serious cardiac side effects, especially in the dose they are looking at, as does the azithromycin that it is often being paired with. Far too serious side effects to be administered without serious caution. All in all, critically ill patients are not being deprived of a "miracle medicine", as there isn't one yet. They are trying hard to find one.
Hopefully, that is helpful. What I really want folks to take away from this is that 99% of these medical personnel are doing their absolute best, with the best intentions, in a brutal situation. They are not committing "murder". While there are kernels of truth in what she is saying, she is misrepresenting the breadth of it - as if it's happening all the time - and the way she is presenting it and painting these dear and brave people is disgusting and reprehensible.
I’m concerned about the number of undocumented cases of Coronavirus. A person I follow on facebook has it, along with her husband, and two sons. Her husband was an essential worker and he brought it home. He went to a testing site and waited over an hour to be tested, only to be told they didn’t want to waste a test. She said she’s pretty sure they documented him as having COVID-19 but she’s also sure they didn’t document the rest of the family.
Think about it, if only one member of the family is documented over and over again, our numbers are at least doubled, if not tripled. We know the deaths are not being documented properly as well.
This leads to people not taking this virus as seriously as they should. Which makes things more dangerous for those of us who are taking this seriously.
That’s what’s on my worry list today.
This is so scary because each state's decisions are based on how many "confirmed" cases and death they have. I know everyone always said the actual numbers are higher than what's being reported, but if they're truly testing only 1 person from household and not testing/counting the rest, then truly the numbers mean nothing.@House Cat my family in philly was told that they are allowed one test per household. My brother tested positive and everyone in the household is presumed positive, but no one asked my brother how many are in the household or any other info.
Yes I'm terrified of the virus and I'm even more terrified after reading this thread again. My dad is in a medically induced coma right now fighting for his life. He went to the ER for dehydration and fatigue due to covid 19 and is now having a heart attack?? Earlier he seems to be fine on just 100% oxygen but they needed to move him to a different hospital and doctors said he needed to be intubated to be moved. My mom and brother are also sick and my niece and my brother's girlfriend is living there and taking care of them but one has lupus and the other has a undiagnosed autoimmune disease (she was in the process of figuring out why she is sick before the pandemic). My sister in Florida is also sick and her bf has been hospitalized for the past 3 weeks. I'm in NYC trying to help coordinate care via facetime and zoom (my parents are in philly). I haven't been able to sleep. It all just feels like a horrible nightmare.
@dizzyakira very sorry to hear about your dad. Prayers for him and your family.
And how is your brother, Arcadian?
Yes you can. Just stay home till you are comfortable of going out in public.[
I'm not sure that is something you should worry about, it's something to be mindful of, but there isn't a lot you can do about it.
DF, love ya my friend.Yes you can. Just stay home till you are comfortable of going out in public.
I have been thinking about this a lot today.
I got to admit im embarrassed about my initial skepticism about covid. There are so many times it turned out to be a flash in the pan with no real boom and at the time I was dodging flu swarms around me trying not to get sick.
I think a lot of people are still not taking it serious enough.
If it is true, the hospital’s location will be obvious due to the neighborhood and clientele it serves. Sadly, social class is an issue when it comes to healthcare in the U.S. which accounts for the majority of the deaths under Covid falling under African American and Latino. I hope the video does go viral and that there is an investigation. That said, I can’t imagine the fear that nurses and doctors face daily on the frontline. But according to the source, there are nurses waiting to be called upon and are not—that can be easily confirmed with an investigation.@Slick1 thanks for sharing. It’s
terrifying. I believe that’s her friend’s experience at that specific hospital. I wish she would have named the hospital. Truly with no info but NYC there’s nothing anyone can do.
Name the hospital. And her friend came to help but instead because she’s afraid to speak out what can be done?
People need to say something when they see something. Isn’t that the motto?
If they don’t they’re part of the problem. IMO.
I was in healthcare and believe me when I saw things happening that were just not right I always spoke out. Why would I want to be a part of the problem and why wouldn’t I do something constructive like blow the whistle?
Damn right I’d blow the whistle. I wouldn’t let people die needlessly as she kept saying.
Horrible situation and I hope it’s not a widespread one.
DD#2 works in a hospital,so my chance of contracting the virus from my daughter is higher than going out. We babysit her kids when she goes to work. I'm not out running around but if I need groceries then I'll go to the supermarket.DF, love ya my friend.
You owe it to your future grand kids to do what you can to stay safe.
They need you to spoil them.
Think about it before going out and running around.
Was told they'd know how much surgery would need to be done by end of week but its something that is inevitable given the circumstances. My parents will keep me up to date.
Last year he was in there for 3 months. Likely it will be something similar.
Ack! It never even crossed my mind that my dad wouldn't make it! I just thought this is all temporary and he would get off the ventilator soon. He's stable, still on the ventilator but just spiked a 104 fever. He's on heart medication and may need a dialysis but I'm hopeful he can pull through.