a glimmer of light

In the blog I wrote on New Year's Eve I felt excited about 2020. It seemed like a year full of possibilities and experiences waiting to be lived. Now, four months into this new decade, we've experienced things we never would've imagined! You can look at it as a disaster or an adventure to be living in a year that will be written about in the history books.

In the last few weeks the numbers of sick people in our hospital have continued to rise. It appears we may have already reached the peak of the curve. If you're interested, here's a tracker that is updated daily on COVID-19 statistics for St. Joe's and Hershey Medical Centers. St. Joe's is one-fifth the size of Hershey but has experienced the majority of cases. Unfortunately we've had 5 deaths and it looks like that number will continue to rise based on how many patients we have on ventilators in critical care. On the bright side, we are discharging people every day. When a COVID patient leaves, it's announced over the loudspeakers and a bit of music is played to celebrate another recovery! 

It's been interesting seeing what drugs are given to positive patients. We are using the anti-malarial drug hydroxychloroquine, even though it's still being studied to see if it's actually effective for this virus. Vitamin C and zinc are flying off the shelves, and the antibiotic azithromycin is also very popular. Albuterol inhalers are in high demand as well. For ventilated patients, we're making hundreds of fentanyl and propofol drips.

Some caregivers have gotten sick from the virus, but so far everyone in the pharmacy has stayed well. We've all been practicing precautions, but from what I've observed, some of my coworkers are much more obsessed with it than I am. I haven't been washing my clothes as soon as I get home or otherwise doing anything out of the ordinary. I'm pretty convinced I already had the virus back in February when I was sick for 2 weeks and off work for a week. My symptoms were very similar, and I really haven't worried about getting sick again.

Yesterday it was announced that Reading Hospital furloughed 1,000 employees. St. Joe's is also experiencing financial stress since overall admissions have been lower in the last few months due to the quarantine and the additional cost of caring for COVID patients. Who knows what ramifications this pandemic will cause. I'm just glad I don't have to worry about figuring out where to cut costs. We've all been told to conserve and only order necessary supplies, volunteer to take time off, and work no overtime. 

It seems like we might be seeing the light at the end of the tunnel. Until then, everyone keeps plugging along.

carry on

I think most everyone is tired of hearing about COVID-19 by now. We've become more adjusted to the "new normal" and if you're staying at home and avoiding the news, you could probably forget about it! That's not my situation though, and it's very much at the forefront when I go to work.

We've seen a surge of sick people in the last week and hospital leaders say we haven't reached the peak yet. The units that were set aside for COVID-19 patients are nearly full, and if cases continue to rise as predicted, another unused area of the hospital will be opened. Since the OR is only doing emergency cases, nurses from the areas associated with surgery are being deployed to assist with patient care. Every time I have to deliver meds to an area where the COVID patients are housed, I want to stop and just take it all in! It's fascinating to see history in the making.

I'll try to describe the scene when I walk into the critical care unit. This is where the very sickest COVID patients are located; there's another whole floor elsewhere of more stable patients. Many of those in CCU are on ventilators, which means they're getting dozens of IV meds. The IV poles are kept outside the patient's room in the hallway, so that the nurses can access those meds without going into the room. Hallways are cluttered with equipment and people in sterile scrubs, masks, and goggles. Nurses in patient rooms communicate with those outside by writing messages on the glass door. It looks like a disaster zone.

These images are from Google, but very similar to what I see at work.

Ventilated patients go through an
astonishing amount of sedatives like propofol (that's what Michael Jackson overdosed on), narcotics like fentanyl and dilaudid, and paralyzing agents such as precedex and nimbex. We are kept busy in the pharmacy getting those drugs made and trying to send them in a timely fashion. Sometimes the nurses let something run dry, then they call us in a panic requesting another bag. If it's something we have to make, it can take a couple minutes, which to them seems much longer! We sometimes get multiple calls while the drug is being made. We do our best but unfortunately the pharmacy is usually too slow for the nurses. Since I worked on a nursing unit before, I've seen it from both sides and can sympathize with nursing and the pharmacy! Many of the drugs that are being used to treat COVID are on shortage, specifically the paralytics. Backup plans and drugs are being investigated, and we try to not waste what we have. Too often patients end up dying (not necessarily COVID patients, but any vented person) after being given high doses of these drugs for several days and it feels like those scarce meds were used for nothing.

IV pole with multiple drips, similar to
those outside COVID patients' rooms 

The general atmosphere at work feels somber. It doesn't help that everyone wears a mask and you can't see smiles and facial expressions. That in itself can be dispiriting. The ear loop masks make your ears hurt after wearing them awhile, and if you wear glasses they're constantly fogging up. I've seen some innovative ways of getting around the ear pain by attaching the loops to buttons on a headband, or using paper clips to hold the loops together and put around your neck instead. I've tried some of those ideas myself, but haven't found anything too satisfactory.

On the bright side, Godiva donated chocolate to Penn State Health workers and we all got to enjoy something delicious! It's wonderful to see the community helping to support those on the front lines.

Earlier this year I requested four days off over this weekend, and it's proving to be just the right time for a break. Even though it won't be an Easter for getting together with family and friends, this too shall pass and we'll look back and say, "Remember when we couldn't go to church on Easter Sunday?" Hopefully we'll be more thankful for the simple things we all took for granted when this is over!