Season 1, Episode 20: Critical Care Nurse Amy Taylor, Maggie Hemphill, and Danielle S. Castillejo discuss the Coronavirus, flow of information, medical supplies, and STAYING HOME

Amy Taylor is a Georgia Native and is a NICU nurse and critical care nurse. When she first heard about the coronavirus she wasn’t inclined to worry about it. As a nurse she thought, “If you’re not bleeding out you’re fine… This will pass…” But within several days it escalated quickly and it became harmful to health care workers.

She described how at the beginning the hospital she worked at would not allow someone to bring more than one person into the hospital with them and each time someone came in to the hospital their temperature was taken. Then big tents were set up outside the hospital and people had to be screened outside. “It looked like something from a third world country where you think ‘this isn’t happening here.’”

Shortages of Personal Protective Equipment began within a few days of Trump acknowledging the severity of the virus. Amy takes about how airborne viruses are combatted by using a negative pressure room so that the virus does not spread through the air vents. She tells the story about a nurse in her hospital having to treat a patient with Tuberculosis with no mask because they’re were none available due to the PPE shortages. And Amy says the shortages had started before it got bad where she lives. “The nurses had no masks. It was health care workers stealing them, it was people hoarding them, management started hoarding them…”

Masks are supposed to be a one-time use but now nurses get one N95 mask and they are to wear it the whole day. There are not enough gowns, which are also not reusable, and nurses are now wearing them all day long. Gowns are, like all Personal Protective Equipment (PPE), are for the protection of both the patient and the health care provider. Health Care Providers could now carry the virus from patient to patient by not changing their PPE.

It’s really scary because not only are these nurses trying to manage their own anxiety as a person in this crisis—making sure they and their family have enough food and supplies—but nurses are also managing the fears and anxieties of their patients, and the fear passing the virus to them now extends bringing it home to their loved ones.

These are not the typical problems of 1st world countries. Amy said the CDC has changed the rules from requiring N95 masks on every nurse to allowing heath care providers to just use a bandana. She said, “That doesn’t actually do anything.”

The climate among the nurses are the hospital she works at is this overall sense of deprivation and fear. “And that fear looks different for everybody… it looks like snapping at other people… it looks like lack of empathy towards others… A crass-ness…” It’s very low morale. There are people who are very angry and people who are very tearful.

Danielle asked if we could sew masks and other protective gear for nurses. Amy said that studies show that homemade PPE is not effective so a better way to support medical staff is to donate N95 masks if you have them, and make your own masks to wear out. Nurses who have been exposed to the coronavirus are getting sicker than others so it appears that there is a cumulative affect to being exposed virus.

The idea that the virus lingers in the air for up to three hours is terrifying because if the virus is in a place that has an HVAC system, the virus would then be pumped to every room of that building through the air vents. It’s a scary thought to enter a building let alone a hospital.

Maggie asked how patients coming into the hospitals have been: Amy said that initially people are just wanting to know [if they have it]— ERs were flooded with people wanting to get tested because they were running a temperature and their hospital didn’t have the capacity to test people who were not critically ill. Amy admits this is difficult to hear this when you have people like Harvey Weinstein being tested but health care workers aren’t being allowed to be tested. But this is one of the big difference between our country and other countries—many other countries initially quarantined people and tested everybody, then they followed the trail of infected people.

“If you would not normally go to the ER for an issue, then you shouldn’t go to the ER because you’re risking being exposed to more things by going there… And it’s hard because you want to know. You want to know if I am infected I want to not be passing it on to my spouse to my kids…”

Danielle says “Its hard to know what to believe. I believe you! … And then you hear our public health officials say ‘there’s tests!”  Even the tests that have been done are prioritized. Some people have been tested and haven’t gotten their results back.

Things vary from hospital to hospital. Amy’s friend who works in a hospital in Florida was caring for a patient for five days along with nurses that had nausea, vomiting and diarrhea but were still being required to work. After the five days, she found out the patient had the coronavirus so she got tested herself but was still required to work her THREE SHIFTS before she was could get the results back.

The fear of hospitals is this: What are we going do to when health care workers can not work because they are sick with the virus? This is part of the reason why they don’t want to give tests to nurses and doctors.

CDC Guidelines have been changed based on the supplies that are available: First is was that nurses need an N95 mask, but then any mask was allowed. This is unreal, unsafe, unethical. “It’s like warfare! And being sent into battle without the equipment that you need… and the soldiers on the front lines die first.”

There is a thing called “travel nursing” where nurses get paid more to meet demands during high seasons in other locations. Amy was offered a job in Washington “Ground zero” for the US but she declined even though the pay for 13 weeks was more than she would make in a year.

There is not enough staff: As more and more doctors and nurses get sick with the coronavirus and have to stop working, the remaining staff ends up working excessive shifts which has been proven to not be safe.

This idea of the “6-foot rule”, practicing social distancing still getting together, but lung doctors say the reality is that we don’t know how safe it is to be even six feet from each other. “So just don’t do it. It's not worth your health.” As well there's this idea that young healthy people don’t get the virus and this is providing to not be true.

There’s just not enough PPE or ventilators to meet the need. Ventilators are supposed to be one per person but they are being used for two people. The first time Amy heard of ventilators being used for more than one person was after a mass shooting in TX.

Amy believes the way that we should be dealing with the virus as a country is everything should be shutting down and companies that make masks or gowns should work exclusively on making them. The worse case scenario would be that we overreacted and now are prepared for a future disaster. The response has been “oh it’s not that bad, it’s not that bad, oh it’s bad!”

We are already running out of ventilators and we haven’t even hit our peak. If you look by the numbers, we are already surpassing Italy and we’re not even testing everyone. It’s alarming.

What will be the last straw? Amy believes that if hospitals begin to operating out of a war mindset —assessing people based on the likelihood of the patient's survival and thus determining who will receive care and who will not. When hospitals are no longer operating with hospital beds and are working out of parking garages and tents outside… It's a war mentality treating only those who you think will survive. This places the weight of responsibility on the medical workers—It will be them carry the weight of negligence of society.

Amy compares it to Chernobyl, where  people were sent into harm's way without enough protection. How valuable do you find medical workers to be? Many nurses and physicians in Italy are having PTSD symptoms and are having trouble coming into work. This is all very traumatizing—nurses not being able to care for their patients. For Amy that has been some of her most defeating moments as a nurse, not being able to care well and connect with her patients. There is no margin in this space, it’s survival mode. Everyone deserves dignity and care no matter what issues they have or where they are coming from.

The long term impact of this pandemic will be global PTSD in addition to the financial problems that ensure after shutting down so much of the economy. No one is untouched.

Seeing other panics breeds panic in yourself. Watching people run for toilet paper and other essentials when this was first starting a couple of weeks ago grew panic in other. Panic breeds deprivation and fear, and then festers.

Danielle poses, If run into the ground our health care workers, if they are physically emotionally and spiritually spent, who is going to run our hospitals? Who will want to enter this field next? We must sacrifice to protect our health care workers, they are literally the people that are saving our lives.

Conan O’Brien says if we run out of toilet paper we can just use CVS receipts because they are so long.

There are companies like Home Depot and Lowes, that have sent their stock of PPE to hospitals… They are trying to help the situation.

What can you do? You can stay home.

People need to stay home.  Amy thinks Christians are the ones who are still gathering together and having church services, thinking that God will protect them. But we are not immune to science. Stay home!

And it’s not about you! Amy says that in America it’s like we don’t care about community, that we don’t know how to care for our neighbors. . . Protector your neighbor by staying home.

Ultimately law makers may move to order “shelter in place” everywhere, not just in the three or four states that have done it thus far. People need to stay home, because that is how we love and honor our neighbor.

Amy reminds everyone that gloves are pointless if you use them all day long. Gloves can be helpful, but be aware of why you’re doing what you’re doing.

Staying inside is the most crucial thing we can do. Our government hasn’t mandate it yet but Amy encourages us think about what we're doing. Yes it's hard to sit inside and struggle with anxiety… but this is how we can care for each other in this pandemic.

Well, first I guess I would have to believe that there was or is an actual political dialogue taking place that I could potentially be a part of. And honestly, I'm not sure that I believe that.