Here in my area, we’ve been lucky (maybe prepared) enough not to get a surge of novel coronavirus patients. And with the lack of elective surgeries, my hospital census is getting shockingly low. We’ve shut our dedicated COVID floor because the few patients we have can be accommodated elsewhere without increasing infection control risks. Our “disaster ICU” was open for 2 nights as a trial—it worked—and now even the idea of needing it seems so remote that the assignment board was dragged back to the normal ICU.
And since we got our first case in that first week of February, we’ve never had more than about 8 COVID patients at one time in the unit. Sure, there was the one day in late February when lord-knows-who approved 9 surgeries and EVERY.SINGLE.ONE came to the ICU afterwards because they developed a fever intra-operatively and now needed to be ruled out for… you guessed it … COVID. Surgical services finally got their socks on the right feet, though, and now we screen everyone pre-op.
But wait, this is a lot of story for a post that seems to indicate it will be about getting cancelled. I needed to set the stage. That day in late February when surgery sent us all their patients—that was the last time our ICU was full. 36 patients. Do you know how many nurses it takes at a minimum to run our 36 bed ICU? 25. That’s our base staffing number—the number of nurses that is recommended to be scheduled every shift. It’s actually pretty hilarious how many nurses we actually need; sometimes 25 nurses for 25 patients. And that’s not really uncommon…
Last night, however, we were already overstaffed when I arrived at 19:00, and patients just kept getting transfer orders and going upstairs to less acute floors. We had cancelled about 5 people before the shift and then at 23:00, 2 more people needed to go home. I volunteered because it made sense with my assignment, but many people are starting to get worried about how slow it is. The per diem staff are getting cancelled every shift, and unless they’re willing to work at a moment’s notice & odd hours, there’s no work some weeks at all for them.
Benefitted staff generally fall into 2 categories: the ones that work their set hours (no more & no less) and the ones who love overtime (and in some cases need it to pay the bills). It’s a hard situation. People want to maintain their financial security, especially with high-profile West Coast hospitals making the news, such as Stanford cutting salaries across the board by 20%.
As nurses during a pandemic, we didn’t think we’d be sheltering-in-place, worried about losing our jobs like the rest of the economy’s workers. But now, at a time when treatment protocols are in flux, when drug regimens are changing quickly, when we ourselves as nurses fear that we will get COVID and perhaps die, we are getting cancelled. We are left to sit at home. We thought we knew one thing: there is work for us to do. But now we’re not even sure about that.