Both of my covid tests came back negative. I feel more confident that there were two negative results, but I was still sick for a little more than a week all told–so I’m baffled. I don’t think it was the flu, but it’s possible. Could have been a cold, I guess–just one of those old-fashioned pre-covid coronaviruses? Luckily, I’m starting to feel better because the ICU is busy and I keep getting calls to come in extra. We planned ahead for the winter & holidays by hiring dozens of traveling nurses and new staff, but we’re still short staffed, unfortunately.
Speaking of staffing, there was an article in the LA Times explaining ICU capacity and why it is so important to use as a metric for “shutting down” California. The Bay Area is currently at 17.8% capacity (slightly about the 15% cutoff for mandatory stay-at-home orders), but according to the article, 36 million Californians are living in areas where the ICU capacity has dropped below 15%.
The bottom line when ICU capacity is so severely limited–and I’m going to give it to you straight as a nurse in one of the best ICUs in the Bay Area– is that the only beds left are often beds at small, less busy hospitals. Yes, a bed may be an ICU bed–but the are not all created equal. You see, there are different types of hospitals. General hospitals provide basic emergency services but may need to transfer patients for higher levels of care. Trauma hospitals is where people are taken when involved in an accident with immediate life-threatening injuries and a full surgical team is always available. A tertiary care center is where patients are sent for specialty care at the highest levels. Doctors, nurses, and other staff at these hospitals that perform more complicated surgeries and regularly care for sicker patients and will be more skilled. They simply have more experience, and may also be involved in research studies–thus giving them access to drugs or treatments earlier than other hospitals.
So in a rural area, you may go to the local general hospital, be diagnosed with covid and admitted. But if you decompensate in a small rural ICU, you may find that the ICUs at tertiary care centers where you need to go for specialty care are no longer accepting patients because they are full–or, and this is more likely–they do not have enough staff.
At my hospital, we are lucky because the charge nurses guard the staffing with their lives. They never let the nurses be forced to take more patients than is safe, even if that means that a nurse is only caring for one patient. But no all hospitals are so lucky. In California, ICU nurses can take care of up to 2 patients at a time. In other states, 3 patients is the norm. I cannot even manage taking care of my sick covid patients AND two other sick patients as well.
Stay home if possible. Otherwise, be safe out there & please wear a mask.