NURSING THROUGH A PANDEMIC

​We lost half of our census at the assisted living facility where I was working during the first wave of the pandemic back in March of 2020. Many deaths and many people no longer suitable for assisted living and sent to a skilled nursing facility. I blame the company who owns our facility for the loss of so many of our residents. I blame the hospitals for sending our residents back to our facility with a diagnosis of urinary tract infections when they were infected with COVID. Now, since our census is low, the administrator, also the marketer, is out recruiting new residents and not really caring if they are appropriate for assisted living, as long as there is a body in the bed. The acuity is high, and the facility is staffed for assisted living. The majority of the residents belong in a skilled nursing facility. The staff are doing the work of 3 people at times. Morality is low and, at this point, no one cares, and the residents are being neglected. They are being left soiled with urine and feces for hours at a time. Their call bells are being ignored. Medications aren’t being reordered on time, so they go, sometimes days without necessary medications. There is no chain of command regarding management of nursing staff. Everyone just comes to work for a paycheck. Going through the motions of a work day, not really caring if they’re late to work, calling out frequently, defiantly declaring what they’re NOT going to do even if it’s part of their work assignment, talking on their phones while passing out medications or giving care, sleeping on the job, and just being insubordinate, confrontational, and being complete and utter, for lack of a better word, assholes. Administration is useless. You can report how badly the residents are being neglected, or how poorly someone is doing their job, but it falls on deaf ears. I don’t know if it’s the staff’s intimidating and confrontational attitudes about almost EVERYTHING that has the administrator afraid to say anything to them or she just doesn’t care about anything but making a buck by filling beds and saving a buck by cutting back staff. All I know is that people’s loved ones are being promised services that we simply cannot provide. The staff just doesn’t care. I’m doing everything that I’ve learned over the 35 years I’ve been working in nursing but to no avail. I always get arguments and confrontation from uneducated, ignorant people. I have the personality type which, even though I know I’m right, I can be almost bullied into doubting everything I do or say. Doubting my own intelligence. It’s so frustrating that people are so ignorant they don’t even see that I’m intelligent and know my job. They question me, undermine me, and plain old ignore me. Justifiably, though, since administration NEVER backs me up with anything. A resident died because everyone ignored my concerns. Her death was attributed to “old age” but she was completely healthy the day before, as healthy as she could be, but nowhere near death. She choked on food in her sleep after I reported repeatedly that I was finding her asleep with food in her mouth frequently and was afraid she would choke. In addition to finding her dead with food in her mouth, she was ice cold and in rigor mortis, so, even though she was on every 2 hour checks for safety, she had been dead for quite some time. The nursing assistant assigned to check on her obviously didn’t really check on her all night. She was face down in the bed, face was blue from livor mortis. Her tongue was hanging out, lips deep purple, almost black, and nose, pushed to the side in a grotesque manner. She resembled a peat bog mummy I saw on television once. I was horrified. It really stayed with me for weeks. I was told by the director of nursing not to tell anyone how I found her. I knew it was from these lazy, neglectful staff members. I knew it was from being ignored when I expressed a concern just two days before her death about her mouth being filled with food from the 3-11 shift. I wrote it on the 24 hour report for everyone to read and to check that she didn’t fall asleep with food in her mouth. Completely ignored by everyone. So now, there’s a dead resident on my watch. I was devastated. I really liked that resident. She lived in my hometown and we knew the same people. Even distantly connected by marriage. Not one blessed soul at that facility was held accountable. It was swept under the rug, and forgotten.

​I don’t know what alternate universe I woke up in, but nursing isn’t what it was when I first became a nurse. My title was respected by other nurses, nursing assistants, and even administration. We all worked together, respected each other, were sometimes friends outside of work, and worked as a team. The work environment, despite some bad days, was always pleasant. I don’t know if it’s the facility where I work now, or society itself, but EVERY DAY is a constant battle. So bad, that I feel like writing this is even pointless since I’m relatively sure, this will be ignored as well.

​Let’s go back to 2020, during the height of the COVID pandemic and the events that occurred then…

​I’ve been a nurse for 30 years. I’ve never seen anything like this. Ok. I don’t work in a hospital, I work in an assisted living facility with the elderly, the most vulnerable population during this pandemic. It’s a whirlwind of confusion since no one was prepared for this kind of disaster. Rules and regulations, policies and procedures, are changing every day, sometimes, every hour. It’s hard to keep up. Most of our staff is surprisingly showing up for work. There are some opportunists, however, who use the virus as an excuse not to come to work, even going as far as getting their doctor’s to put them out of work for MONTHS. Then there are those with a scratchy throat from allergies swearing to God they’re dying from the virus. I’m not saying it’s not scary as fuck, but some people just don’t like to work, regardless. I feel sad for the residents of our facility. Sad for the co-workers who have to do twice as much because there is no staff.

​So far, there have been 11 confirmed cases of COVID in our facility with 3 deaths. Two positive cases, that are confirmed, are currently in the facility, however, there are people throughout the entire facility with symptoms. I haven’t heard if any staff members have tested positive yet. I’ve been coughing and wheezing with a headache for 6 days now.

​I called out Monday and tried to call the Camden County testing site for an appointment but no return call as of yet. It’s been 3 days. Work calls me on Tuesday and tells me I HAVE to come to work anyway since I don’t have a fever. I haven’t had a fever in 20 years despite having been extremely ill a few times throughout those 20 years. I generally don’t get fevers when I’m sick.

​Well, here I am, getting ready to do care on 2 COVID positive residents without sufficient PPE, personal protective equipment. I have an N95 mask I’ve been spraying with Lysol and reusing for the past 2 weeks. Thin, yellow, isolation gowns that tear when you put them on. Gowns that are for one use only that we are told by administration to hang outside the COVID rooms and reuse. One size of shoe coverings that do not fit my size 11 feet. Some of the staff are using them for head coverings. No face shield. Reusing my pulse oximetry device and forehead contact thermometer on symptomatic residents, confirmed positive residents and “well” residents. A positive resident coughed in my hair. I had to douse my head with Lysol spray.

​I know I was exposed to at least two positive cases of COVID over the course of the past few weeks with minimal PPE before we were aware they were positive. I’m wondering why the facility didn’t test the employees, right after exposure and why we have to wait to get a fever before we can be tested. Not everyone gets a fever, apparently. Those of us who were exposed could be asymptomatic yet spread the virus throughout the facility unwittingly since there were no policies in place at the facility when the residents started getting sick, nor the proper PPE.

​Another interesting thing is happening. The nursing assistants and medication aides are completely avoiding patient care. They’re not even going into the residents’ rooms and checking the residents for anything. They’re not toileting them or answering their call lights. Just leaving them floundering on their own because they don’t want to touch them. Oh, but they are showing up and collecting their ‘hazard’ pay but flat out neglecting the residents. I’ve found medications in resident’s rooms, not given from the previous shift, just sitting on a table, untouched. Nurses and med aides are supposed to watch residents take their medications normally. Incontinent residents are being left lying in bed in their own filth for hours at a time. Food remaining uneaten at the bedside, rotting. Empty plastic cups lined up on bedside tables. Piles of soiled linens thrown on the floor in the corner of the room. You get the picture. I’ve been verbalizing this situation to the Director of Wellness aka Director of Nursing who has pretty much bailed out and isn’t coming back to work because of her second 14 day quarantine. The administrator, I believe, is totally overwhelmed and has been blind-sided by this entire pandemic, but she should still make the staff accountable for neglecting the residents. The corporation that owns this facility should also be held accountable for not providing enough PPE, or at least, the correct PPE, to its employees.

​They are calling healthcare workers “heroes” these days but the staff here? Not very heroic. Calling out when they’re not sick, avoiding patient care altogether, and letting the call bells ring until someone falls and gets hurt.

​I know I’m trying MY best to be a “hero” since I’m the person designated to go into the isolation rooms and care for the residents we already know are positive. I have to piece together PPE to go into their rooms but I know it’s not really safe. I’m hoping the N95 mask and gloves can hold me from catching the virus. We’re out of gowns now. Had to use the gowns hanging on the doors inside of the isolation rooms. They’re supposed to be disposed of after one use. I don’t know why I just don’t refuse to care for the infected residents like everyone else here does until the proper PPE is available but Im not going to leave these poor old souls neglected like my ignorant co-workers. Of course, they’ll continue to collect that hazard pay for doing almost nothing.

​I bring a cup of ice water to a resident with her 6 am medication and she drinks it like she’s been stranded in a desert for a week, asking, “Where did you get this ice water? We never get ice water. Can I have some more please?” This is so sad. I want to break down and cry right there. It’s absolutely disgusting. I go into the isolation rooms that we call “the COVID corner”, which is basically 3 rooms behind a big plastic sheet, and see nothing but neglect. I know I’ve already mentioned this but I have to repeat it because this is basically deplorable. Behind the curtain, overflowing trash cans, food trays not discarded with rotting food, residents laying in their own urine and feces, call bells not being answered or reset, wearing the same clothes for days at a time, dirty linen thrown in the corner of every room, and the smell…I can smell it through my N95 mask, human waste and rotting food. I report it to administration but no one cares or takes any action at all. I come to work and the 3-11 supervisor is sitting in the lobby reading a book. I’m always 15-30 minutes early to work out of consideration for my co-workers who want to leave on time at the end of their shift. She’s waiting for me to just walk in the building. She clocks out the minute my foot hits the doorway of the main entrance of the building. No report about the residents from her shift. Multiple call lights left unanswered.

​I put my things down in the office and feel my frustration getting the best of me. I want to explode but it doesn’t do me any good. No one is listening anyway. Day # 7 of scratchy throat, cough, and headache. I was told when I called out about a week ago because I just wasn’t feeling right that ‘they’, whoever ‘they’ are, “won’t test me if I don’t have a fever”, and if you’re ‘essential’ you “have to come to work if you don’t have a fever.” HELLO, some people with mild symptoms don’t get a fever. Oh well, here I am, at work, could be positive yet I continue to care for the elderly, the most vulnerable population for COVID fatalities, with improper PPE to protect myself or the people who I’m caring for.

​23 positive cases. 25 if you count employees. So far, 5 deaths.

​You know when a ship is sinking and the order is given when there’s no hope left, “Every man for himself”? That’s where we are right about now.

​I AM IN HELL!

​May 9, 2020 Happy Nurse’s Week

​13 deaths from COVID. 3 people in isolation. 15 others still in hospitals or rehabilitation facilities. We risk infection, illness, death every day since this whole pandemic started.

​Wednesday, May 6, was “Nurse’s Day”. The company I work for thought it was motivating and morale boosting to give us generic candy bars. Not king sized, brand name candy bars. Just no frills bars of shit.

​The next day was, for 11-7 shift anyway, stale donuts. 7-3 and 3-11 shift left us a cold ‘box of joe’ and an empty donut box on the table in the break room.

​Day # 3, the culmination of “Nurse’s Week”, there was a celebratory luncheon happening on day shift. Day shift gets a huge hoagie tray with all of the trimmings. When I get to work, all that’s left, as predicted, are empty trays of SADNESS and some dried up macaroni salad. Well, there are flowers shoved into a giant vase with 4 people’s names on them. I don’t want mine. Flowers that were probably gathered from the graves of our dead COVID residents.

​I’m neither motivated nor is my morale boosted. I feel unappreciated. I’m pretty sure I’m not the only one. The five employees, sick with COVID, definitely aren’t impressed at all. I’m sure.

​This is how disgusting the corporation that owns this facility is: They increased the remaining residents’ rent on May 1st, after they were totally incompetent with managing this COVID outbreak at their facility. With deaths and hospitalizations, the census went down substantially. What else could they do to make money? Disgusting because they mismanaged EVERYTHING related to COVID so it spread like wildfire.

​As I was giving out medications this morning, I noticed the residents had these blue papers in their rooms. Since they were in every room I visited, curiosity got the better of me, so I decided to read it. Well, I was utterly disgusted by what I read. It was a list of food products and paper products FOR PURCHASE from the activities department. The residents’ families can’t visit and bring them what they need or want so now the activities department is going to CHARGE them for toilet paper and potato chips? Right after the company/corporation raised the rent? Right after the beginning of the month when they get their miniscule amount of spending money? I am so sad about how these people are treated. They can’t just give them toilet paper, candy, cookies, chips and soda? It’s so horrible and makes me feel almost “dirty” working for this company.

​The latest I just heard from a “reliable” source is that these neglectful, shitty excuses for health care workers aren’t going to be fired right now because the company that owns this god forsaken facility will have to pay too much out in unemployment. I suppose, these useless employees can continue to abuse and neglect the residents, call out every other day, or not show up at all whenever they feel like it, but still have a job? How fucked up is that? A company who puts money before good care? It’s disgusting.

​July 7, 2020 Where Am I?

​Where am I? What time is it? I don’t even know anymore. Is this the United Stated of America or some 3rd world country where I wake up every morning anxious and scared? This is supposed to be, ‘the home of the free’, yet I don’t feel free at all.

​Nursing Through A Pandemic: The Second Wave

​November 23, 2020

​11/12/2020 The second wave of COVID is upon our facility. 5 positive cases: one employee and four residents. Two in house. Two in the hospital. The employee is quarantined for 14 days at home. Two other employees already had their doctors put them on medical leave. The CNA on my 11-7 shift staff is refusing to care for the two in-house COVID residents. When I got here last night, no N95 masks or other PPE for 11-7 shift. However, there were N95 masks in little baggies with names on them for the dayshift staff. What the fuck is that? Where’s our extra money? I’m sure as shit not caring for COVID residents without proper PPE or hazard pay. Not right now with this horrible cough and the fact that I probably have early stages of COPD. I’m not in the mood for the COVID fuckery again.

​Tonight we didn’t even have regular surgical masks. I sent a text message to the wellness director at the beginning of the shift and got no answer. Then I sent a text to the administrator. She answered and directed me where to find them. It’s now 6:15am but still no answer from the wellness director. Dayshift got everything THEY needed AND pizza. Fuck that!

​November 13, 2020

​COVID is back. I’ve been exposed at work. I tested negative two weeks ago. I’ve had a severe cough since then but still had no choice but to go to work. Then, yesterday, the coughing was unbearable and I was short of breath. I was tested at work on Wednesday and was told I would have my results by Friday. I called out of work last night, with a lot of resistance from administration, out of concern for my residents and mostly, concern for my own health. I was told to go to a rapid testing facility because, now, the cheap lab our company uses can’t have our results until next week.

​This is what, I thought, was really fucked up and disrespectful…

​I went to Riverside Urgent Care in Runnemede, NJ for rapid testing. There were only three people in the waiting room. I explained to the receptionist that I was a nurse and worked in an assisted living facility with the elderly. I’ve had a cough going on two weeks. I needed rapid testing, not only to protect my elderly residents, but my partner aka girlfriend, and for my own peace of mind. Guess what? They told me they were filled to capacity. Three people in the waiting room. Five cars in the parking lot. All Riverside Urgent Care facilities were filled to capacity and I had to make an appointment. Nothing was available until next Wednesday. I repeated that I was a nurse and worked with the elderly but to no avail. They were like, “Sorry.” I hate confrontation, but I was about to lose my shit. I’m a fucking nurse working with the most vulnerable population and you’re going to turn me away?! So much for professional courtesy. Heroes? Essential? Such bullshit.

​This is why we are having a second wave of COVID. Not because of bars and restaurants, but because of fuckery like this!

​Pandemic Now: November 7, 2021

​Every day continues to be a struggle in healthcare. I’m vaccinated and feel fairly confident not wearing a mask. The facility where I work has been COVID-free for months. We are still testing weekly, our unvaccinated employees. They are refusing to be vaccinated. That’s about to change. The US government is about to mandate that ALL healthcare workers MUST be vaccinated to work in healthcare. I don’t know what’s going to happen then. I guess, either they comply, or be unemployed. Right now, I’m focused on doing the best that I can for my residents, given the mess that was left behind by this pandemic. I’m hopeful that there are better days ahead for me and everyone else who works in healthcare. Maybe, one day, I’ll feel worthy of being called a “healthcare hero”.

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