🧵Let’s go through this again...

Many hospitals and ICUs across the country are full. Don’t believe me? Look through my timeline or that of any legit healthcare professional. I’ve RT stories from across the country. We are getting phone calls to transfer patients from several
states over/away. It’s not just near me. This is happening across the country.

What does that mean?

It means that hospitals are so full that they will be closing to ECMO, Stroke, Trauma. They will be closing down for elective spine, orthopedic, and cancer surgeries. So, when
patients come in needing heart-lung bypass or want their suspicious looking pancreatic mass removed, their painful spinal condition fixed, or their hip replaced after waiting years to get it done... they will likely have to wait. Waiting will worsen outcomes.

It means
that routine conditions like trauma and bowel obstructions will be harder if not impossible to treat due to lack of available staff.

Notice that I did not say “beds”. We are facing a nationwide bed shortage, but lay-people don’t understand that terminology. When we say we
don’t have beds, what we mean is that we may have a stretcher but that is worthless without housekeepers, physical therapists, nurses, nursing aids, doctors, etc to make sure the room and the patient are taken care of properly. If you think that hospitals are just empty
rooms like a hotel, then I would suggest you try being critically ill in a hotel and see how that goes.

We haven’t even hit thanksgiving yet. And hospitals are already full. Thanksgiving appears to be on track to be a nationwide super spreader event. Because people aren’t
listening. So while hospitals are full now, they are about to exceed capacity. Because all the COVID that gets spread over thanksgiving will likely result in increasing cases and hospitalizations right before Christmas.

There is no end in sight. And that is just the short
term issue.

In the long term, you are taking an entire profession worth of healthcare workers who are already distraught and experiencing PTSD... and adding more work, less sleep, and more despondency. Why? Because there are nurses and doctors who are so
far past burnt out that they want to leave medicine. ALREADY. They need to leave. They need some self care. But they won’t.

Why? Because they know that if they call out or no show at work, a colleague, friend, and fellow survivor will have to pick
up their patients and their workload for the day. And they simply will not do that to their fellow nurses or doctors.

Because that is who we are.

It is the same trait that has allowed healthcare administrators and insurance companies to abuse healthcare
professionals for decades. They take advantage of our altruism. But now, instead of that abuse coming from one direction, it’s coming from all sides. It’s coming from an entitled, ignorant, and disrespectful public as well. It’s coming from politicians who have a vested interest
in undermining medical professionals who are screaming for help and in doing so exposing problems they don’t want you to hear about.

And that is, as they say, the straw that broke the camels back.

So, what we are now seeing and what we will see for months and likely years to
come, is a mass exodus from the bedside.

Next year, or three years, or ten years from now... when you or your loved ones end up in the ICU or need spine surgery or want your hip replaced, the chances are getting higher and higher that you will have a brand new surgeon or nurse
or tech. They will be well-trained, intelligent, and hard working. They will pour their hearts into giving you and your family the very best they can. But there is no substitute for a nurse or doc who has been in the ICU for 20 years. Who has seen it all and can do it all. Who
recognizes when a patient is getting sicker in front of their eyes and has an idea about how to fix it.

Suffice it to say, this post will be called fear mongering. These are not my fears. These are predictions that many experts are making based on current FACTS. These are
not my feelings. These are extrapolations of trends we are already seeing.

We are tired of screaming out to a nation that has disregarded science and it’s healthcare workers. We have no incentive to say these things. Not one of us gets paid to share facts or concerns on Twitter
We are not paid by the media or the deep state. We get nothing but grief out of writing these posts. We receive hateful and disingenuous comments from trolls. As if we have the time or energy for that right now. And I’m not alone. None of us has the bandwidth to address the
trolls or the hatred. So please, don’t waste your energy. We are not going to respond. We are going to speak our truth and then when folks say hateful things, we
will block, move on, and go back to caring for our patients the very best we can.

Because that’s who we are. It’s
who we have always been.

And if, god forbid, you get sick during this surge after trolling and harassing healthcare workers online and denying the pandemic as a “hoax”, you will still receive the very best healthcare that we are able to provide.

Because that is who we are.
We are just a bunch of folks who genuinely care for others. We are trying to help you. We are trying to keep you from getting sick. But you have to open your minds and your hearts and help yourselves too. We cannot do this alone.

Please 🙏

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More from @kari_jerge

20 Nov
To all the folks speaking out on Twitter about working conditions in healthcare right now:

DONT STOP!

The media is listening and trying to spread the word. @siobhanneela at Mashable wrote a really nice article including tweets from MedTwitter.

mashable.com/article/covid-…
The best and brightest of MedTwitter are included here:

@meganranney
@laxswamy
@iDocAnonXX
@BsnDude
@ShiriSharvit
@KellyCawcuttMD
@MsJuneDiane
@JodiDoering
@TheBlondeRN

And more...
To my friends like @BKendallMD and to all MICU and ER staff, please keep speaking. Honor the dignity of your patients and their families. Protect HIPAA. But if it will not traumatize you to do so, speak out!!

The media is paying attention and they are trying
Read 5 tweets
20 Nov
Trying to fight the doom-scroll... so I want to post something that makes me super happy.

One of my good buddies is an Ortho Trauma guy on Instagram. Super hardcore. Dudes dude. In the gym all the time. Like super ORTHO. 😂

Anyway, every day or every other day, he posts or
puts up a story about his wife. She is gorgeous, competes in fitness challenges, cooks, bakes, throws parties, and reads to the kids every night at bedtime. How could I possibly know this much about their marriage?

Because he celebrates her EVERY. DAY.

It might be one of the
coolest things I’ve ever seen. He truly appreciates and celebrates this woman for everything she is and everything she brings to the table. Every time I see it it makes me smile.

Women don’t hear enough of that. I know men don’t either, but historically the ones who seem to
Read 5 tweets
18 Nov
A handful of you know that I have been moonlighting in the Covid ICU. I’ve learned a decade worth of intensive care medicine in a couple of months… I’ve seen some wild things that I thought I would never see… But really the biggest take away from all of this for me has been
how overworked, underpaid, and underappreciated our medicine ICU doctors and nurses are. I don’t like the term hero especially not in the context of Covid… But these people are literal heroes. They have been going for months on end with minimal time off providing excellent care
to the sickest population of critically ill patients that any of us have ever seen in our lifetimes. They are physically and emotionally exhausted. They have been doing this now for a year. There’s no sign of it stopping in fact it’s only going to get worse. And they still have
Read 6 tweets
17 Nov
Just to put this in context, a rare and potentially deadly disease process that has nothing to do with COVID. This serious illness should be treatable. And it may not be because hospitals are full.

My ICU is full tonight. If you called to check, I’d bet your local one is too.
And your healthcare “heroes” have been crying, screaming into the void, and begging for help for months.

THIS IS WHY.

Grandmas stroke may not be able to get appropriate care because hospitals are full.

Your brothers pancreatic mass may not be able to be removed bc
surgeries are being postponed because hospitals are full.

Trauma patients who belong in the ICU may end up stuck down in the Emergency Room for days at a time because there are no beds because hospitals are full.

And the most compassionate, dedicated, intelligent, and loving
Read 8 tweets
15 Nov
Little story about grace...

Early on, I had posted a statement about a medical trend that concerned me. Got several heated responses, some of which were hostile, few that were man-splainy. Got a few that were reasonable counterpoints but as I was already on the defensive, I
Interpreted the wrong way and assumed it was yet another personal attack. Blocked that person. Have watched from afar, come to realize this is an entirely reasonable person who is friends with several folks on here that I adore. Took down the block after realizing that getting
wires crossed with an otherwise solid human is something to learn from and move forward with... and the interactions with this person, who gave me grace and assumed the best, have since been delightful. Thank you for letting me grow and evolve. 🙏

Second example. Retweeted
Read 12 tweets

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