Thread by @CassieY4

I'm seeing a lot of trash takes on ICU capacity today, so here goes me explaining things (before I very much log off to write):

Yes! We have flu seasons here! And yes, our hospitals can get full during those flu seasons!

But what armchair ICU managers aren't realizing is

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that it is unheard of for ALL ICUS EVERYWHERE IN THE STATE to be under thread of running out of beds (or currently out of them!)

Usually regions of the state can help one another. There's a fire, a disaster, the ambulances run, everyone pitches in.

I used to be a burn RN

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And I got to see this collaborative process several times, first hand.

When there was that big gas explosion in Nor Cal a few years ago, you'd better believe every burn center in the state was overstaffed just in case.

Same same for the fires when the Camp Fire occurred.

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But we don't usually have to staff up like...this.

Y'all, this shit, this upcoming wave, which the data very well tells us is coming...

IS UNPRECIDENTED.

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So it doesn't matter what our average capacity for a flu season is!!!!

That's just a stupid right wing 'I don't want to feel bad about not wearing a mask and kissing grandma' canard.

Health care workers are staring down the barrel of a gun.

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We're telling you there's a tsunami coming, and y'all are out there saying, 'Nah, man, I saw a tide like that last winter.'

IT IS NOT EVEN VAGUELY COMPARIBLE.

It's just...not.

And someone asked me questions about what we can do to help things or prepare now...

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THE MOST IMPORTANT THING YOU CAN DO TO HELP US IS TO NOT BE A VECTOR OF TRANSMISSION.

This means staying home as much as possible and masking like your life literally depends on it (because it does) when you are out.

& don't trust anyone you know who is casual about masking
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You know your grandma cheats and goes to bingo night?

Cut that bitch right outta your life!

I kid, but...not really. My intubated and rotoproned pt yesterday had 2 siblings also in the ICU (other hosps.)

Family transmission is unbearably tragic.

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We can 'build rooms' and make tents and use empty hotels and what not to create space for covid patients -- and the other patients they invariably displace, with each of their 2-3 long courses of care -- THAT IS A LONG TIME TO BE EATING UP A BED IN THE ICU BTW -- but we can't

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magically whip up more staff.

STAFF IS A FINITE RESOURCE.

I don't mean to brag, but it takes at least 7 years of training to get you a 'me'. (If you count pre-reqs, etc.)

There's no tree you can shake that more RNs or RTs (respiratory therapists) come out of.

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Hotspots are in FIERCE competition -- we're talking $8000/week pay competition!!! -- to get traveler RNs for this very reason.

Like we always get a few travelers over flu season, because yes we're busier then, but they're not getting paid those $$$ amts.

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And obviously, there's a finite # of traveler RNs for all of our simultaneously at capacity hospitals to draw from --

AND ON TOP OF THAT STAFF (or relatives they need to help care for) IS GETTING COVID.

Which is another drain on the system.

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SO NO THIS ISN'T A NORMAL FLU SEASON.

Hundreds of thousands of medical professionals are not pulling one over on you.

Nor are they paying out the wazoo for staff for funsies.

Go back and read my tweets -- you think I enjoy my job right now? Fucccckkkkkk.

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I know people want to believe the worst of Newsom for some reason, and they don't want their businesses to be shut down, and I get that, covid is fucking up my job something terrible too.

But that's because the FEDERAL GOVT HAS FUCKED US OVER FROM DAY ONE.

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They fucked you by lying about the science (which the outgoing admin still is) and by not providing a universal basic income incentive to stay home, by abdicating all responsibility for contact tracing to stop the spread of covid.

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And they fucked me by making me BEG FOR PPE.

You want to feel disposable?

Listen to Trump and Kushner tell your state to suck it in the middle of the worst health crisis we have ever had.

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Listen to families talk to their dying loved ones via phones on speaker phone and face time DAY AFTER GODDAMNED DAY.

Manage families expectations via those selfsame mechanisms.

Try not to tell them their loved one is gonna die while not getting their hopes up.

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Consider that by the time you visit me, in the ICU, you are likely very, very sick, and probably far less likely to survive than if you'd made it through covid on another floor, due to the severity of your illness.

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Consider too, people who're all 'this is a normal flu season!' that NO ONE WANTS TO KILL GRANDMA ON OR AROUND CHRISTMAS.

Which means that everyone's gonna hesitate to make grim decisions 10 days from now, despite the fact that nothing will change and we'll need the beds

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So -- no, this is not just another flu season.

It's not even vaguely comparible.

Newsom is not an asshole, he's trying to save your life.

Me?

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As an ICU RN? On here? Listening to disinformation spewed from aggressive men day after day who refuse to listen?

I've just about fucking had it.

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If you're being contrarian because that's your personality type, fucking stop it. Give it a rest. The devil needs no more advocates.

If you legit believe this 'it's just a flu season' stuff -- kindly fuck off into the sun with your shit science takes and lack of knowledge.

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I need everyone who reads and agrees with me to step the fuck up and combat this stupidity wherever it takes root in your life.

I cannot be the person who does this at the hospital and the person who also does it here.

I'm exhausted.

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I definitely have PTSD from round one in the spring.

(Specifically the day I was given one box of gowns for two positive patients. Scarred me. I reused chemo gowns so my RTs and janitorial could have the 10 plastic ones.)

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(And I know I've got it good! Our travlers tell us stories of working in AZ where they'd show their n95s masks for inspection and if it wasn't literally in pieces they'd be told, "nah, that's ok." and sent back into covid rooms.)

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You throw us into the meatgrinder, endlessly, we do it because we're literally the only people capable of doing what we do, and then people try to pretend that this shit isn't happening or that science is lies or that reasonable government measures are out to get them.

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Anyhow.

Sorry for showing my ass on here today, I guess that's my brand, heh.

I'm going to go write dragon-shifter romance and pretend that people aren't actively sabotaging the health of their family and friends by lying on purpose like assholes.

27/fin

No, you know, actually?

I don't usually cross nursing advice streams, bc I don't want to cheapen my advice -- but I do want to go per diem and write more. So if you <3 me or steamy paranormal romance help a girl out.

amazon.com/Dragon-Called-…

One more addendum, since this seems viral (for my definitions thereof).

PEOPLE WE ARE SO CLOSE TO A VACCINE.

SO DAMN CLOSE.

Let's all get across that finish line together!

Please. I'm *begging* you. Wear your mask and encourage others too!!! BE VIGILIANT!

1.1/

Like anyone dying now, or getting sick because they traveled over Christmas -- man that's exactly like dying right before they liberated your town in the French countryside in WWII.

That's how we need to be thinking right now.

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We all need to do everything we can get to everyone over the finish line together.

We're so close.

Don't be the person who died senselessly before the allies came to town out of some bizarre sense of 'I know better than ALL OF KNOWN SCIENCE' pride.

1.3/

I'm sorry that the outgoing administration profitted from your losses, & sold you meds (HCQ) that didn't work. I'm sorry Youtube algos took you into dark corners of the internet where you were lead astray.

But it's so easy to come back to the light.

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We want you here.

I want you here.

I want us all to survive together, passionately, from the bottom of my increasingly broken heart.

So come back, please, and bring your friends with you.

Let's take care of each other. We're so close to the end.

Always help. Never hinder.

Okay, last last proof it's not a flu season -- my work just sent this out ten mins ago.

My hospital only has 6 floors. And if the ICU has taken over the 2nd floor, we're full and taking over PACU beds.