They are having people bring down plastic shower curtains they they will be hanging up. But right now the regulations say that if you are not in your home, you have to have a mask on everywhere, so yes all people will be wearing masks at all times in the center. We have only has a handful of cases, but testing has been VERY selective. They have been sending tests out and it takes 2-4 weeks to get results. We have a PCR testing machine but they just used it for the first time yesterday...
and of the around 130 tests, 60 came back positive, We have 8 in the hospital as of yesterday. I am not sure at what point they will have more than day patients at the covid center I posted. We do have 100 breathing bpap machines that were donated from New York, but we do not have the medical staff to work them. Last I heard there was only one nurse on the island who had been trained to use one.
Yikes. Where I am, nurses don’t run bipap machines, respiratory therapists do. Nurses have no training on the machines themselves (at least where we are; nor is it part of the nursing curriculum, RT is its own specialty), but we do care for the patients who are wearing them. I have never worked as closely with respiratory therapists as I did during COVID. RT’s were assigned to the same ICUs as us so they were right there and we were all part of teams. Many patients were intubated and ventilated so there were things both the nurse and the RT had to do, along with a lot of troubleshooting. So they will need to recruit RT’s as well as nurses and doctors. And others to help run the units so the nurses, doctors and RTs can focus solely on patient care. It’s a lot.
For sick patients wearing masks, it’s not always easy. They are utilizing oxygen (and sometimes other things in that area of the face including feeding tubes) and it may not always be the type that sits in the nostrils. It can often be a face mask. And people take them off for various reasons and if they’re confused, etc. So not only does that preclude them wearing a regular mask to prevent germ spread, someone has to be right there to help get the mask back on them or they desaturate (or their hands have to be restrained) So that person would be at risk, and aerosolization of germs in the air will travel around the whole facility from people coughing. Shower curtains only go up so far. In negative air flow rooms those germs in the air get pulled back into a room so they can’t make it outside the room; doors remain shut. (There were some studies done about this.)
Certainly not trying to be a downer because I understand the situation there, but just pointing out that for COVID patients, a facility like that may wind up spreading more illness if it can’t be contained properly. Staff will have to wear PPE continuously, with no break. We, at least, could take it off when we came outside of rooms (with a whole protocol and ideally an observer to help us do it right, granted not always available). And we weren’t allowed to stay in rooms too long, ie a minimal amount of time. One time I couldn’t get out of a room for almost two hours because the patient was very sick with a lot to do, and others were banging on the door telling me I had to get out. We had hundreds of staff sickened so it was our unfortunate reality. Staff have to take PPE off at some point during their shifts to eat and go to the bathroom, and it has to be done very carefully as COVID germs are on the outside of masks, shields and gowns. It’s a tall order for people working 12hr shifts and longer. If staff start getting sick, who will be left to care for patients. Sucky situation all round - everywhere, and for everyone.
PS I hesitate to post this because I don’t want it to come across as
, but I also think it’s important for people to understand the complexities in caring for these patients, too. Staff working in that facility will need a lot of support and reinforcements. But I do wish you all the best. We’re all in this together as a global community.