I have mentioned one of the biggest improvements that I have seen since I have been here is the amount of nurses there are to help lighten the load. My first week here ICU nurses had anywhere from 4 to 6 vented patients that were all unstable and needed close attention. For the past couple of weeks I think I have only had 3 patients maybe once or twice and the rest of my shifts I have had only two. One of the main reasons there were so many nurses here is because FEMA signed a contract with an agency called Krutial. Well this weekend Krucial sent home 400 nurses from New York. Most of the nurses didn't want to go home yet. My hospital was hit very hard by this decrease in nurses. I was sent to another Covid ICU last night and when I showed up I was the only nurse assigned to the unit with 12 sedated and intubated patients. The daytime charge nurse was freaking out and frantically trying to get me as many nurses as she could. One other nurse showed up and for two hours me and her bounced around the unit trying to make sure everyone stayed alive. Eventually they were able to pull 4 ICU nurses from other ICU's in the hospital and we each had three patients. We did not have any techs or other med/surg nurses to help us through the night. It was a pretty challenging night trying to stay up on all the meds and other tasks. Just like pretty much every other shift I have had, there were times where my patients started to decompensate and they required a lot of time and effort to stabilize their airway and blood pressure. However, by the end of the morning we left with all 12 of our patients making it through the night.
I have mentioned that every floor has turned into an ICU to accommodate the influx of Covid-19 patients that require ICU care. The ICU I was on last night is originally the mother/baby unit. I thought it was kind of interesting to be running from room to room to treat these patients and right in the middle of the floor is a nursery. Instead of babies in it, there are IV poles and pumps and all sorts of other kind of medical equipment acting as our central supply for the unit.
The goal over the next several days will be to shut down a lot of these ICU's and start consolidating all the Covid patients into just a couple of ICU's. This will hopefully make staffing more efficient. I was starting to feel good about the flow and state of the healthcare system, but with the drastic decrease in nurses it has that overwhelming feeling again. Even though the amount of patients are less, so are the amount of nurses.