perpetual pandemic

Here we are again in another surge of cases of Covid-19 with the rise of the delta variant. Just as we thought we could finally relax and get out of our covid pods for in person activities, mask recommendations are returning even for vaccinated folks. At least for activities indoors where many people gather like stores, restaurants, and offices. We in the emergency room have renewed our attention to wearing proper PPE with all patient contact and stay masked when we hangout in the break room with our coworkers. There have been a smattering of new infections in our staff, though it is unclear whether or not they are vaccinated. Last week our psych emergency department had to close for quarantining due to a staff member reporting to work with a covid test pending that turned out to be positive. This caused a backup of patients needing psychiatric care, waiting in the ED for many hours putting stress on our staff due to the one to one monitoring necessary for these patients.

To give you some background, for most of the pandemic we as staff, we were required to enter the hospital through a single entrance where we had to show a completed online screening form and get our temp taken, we were then given a sticker that showed we did the screening for that shift. First they dropped the temp check and then they dropped the screening questions and now we just all walk in through the single entrance and get a new mask. We used to complain that it was ridiculous make us screen, it was annoying and time consuming, and with separate bank of covid sick time, it seemed like who would come to work sick? But this psych department case illustrates the denial that still exist among the staff. I wouldn’t be surprised to see at least the online screening requirement come back.

Now there is a mandate for all city workers to be be vaccinated once the vaccine receives its FDA approval or face disciplinary action including possible termination. For the state of California, all state employees will need to be vaccinated or face weekly testing. My first reaction to hearing this was resistance; I don’t like being told what to do; I love my autonomy. But the more I talked to people I trust, I have come around. This is not a crazy requirement for those of us in healthcare, as nurses we are required to have all our other vaccinations in order to work anyway. We can decline the flu vaccine but have to mask during flu season. This is moot since we are masked at work already. Since I come to nursing from a science and research background, I have always been curious why some nurses don’t trust science. The work that we do is based on science and research. I believe it is our responsibility to stay current on the research and educate our patients. In addition we owe our patients the safety of knowing that when they are come in seeking care because their health is suffering, they will not be exposed to infections during their interactions with the the staff taking care of them. Now that we have the vaccine, and it has been shown effective, it takes another level of risk away. Vaccines and masks will keep our patients safe when they are vulnerable. We as healthcare workers just spent a year without the vaccine, wearing full PPE, caring for patients with covid and did not get sick in large numbers. These precautions have kept us safe, and they will continue to do so. Our public health depends depends on us.

Since I work in a city that has a 84% vaccination rate and has had low case and death statistics, I think we will fare okay in the next wave. The latest data is showing that the delta variant is way more infectious, by and it is now the predominant variant in the US, we are facing a formidable fall. The current data clearly shows that if you are vaccinated you are much less likely to be seriously ill, be hospitalized or die if you are one of the rare cases of a breakthrough infection. I have to say, I am tired, we all are tired. We have been working with reduced staff, we have an increase in substance abuse, overdoses, intimate partner violence and random violence in general. The patients coming in are sicker than ever and we are back to 40 people in the waiting room and 6-8 hour wait times. Everybody is anxious, and stressed and short tempered. On top of this the usual activities that we use to relax and recoup our energy are still unavailable. One of my main escapes is international travel, which is still limited. We have all had to find other ways to cope. For me I have used sick days as mental health recovery, I have used writing as a way to process my stress, grief, and anger, I have taken advantage of the counseling for frontline workers. And while I know that getting outside for hikes or bike rides really helps me feel better, I have a really hard time getting the motivation up to do them. The most I can manage some days is to eat my meal outside in my garden. I am slowly learning to cut myself some slack and not berate myself for my failures and shortcomings but try to find a few things I have succeeded at and to be grateful for.

My recommendations going forward are to support those who are still hesitant about vaccination to get what they need to get vaccinated. That all of us should be wearing masks indoors regardless of our vaccination status. That we still need to avoid large gatherings of unmasked participants and we should listen to each other for understanding and demonstrate compassion. This pandemic has exposed our vulnerability and we have a choice to be clear headed and open hearted to wade through or shut down and shut out people that don’t agree with us. I will choose love, every time.

PS two insta accounts I just started following Epidemiologistkat and catalystforselfcare that I find uplifting and helpful.

Speak: Silent no more

April, is when we eagerly watch for new leaves and wildflowers. April is also sexual assault awareness month when we acknowledge the pervasive and unspoken trauma so many people suffer from surviving sexual assault at some time in their lives. We can bring this into the light, speak up, ask for help and take care of each other.

Bringing Sexual Assault into the Light

The observance encourages people across the country to raise their voices in support of survivors and speak out if they have experienced sexual assault themselves. One month isn’t enough time to solve this serious issue, but it’s an excellent place to start. This month, do your part to end the widespread problem that is sexual assault. Here’s a list of statistics about sexual assault in the U.S.

  1. Nearly 1 in 5 women in the United States have experienced rape (or attempted rape) at one point in their lives.
  2. 1 in 67 men in the United States have experienced rape (or attempted rape) at one point in their lives.
  3. Every 98 seconds, an American is sexually assaulted.
  4. Only 5 out of every 1,000 perpetrators will end up in prison (which is why it is important to speak out if this happens to you).
  5. The majority of sexual assaults happen at or near the victim’s home, often by someone they know and/or trust.
  6. Health care is 16% higher for women who were sexually abused as children.
  7. Rape is the most under-reported crime; 63% of sexual assaults are not reported.
@speakyoursilence

I support an organization called Speak your silence that is focused on helping others realize their innate value and worth so that they can take the necessary steps to move forward and live the great lives they were created to live. They help people get one on one counseling, they provide a forum to share your story, and move forward. You can help those you love by simply wearing their iconic orange zigzag – called “The Stitch” – which symbolizes your voice. It’s typically the most subtle of gestures like this that make all the difference in helping people finally get their stories off their chest. They have a campaign for self guided path to recovery called the six steps to freedom. with the goal to help 1000 people complete these steps this year!

This cause is close to my heart as my daughter, Rosie is a survivor of sexual abuse by her father and our entire family has been healing from the trauma this has caused her and each of us. Silence is the enemy and as long as this topic is taboo and surrounded by shame and fear too many will continue to suffer. Rosie’s abuse came into the light in 2015 when she told her brother who then told me. We spent a few years in the turmoil of police, courts, divorce, counseling, moving out of the house, moving back into the house and trying to rebuild our lives with love and trust. It has been rough, I am not gonna lie. Out of respect for Rosie, I have kept quiet, sharing only with those close to us, and those who could help and support us. I have wanted to blog and build community for “non-offending parents” (that is what we are labeled) because it is such a lonely and guilt ridden road, however, the story is Rosie’s first and until she was ready to share, I could not. Counseling, talking to each other, sharing hard painful feelings and being present for each other has helped us through. Last year, Rosie told her story on a podcast at Mdrnday Muse and this year she has poured her energy into a clothing line she calls BUMMER, donating $5 of every sale to Speak your Silence. Please go see her instagram @bummer.bywosie, she has videos that tell the origin story of the BUMMER clothing line and details about this month’s collaboration with Speak your Silence. It has transformed her outlook. She has been working her way through the six steps:

Get it off your chest

Strip the weight from it

Tell yourself “you Rock!”

Diffuse the anger

Choose to forgive

Visualize what you want your life to look like

CALL TO ACTION

I have not gotten there yet, I spent most of the first 5 years making sure Rosie and her two brothers were going to be okay. It is hard to let go of being mom to even adult children when trauma happens and you are suddenly a single parent. This year my counseling has turned to helping me with my own grief and trauma. I must learn to trust and forgive which I find so so challenging. Rosie inspires me with how much she has healed and grown on her own path in her own way. I have been using counseling, writing, playing music and time in nature to help me reclaim myself. Many days are hard, I don’t want to get out of bed, I don’t want this to be our life and I dream about changing my name and escaping to a cozy seaside town in Maine where nobody knows me…….. but I would miss my kids and all the other blessings in my life. So I work every day to stay grounded in the here and now, I work to find things to be grateful for and I throw myself into my work as and ER nurse. It is crazy to use my work in a trauma center to escape my own trauma but it allows me to help other people through theirs.

This post is to help Rosie reach her goal of 100 shirts this month so her donation to Speak your Silence will be matched. 100 shirts = $500 donation! with the match is $1000!!!!! You can email her at bummer.bywosie@gmail.com to order your shirt by April 30 and she will ship it to you beautifully packaged in May.

Resources

RAINN. https://rainn.org

National sexual violence resource center https://www.nsvrc.org/saam

No More https://nomore.org

A guide to help survivors https://www.nsvrc.org/sites/default/files/2017-10/friends_and_family_guide_final.pdf

this week

this week I
had a mammogram
which is always painful 
and degrading and cold
something suspicious sent
me back for a repeat
more compression and waiting
possible biopsy
turned out to be a cyst
I drank a mimosa and ate avocado toast in the sunshine

this week I 
worked at the triage desk
and received patient after patient
with small and dire emergencies

this week I 
saved the life of a young man
with a GSW to the chest
pouring unit after unit of blood into his body
while the trauma surgeon opened his chest
and shocked his heart and
gave him intracardiac epi

this week I 
lost the life of someone's 
mother and grandmother
all the efforts to repair her head wound
keep her heart beating 
and warm her body enough to support her blood pressure
failed to save her
she had told her family 
she wanted to die and jumped
down a ravine into the cold creek

this week I called my brother 
in the hospital with sepsis from a
necrotic wound from his wheelchair
he sounded discouraged 
to not be able to tend to his patients
the children of migrant workers
instead he is the patient
going to the OR and ordered 
to not work for 6 weeks

this week my phone died
disconnecting me from everything
I learned how dependent I am on the 
small block of glass and metal
that is also a powerful computer
as well as a lifeline
I didn't know I was missing calls
and texts, the silence was 
unnervingly blissful

this week I 
had an out of body experience
my hands and feet carried out
their usual activities but
my mind could not connect to the present moment
was I dreaming
did that happen
did I have that conversation
the words went through my ears 
but never reached my heart

this week I 
had an argument with my love
hearing  his voice raised in frustration
my heart slamming against my cold sternum
shocked muddled confused
what just happened
why are you yelling
I am not like you
yet I apologize
but don't know what for

this week I 
held the phone for my patient
to speak to his family 
in breathless one word phrases
just before he was intubated 
the virus claimed another set of lungs
and I pushed his bed to the ICU

this week 
I launched a new nurse into practice
after weeks of training her
to think critically under pressure
advocate for her patients 
recognize subtle but dangerous trends 
in her patients conditions
speak up in a noisy trauma room 
because she noticed  the problem
she is ready to be independent

this week I 
laughed and joked with my nurse colleagues
inappropriate and crude
to let off pressure after a grueling shift
the young man whose heart stopped twice
after we shocked him back to life
will probably not recover
and we will never know the truth
about what happened to him
I think of his mother getting the call 
and my laughter turns to tears

this week I 
slept for days
exhaustion never leaving my body
or my soul
no matter how long I slept
my eyes burning from the light
my legs so over tired they feel like cedar logs
my breath slowing
as dreamlessness takes over
then bring coffee




life suspended

I look at the body I was given

lying there on the alley pavement

unmoving and cold

paramedics surrounding me

pushing hard on my chest

but I don’t feel the gravel bite into my back

they shove what looks like an inflatable plastic shovel

in my throat and scoop me up

am I dead?

should I go with my body to the hospital?

for a moment my heart flutters and I feel

a rush of pain in my head

my chest burning

and my feet feel so cold, can’t I have a blanket?

next thing ten faces are

shouting things at me prying open my eyes

and I hear “pupils six and fixed”

someone is pushing air into my lungs with a large purple balloon

and I realize I am seeing my body again from the outside

shredded cloths all around me and my body exposed

it looks like me but it doesn’t feel like me at all

in fact I don’t feel any pain

that must mean I’m dead then I feel the jolt of

electricity sear through me and my heart jumps to life.

it is a lot

there are people who will tell you
that you create your life
the good things and the horrid things
are there because
you allow them 
or they fill some deep need

do I respond to life or create it?
do affirmations make things real?
can a vision collage bring my
dream house on the beach?
my ideal relationship?

pressure is all around to be 
whole and healthy
it is a lot
to do all the self care
time for yoga, flossing, affirmations and gratitude
meditation, hot baths and massages
it is a lot
when I just want to get in my car 
and drive to Maine and 
eat a giant lobster roll
was it down with a cold beer
and keep my cell phone off
so nobody can find me
and stare at the waves while
I breathe in the salty seaweedy air
it is a lot
to be a compassionate listener
to be the stable rational one
to always be the one with the answers
when really there are no answers

it is a lot

I always knew I loved

I always knew I loved leaves

viewed from below

as I lay in the dirt daydreaming

their shapes like hands

open to catch the rain

but I didn’t know I loved

the space inbetween

that my grandmother urged me to study

if I scrunch my eyes

the leaves fade and the sky takes shape

coming forward like a cartoon

flat and smooth with edges

I can take a bite out of

tasting as buttery and soft as the snickerdoodle

that I stole from the cooling rack

I know I love a celebration

when friends come inside with hugs

and smiles and bottles of wine

stealing private conversation

while everyone is dancing and toasting

but how about the ordinary days

not marked by events or memories

those days that stretch and meander

like a lazy hike to the top of the hill

out of breath and panting

breathing in the aroma

of cow paddies and dead grass

grateful for legs and lungs

and my mountain.

the thing is…

the thing is….

we couldn’t predict what it would feel like
to be inside all the time
not touching except with our eyes
inside homes
inside heads
isolated in our individual lives
zoom connection that felt like the stuff of the new millennium
is how how we desperately connect
our world is funneled through a
thirteen inch Brady bunch screen
masks cover our expressions in real life
the world outside spells danger
in viruses, violence and ubiquitous smoke
when will it lift you ask?
the thing is…
…it won’t

Thank you Seema Reza for your work with us on Community Building Art Works. The writing group for healthcare workers has been so nurturing and inspiring, giving me hope through these dark days

moving forward

I feel like I have been holding my breath for six months. As the pandemic continues amidst political upheaval and controversy; we are learning more about COVID19, about how we function as a society under stress, and about what is really necessary in our lives. I struggle everyday, trying to keep my spirits up in isolation. I am trying to stay positive as the mishandling of our public health unfolds in front of me. I am grateful that I still have a job, and that it is a job I love, even with the challenges we face working in the ER during a pandemic. Trying to stay healthy in these times is becoming more difficult, the fires all up and down the west coast keep us inside with windows and doors sealed. The record heat waves have us sweltering and COVID keeps us out of the usual refuges of the movies, the mall and the beach. COVID also keeps us isolated from family and friends (though we expanded our little pod to occasionally include our children visiting.) I can easily fall into a melancholy despair, I fight against it every day. I joined a writing group online for healthcare workers that has been fantastic at opening up a creative outlet for my experiences. I started guitar lessons online after years of playing and now have some direction and focus to my playing. I have been knitting and knitting and reading so many books and watching so many movies and documentaries giving rise to great conversations with my partner and our families and friends. We are living in such a strange mind blowing time.

Knitting gives me so much joy, I love making things, learning new techniques, handling the beautiful yarns, enjoying the feel and the colors. I joined a knit along for a pattern I bought last spring called Moving Forward Wrap. It seems appropriate for the time, an arrow shaped wrap with a variety of lace and garter stitches. I happened to have a great yarn in my stash just waiting for a project, a lovely handpainted merino wool sock yarn from Knit Picks. I look forward to sharing in the zoom calls and online group as we all make this wrap together and contemplate moving forward out of this dark pandemic, heat, fire, protests, political disaster, into a new world where we are more kind, authentic and caring with each other.

pandemic continues

And though we know that the pandemic cannot last forever
the end is beyond my sight
around the corner or just ahead
or beyond th e horizon where the moon rises
swollen and blurred behind the fog

and though we know there will be an end
the self proclaimed experts do not know what that will look like
the day we can leave our cocoons
with our faces turned up to the sun and breath in the unencumbered breeze

the day we forget what it felt like to hesitate before a hug
not because we fear intrusion

it has been a while since I first learned to recognize my coworkers
by their eyes behind goggles and shields
or the way they move their bodies
or the sound of their muffled lipless speech

it has been a while since the waiting room teemed with bodies jostling for the chair near the outlet
knowing they would wait hours for help with what they cannot tend to on their own
on the days when the radio rings with yet another unresponsive likely overdose
so many that we have run out of curiosity
so many that the act of giving breaths and placing tubes and giving narcan
no longer leads to surprise or annoyance that the supply drawer is never stocked
and the floor is a field of wrappers and blood and vomit
on these days we just look at each other in understanding and sadness
there are no words

Thank you Seema Reza for your work with us on Community Building Art Works. The writing group for healthcare workers has been so nurturing and inspiring, giving me hope through these dark days

Rage Writing

Rage Writing with Seema Yasmin
— Read on seemareza.com/rage-writing-with-seema-yasmin/

There are people who will tell you that
you must care for the drunk driver who
was unaware that her decision ended the life of the mom whose
teenage son’s world is about to change when he
wakes up from the sedative given to fix his fractured wrist

he must heal his heart and body without her
the mom who would fill the ziploc with ice and carefully wrap it in a kitchen towel
who would wipe his tears and wrap her arms around his big man body as he cries
in the one bed in the flat they share with his school papers strewn on the floor

There are people who will tell you that
you must forgive
forgive those who slash open your heart with the betrayal
of the only promise that really mattered
they tell you forgiveness is for you not the one
who undermined your reason for living

I want to be hated by those people who want to silence the rage
that falls from my pen
the depth of anger that erupts through my scalp
at the man who harmed the child we promised to protect
that man who walked through his life with
an earnest face and a vile secret 

there are people who will tell you that
that life with three squares and no freedom is enough
enough to atone
is there atonement for the hate?

Thank you Seema Reza  for your work with us on Community Building Art Works. and to Seema Yasmin for the special online writing workshop The writing group for healthcare workers has been so nurturing and inspiring, giving me hope through these dark days