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.