Nurse Jess entered the Emergency Department with her trademark walk, hopping with every other step, swinging her arms as she went straight to the Charge Nurse Station. As the Director of Nursing, she could have just looked at the dashboard on her Mango watch/minicomputer/phone to see the unit metrics. But she likes being in the middle of the action. Besides, her usually unflappable charge nurse Mae seemed a little bit frazzled as she answered her Comdevice, and mumbled something about “Remember 2020”.
Jess entered the ED where she had been a nurse for 20 years,
the last two years as the much-respected nursing director. Finally, they are in the new ED wing, a
state-of-the-art facility. Thanks to the generosity of the family of a
prominent New York trillionaire. The 78-year-old man came in with a broken
femur after a nasty fall but was so impressed by the efficiency of the ED
staff before he was whisked to the OR. He lingered on just in time to say his
goodbyes to his family, but he made them promise to build a new ER. And the
family donated billions of dollars to create an ED well-suited to meet the demands
of a new Covid19-like crisis. No more hallway patients, every patient in their own private room with some amenities like a tv, electronic patient tracker, and a nurse-call device.
Jess outfitted in the hospital-mandated IRC (Infection Repellent Clothing) for this new disease outbreak from Texas. The Tyvek 3rd edition suit is very light with its own breathing apparatus the size of her hand. Her face shield mask is clear and does not fog nor suffocate. The plastic material covers her entire face and connects to the Tyvek suit itself. Thankfully, this new disease is not anywhere as virulent and as overwhelming as COVID-19. A shudder went through Jess’ body as she remembered the year 2020, the Year of the Nurse which nobody ever anticipated to turn out to be a nightmare year for every healthcare worker. In the year 2030, it looks like they’re in a repeat of 2020.
Last month, ten years ago was a distant memory, relegated to
the hospital archives. Right after the nth ZoomstatCom meeting with the Infection
Control Czar last week, the hospital leadership went into UltraPreparedness/Response Mode. The Incident Commander declared in his
authoritative voice, “We are now in ICS level 2 and we expect to be in Level 3 soon.”
After the meeting, she scrolled back on her personal online blog
to look for her Covid Diaries. In 2020, the ED was declared an endemic area.
Ground Zero or more accurately, the war zone, for the hospital as the patients came in gasping for breath and the ED staff rushed in to fight for the patients to survive. The
staff heroically stepped up to the plate, buried their emotions, and proceeded
to take care of the patients. It was a whole year unlike any other that no one in
his right mind would ever want to go back to. In one of the Covid-19 memes, The “Back
to the Future” Emmett Brown admonished Marty McFly not to ever go to 2020 with
his time travel machine.
Jess did not have to peruse the blog to relive the memories.
Her heart ached in remembrance. She thinks she had some form of PTSD from that
event, just like some of her colleagues. Thankfully, she was able to draw
strength from her family and friends, as well as from her ED work family. Going
through Covid hell proved how resilient healthcare workers are.
“Thank God, you’re here!”, Mae uttered in relief. She was
still in nursing school when Covid-19 exploded. She heard terror stories from
all the senior nurses, but now, her wild-eyed look resembled what Jess' 2020
nurses looked like. There were still several of those bad-ass nurses around; their eyes are calmer now, their experience during the Covid war gave them steel of nerves, and today, they serve as inspiration to their younger colleagues.
Jess swallowed her fear and made sure her smile reached her
eyes above her mask. As the nursing director, she had to be a tower of strength, a source of truth, a comforting presence, and a
purveyor of hope. Even if she felt a little apprehension as she saw the electronic
dashboard in the Nurses' station with the throughput metrics and unit statuses highlighted
in Red. It has not changed through the years, we still use the Red Surge as a common language that the ED is in crisis.
Dr. Johnson sauntered to the Nurses’ station. Like Jess,
Brad experienced Covid-19. He wore his veteran status with honor, which in a
way, comforted his fellow doctors. Jess and Brad are ten years older now, wiser and toughened by their experience. Jess consulted with Brad and they decided to
call a unit huddle.
Mae’s voice crackled over the staff’s Communication devices
that were clipped on their scrubs. Except for those currently involved in a
patient’s care, most of the unit staff gathered in the 5-bedded Resuscitation
room. Unable to maintain physical distancing, the nurses, doctors, techs,
pharmacists, registrars, environmental services members, transporters,
respiratory therapists, case managers, and even the paramedics attended the
huddle.
Brad addressed the whole staff, “Ladies and gentlemen, we
are at this point of declaring the ED as an endemic unit. Meaning, you will
have to be in full PPE when you enter the ED door. Don’t give me this crap that
you cannot breathe because our masks are a hundred times more comfortable than we
have in 2020. We cannot afford to have some of you out sick. Use your PPE”.
Jess addressed the staff. Knowing that everyone is compliant
with the Covid and flu vaccine, she proceeded to tell the staff that another similar
mRNA vaccine is being tested by the scientists. There will be some protection
from the Covid vaccine, but this new vaccine will be specifically targeting
this new disease called Joslin30.
Jess reviewed the surge and escalation protocol. Although
the NEDOCs score is high, all the patients are secured in their private rooms,
most of which are with negative pressure. The patients have their own
sophisticated TeleFam monitors to connect with their families remotely. Visiting
hours were suspended except for special circumstances. The newly-reorganized CDC
Fauci organization issued a much-vetted Joslin30 treatment algorithm which is
immediately started in the ED. The point-of-care Joslin30 screening test is
top-of-the-line accurate with a one-minute result time. Additional medical and
nursing staff reinforcement from the National Medical Guard will be in the ED
in two days. Supplies and equipment, and most importantly the ventilators are
well-stocked. Three additional hospital units are being prepared for additional
patients and will be available in a few hours.
As Jess relayed all the updates, she could see the staff
visibly breathing in relief. They needed to hear the updates; needed to hear that no patients have died so far, and that patients are responding to the aggressive drug cocktail. Jess herself believed that the world is much better prepared for this new challenge. They clapped at the end of Jess’ summary of the ED
status. She brought them hope and confidence that this crisis will soon pass.
“This is 2030, not a repeat of 2020. This time, we have an
intelligent and responsible President who does not quarrel with her own
Infection Control chief. This time, the science we trusted in 2020 is bringing us a new vaccine soon. This time, the government officials are on the same page. This time, our hospital is prepared for all eventualities. This time, we
will get through this in just a month or so. Thank God, this is not 2020.”
