As the Coronavirus (COVID-19) continues to spread in the United States, as critical care nurses we are being pushed to the limits to care for those in need and or affected by COVID-19. Physically and mentally exhausted, we face a new challenge, in addition to the virus, a shortage of personal protective equipment (PPE) is putting the health and safety of our patients, our loved ones and ourselves at an increased risk. AACN President Megan Brunson and AACN President-elect Elizabeth Bridges talk about the scarcity, evidence and efforts to advocate for PPE.
Megan Brunson:
Hi everyone. My name is Megan Brunson, and I'm president of the American Association of Critical-Care Nurses. I wanted to call up Liz Bridges, who is the current president-elect who lives out in Seattle and do what we do best in nursing and find out what is going on in the other side, 3,000 miles away in a city that is very impacted by this COVID crisis. Hi Liz, how are you?
Elizabeth Bridges:
Good. We're doing good out here, Megan.
Megan Brunson:
Good. It just made sense for me to ask you how things are going in Seattle and exactly what you think nurses need to do to prepare. My city hasn't actually quite ... I should say my hospital hasn't been quite impacted yet, so I wanted to make sure that I and my teammates were completely prepared.
Elizabeth Bridges:
I think probably the biggest lesson we're learning out here is that there are resources, there is guidance, there are recommendations on how we should prepare for these patients, how we should be caring for these patients. And I think it's really critical that you identify in your communities, in your hospital, word of sources, really reliable information are and keep your focus on using those resources.
The other thing I think in a hospital it's real easy to hear, well I heard. So again, you need to know where are those sources of work. Can you channel those questions because you need to ask the questions and you need to get answers. But to figure out where those sources are to get the right answers back to your questions. I think communication is critical right now.
Megan Brunson:
Right. What do you think are some clinical presentations? So what are these patients going to look like? What kind of things are you seeing out there with these patients and what their suffering looks like?
Elizabeth Bridges:
I think that we have learned from our colleagues in China certainly more recently, and our colleagues in Italy have been really incredible in sharing their experiences and their understanding of patients. We're seeing similar sorts of profiles out here in Seattle. And when I see in the literature, everybody's seeing the same thing right now. Traditionally right now, it's still predominantly of critically ill patients are tending to be the older individuals with comorbidities.
The presentation is that this is a single system disease, predominantly an acute hypoxic respiratory failure on the secondary sequelae that we're seeing in the ICU patients is some sort of cardiomyopathy. So if you start thinking about what's the kind of care we would need to give to those patients, it's the care we give to patients with ARDS, it was cardiac failure already, which is really important for us to remember because we know how to take care of those patients.
The other thing is eight out of 10 patients; people who are COVID positive will not need to even come into the hospital. So there's only going to be about 20% of them who are coming into the hospital, and at least two-thirds of those patients are going to be out on the acute care floors. And then there'll be that smaller group that is going to come into the critical care. So in terms of planning for potential numbers, I think that's important again, and knowing what's going on in your communities is really important.
Megan Brunson:
Right. One thing that for myself, I always felt like going to find resources to care for these patients, AACN has such a wonderful stockpile and we certainly are going to be getting those out to our community. But also it's important for us to brush up on our own policies and procedures within our own hospital. And I'm sure that you guys have done that too out in Seattle, right?
Elizabeth Bridges:
Oh, absolutely. Absolutely. I think every hospital has a disaster plan, but perhaps not for this. I think what's even more important right now is do not recreate the wheel.
Megan Brunson:
Great. Yeah.
Elizabeth Bridges:
Absolutely. Use your evidence-based sources of the CDC, or your local public health is telling you about those things. In our facilities, we are sharing across our community the standards of care. Every one of our hospitals has agreed on those standards of care. Those resources are available. We're making them available online to people. So if you need them, use those resources and then adapt them to yourself locally, but do not recreate the wheel. Do not recreate evidence. We know how to take care of these patients, use the expertise that we already have out there in the community.
Megan Brunson:
Right. This is going to be a marathon, not a sprint, Liz. And unfortunately, we don't have a stop date on this, and nurses have always been there on the front lines. And right now, we all are expecting this surge in patients. I just want to tell you from the bottom of my heart; we're all thinking about the nurses in these kinds of red zone areas, Seattle is one of them. And we're going to use your guidance to prepare for the patients that are coming our way. Thanks so much, Liz. I appreciate it.
Elizabeth Bridges:
Thank you so much, Megan.
Megan Brunson:
Yeah.