Where to start...without breaching confidentiality I am going to tell you a few stories and describe what I, as a nurse, perceive to be a HUGE problem going on in my profession and healthcare in general.
Story #1. The father of a dear friend passed away recently from COVID and nothing I am going to say here is from personal observation, it was passed on to me by my friend but it is telling and extremely indicative of what is going on right now in every hospital. While he was ill, in the intermediate care unit the nurses were obviously being run ragged. They were busy and overwhelmed but some really minor things simply fell through the cracks. For instance, the nurse was charting that he was independent for ADLs (activities of daily living) and that was true, he could feed himself, use a hand-held urinal and even get up to go to the bathroom with some assistance BUT he was also requiring high levels of oxygen in order to do those things. My friend and her sister, who were NOT allowed in his room to help him (in spite of the fact that they both had either been vaccinated or had themselves had the Covid Delta Variant), observed from a window that the tray was literally left out of his reach and his urinal was on the floor, again out of his reach. Well, if a patient cannot reach his food without extreme effort it is not really being given to him is it? This wasn't unique to them or this facility and in fact leads right in to...
Story #2. A dear friend who also had COVID was "nursed" through the most acute phase of the illness and then transferred to a "rehab" facility. I was going to see her and called to ask if I could bring her anything and she asked for Chic-fil-a. So, I stopped and got her some lunch before I went to see her. Since she no longer had active disease, she was allowed a single visitor for a very limited part of the day. When I arrived, she was sitting on the side of the bed wearing an oxygen mask and looking very tired. I gave her the lunch and she pulled off her mask to eat, it seemed to be what she did normally. As she was eating, I noticed that her sats (oxygen saturation level, a tool to measure oxygenation) were dropping, and dropping significantly! I also noticed that she didn't have any other equipment, such as a nasal cannula, to deliver oxygen. I called her nurse to ask if she could be put on a nasal cannula while she ate and the nurse put the mask back on. I asked again about a cannula, which would enable her to eat, and the nurse said that she needed an order for a cannula and would have to call RT (respiratory therapy). Nothing was done for my friend's comfort except putting the mask back on, which she could have done herself, and which then made eating impossible.
Story #3. I cannot go into a lot of detail here but I work in an endoscopy unit, the place you go for colonoscopies, esophogastroduodenoscopies, bronchoscopies, and other "scope" procedures. We received a late add-on case of a GI bleed for an elderly woman with dementia who, from what I could tell, came from a nursing home. She was extremely agitated prior to the procedure and I was trying to get her to relax. She wasn't actually my patient but I was doing a very generalized assessment of her. Her skin was dry and flaky, she had what appeared to be dirt on her neck and chest, her hair was sweat-soaked and clinging to her scalp and her lips were dry and cracked but the inside of her mouth was the worst part of this assessment. Her teeth were caked with dark residue at the gums and her tongue was coated with a thick blue substance. It appeared that some type of pill had been put in her mouth and just left there to dissolve. I would be willing to bet any amount of money that she had not had any oral care, meaning teeth brushed (even with just a sponge), for days if not longer.
These stories have one primary thing in common, poor care. I understand that nurses are being run ragged. I understand that nurses are overwhelmed and under-staffed. I also understand something else; the real problem is not poor NURSING care; it is no personal/family care! COVID has been used as an excuse to shut families out of the hospital and out of the care of their loved ones. The reality of nursing right now is that we are forced to spend a ridiculous amount of time looking at a computer screen instead of at a person and nurses can barely get through their shifts. I have myself had days when the shift was so bad that I reassured myself with these words: "Well, they got their meds and they're still alive". I have said for years (out loud) that no member of my family would be hospitalized without me there to take care of them, words I had to eat when my own mother had COVID and spent 4 days in the hospital alone, but I have now reached the point where I am not sure I would even want a member of my family to BE hospitalized! My friend in story #1 is a Registered Nurse!!! Imagine how much help she could have been if she had been allowed to stay with her father! The shutting out of families from the care of their loved ones is one of the biggest tragedies of the pandemic. The number of people who have died alone and isolated is a travesty. When the pandemic has passed, the way hospitals, nursing homes and rehab facilities have treated families, and ultimately contributed to the misery and death of those entrusted to their care warrants serious investigation!
