Wednesday, April 8, 2020

There's a German word for everything

I learned a new word this week:

I'm not Germanologist, but I seem to recall that in that language you can pretty much make endless compound words. I don't know if we've all been grief eating, but we definitely have been stress eating.

We are fortunate to have businesses and neighbors feeding us everyday, every shift. Pizza, lots of pizza. Trays of Italian ziti, salad, sandwiches. Buffalo Wild wings. One woman brought us bags of snacks from CVS, like she must have cleaned out their fridge of humus, yoghurts, and string cheese. Two big bags of apples and oranges appeared. Oh, and someone gave us a HUGE tray of those tiny donuts from Doughnuttery in the Turnstyle Underground Market. Mmmm.

Cheeseburger & tiny doughnuts,
don't judge. 

I'm keeping all the names, menus, and notes attached so that we can thank everybody in some future day. It's nice being appreciated. I don't know if I'm comfortable with the "Hero" label but I know that my staff are working their asses off. This shit is nuts. And literally everyday something changes...charting, work flow, patient flow, PPE requirements, who can get tested and when, how to contact Employee Health. It adds to the stress.

One good thing is that people are staying away from the ER with minor complaints. This truly helps. Accept for the occasional drunk or EDP (emotionally disturbed person), we pretty much get to concentrate our efforts on people with Covid or suspected Covid.


We've also been getting Thank You notes and cards from people near and far....





 Thank you cards put up around the unit :)

It makes a difference, for all staff. Everyone is working harder and hoping that they won't get sick and that they won't bring it home and get their family sick. Since this started, I know several people who sent their family away to live with grandparents, etc. We all have routines for shedding our work clothes at home: leaving the shoes in the garage, getting undressed just inside the front door. I change into street clothes before I leave and put my scrubs and work shoes in a plastic bag.

I haven't seen my dad in weeks, we talk over the phone which is great because he's so hard of hearing and this usually involves screaming at each other until he finally says, "I think I'm having problems with my phone, I'll talk to you later!"

This seemed like we were being overly cautious a few weeks ago now seems like the right thing. You hear news about how easily this disease spreads-in NJ four family members died after being exposed to a friend who had Covid at a family gathering. In Washington state, 2 choir members died and 45 got Covid after going to choir practice, even though they took prudent precautions. It's not bad until it's bad. My mother's cousin was buried today with only his daughter at the grave side because of Covid. How heartbreaking and it's happening all over the country.

Choir members get Covid
4 members of NJ family die of Covid






Sunday, April 5, 2020

Viral Diaries part II

I am hoping we are at the peak and will start trending down. I'm no epidemiologist, but stats for NYC show the first day of less deaths than the day before. Then I guess we'll start seeing the Covid wave as it's breaks over the rest of America.

Thursday, I spoke with an elderly man who was pretty sick and had an extensive medical history. I talked to him, helped reposition him, tried to get an IV in him. A few hours later he was dead. Ok, I mean, you all know I work in an ER and have been an ER nurse for many, many years. It's weird, though, that the actual witnessing of an awake person who then "passes on" before you eyes is pretty rare. Like, people either come in dead (or mostly dead) and are pronounced in the ER or the go upstairs and die in the ICU. Healthcare professionals have gotten very, very good at keeping people alive on ventilators, keeping their heart beating, their lungs pumping. Sometimes they live, sometimes they die, but they don't do it in the ER.

I'm thinking of a woman who came into a small community ER I worked in as an agency nurse years ago. She had very bad heart failure, like 10% of her heart worked or something and she was failing but she was wide awake and coherent. The ER doctors talked to her and she was adamant that she did not want to be intubated or have CPR done when her heart stopped. Her daughter and son in law at her side agreed. But, when she started "circling the drain" as we say, and her blood pressure was 40 nothin', the residents started to look scared and even though she did not want extraordinary measures, they were ordering everything they could possible think of short of that to try and keep her alive. And I don't blame them, we are in it to keep people alive. I saw that she was going into Vtach, then V fib and the residents didn't know what to do. The family looked at me. I said, "Do you want us to press on her chest? And the daughter was like, "NO!" So I told her to say what ever she needed to say to her mom, because she was going. The woman was actually awake and coherent and seemingly unafraid up until her last minutes. When she was gone, I told her. That does not happen a lot.

So forgive us ER people if we seem upset that patients are coming in and dying within hours, at times coming in and not looking too sick, like not "dying sick". We have been around a lot of death but not a lot of dying.

This past weekend my mother's cousin died of Covid and his wife is sick too. They're both elderly. Nice people, very friendly. I hope his wife comes through it. A lady I knew from church died, I assume from Covid but I don't know I'm just assuming anyone who dies suddenly right now is from Covid. Clara was the sweetest, kindest lady. I loved listening to her sing, she had a small but mighty voice. She was pretty humble but occasionally could be coaxed to sing Amazing Grace and it gave me goose pimples every time. Good bye Miss Clara and God speed.

It's always more shocking when a young person dies. I mean, I love Miss Clara but she was old, old like God's older sister. It is not shocking that she died, it's just so sad. I think the media spends a lot of time focusing on young people who have died. That's good for visibility, I guess, if it teaches young people to not take this for granted or think that they are immune to Covid. But most people are not going to die and I plan on being one of the ones who don't die. My husband has taken to reading studies and statistics. He said that recently in Italy someone took 60 random people who hadn't been sick at all and 40 of them had antibodies to Covid. So, that's good.  He also is packing me vitamins to take every day and zinc lozenges to suck on. In the middle of all this, I started menopause, so it's been a fun week playing "fever or hot flash?"

Back to work tomorrow. I still don't feel particularly heroic or brave, I feel tired. I will go in, do the schedules, make sure have supplies, welcome the new agency nurses we found from God knows where and try and back up the staff.


Friday, April 3, 2020

The Viral Diaries

I think the worst thing is the loneliness, being disconnected from people. I haven't visited my dad in weeks, nor my sister who has cancer. Worse, though, are the people who don't want me around; friends have cancelled plans "just to be safe", the person who no longer wants G to tutor their son. G actually lost his pizza job, I think partially because business is bad, but also because the owner was "freaked out" when he heard his wife worked in a NY ER. I feel like I'm a carrier of plague.

Meanwhile, the ER carries on. I guess about a 20% of my staff is out with "febrile illness." They aren't testing people, for the most part, because testing supplies are low or because it doesn't matter. To them. I mean, most of them want to know if they're positive. I wanted to know if I was positive because I figured it would let me know if I had some immunity to it and it'd buy me a little peace of mind. Some of my staff have tested positive, though. So far, knock wood, no one is seriously ill. The assistant nurse manager of the tele floor died, one of several people exposed up there. He had bad asthma but still he was young and healthy. It's surreal. His face is everywhere. CNN interviewed his sister, he's on Buzzfeed. Well, all the news is about Covid anyway.

I'm not scared until I'm scared, if you know what I mean. If people ask me, I say I'm fine, but when I'm lying in bed it hits me-what would I do without my family, what would they do without me? It's hard to even know what's the right thing to do to stay safe. A few weeks ago we had a handful of Covid patients, each in an isolation room. We'd gown up before we went in and there was a clip board on each door with a tracking sheet. If the patient was covid +, they would call you and see if you were inadvertently exposed, then keep you home for 14 days. We had a nurse who came back from the Philippines during the early days and, because her flight stopped in South Korea for a few hours, she had to stay home for 14 days despite having no symptoms. She came back to work and now she's out with Covid. There's no more tracking sheets, no more isolation. We have red tape on the floor marking off where the covid area begins. When that started you only needed to wear PPE if you went across the tape and we were telling people not to wear PPE outside of it to save on PPE. Now, we still have the Covid side (about 2/3's of the ER, it's gotten bigger) but people are wearing PPE in all parts of the ED and are encouraged to do so. Certainly you can't work in the ED if you're not wearing an N95 and that was something we were originally fighting for. We have enough gowns, but we're all wearing the same mask all day, maybe multiple days. I have a good mask right now that I got from my director and I'm holding on to it-it's comfortable, close fitting and thick. It seems very protective.

Covid nose aka mask indentation
Friends are checking on me and supporting me (from afar!), which is very, very nice and I'm trying to keep in touch with me friends from RWJ to see if they're ok.

And the food! People are sending us food, snacks, water...everyday there's something to eat in the break rooms. People show their love with food.

Plastic sheeting separates our 
resus bays, 
clean from dirty
My office is also full of donations: face shields, N95 masks, gowns, homemade masks, gloves. NY'ers want to help. And every night at 7pm, they hang out from their windows and cheer. Every borough. I went out last night to finally hear it in person and it was more emotional than I thought it would be. People cheering for us. I went across the street the other day for coffee and a young man thanked me for my service. Like I'm in the armed forces fighting a war, which I guess we are. I don't feel like a hero, I feel like I'm doing what I've been trained to do since I started nursing. This is our 9/11, our WWII, our Spanish Flu, our Crimea. You train and train, set up decon tents and do drills for MCIs and now, here it is. What we prepare for.
We made a window!

My husband has been incredibly supportive: he packs my lunches, he rubs my back at night. I mean, he's done that for a while but now with more hugs and fierce "I love you's". He also bought a weekly pill organizer and he sends me off with various supplements to support my immune system: Vitamins C&D, pycnogenol, Lactoferrin, and Zinc. We also bought more life insurance, for both of us, and we talked about how we need wills. That should have been something we did ages ago, but now it seems particularly pertinent. We've had serious discussions with our adult daughter who lives in Brooklyn, who is so scared she quit smoking, so that's something. Seriously, we asked her to watch our youngest is anything happens, and we discussed finances, how to keep safe and healthy, and to call us if anything happens-you get sick, you need money, food, escape from the city. Anything.

I'm getting ready to go back in, working 3p-3a for more managerial coverage and support for the staff. Yesterday I spent almost all shift working on the floor and helping out as best I could, in resus, in codes, moving people who needed to be moved, I don't know what else, there's always something else. Calling for more PPE, calling people who are out sick to see how they're doing, calling the floors to beg them to take report. Doling out donated food, keeping track of who donated so that in some future, not busy day we can thank them. It is starting to feel like "when it's over" is some imaginary time in the indeterminate future. I know that sounds overly dramatic but it's like this is all we've been doing and all we're going to do. We can't look behind and we can't look forward, we can only think about what needs to get done, right now. And every conversation ends with, "Be safe. Keep yourself safe. Be careful out there."

I'm tired. And fat.
I'm going to be so fat when this is over.

Tuesday, January 7, 2020

Love Poems

My Not a Love Poem                           4/24/98

If this were just a love poem,
it'd mean I loved you less.
For you are love and more, my dear,
you are the feast, you are the guest.
You're everything a heart could bring,
you are my sex, you are my soul.
The are the man, woman, and child of me,
for you are me and more.
You know the silent need in me,
you are my wanderlust, my home.
For you are more than love, beloved,
you are the poet, you are the poem.


Thunderstorm Poems                               August 24, 1999

I

Summer night lighting
over phone line crackles
you whispered good night
and left me staring into
strobe light, sky-ripping wonder
at the fury of the night sky
the storm in my heart.
Cool now,
and a little spent sadness
after.

A still expected siren, far off in the night.


II

If
you were
coming
here
into the storm
I'd
have the
covers turned down
waiting
to share
the rain
with you.

No.
If
you were
here,
coming
into me
while the storm
crashed
over us
I'd
wrap my
legs closer
around
and let you
watch
the lightning
dance
in my eyes.


III

This
is my
not-so-nice
drive off the road
daydream poem.
Let anyone read it,
I don't care
what they think, 'cause
with you on my mind
I'm way past the
brink of sanity.
Sitting in traffic and
think, think, think,
of your hands
sliding past buttons
plink, plink, plink,
and undoing things-
parts of me quiver
and parts of me sing
and you're well past
the point of
undoing me.
Then I sink, sink, sink,
to the part
with your lips on my neck
I'm shuddering now,
what the heck
if I'm wet. You
start to mount, one leg is in
one is out of
my pants and I
give a spontaneous shout
my body is taut and
I'm ready to pop
when I notice
that traffic
has come to a stop.

Sunday, January 5, 2020

Perfect

Perfect

In another life
I'd be perfect for you.
Be your off-beat girlfriend,
who'd impress your parents
and tease your friends.
And only argue with you
about politics and other
topics of no consequence, til
we'd settle it all with a wrestling
match. I'd let you win.
I'd understand your need
to protect me and why sometimes
you're still a little boy.
I'd dare to run my hands
up your thigh under the table
why you do multiplication tables in your head.
And never get jealous when you look at other women.
And spend my days happy
to have found you, my nights
finding your ear with my lips
and whisper I love you.

And never worry if it was enough.

In another life
you'd be perfect for me.
Be my strong, sensitive boyfriend,
who'd shoot pool with my brother,
drink beer with my dad.
And think it perfectly
natural for a woman
to keep a wallet in her
back pocket. I'd let you pay.
You'd understand that sometimes I need to be the strong one, too
and why sometimes I need
to bury my head in your chest and forget.
You'd dare to run you hands
over my nipples while I talk
on the phone with my mom.
And never get jealous when I look at other women.
And spend your days always
discovering another side to me, your nights
showing me how many ways there are
to say I love you.

And never worry if it was enough.

Some new, old poems

Sunrise in Asbury Park                               11/16/99

Fall's light flooding
on an ambition
of empty streets.
A black girl's beat.
And loneliness-
a black-top, boarded window sunrise
bleaches the city
clean as a new day.
And for one long minute
the carousel house is
alight again
with sunbeams and twinkling dust.
But the beach at the end of Second Avenue
is still full of crushed butts
and empty works.
And the burnt out buildings
whisper a whore's promise
of a good time, boys, a good time.


New Brunswick Sunset                             11/10/99

Finish the day at sunset, molten-pink
as the slash of coral on an old woman's mouth,
a bright ring on a crushed cigarette butt.
New Brunswick sunset-a gaudy scene
to rival the Mexican girls on hot Summer nights
click-clacking their impossibly high heels
down the street, arm in arm with their
toughtender boyfriends in tight, black jeans, swaggering
past downardly-mobile college kids
who wear their poverty
like a preacher, righteous and proud.
And the Mexican girls would laugh
if they knew
that poverty is a noble cause.
The sun sets on bodegas and beat kids,
the black men swigging from paper bags,
Catholic schoolgirls, running home with the threat of Fall up their skirts.
A smudge washed, pastel display smeared across the sky
and settles into deep purple and crimson thumbprints.
A long figure stands outside the ER and bums a cigarette.
And the New Brunswick night comes up quick, like a bruise.


Provincetown                                         1998

I thought of my love
on the Saginaw bridge
and the wind blew ten degrees colder.
I thought of my love
in the Shawnee forest,
black trunks stark against the sky.
Ten thousand twisted pine reaching
reaching for something that never was mine.
I thought of my love
on the docks off Commercial,
where, wondering where, is my home?

Monday, November 11, 2019

Some oldies but goodies...

Daughter

Daughter
Be Strong.
You are all of my dreaming
Filled with the breath
Of a girl-child.
Be strong
Against my neediness.
Be your own self.

My daughter,
I cried bringing you into
This world, a baby
Small and weak.
A girl-baby,
Who’ll protect her?
Now I applaud
Your fierce spirit.
I say with pride,
“She’s stubborn.”
I stand up and applaud
Your independence
I kiss the tears away
When you tire and fall.
I lose when I try
To outsmart you.
And my heart aches
As I watch you
Sprawled asleep.

Milagros, my daughter,
Cry all your tears
And laugh all your laughter.
Scream all your pain.
These things are free
Like rain and
No one can take them
Away.

13th November 1992


Song of the Sea

8.5.99

I wish to tell you
the tale and the true, you sang
me a song and that song is you.
Come
and I’ll sing you the song
of the sea. You’ll know by its silence that
that song is me.
You’ll drink in its pauses and drown
in its notes that thrums
on your lips and tickles your throat.
This is the sea
and the strange and the soul
of the quest,
that everyone knows but nobody gets.
This is the song
(the song of the sea)
of the real and the true and the why
that’s in me.

This is the song that is me. 




Some Girls

Some girls
stay home at night
keep their knees together
tight. Wear appropriate clothing
for every occasion.  Own pale pink
sweater sets with add-a-pearl
necklaces. Save themselves
for the marriage bed. Never
a rebellious thought in their head.
Always content when they turn out the light.
Some girls do everything right.

Some girls
stay up late,
give it up on the very first date.
Curse at their parents and
run from cops. Some girls
don’t know when to stop.
Tease their hair and wear
tight pants and tube tops. Hang
with the boys, drink beer in the woods.
Some girls are up to no good. 



1st September 1997