Triage nurse steels herself for pandemic’s peak

Betty BeanKnox Scene

Nurses are toting a heavy load in the fight against the COVID-19 pandemic, but fortunately for the rest of us, they’re up to the task: tough when we need them to be and good at faking it when they’re not really feeling it. Check this news clip from Europe, where the pandemic took hold about two weeks before it hit the United States.

Nurse A (I’ll not use her name, but she is a registered nurse with decades of experience) shares the same worries as the rest of us, only more so.

“I feel fear for my parents, who are in their 80s. I am afraid of getting sick and leaving my daughter without a mom. I have several pre-existing health issues, and I worry that, if I need one, a ventilator will not be used for me.”

She is also deeply concerned about her friends and co-workers:

“I fear for all my colleagues on the front line – in hospitals, ICUs and emergency rooms.”

Her fear is tinged with anger at the sluggish American response to this as-yet incurable new virus and the pandemic that was predicted in January.

“I’m angry that hospitals are relying on homemade masks and PPE (personal protective equipment). I have anger for a lot of different reasons, and anxiety. Every single caller has the same anxiety, and that sometimes mimics symptoms of CV19 – chest pain, shortness of breath, elevated heart rate. How do you decide if a person experiencing these symptoms is having an anxiety attack or suffering from the virus?”

Nurse A is a triage nurse and her employer serves primary care providers – family medicine practices, specialty practices, colleges, hospital organizations, managed care organizations, even prisons.

“We take calls when the provider can’t, either in off hours or busy times, 24/7. The clients pay us to take calls from their patients, and we do the legwork, so to speak. A patient calls, they speak to a registered nurse, who collects their symptoms and asks them specific questions, based on protocols, designed to come to a disposition. We have a set of standing orders for each complaint, and can provide nursing orders (take fever reducer at this dose, at this frequency, drink fluids, call us back for this symptom).

“In addition to recommendations for follow up with their primary care physician, we send urgent complaints to the ER. We sometimes contact EMS and we sometimes call on-call providers for further triage and verbal orders. In some cases, we perform suicide or poisoning first response, and can dispatch EMS or police for intervention. But mainly, we care for people when they have no reasonable access to their doctor (or sometimes any doctor).

“It’s the most rewarding job I’ve ever had in nursing. I truly love my job, and when my patients hurt, I hurt. This is why I became a nurse – to be a care-er.”

She has given much thought to questions of personal liberty versus public safety during a pandemic. Here’s where she comes down:

“I believe in science. I understand the mechanism of microbes, and how they multiply and reproduce. Viruses are constantly changing, evolving and mutating to become the very best virus they can be, in order to reproduce far and wide. We know that the more a society can prevent the spread of disease, the better chance there is of that society remaining on top – because it’s us versus the microbe.

“Nobody questions that smoking causes cancer.* It is established science. Nobody questions that the best treatment for disease is prevention: the modification of our actions to prevent disease from gaining a foothold.

“We have all heard that early detection is the best cancer prevention, right? That’s why we wear pink ribbons in October – early detection. The smallpox virus was eradicated when a smart dude – Edward Jenner – postulated that milkmaids were seemingly immune to smallpox, and wondered if that was due to their exposure to cowpox, a similar disease.  He performed the first successful vaccination, or inoculation, and he changed the world. This was in 1796!

“So, when I see people, our fellow citizens, (in some cases our own family members) scoffing at expert advice in the name of personal liberty, I feel … conflicted. Part of me is angry, part of me is sad and the rest of me is just mystified.

“Where did American education go so wrong? When does someone else’s personal liberty begin to supersede my right to a life free of contagion? I don’t get it, at all. That was a long way of saying, “It boggles my mind. People be cray!”

And she says we’re not ready.

“Every day is exponentially worse.”

*Note: Nurse A is probably too young to remember, but radio talk show host Rush Limbaugh once made a living promoting smoking and minimizing its harmful side effects.

Betty Bean is a veteran reporter/columnist covering Knox and Sevier counties.

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