We set a record with Covid patients today at my hospital

[Dred Pirate]

Our system (12 hospitals) just set a record with number of Covid patients. Plus a record number of staff out, 300 at just my 450 bed hospital. Projections say now it may go up another 75%. Last January was the busiest month of my 18 year career, I am not looking forward to the next month.

And before some of y’all jump in the “with Covid vs because of Covid” of course not everybody who has Covid is in because of it, but the vast majority are. we have had to cancel elective surgeries because of lack of bed space (and those make big money so no way they are gonna do that unless they have to). Despite this are hospital is still overflowing with making extra units (of only we had the staff).

Almost 80% of all Covid patients are Unvaccinated, 94% of icu patients aren’t. Of the 20 patients I did admission orders for over the past 3 shifts, 17 were unvaccinated. This all in a county with 75% vaccination rate. So anybody with a basic understanding of statistics can tell you the vaccine is preventing a lot of morbidity and mortality.

I am guessing y’all have similiar stories. Get your damn shot. Rant over. .

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[Rockinacoustic]

Over 800 COVID+ admissions, 70% unvaccinated, < 5% boosted

 

[sdh0202]

Yea pretty much the similar stats for my hospital too... I'm only 10 months into the solo night shift geek (coming from 2.5 years of retail exp) and I'm starting to feel little uncomfortable working and covering 2 campuses (300+ beds hospital plus remotely covering 50 beds campus) by myself.
There are more events in overnight than ever (codes, trauma, rapid responses) and I didn't really expect all these craziness when I first started training here- I was literally bored to death back then lol

 

[Reirrac]

I'm curious; is it the Delta or Omicron variant currently making patients deathly sick?

 

[gwarm01]

Do you have a contingency plan if half the pharmacy gets sick at once? It sounds like Omicron is knocking out entire departments with how contagious it is.

 

[Dred Pirate]

I'm curious; is it the Delta or Omicron variant currently making patients deathly sick?

What I can say is in my state 78% of the tested samples were omicron, that was a little over a week ago, so o assume it is higher now. Our icu to floor ratio is much lower than with the delta spike (now it is 3-1). So likely mostly omicron

 

[Rockinacoustic]

I'm curious; is it the Delta or Omicron variant currently making patients deathly sick?

Neither, it's being unvaccinated.

For a less flippant reply- I do not know what % of our critically ill patients have delta vs. omicron. Everything I read is that while Omicron is less likely to cause severe disease, it is way more transmissible. Thus, the sheer number of hospitalized and critically ill patients may exceed prior waves despite being "less likely to cause severe disease"

 

[Rockinacoustic]

Do you have a contingency plan if half the pharmacy gets sick at once? It sounds like Omicron is knocking out entire departments with how contagious it is.

We are mitigating this with proper PPE (minimum KN95), telework for those positions able, and offering incentive pay to those who pick up critical shifts. Next steps would be scaling back our less essential "clinical duties" and just making sure meds get to the patients in a safe and timely manner.

 

[Dred Pirate]

We are mitigating this with proper PPE (minimum KN95), telework for those positions able, and offering incentive pay to those who pick up critical shifts. Next steps would be scaling back our less essential "clinical duties" and just making sure meds get to the patients in a safe and timely manner.

we are looking at doing a lot of remote order verification / do consults from home. honestly 90%of the clinical work can be done from home - so we could loose a lot of clinical people and still be OK if they are well enough to work from home. We are cross training our clincial people in operations, so if ops gets hit, we can push people one way or the other as needed/

 

[pinkpharmd]

we are looking at doing a lot of remote order verification / do consults from home. honestly 90%of the clinical work can be done from home - so we could loose a lot of clinical people and still be OK if they are well enough to work from home. We are cross training our clincial people in operations, so if ops gets hit, we can push people one way or the other as needed/

And everyone is willing to change? My management will not entertain any idea of remote work, even if the person comes in to sit in front of a computer all day. The clinical people will never do actual hands-on pharmacy work (cart fill, answer a drug inquiry, forget having them to fill a Pyxis if needed, etc).

 

[Dred Pirate]

And everyone is willing to change? My management will not entertain any idea of remote work, even if the person comes in to sit in front of a computer all day. The clinical people will never do actual hands-on pharmacy work (cart fill, answer a drug inquiry, forget having them to fill a Pyxis if needed, etc).

There are obviously some who feel to good to help out, but some times you just have to do what you are told, or mgmt can make life a pain for you until you leave if you are a problem employee. But our mgmt doesn’t want to do remote work, but if we get hit so hard that enough people have to isolate at home, they can at least do work while there.

 

[samven582]

And everyone is willing to change? My management will not entertain any idea of remote work, even if the person comes in to sit in front of a computer all day. The clinical people will never do actual hands-on pharmacy work (cart fill, answer a drug inquiry, forget having them to fill a Pyxis if needed, etc).

VA management will never change no matter how much you try. My suggestion, learn new skills and get the hell out of that crap shoot of a station.

 

[PharmDminus]

Yea pretty much the similar stats for my hospital too... I'm only 10 months into the solo night shift geek (coming from 2.5 years of retail exp) and I'm starting to feel little uncomfortable working and covering 2 campuses (300+ beds hospital plus remotely covering 50 beds campus) by myself.
There are more events in overnight than ever (codes, trauma, rapid responses) and I didn't really expect all these craziness when I first started training here- I was literally bored to death back then lol

how was your transition from retail to overnight hospital? how long did it take for you to feel comfortable being solo?

 

[sdh0202]

how was your transition from retail to overnight hospital? how long did it take for you to feel comfortable being solo?

I was lucky. I applied for per diem clinical staff rph position when position became available - did my training for all of my off days from retail. Toward the end of my training period, the overnight position (7 on 7 off) suddenly became available due to internal movement. I realized that our hospital prefers to transition from per diem, part time people to FT position so I ended up getting a job.

Took me a good 3 months to got into a groove with work pace and time-management. I try to prioritize everything since its only two of us in the department overnight (me and a pharm tech). Stroke, trauma, MI alert, and rapid responses come first instead of damn diaper rash ointment. Keep an eye on supplies of IV fluids that we have to reconstitute (Nimbex, Vaso, Norepi, etc...). I try my best with medication reconciliation when it comes to ED admission orders, but sometimes I have to pick a battle as its not ideal for me to spend lots of time on certain orders. I built some rapports with certain hospitalists and residents since they are my resources for them overnight... but again I try not to spend too much time on answering complicated questions or I tell them I will get back to you through messaging apps (I love it)

At the end, if you know where and how to look up your questions, you will survive just fine. I believe that this shift makes you a jack of all trades but master of none in the long run. But I seek out for help from other pharmacist in different campus if I'm stuck in clinical situations so its always good to have those back up plan too. When I was training for overnight shift past summer, I was bored to death and often spent time on SDN/reddit pharmacy forum but its much busier now so I'm kind of glad this is happening on my 10 months mark. I realize I still have a lot to learn and will never be competent as residency-trained person but I will probably aim for BCPS down the road (not really for the pay cuz we have no incentive) but for my credentials and clinical knowledge. Hope my post answered your questions lol

 

[Dred Pirate]

We broke 650 Covid patients in our system today. And just my hospital now has 525 staff with Covid. Approaching 10% of staff out.

 

[PharmDminus]

I was lucky. I applied for per diem clinical staff rph position when position became available - did my training for all of my off days from retail. Toward the end of my training period, the overnight position (7 on 7 off) suddenly became available due to internal movement. I realized that our hospital prefers to transition from per diem, part time people to FT position so I ended up getting a job.

Took me a good 3 months to got into a groove with work pace and time-management. I try to prioritize everything since its only two of us in the department overnight (me and a pharm tech). Stroke, trauma, MI alert, and rapid responses come first instead of damn diaper rash ointment. Keep an eye on supplies of IV fluids that we have to reconstitute (Nimbex, Vaso, Norepi, etc...). I try my best with medication reconciliation when it comes to ED admission orders, but sometimes I have to pick a battle as its not ideal for me to spend lots of time on certain orders. I built some rapports with certain hospitalists and residents since they are my resources for them overnight... but again I try not to spend too much time on answering complicated questions or I tell them I will get back to you through messaging apps (I love it)

At the end, if you know where and how to look up your questions, you will survive just fine. I believe that this shift makes you a jack of all trades but master of none in the long run. But I seek out for help from other pharmacist in different campus if I'm stuck in clinical situations so its always good to have those back up plan too. When I was training for overnight shift past summer, I was bored to death and often spent time on SDN/reddit pharmacy forum but its much busier now so I'm kind of glad this is happening on my 10 months mark. I realize I still have a lot to learn and will never be competent as residency-trained person but I will probably aim for BCPS down the road (not really for the pay cuz we have no incentive) but for my credentials and clinical knowledge. Hope my post answered your questions lol

this was very helpful actually. i have been in retail for a long time and have an opportunity to jump to overnights at hospital. i know i will feel like a fish out of water but for how long im not sure. also i wouldnt have a tech. hospital about 100 beds. this post was insightful

 

[JustFillIt]

I’m sitting here realizing something…

We are about to find out what happens when just about everyone in our country gets sick with a moderate case of covid in approximately the same time (within weeks/months). I would not call it “mild” either.

Dunno about you guys but it just hit me - I’m going to have to call in tomorrow myself.

Let’s hope I’m wrong. But so far, from my estimation, this new variant is freaking bonkers.

 

[RxPreceptor]

Conversely, I think I hit a personal best shear number of administered COVID vaccines solo in a "community" setting...~60 over 14 hours or so. #Vaccine B!tch

 

[Dred Pirate]

I’m sitting here realizing something…

We are about to find out what happens when just about everyone in our country gets sick with a moderate case of covid in approximately the same time (within weeks/months). I would not call it “mild” either.

Dunno about you guys but it just hit me - I’m going to have to call in tomorrow myself.

Let’s hope I’m wrong. But so far, from my estimation, this new variant is freaking bonkers.

the transmissibility of omicron seams crazy.
Hope you do well man - not fun. I think for MOST vaccinated patients without significant co-morbidities it is mild, for unvaccinated/immunosuppresed/other medical conditions - ya - overall moderate (with the obvious severe cases).

I am holding out hope that it spreads so quickly (with minimal mortality of course) that we actually reach heard immunity,

time will tell

 

[JustFillIt]

the transmissibility of omicron seams crazy.
Hope you do well man - not fun. I think for MOST vaccinated patients without significant co-morbidities it is mild, for unvaccinated/immunosuppresed/other medical conditions - ya - overall moderate (with the obvious severe cases).

I am holding out hope that it spreads so quickly (with minimal mortality of course) that we actually reach heard immunity,

time will tell

Yea - today it really just feels like a normal cold. I have had 3 Covid shots since they came out. Only difference that I notice so far is that I have a bit of a headache that is coming along with it.

I’m trying the “Benadryl and milk” remedy. But in all honestly it’s just an excuse for me to whale on some diphenhydramine and drink chocolate milk while eating cookies (no loss of taste to report) and watching lord of the rings all day. I have the extended versions of all 6 movies. I keep missing pieces due to passing out from antihistamines.

Anyways - so far my Covid experience has been horrible as you can imagine…. This might have to turn into a case of “long Covid”. I have been wanting to re-watch Breaking Bad. 😂🤣

 

[confettiflyer]

. But in all honestly it’s just an excuse for me to whale on some diphenhydramine and drink chocolate milk while eating cookies (no loss of taste to report) and watching lord of the rings all day. 🤣

Living your best life, sir. I salute you.

 

[njac]

Do you have a contingency plan if half the pharmacy gets sick at once? It sounds like Omicron is knocking out entire departments with how contagious it is.

We’ve lost half our technicians at one point or another. Directors working the carousel, managers delivering. Specialists making delivery rounds for patient specific meds.

 

[Sparda29]

We’ve lost half our technicians at one point or another. Directors working the carousel, managers delivering. Specialists making delivery rounds for patient specific meds.

Is that despite wearing N95 masks all the time and hand hygiene?

 

[Sparda29]

I was lucky. I applied for per diem clinical staff rph position when position became available - did my training for all of my off days from retail. Toward the end of my training period, the overnight position (7 on 7 off) suddenly became available due to internal movement. I realized that our hospital prefers to transition from per diem, part time people to FT position so I ended up getting a job.

Took me a good 3 months to got into a groove with work pace and time-management. I try to prioritize everything since its only two of us in the department overnight (me and a pharm tech). Stroke, trauma, MI alert, and rapid responses come first instead of damn diaper rash ointment. Keep an eye on supplies of IV fluids that we have to reconstitute (Nimbex, Vaso, Norepi, etc...). I try my best with medication reconciliation when it comes to ED admission orders, but sometimes I have to pick a battle as its not ideal for me to spend lots of time on certain orders. I built some rapports with certain hospitalists and residents since they are my resources for them overnight... but again I try not to spend too much time on answering complicated questions or I tell them I will get back to you through messaging apps (I love it)

At the end, if you know where and how to look up your questions, you will survive just fine. I believe that this shift makes you a jack of all trades but master of none in the long run. But I seek out for help from other pharmacist in different campus if I'm stuck in clinical situations so its always good to have those back up plan too. When I was training for overnight shift past summer, I was bored to death and often spent time on SDN/reddit pharmacy forum but its much busier now so I'm kind of glad this is happening on my 10 months mark. I realize I still have a lot to learn and will never be competent as residency-trained person but I will probably aim for BCPS down the road (not really for the pay cuz we have no incentive) but for my credentials and clinical knowledge. Hope my post answered your questions lol

A PGY1 or PGY2 would be scared ****less if they had to work a solo overnight.

 

[njac]

Is that despite wearing N95 masks all the time and hand hygiene?

Staff not involved with aerosol-generating procedures weren’t required to wear n95s until this week and people without direct patient contact weren’t wearing eye protection all the time either.

They were likely out giving it to each other in social situations, not at work. But the levels of staff from all departments out with positive Covid tests is unlike anything we’ve seen so far.

 

[Sparda29]

Staff not involved with aerosol-generating procedures weren’t required to wear n95s until this week and people without direct patient contact weren’t wearing eye protection all the time either.

They were likely out giving it to each other in social situations, not at work. But the levels of staff from all departments out with positive Covid tests is unlike anything we’ve seen so far.

But why wait until you are required to wear a damn N95? It's not an uncomfortable mask.

 

[JustFillIt]

But why wait until you are required to wear a damn N95? It's not an uncomfortable mask.

This is true - I have a beard that drives me crazy when I wear a surgical mask. If I am required to wear a mask I would much rather wear an N95 because it comes forward off my face. I hate how the surgical mask presses my nose and aggravates my face.

My face gets all twitchy and weird when I wear a surgical mask. Almost feels like I have a movement disorder or something

 

[Sparda29]

This is true - I have a beard that drives me crazy when I wear a surgical mask. If I am required to wear a mask I would much rather wear an N95 because it comes forward off my face. I hate how the surgical mask presses my nose and aggravates my face.

My face gets all twitchy and weird when I wear a surgical mask. Almost feels like I have a movement disorder or something

So I went to the gun range the other day. Walked in wearing something like this:

Got some weird looks. It's an indoor range. You should be wearing an N95 even without Covid being around because of the lead exposure.

 

[JustFillIt]

So I went to the gun range the other day. Walked in wearing something like this:

Got some weird looks. It's an indoor range. You should be wearing an N95 even without Covid being around because of the lead exposure.

Oh gotcha - yea, when I was a kid I used to chew on lead pencils daily for years. I also played with the mercury inside of thermometers.

It didn’t effect me one bit. Just because I can see the colors of music now and then does not mean I’m crazy