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To Quarantine or not to Quarantine? This is Corona.

March 15, 2020 by NurseTwain

I have debated on posting about this topic for several reasons. First, I am already tired about hearing about the coronavirus. Second, the world is in a state of panic over this pandemic and I do not want to add to the chaos. However, I am now writing because some facts and concerns need to be clarified using reputable sources.

What is the coronavirus?

There are many different strains of the coronavirus, of which 7 cause human illness. The one in concern today is the COVID-19 (coronavirus disease 2019), previously known as SARS-CoV-2.

What are signs and symptoms?

The most typical signs and symptoms in order of prevalence are fever, cough, and shortness of breath. The incubation period (time in which the disease creates symptoms) is anywhere from 2 days to 2 weeks. A majority of cases are mild and DO NOT require hospitalization. 1 in 5 people develop serious illness and around 2% of the cases have been fatal.

How do we test for the COVID-19?

Testing is increasingly becoming more available locally using respiratory specimens. Most testing is done officially by the CDC, taking 3-5 days for final results. If other respiratory pathogens are positive (influenza), then the COVID-19 is ruled out.

How is it treated?

There is no specific medication, cure, or vaccine approved for the COVID-19. Antibiotics are not effective because this is a virus, not a bacteria. Treatment is supportive- Tylenol, decongestants, rest, hydration, etc. People are advised to call the doctor’s office and if not severe, to remain home. Anyone who exhibits symptoms, but would not normally see medical care should remain home, even if they suspect the virus. Serious cases are those that require breathing tubes or assistance, and need trained hospitalized care.

Let me reiterate. Patients who present to the ED with mild symptoms are sent back home. Patients who cannot breathe are admitted into the hospital. These patients are placed on airborne and contact isolation in a negative pressure room. Health care professionals are required to wear a gown, gloves, N95 mask, and face shield when performing medical care.

Though no current medication has been specifically approved for the COVID-19, China has trialed the medication chloroquine phosphate (an anti-malarial) which was successful for SARS.

Who is at risk?

Currently, the risk for transmission is still low for the general population. High-risk populations include older adults, males, hypertension, diabetes, obesity, lung disease, and an elevated D-dimer (lab shown to be elevated in blood clotting disorders).

How to prevent the spread?

Handwashing and sanitization are the most important… why are we out of toilet paper and paper towels?

If you are sick and do not need hospitalization, stay home. The closures of schools and businesses is a way to “flatten the curve” of transmission. Large, crowded areas allow the reparatory droplets to spread through the air and infect multiple people. That is why avoiding crowds is important.

The COVID-19 is an airborne virus, so surgical masks are not effective. Surgical masks are only useful for very large particles, such as to prevent a surgeon from sneezing or coughing directly into an open wound.

Warm weather has not been proven to halt this virus.

What is the current situation?

As of March 14, 2020… Globally, there are 142,539 confirmed cases and 5393 deaths.

Final thoughts…

Yes, this is a serious pandemic. No, we do not need to panic. No, we do not need to stock up on unnecessary items like toilet paper and paper towels.

It is important to respond, not to react. Wash your hands, avoid large crowds, stay home if you are sick, and have peace over panic.

Resources

https://reference.medscape.com/slideshow/2019-novel-coronavirus-6012559

https://www.who.int/health-topics/coronavirus

https://www.cdc.gov/coronavirus/2019-nCoV/index.html

Until next shift,

Shania

Filed Under: Uncategorized Tagged With: coronavirus, COVID19, illness, nursetwain, patient, patienttalk, talk

Terminal Agitation

March 2, 2020 by NurseTwain

Terminal agitation. I have never heard of this term before until my last shift. A patient I had a week ago, who was admitted with a fall, died today after being placed on Hospice care. The previous week, the patient was not oriented to person, place, time, or situation, and was very restless. She was able to communicate, however inappropriately. She constantly wanted to get out of the bed, and never went to sleep. She had dementia and I thought this was a progression of her dementia. I found out on this past shift that this agitation was actually her quick decline to the end of her life.

Another nurse on the floor worked in Hospice care for several years and had a hint that this was terminal agitation. The patient was seen to be picking at the air and stated that she was seeing her late husband. I have never encountered these signs before and contributed them to hospital delirium and her baseline dementia. I could not believe that the next shift I had, was this same patient who was now comatose and passed within 24 hours after transitioning into Hospice care.

Until next shift,

Shania

Filed Under: patient stories Tagged With: hospice, hospital, nursetwain, nursing, patient, patienttalk, talk, terminalagitation

A personal care plan: how to refuel after a shift

December 2, 2019 by NurseTwain

Nurses create care plans for patients to guide nursing interventions toward favorable outcomes. We also need to create our own care plans for ourselves in order to continue to care for others. I have created a list of healthy interventions to ensure that I am full, so that I can pour out to others.

  • EXERCISE 3x/week- running, hiking, walking, lifting weights
  • Eat a variety of healthy foods and colors- meal prep for the week to save money and prevent yourself from choosing unhealthy choices
  • Socialize- LIMIT social media. Engage in community events and groups.
  • Go outside- it’s amazing what fresh air can do.
  • Read- fiction, nonfiction, articles, online journals
  • Sleep- Try to take the hour before bed to really wind down from the day.. Stay off the phone and any social media. Read a book or take a nice warm bath.
  • Take a long shower
  • Binge-watch netflix
  • Watch a movie
  • Paint/Color
  • Journal
  • Pray
  • Get your nails done
  • Prepare for the next shift

Until next shift,

Shania

Filed Under: Nursing tips Tagged With: nursetwain, nursing, patient, patienttalk, stress, talk, tips

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