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Hospitals capacity and Covid


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24 minutes ago, wathe said:

I hear you loud and clear (and my area is nowhere near those levels yet).  HCW are burning out, and there won't be anyone left to replace them.  That will be a real disaster.  ETA it's already a real distaster of course.  It will become an even worse disaster, catastrophe, other noun of your choice for terrible terribleness.

It is horrendous! I’ve seen a patient write a note to his wife on a whiteboard before he got intubated saying he loved her. She was outside his window looking in. His nurse took a picture of it just in case and unfortunately he didn’t make it. My patient last week told me he knew he wasn’t going to survive. He’s still hanging in there at the moment. Honestly I am in tears just writing this. It is relentless and never ending.

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It is secretly official (I think the info will go public this morning) That hospitals in my state are full and will no longer take transfer patients of any kind from the rural/small town hospitals- no

In the ICU where I work 75% of the beds are now taken by Covid patients. We are all exhausted already and I think it is going to get worse. Our governor refuses to make any mandates and says it is up

It is horrendous! I’ve seen a patient write a note to his wife on a whiteboard before he got intubated saying he loved her. She was outside his window looking in. His nurse took a picture of it just i

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45 minutes ago, TCB said:

It is horrendous! I’ve seen a patient write a note to his wife on a whiteboard before he got intubated saying he loved her. She was outside his window looking in. His nurse took a picture of it just in case and unfortunately he didn’t make it. My patient last week told me he knew he wasn’t going to survive. He’s still hanging in there at the moment. Honestly I am in tears just writing this. It is relentless and never ending.

Thanks for being on the front lines.   

Other than being careful, masking, etc can the rest of us do to support our health care workers and support staff?

I know our local hospital has had donations if pop, water Gatorade, soups, salads and meals, as well as grab and go snacks for the workers.

It seems popular as local restaurants that are shut down are being paid (by donations from the public) to make up the soups, salads, sandwiches, meals, etc.    That gives them some income and blesses the health care workers.

Anything else?

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I am watching ABC Works News Tonight, from last night, on Hulu.  They went to Lawton, Oklahoma (home of Fort Sill) and a doctor there said they are full and can’t transfer patients who come in.

But officially the governor says the hospitals are fine.

 

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https://abcnews.go.com/Health/full-capacity-hospitals-us-lack-beds-equipment-treat/story?id=7426300
 

https://www.msn.com/en-us/health/medical/ccmh-concerned-with-ability-to-treat-patients-as-covid-19-cases-surge/ar-BB1b4aO7
 

Articles about Lawton..... I posted this on Facebook and there’s a decent chance I’m going to have people pop up saying “masks don’t work don’t wear them.”  
 

We live about 90 minutes away but we went to Fort Sill this summer — to get our new ID cards now that my husband has retired.  

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1 hour ago, TCB said:

It is horrendous! I’ve seen a patient write a note to his wife on a whiteboard before he got intubated saying he loved her. She was outside his window looking in. His nurse took a picture of it just in case and unfortunately he didn’t make it. My patient last week told me he knew he wasn’t going to survive. He’s still hanging in there at the moment. Honestly I am in tears just writing this. It is relentless and never ending.

Oh, I am so sorry 😞 . Thank you so much for all the work you do. I can't imagine being in your shoes. 

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3 hours ago, TCB said:

In the ICU where I work 75% of the beds are now taken by Covid patients. We are all exhausted already and I think it is going to get worse. Our governor refuses to make any mandates and says it is up to the local government to do that. He is a spineless idiot who has shown no leadership during this time. I can’t tell you how much I despise him. Our local officials got so much pushback during the initial lockdown that I can not imagine them having the guts to do anything. I feel like we are just alone and no one is going to do anything to help us. I have never experienced anything like this in my 30+ years as a nurse.

I am so sorry. I have no words to express the frustration and anger I feel now when I see and hear people making light of this virus, or even worse, saying it doesn’t exist at all. People who think this is all some inexplicable political pawn, I just don’t understand how they have allowed themselves to become so deluded and to be so callous and I feel such despair for what everyone on the front lines is dealing with right now. 😢

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2 hours ago, Ottakee said:

Thanks for being on the front lines.   

Other than being careful, masking, etc can the rest of us do to support our health care workers and support staff?

I know our local hospital has had donations if pop, water Gatorade, soups, salads and meals, as well as grab and go snacks for the workers.

It seems popular as local restaurants that are shut down are being paid (by donations from the public) to make up the soups, salads, sandwiches, meals, etc.    That gives them some income and blesses the health care workers.

Anything else?

I think seeing people being careful feels like they are showing solidarity and that really helps me. 
We have had people donate meals and cookies and fruit, and something that was really good was a donation of those small water bottles. Things like that mean that you can grab something to eat and drink easily when there is so little time. 
I don’t really know of other things, but it really helps my heart to know people are thinking of us.

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3 hours ago, TCB said:

It is horrendous! I’ve seen a patient write a note to his wife on a whiteboard before he got intubated saying he loved her. She was outside his window looking in. His nurse took a picture of it just in case and unfortunately he didn’t make it. My patient last week told me he knew he wasn’t going to survive. He’s still hanging in there at the moment. Honestly I am in tears just writing this. It is relentless and never ending.

TCB, I believe you. And I am so very, very sorry that people are making such poor choices. Thank you, from the bottom of my heart, for the work you are doing. May God bless you.

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4 hours ago, Corraleno said:

There's a nurse in South Dakota who has been all over the news after tweeting that the situation in her hospital is like a "horror movie that never ends." In interviews she says that the nurses and doctors are so depressed and demoralized by what they are seeing, so many people are still in denial even as they are literally dying of covid — people refusing to call their families to say goodbye because they insist they just have flu and will be fine, patients yelling at staff for wearing all that stupid PPE for no reason since covid doesn't exist, patients whose last words are "this can't be happening, it isn't real." 😥

I blame leaders for this- both political and religious 

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On 11/16/2020 at 11:31 AM, The Accidental Coach said:

@mlktwins Our schools are phasing in classes. K-2 began last week, 3-4 will be in buildings by the end of the month. I am shocked and dismayed with these decisions. Our cases are rising, hospitals are full, restaurants are back to outdoor dining/pick up only, more restrictions are being put in place, so let's send our children to school.

Last week a nearby town was begging for substitute teachers at $150 a day for people with AA degrees. They are in dire straits due to teachers being out with + results or due to exposure. That school district announced they are going virtual as of this Wednesday because they can't staff the classes.

I, too, am shocked by what people are posting on FB. 

Our schools returned elementary students a month ago and high school students last week(!) but acknowledged at a board meeting (Monday) that cases are rising again. My bet is that things will be virtual by Christmas break. We elected virtual for the full year so it doesn’t affect our routines. Meanwhile, I am still doing grocery delivery/pick up and have no trouble with same-day orders.
 

The local military base has locked down again. Most of the ppl. I see are masked but, geez, if my neighbor (active duty military) is any indication...we’re doomed. They hosted a Halloween party with multiple households of unmasked ppl. PPL. are STOOPID.

Edited by Sneezyone
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Thank you for the kind words. It does really help to know that people care about us. Hard as it is to watch, I am so thankful that we can be there with people going through this. I have seen the people I work with do so many kind and caring things for our patients.

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45 minutes ago, Jean in Newcastle said:

I blame leaders for this- both political and religious 

It's really hard to fathom that for some people the possibility of never seeing their loved ones again or getting to say goodbye is actually less painful than admitting that they trusted the wrong people and were lied to. 😥

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On 11/17/2020 at 7:14 AM, cintinative said:

I don't think our numbers are the same magnitude per population here as yours (I haven't checked to be honest) but our hospital officials are warning of the same thing here. We are going to run out of healthy workers before we run out of beds.   

I just don't know that the governor here is going to be successful in getting people to change their attitude. There is a total lack of understanding about the fact that their choices affect others in the community.  I have seen "Don't shut us down. Let us live our lives. Protect the vulnerable," but I don't think people have thought that through. So, all the people in healthcare from nurses to sanitatation workers need to lock down and not have a life so that you can go out and have a huge Thanksgiving? It's like they think that the only people that would need to isolate are the very old, but they ignore that the people in the nursing homes are locked down and they are still getting COVID from the staff that live outside the home.  When there is community spread like this, that just happens. And, when Uncle Ned has a heart attack and needs to use the hospital and it is too full, will you still be yelling, "Don't shut us down. Let us live our lives. Protect the vulnerable"? I know I am preaching to the choir here, but it just makes me so, so sad. 

Short of massive casualties such that there are refrigerated morgue trucks everywhere, after so much purposeful misinformation and propaganda from the very top all the way down to the lowest levels that is sustained and perpetuated by social media and media bubbles, I don’t think many attitudes in the US can be changed at this time. We’ve shown the world our true selves this year and it’s both very sad and very scary.

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10 minutes ago, Frances said:

Short of massive casualties such that there are refrigerated morgue trucks everywhere, after so much purposeful misinformation and propaganda from the very top all the way down to the lowest levels that is sustained and perpetuated by social media and media bubbles, I don’t think many attitudes in the US can be changed at this time. We’ve shown the world our true selves this year and it’s both very sad and very scary.

I'm not even sure the trucks will do it at this point. And we might wind up testing that hypothesis 😢

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18 minutes ago, Not_a_Number said:

I'm not even sure the trucks will do it at this point. And we might wind up testing that hypothesis 😢

Sadly, I agree. I mean if actually being in the ICU, gasping for air, being told you're about to be intubated, isn't enough to convince some people that covid is real, then reports of morgue trucks won't do it either. I used to think that people would change their minds once their own local hospitals were overwhelmed, or someone close to them died, but clearly there are people who will just never accept the truth and will continue to buy into the crazy conspiracy theories. The nurse from SD said that one patient insisted they couldn't possibly have covid and it was most likely lung cancer! How do you even deal with that level of denial??? ☹️

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1 minute ago, Corraleno said:

Sadly, I agree. I mean if actually being in the ICU, gasping for air, being told you're about to be intubated, isn't enough to convince some people that covid is real, then reports of morgue trucks won't do it either. I used to think that people would change their minds once their own local hospitals were overwhelmed, or someone close to them died, but clearly there are people who will just never accept the truth and will continue to buy into the crazy conspiracy theories. The nurse from SD said that one patient insisted they couldn't possibly have covid and it was most likely lung cancer! How do you even deal with that level of denial??? ☹️

My local ex-friend just accused me of hysteria when I mentioned the issues locally in NYC... for example, I mentioned that they had talked about digging graves in the park, and she triumphantly told me that didn't ACTUALLY happen, so it was fake news -- never mind that it had really been discussed by City Council. For her, it wasn't political, it was tied to the fact that her and her husband's jobs (entertainment industry) were in peril. 

People are very good at motivated reasoning and burying their heads in the sand. I would guess she'd only be convinced if a close relative or very good friend is hospitalized. 

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6 minutes ago, Corraleno said:

Sadly, I agree. I mean if actually being in the ICU, gasping for air, being told you're about to be intubated, isn't enough to convince some people that covid is real, then reports of morgue trucks won't do it either. I used to think that people would change their minds once their own local hospitals were overwhelmed, or someone close to them died, but clearly there are people who will just never accept the truth and will continue to buy into the crazy conspiracy theories. The nurse from SD said that one patient insisted they couldn't possibly have covid and it was most likely lung cancer! How do you even deal with that level of denial??? ☹️

It’s like the parents of the young boy in my state who was not vaccinated and got tetanus. He suffered greatly and was hospitalized for almost two months followed by time at a rehabilitation facility. The parents still refused to have him get vaccinations. And having tetanus doesn’t give you immunity.

https://www.nytimes.com/2019/03/09/well/oregon-child-tetanus-vaccine.html

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1 hour ago, TCB said:

Thank you for the kind words. It does really help to know that people care about us. Hard as it is to watch, I am so thankful that we can be there with people going through this. I have seen the people I work with do so many kind and caring things for our patients.

My family is incredibly grateful to ICU nurses and others  for the incredible work you do.  People like you made an enormous difference to us over the past two years.  

Edited by BaseballandHockey
Grammar, it is the WTM afterall
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14 minutes ago, BaseballandHockey said:

My family is incredibly grateful to ICU for the incredible work you do.  People like you made an enormous difference to us over the past two years.  

I know that must have been a really difficult experience! 

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11 hours ago, Mrs Tiggywinkle said:

I frankly think the vaccine will be a very hard sell to the public anyway. Even the non-crunchy, fully vaccinated people I know are saying they won’t get it until there’s more research.  And similar to other 3 or more part shorts, the compliance rate with all 3 is likely to be low.

I was wanting to wait, but with two vaccines with good data, I think I would line up pretty early if given the chance. DH says the data looks really, really good even in comparison to vaccines that have been around a while for other things.

9 hours ago, Starr said:

Seriously though, folks are unwilling to take a vaccine to contribute to herd immunity but will contribute by having the virus or giving it to someone else to contribute. Mind boggling.

I keep seeing people on FB saying that now that we have a vaccine, we can chuck all the rules...yet, I assume a fairly large chunk of those people will reject the vaccine due to conspiratorial thinking. 

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11 minutes ago, BaseballandHockey said:

Well yeah but the nurses worked hard to make it a little less difficult.  

I’m really glad they could help. We have felt strong bonds with some of the families who have spent a lot of time in the unit over months and years.

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@TCB, you and your team are the best. 

I'm sorry our stupid country is not recognizing and telling you this and supporting you every chance we get.

I hope things shift politically in the next few months such that health care workers and public health officials not only feel our nation's appreciation, but also are front and center in shaping the policies that move us out of this crisis and into a place where we prioritize and properly fund public health. 

Bless you bless you and bless you,

Amy

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Yesterday our hospital noted they have 90 Covid patients. I looked it up, the hospital was originally set up with 48 Covid rooms. As of Monday, 10 people in my county have died - my town is about 75k, there are about 10k people in the rest of the county. 

 

 

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I’m in Oklahoma. Where the CEOs of the hospitals are placing full page ads in newspapers and elsewhere digitally saying to for the love of neighbor please put a mask on and distance bc their beds are teaching limits and their staff is beyond reaching their limits but the governor still will not issue a mask mandate and is still adamant that all schools should be in person by January. He did say that as of today bars and restaurants have to be curbside only after 11pm.

It’s exhausting bc on the one hand, I want to do my part and we are back to almost being in self quarantine.  More and more people we know are testing positive but so far so good lately on getting through it. 

I think the fear goes both ways. I want to shelter so I can spend more time with loved ones. But it only works if everyone shelters. So if no one else is going to and they are risking their life - well dammit, I want to be with them while I can then. Most people I know irl are refusing to even get tested or share contact info. If they are not symptomatic they will not get tested bc then they would feel they have to tell work or school and don’t want to change their daily life more than they already have. (Which is laughable. In my state, if you own a mask and sorta kinda wear it sometimes, then that’s all the daily change they have and most don’t have to do that much.)
 

I have had to do without anesthetic for an emergency cesarean delivery. And that was 9 years ago at a private hospital with better staffing.  I have absolutely zero doubt that people will die, not because of Covid, but for lack of available medical intervention here. It scares me to know we are heading that direction. I wouldn’t wish it on anyone. 
 

oh. And side rant. Please remember how badly we need more staff the next time someone witches about how unfair it is to forgive student loans because they paid theirs. If anyone had loans they could pay off - they are either more wealthy than they know or they got their degree 20 years ago. Debt is the #1 reason students do not seek higher learning (which includes trade schools btw) and debt is the #1 reason students don’t finish their degree too.   We need educated and trained people in our country and the bottom line is student loan debt is restricts that access to a socially harmful level. 

 

 

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13 hours ago, Acadie said:

@TCB, you and your team are the best. 

I'm sorry our stupid country is not recognizing and telling you this and supporting you every chance we get.

I hope things shift politically in the next few months such that health care workers and public health officials not only feel our nation's appreciation, but also are front and center in shaping the policies that move us out of this crisis and into a place where we prioritize and properly fund public health. 

Bless you bless you and bless you,

Amy

Thank you so much for this! I can't tell you how much your comments and those of others on this thread have encouraged me!

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15 hours ago, Not_a_Number said:

 it wasn't political, it was tied to the fact that her and her husband's jobs (entertainment industry) were in peril. 

People are very good at motivated reasoning and burying their heads in the sand. I would guess she'd only be convinced if a close relative or very good friend is hospitalized. 

I have a son who is working on 2 production crews. Oddly enough production is sorta booming in Oklahoma lately. Like 5 ? films currently in production here and a production studio is about to start up. 
 

Anyways. He says some genius (sincerely stated) decided to be Covid friendly by having a strict schedule of teams. Teams A - E work together (production uses masks all the time anyways and distance usually isn’t an issue either). If anyone in their team gets sick - they shunt them and redo the schedule so another team can fill the gap. 6 weeks and only one team of 8 had to be out for 2 weeks.

I don’t fault anyone for wanting to have income. We all have bills to pay and people to feed. Our American society needs to have legit family policies even outside of Covid.  Most people want to work and be Covid aware. But if they have to choose one over the other, they are going to choose the one that lets them buy groceries and pay rent. 

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17 hours ago, kand said:

I am so sorry. I have no words to express the frustration and anger I feel now when I see and hear people making light of this virus, or even worse, saying it doesn’t exist at all. People who think this is all some inexplicable political pawn, I just don’t understand how they have allowed themselves to become so deluded and to be so callous and I feel such despair for what everyone on the front lines is dealing with right now. 😢

Exactly this. 

17 hours ago, Jean in Newcastle said:

I blame leaders for this- both political and religious 

But at some point, we need to hold individuals accountable. At some point, there is callous indifference. We’re smack dab in a hot spot. Anybody who cares enough to ask, can find a real live human working in the hospitals IN our city to ask, “Is this overblown? Is Covid just nothing more than the flu?”

At some point,  the individual CHOOSES deniability because he refuses to admit either:

(A.)the circumstances have changed AND you were wrong (to be frank, me)

OR

(B.) He just wants to be right, insist on cheering on your “team” - (whether that’s the political team or just the team that states masks don’t work and I refuse to help in any slight way) and willfully refuses to admit either pride or willfulness.

 

I felt so guilty about stopping activities and now I’m really, due to changing circumstances, feeling angry with people who steadfastly stick to what they insist, disregarding human factors and any shred of decency  

 

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20 hours ago, Lecka said:

I am watching ABC Works News Tonight, from last night, on Hulu.  They went to Lawton, Oklahoma (home of Fort Sill) and a doctor there said they are full and can’t transfer patients who come in.

But officially the governor says the hospitals are fine.

 

I have absolutely nothing good to say of our governor. He is a wanna be Trump and can’t even be that “good”.

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25 minutes ago, Murphy101 said:

I don’t fault anyone for wanting to have income. We all have bills to pay and people to feed. Our American society needs to have legit family policies even outside of Covid.  Most people want to work and be Covid aware. But if they have to choose one over the other, they are going to choose the one that lets them buy groceries and pay rent. 

Sure, that’s fine. I don’t see the point of deciding it’s a conspiracy theory, though.

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16 hours ago, Not_a_Number said:

My local ex-friend just accused me of hysteria when I mentioned the issues locally in NYC... for example, I mentioned that they had talked about digging graves in the park, and she triumphantly told me that didn't ACTUALLY happen, so it was fake news -- never mind that it had really been discussed by City Council. For her, it wasn't political, it was tied to the fact that her and her husband's jobs (entertainment industry) were in peril. 

People are very good at motivated reasoning and burying their heads in the sand. I would guess she'd only be convinced if a close relative or very good friend is hospitalized. 

I think this is why my sister has been so angry lately.  She does wear masks, but she rants a lot about schools needing to be open and things like that.  Her husband is in the luxury hotel business.  

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14 minutes ago, Not_a_Number said:

Sure, that’s fine. I don’t see the point of deciding it’s a conspiracy theory, though.

I don’t think they “decide” it in the way we normally think of coming to decisions. I think they lie to themselves so they can live with their reality. 

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Youngest had a medical crisis yesterday, something beyond what can be done with a virtual visit.  We tried for over an hour to get in to her doctor's office (phone rang, and rang). We tried for an urgent care appointment across any of the hospital systems here. They were all booked up.  The drugstore based urgent cares have all moved to virtual visits.  Youngest eventually got the care she needed (a hospital triage FNP helped us get in to her doctor). We are still working on getting her all of the medicine she needs--orders had to be re-written into something that was order able with the shortages going on, still waiting on the shipment to come in, etc. We really didn't want to overload a very busy ER or risk exposure.  I think her example, though, is a good indication that the healthcare system locally is overtaxed....even if so many of the covid cases are mild.  Her non-covid, urgent and serious issue couldn't get addressed easily.

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2 minutes ago, prairiewindmomma said:

I think her example, though, is a good indication that the healthcare system locally is overtaxed....even if so many of the covid cases are mild.  Her non-covid, urgent and serious issue couldn't get addressed easily.

I’m sure it’s not the mild cases overtaxing the system...

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6 minutes ago, Not_a_Number said:

I’m sure it’s not the mild cases overtaxing the system...

I think all the cases contribute to the problem.  HCW's treating mild cases still need N95's, contributing to shortages.  Mild cases also contribute to the backlog in testing, which means that we need even more PPE because of treating possible cases as if they're infectious.  Mild cases in HCW's mean that people are home sick and contribute to the shortage of staffed beds etc . . . 

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12 minutes ago, BaseballandHockey said:

I think all the cases contribute to the problem.  HCW's treating mild cases still need N95's, contributing to shortages.  Mild cases also contribute to the backlog in testing, which means that we need even more PPE because of treating possible cases as if they're infectious.  Mild cases in HCW's mean that people are home sick and contribute to the shortage of staffed beds etc . . . 

Sure, that’s true. I’d just guess the actual hospitalized patients are the biggest current problem.

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1 hour ago, Murphy101 said:

I’m in Oklahoma. Where the CEOs of the hospitals are placing full page ads in newspapers and elsewhere digitally saying to for the love of neighbor please put a mask on and distance bc their beds are teaching limits and their staff is beyond reaching their limits but the governor still will not issue a mask mandate and is still adamant that all schools should be in person by January. He did say that as of today bars and restaurants have to be curbside only after 11pm.

It’s exhausting bc on the one hand, I want to do my part and we are back to almost being in self quarantine.  More and more people we know are testing positive but so far so good lately on getting through it. 

I think the fear goes both ways. I want to shelter so I can spend more time with loved ones. But it only works if everyone shelters. So if no one else is going to and they are risking their life - well dammit, I want to be with them while I can then. Most people I know irl are refusing to even get tested or share contact info. If they are not symptomatic they will not get tested bc then they would feel they have to tell work or school and don’t want to change their daily life more than they already have. (Which is laughable. In my state, if you own a mask and sorta kinda wear it sometimes, then that’s all the daily change they have and most don’t have to do that much.)
 

I have had to do without anesthetic for an emergency cesarean delivery. And that was 9 years ago at a private hospital with better staffing.  I have absolutely zero doubt that people will die, not because of Covid, but for lack of available medical intervention here. It scares me to know we are heading that direction. I wouldn’t wish it on anyone. 
 

oh. And side rant. Please remember how badly we need more staff the next time someone witches about how unfair it is to forgive student loans because they paid theirs. If anyone had loans they could pay off - they are either more wealthy than they know or they got their degree 20 years ago. Debt is the #1 reason students do not seek higher learning (which includes trade schools btw) and debt is the #1 reason students don’t finish their degree too.   We need educated and trained people in our country and the bottom line is student loan debt is restricts that access to a socially harmful level. 

 

 

While I’m not going to get into whether or not I agree with your take on student loan forgiveness, the primary reason for shortages of healthcare workers of any type in the US is a lack of available training slots, not debt. We have a plethora of qualified, interested young people, including many willing to take on whatever debt is necessary, but simple not enough training slots. For example, among other industrialized countries, we rank near the bottom for educating doctors here, rather than importing them. I’m not saying there aren’t issues with student debt in this country, but solving them will not produce any more healthcare workers if there are not more training slots.

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2 minutes ago, Frances said:

While I’m not going to get into whether or not I agree with your take on student loan forgiveness, the primary reason for shortages of healthcare workers of any type in the US is a lack of available training slots, not debt. We have a plethora of qualified, interested young people, including many willing to take on whatever debt is necessary, but simple not enough training slots. For example, among other industrialized countries, we rank near the bottom for educating doctors here, rather than importing them. I’m not saying there aren’t issues with student debt in this country, but solving them will not produce any more healthcare workers if there are not more training slots.

Why are there no training slots? (I really don't know.)

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9 minutes ago, Frances said:

While I’m not going to get into whether or not I agree with your take on student loan forgiveness, the primary reason for shortages of healthcare workers of any type in the US is a lack of available training slots, not debt. We have a plethora of qualified, interested young people, including many willing to take on whatever debt is necessary, but simple not enough training slots. For example, among other industrialized countries, we rank near the bottom for educating doctors here, rather than importing them. I’m not saying there aren’t issues with student debt in this country, but solving them will not produce any more healthcare workers if there are not more training slots.

Yes, and WRT student debt the foreign doctors come to this country with no debt but their American trained colleagues are burdened with an average of $200K in student loan debt. 

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1 minute ago, Not_a_Number said:

I guess I don't know how the system works. Is this at the medical school level or after? 

It's a problem for all healthcare workers including techs, nurses, and physicians. In some states, people have to wait a few years to get into a nursing program. 

How the United States depends on doctors trained in other countries.

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Every year the United States relies on thousands of medical graduates like Trevor to fill postgraduate residency positions because it does not produce enough doctors to meet its own needs. In 2019, nearly 19,000 American allopathic medical school seniors (USMDs) vied for over 32,000 first-year residency positions. Nearly 94 percent of them were successful, but even if 100 percent had “matched” to a residency, there would still have been more than 13,000 positions left over. That means the United States does not graduate enough M.D.s by about a third every year. In fact, since the advent of modern residency training in the 1950s, the United States has produced 20 to 45 percent fewer M.D.s than are needed to staff residency positions nationwide.

 

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5 minutes ago, Not_a_Number said:

Why are there no training slots? (I really don't know.)

There just aren’t enough. I don’t know all of the reasons but one would be funding, especially for state programs, and at least for nursing I know getting enough instructors (they can often make more $ being a nurse) and practicum sites can be an issue. When universities find profitable programs, they rush to add or expand them. Hence, it is why we now in general have a surplus of pharmacists with competition for hospital positions being very keen and generally now requiring a residency. But training pharmacists really isn’t very expensive in terms of staff and facilities compared to other healthcare professions and universities can get away with charging very high tuition because salaries start in the six figures. For example, the state PharmD program in my state is at the same state U as the vet school and they charge similar amounts for tuition, but the resources allocated to the two programs are very, very different. So the PharmD program is very likely a money maker for them and the opposite is likely true for the DVM program.

Also, much of the medical residency funding comes from Congress so they ultimately control the number of government funded slots. Currently, we don’t remotely produce enough medical school graduates here to fill all of the residency slots and many would argue we need even more residency slots, especially in certain areas such as primary care and psychiatry.

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2 minutes ago, Ordinary Shoes said:

It's a problem for all healthcare workers including techs, nurses, and physicians. In some states, people have to wait a few years to get into a nursing program. 

How the United States depends on doctors trained in other countries.

 

It’s a function of trying to maintain a lean healthcare system based on profit and just in time service delivery. There’s insufficient slack in times of crisis. This has long been an issue WRT rural healthcare because professionals with huge debt loads can’t afford to practice in rural areas and pay their loans off. We have a similar supply/demand issue WRT legal education.

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11 minutes ago, Ordinary Shoes said:

Yes, and WRT student debt the foreign doctors come to this country with no debt but their American trained colleagues are burdened with an average of $200K in student loan debt. 

And often those foreign doctors are coming from countries that need doctors even more than we do. Personally, I think it’s a travesty that we spend significantly more on the military than any other country in the world, but we can’t invest the money to train enough healthcare professionals here and give our young people sufficient opportunities to realize their career goals. Personally, I think if anything we should be heavily subsidizing the training and producing a surplus to be exported through programs like the Peace Corps.

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6 minutes ago, Sneezyone said:

It’s a function of trying to maintain a lean healthcare system based on profit and just in time service delivery. There’s insufficient slack in times of crisis.

We don't have enough trained staff to even maintain a "lean" system. We have to import foreign trained doctors to make up the difference. States have not increased the number of medical school spots in years even though the population increased. This is partially because it is very expensive to train a doctor. It also benefits physicians by reducing the supply. 

We've been importing foreign trained nurses for years as well. 

 

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9 minutes ago, Ordinary Shoes said:

We don't have enough trained staff to even maintain a "lean" system. We have to import foreign trained doctors to make up the difference. States have not increased the number of medical school spots in years even though the population increased. This is partially because it is very expensive to train a doctor. It also benefits physicians by reducing the supply. 

We've been importing foreign trained nurses for years as well. 

 

Indeed. In legal education, opposition to journeymen legal personnel, think Physician assistant level, is fierce and lead by bar associations that want to maintain high barriers to entry. It’s profitable to have an exclusive skill set/certification/credential. We have multiple systemic issues.

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