It’s shelter-in-place Day #9867403. It’s also the week after Easter. Amazingly, the Easter Bunny made it to our patio in these challenging times. There were some colored eggs and some little baggies of jelly beans in rather obvious place. There are unconfirmed reports that Easter Bunny was wearing a bathrobe and did not mobilize till after 8am, but really, who’s judging?
The recipient of the little gauze bags was delighted that Easter was still alive and well during the global pandemic. I told her that even though she’s 18 now, there will be an egg hunt for her until she is hiding eggs for her own kids. This may not strictly be true, but Easter Bunny got to eat a few handfuls of jellybeans before and during the whole hunt thing, so there is some investment in keeping up the tradition. I won’t even mention the Cadbury’s cream eggs. They never actually made it to the baggies. So relieved another candy-fest is behind us.
Easter being somewhat muted by having to stick-in-the-mud, we decided to console ourselves with a little online shopping. Mom, said teen excitedly, glued to the Urban Outfitters website, I have $1064 of clothes in my shopping cart! I told her this was wonderful news, and she could have them all, as long as she started college a month later than everyone else. Of course, it’s anyone’s guess whether college is even going to happen in August. So that one went down like a lead balloon.
This Wednesday, April 15th, was a big day for me. Not because it was tax day, because it strangely wasn’t. Ha! But I got to drive to my office and pick up my PPE. People on the internet are dressing up to go to their mailbox, or bring the trash out. Imagine the excitement of going into the office! I nearly put on lipstick, but I don’t have any. Instead, I put on a face mask and sanitized my hands. I also made sure I was wearing pants. If you’ve been in any Zoom meetings lately, you’ll know what I’m talking about.
I let myself in through the locked front door of my office building with my special badge that makes the door k-chunk open in a satisfying bank-robbery kind of way. Then I walked through some weirdly propped open doors to the PPE room. My office, usually humming with activity, was eerily empty and quiet. A table blocked the door of the conference room where once a week my team used to sit around a big table and have our friendly team meetings. I stood a respectful six feet from the person giving out the baggies of PPE from behind the table. My baggie had a gown and mask in it, and a superfine washable face shield (new this week). I was also permitted to select a home-made cloth mask made by kind volunteers. It took me a while to choose which pattern I wanted. Don’t rush me, I wanted to say to the volunteer in case she was judging me for my indecision over a free face mask. I’m shopping here.
Then I went back out to my car, sanitized my hands and everything else I could see, including the entire parking lot, and drove home. The week’s been a bit downhill from there.
Thursday I spent from 9am to 1pm sitting on my kitchen chair in Zoom meetings. I also ate a lot of cinnamon raisin toast. Some of it was for breakfast, but some of it, interestingly, was for lunch. The second Zoom meeting, a presentation by a UCSF doc in how to provide telehealth, had 85 participants. Zoom was experiencing a few glitches in its muting capabilities. The host muted us all, but we could still hear one of the participants ordering a burrito to go. She did not need a straw with her beverage.
You might be wondering how a hospice nurse can do her job effectively during shelter-in-place. If you find out, please let me know. I cannot see most of my patients in person. I cannot touch them, or hug them, listen to their lungs with my stethoscope, or check their skin for bedsores. I can’t put my hand on their arm to reassure them. I cannot lay my hand on their febrile brows. And I can’t sit with their families while they cry and laugh and tell stories and grieve. It is starting to feel like negligence, this socially distanced nursing, but it’s what we must do. I have to remind myself: would it be better to go see someone and maybe bring them coronavirus?
Today, I had to visit one of my patients in person. In-person nurse visits now have to be approved by my team leader. My patient is dying. For the entirety of this week, she has been exhibiting clear signs. She can’t swallow any more, she doesn’t want food, she closes her mouth against her medications, she’s sleeping most of the time, and today, she was breathing heavily. I texted my team leader: my patient seems to be dying, it feels like gross negligence on my part not to visit her, can I go? I gave some objective data, besides my subjective plea, and she said yes, by all means go.
I drove to the facility. Highway 101 was pretty empty, and so were the surface streets, apart from a marked increase in hazardous drivers. I like to think of it as coronarage. Young probably male drivers, stuck at home for weeks, suddenly let loose on the roads. Possibly with high levels of blood alcohol and illicit drugs. I’m not joking about this. The amount of reckless weaving on 101 today was shocking.
I made it to the facility where my patient lies dying. I put on my PPE in my car in the parking lot, including my trendy new clear plastic face shield. Frankly, I felt like I was about to board Apollo 13. Inside the facility, I had my temperature checked and the usual coronavirus screening questions asked, although today they were a little less rigorous. I did not have to explicitly deny having travelled to China in the past 14 days. The receptionist used her key to let me into the stairwell and I was on my way.
Let me just mention at this point that as soon as you put on an N95 respirator mask, your nose develops an irresistible itch.
At the top of the stairs I rang a bell and soon a medtech came to let me in the locked door to the second floor. There were signs everywhere saying full PPE needed to be worn, but the medtech was wearing only a mask. I assessed my patient. She was doing fine, considering. I went to the medtech station to chart, educated the medtech on when she should call hospice, and checked that all the right medications were present.
I was bumbling around in full PPE, rustling when I walked, my breath noisy, all a bit Darth Vader. The medtech was not even wearing a mask. I advised her to wear one. She said it made her feel claustrophobic, so she only wore it outside the medtech room.
Because, you know, Covid-19 doesn’t really like that room. It only likes outside that room.
When I got home, I left all my clothing and shoes in a plastic bag in the carport and nimbly darted into the house in some clothing that could not have come in contact with the covid 19 virus. Since everyone is sheltering at home, no neighbors witnessed this scene. I’m hoping.
Tomorrow is not a work day and I don’t have to dress up as Darth Vadar, so naturally I plan to climb a staircase with 187 stairs fifty times. See previous blog post. I just don’t have what it takes to explain this sentence. I like to tell people that the stair climbing is keeping me sane but actually tonight I wonder if I have that ass backwards. For the past few days, I’ve been making very poor headway in my training schedule for the whole stair climbing challenge thing. I was only able to climb the staircase 5 or 6 times and those were primarily propelled by annoyance. Trudging would be a good way to describe my climbing style. Quite a bit of muttering was involved.
However, I signed up for this thing and I’m going to try and see it through. My left knee hurts, and it being Friday, happy hour was a lot more prolonged than it probably should have been. I’m really looking forward to an inspiring speech by Bill McKibben at 8am tomorrow, encouraging us Climate Risers to get out there and promote change in the world. And if this means I do two staircases and then have to collapse in a heap, at least I will do it in a trendy looking cloth face mask. Maybe I’ll even wear my Darth Vadar face shield. Just for the sound effects.
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