Update 12/1/22

When in the best of times remember they will end and when in the worst of times remember they will end !    These are difficult days but your teamwork and ability to handle these record numbers amazes me.  I’m so very proud of y’all !!!   A source who is really great at predicting the cycle of infection for flu season etc is estimating the end around the middle of February.  Thank you to all of you who have signed up for extra shifts, this will be very helpful.  If anyone wants full shifts or a few hours please let us know!

1)      At 330 every shift the house sup will be calling to see how many “probable admits” we have.   This will help accuracy in the daily meeting.  If there are 6 rooms available in the house and we will probably need 3 then the main ED has an idea that they might get 3.  Any nurse can tell the HS the number if the CN is occupied.

2)      TSQ lab testing – we now have 2 Sophia machines that have the ability to test antigen flu and covid at the same time.   While the PCR is a more accurate test, we only have 2-3 channels in that instrument and the test takes 47 min each.  With our current volume the backlog could be hours.   The triage nurse ordering protocols should communicate with the lab to optimize the instruments by ordering accordingly.    Some of the doctors are not wanting swabs ordered as much as others is another factor to keep in mind.   If a family of 3 all come in with the same s/s during peak it may be prudent to test the sickest one only; of course, I have this conversation with the family and physician first.   Also, remember that the antigen test in particular is only as good as the swab / sample you get – be sure to obtain in the right manner.

The Sophia can tests the antigen covid and flu at the same time regardless of if you order one of them or both.  There isn’t a combo order for this they must both be put in:   “Flu A/B Ag Rapid” and “SARS Antigen”

I’m sure you all know by now that the PCR triple (Covid/Flu/RSV) is “SARS-CoV-2/Flu/RSV PCR”    While TSQ only has a couple of these slots in the instrument GST has numerous, that is why we added the antigen to the TSQ location.

3)      We are looking at options for a winter party in January….let us know if you have any great ideas !

4)      While I acknowledge that ideally we are not holding admitted patients long… please remember to put them in hospital beds, order food (when applicable), chart some kind of interaction with them hourly, and keep their VS updated appropriately per their condition

5)      We suspended our patient call back process for a bit during this volume.   It is a great addition to the patient experience and I really have enjoyed doing the calls more than I expected.   When volumes get back to an avg 55/day for a consecutive week we will resume these.

6)      The Soft Holiday schedule is out on the website:  www.nwthsfed.com

Email: nwfedstaff@gmail.com

Password: nwfedstaff

7)      Pain reassessment !

8)      Recently we had a ticket placed on the doppler.  Biomed picked it up and took it not realizing we did not have a backup.   It is probably a good idea to place the information that we don’t have a spare on the ticket so that they can pursue getting us a backup while it is being repaired.  I had not thought about this prior to now.

9)      Daniel’s last shift is Sunday !  He is going to work at Pantex; he will remain prn.   We are glad to have Tony with us in radiology now 😊.    Drew will be going to the cath lab as of 1/1/23 ☹.   There will be several other new faces to look for:  Erin, Amber, Mandi, Rachel, and a new traveler will be here Monday.  

Thanks for all you do !