It is one thing to take care of patients who you know have COVID-19, but it's another thing to take care of a patient who you have no idea has it. The latter happened to me recently. We'd been seeing the patient for a newly diagnosed cancer. His cancer and his symptoms had nothing to do with COVID-19 yet days later we find out he in fact has it, and was asymptomatic (had no symptoms).
Now thankfully, before this, the hospital had already instituted a policy that every healthcare professional would wear a mask and protective eyewear in every patient’s room. They later expanded the rule to say that everyone would wear them in the hospital period, whether you were in a room with a patient or not. I've been doing my best to protect myself during this time but I'm so thankful for the extra measure put in place. Ordinarily, you don't wear personal protective equipment (PPE) in every room, only the ones where it is necessary. These aren't ordinary times.
This patient started running a fever, but this was not alarming. The type of cancer he had is sometimes associated with fever. I found out he tested positive the day after I'd seen him and had spent between 20-30 minutes with him. I'd examined him thoroughly and explained a few details about his cancer.
My first thought was oh no, this can't be happening. Then I reminded myself that I'd taken all of the precautions available to me. However, I've read about cases of healthcare professionals getting COVID-19 despite wearing PPE. Rationally, I knew that I was at a low risk of exposure per the CDC exposure chart, but irrationally I couldn't fathom the thought of exposing my family to anything.
As much as I love my career as a nurse practitioner and the patients I serve, I do not want to risk the health of my family. I love them the most. I considered a lot of things. Maybe I could quarantine myself in my bedroom when I was home. That wouldn't work because I'd still have to walk through the house having come home from work to get back and forth to the bedroom. I considered going to a hotel, but was that really necessary? My husband even joked around about camping in the back yard. We ultimately decided these actions were overkill, but that does not keep me from praying often that I do no harm to my family inadvertently.
From this situation, I learned a few things. Don't have false security that someone doesn't have COVID-19 just because that's not what they are in the hospital for. Treat everyone as though they have COVID-19 in addition to whatever else is going on with them. This means making sure I wear PPE basically all day, especially in the hospital. I am also wearing a mask with every patient in the clinic too. My priorities are two-fold; taking care of my patients and taking care of myself. Taking care of myself means taking care of my family.
For those who are not healthcare providers, you too should be more cautious. You should only be out in public when necessary. Assume everyone could be COVID-19 positive if that will motivate you to stay home or shelter in place. When you are out, it is ok to wear home-made masks. Visit the CDC website for a tutorial and specifications. Reserve medical-grade masks including N-95 masks for healthcare professionals. Once your mask is in place, try not to touch it or your face until you are ready to take it off and wash your hands. As we find out more and more about this virus, we have learned that the virus droplets can live longer in the air than suspected.
If you are going to wear gloves, be sure to take them off and dispose of them properly. Do not touch multiple surfaces with the same pair of gloves and then touch your personal belongings and your face. Doing this would potentially spread germs and/or infection.
Stay away from environments where you cannot maintain at least a 6 feet distance. Wash your hands often and thoroughly for at least 20 seconds. Do your part to keep yourself and your family safe. Find ways to keep yourself encouraged. Though we are living through a pandemic, it does not have to be pandemonium.
For more information visit www.cdc.gov.
What have you learned during this time? Who can you call if you need some encouragement? Are you doing all you can to stay healthy?