Health Care in the Time of the Coronavirus

BY SPENCER MILLER, RN

I've been offered an RN job at the California Corrections Center in Stockton. Part of the on-boarding process is a physical. I went online to schedule an appointment with my doctor, but the online system has been taken down. When I called, I was triaged to the back of the line (appropriately). How about a telephone appointment? Great! I'll take it. After sending over the many forms, the doctor called me and said the nature of the questions (a rectal exam...of all things!) means I have to come to the office. So, I waited a month to get an in-person exam.

triage patients as possible to decrease clumping.

The National Guard has set up a 250-bed facility at the San Jose Convention Center for less sick patients that can’t quarantine at home. They will accept patients from local hospitals and will staff the facility themselves.

So, how are local nurses reacting? As you might expect to avoid direct patient contact. The primary role of nursing is to be an advocate for the patient, the family, the group, and the community. Everyone wants to help within their capacity.

Santa Clara County is not waiting for instructions from the Federal Government. We’ve been sheltering in place since March 17th. The roads

When I arrived at the medical building in San Jose, there were two tables set up manned by personnel in full PPE—gown, gloves, mask, booties, and face shield. After having my temperature taken with a wand, I was passed through. An embarrassing half hour later I had my paperwork

So, how are local nurses reacting? As you might expect there is some trepidation. However, the ones I’ve spoken to are eager to participate in the emergency response.

in hand, certified free from tuberculosis, inguinal hernias, and hemorrhoids.

After this I decided to call some of my nurse friends and take the temperature, as it were, of this new method of health care. Here's what I found out about what's going on in Santa Clara County.

First of all, I was lucky to get an appointment at all. Santa Clara Valley Medical Center is closing most of its primary care centers per its mass casualty plan. The county is going on an emergency footing. Ambulatory clinics in Sunnyvale, Milpitas, Downtown, and East Valley are all closing except for emergency dental, adult, and pediatric urgent care. The county is using the term Influenza Like Illness (ILI) to describe potential coronavirus cases. East Valley Clinic will be open for nonILI phone consults and urgent care. The Downtown Clinic will accept ILI patients at its urgent care and will have a drive-through testing center. The Gilroy Clinic will be open as usual.

Clinic nurses are all going into the labor pool. They are looking for any nurse with ICU experience even if it’s years old. Nurses with ICU experience will be assigned to ICU teams with experienced nurses. Depending on where the nurse worked before the emergency, they might get assigned to something similar but no guarantees. The choices are Skilled Nursing Facilities, Homeless Centers, Emergency Room, and Tent Rapid Medical Exam Centers. Rapid Medical Exam is basically triage with a doctor or PA/NP that can right away prescribe medicine and discharge or admit the patient as appropriate. The goal is to move as quickly through the there is some trepidation. However, the ones I've spoken to are eager to participate in the emergency response. One of my friends is a 58-yearold charge nurse at a primary care clinic that is closing. She’s already gathering her emergency go-bag with extra scrubs, snacks, water, and toiletries just in case. Most of her experience is in ER so she’s ready to get back in the mix, though she admits she hopes it doesn’t last too long.

Another nurse is sad that she will have to sit it out. She has underlying lung disease and two small children at home. She will try for a phone bank job, but failing that, will have are devoid of traffic and people keep a respectful distance from each other at the supermarket. Safeway has installed sneeze guards in front of the cashiers. In a thousand little ways, we

In a thousand little ways, we are working to flatten the curve of this pandemic and nurses are stepping up.

are working to flatten the curve of this pandemic and nurses are stepping up. We are always at the bleeding edge of medical emergencies and this is no different.