I'm Married to an ER Doc in NYC • Hacker News Board

Re: I'm Married to an ER Doc in NYC

#31

Post by skwb » Thu, Jun 11, 2020, 3:31 AM UTC

el_nahual wrote: post #16

throwawaylalala wrote: post #12

Earlier quoted context omitted.

It's actually not easy; not every place has facilities for that. Wife is a nurse, and we went through this discussion of the best process when she was an ICU nurse during the Ebola scare five years ago. Remember too, sometimes folks are on the way to work in their scrubs, not necessarily leaving work.

What "facilities"? We're talking about changing clothes . Shower curtain ought to be enough! And the point about going to work in scrubs is also bad: scrubs should be as much about keeping stuff out of the hospital as in . If a neighborhood yoga studio can provide a place to change, pretty sure any healthcare facility can too.

The argument that's usually given is that changing 2x more per day is too much. I used to work for a research doctor and he would regularly hold meetings in his scrubs with high profile scientists.

Re: I'm Married to an ER Doc in NYC

#32

Post by m4rtink » Thu, Jun 11, 2020, 3:35 AM UTC

dr_ wrote: post #3

Not an ER doc, but a doc in long term care facilities which have been hit particularly hard. Fortunately things have slowed down considerably now, but at its peak it was absolutely nerve racking. There’s an element to this pandemic which many people working in healthcare have felt. We see patients fall sick often, and we see them die often, although this was at an near overwhelming scale. But what we don’t see often…

This is what I thin many forget when they speak against lockdown and for "heard immunity" - that this would not only result in a huge ammount of unnecessary deaths, but also pretty much wear out if not outright kill a signifficant part of medical personel.

It's basically condemning them to working nonstop for months if not years, watching people die all day long & being in infection danger at all times while at work.

And you can't replace all the people that burn out, get ill or die quickly - training medical professionals takes many years.

Re: I'm Married to an ER Doc in NYC

#33

Post by wahern » Thu, Jun 11, 2020, 3:43 AM UTC

el_nahual wrote: post #30

wahern wrote: post #23

Earlier quoted context omitted.

The fact they're worn around so freely should be a hint that they merely look like surgical scrubs, not intended to be used like surgical scrubs. Realistically, I would think scrubs are common because 1) they've become emblematic of healthcare occupations[1] and 2) they're easier to clean and relatively cheap--they protect the wearer from spills and contamination, not the other way around, and in contrast to traditio…

Yes, I know surgeons actually change into sterile scrubs before going into surgery, but even "normal" parts of hospitals are biologically filthy. Even the possibility of bringing MRSA into the outside world should merit a change of clothes.

Clothing is probably the least problematic thing. Every time some nurse or doctor uses a keyboard I want to scream. I regularly see doctors use the keyboard, wash their hands, and then use the keyboard again before beginning an examine. Recently I've started to see plastic covers on the keyboards, as if that mattered relative to the order of touching things.

Realistically, cross-contamination in the hospital is almost certainly far more dangerous and consequential. Hospitals are full of infectious people, afterall, and why MRSA is more common in hospitals than in other environments. I'd rather be treated by a garbage man fresh off his route who's more mindful about what he touches after washing his hands and after touching something possibly contaminated, even if his clothes are filthy.

Re: I'm Married to an ER Doc in NYC

#34

Post by robbiep » Thu, Jun 11, 2020, 3:44 AM UTC

el_nahual wrote: post #9

> When Alex finally gets home, he takes his scrubs off outside our front door and stuffs them into a plastic bag that he ties off tightly. He takes his hospital clogs off and leaves them outside, along with his backpack and coat. Why do doctors and nurses walk around outside in their hospital scrubs? It was unsanitary even before COVID and I just don't get it. How hard can it be to change into street clothes before l…

Outside of theatres the function as a uniform. In operating theatres (most places I’ve worked) if you go outside in theatre scrubs you have to change when you come back in

Re: I'm Married to an ER Doc in NYC

#35

Post by bsder » Thu, Jun 11, 2020, 3:50 AM UTC

klmadfejno wrote: post #2

The way things are described make the doctors sound powerless. I've been frustrated by the lack the information on the usefulness of hospitals. The impression I've gotten is that they cannot do much, and if they would go as far as intubation, you're highly likely to die even with intubation.

> The impression I've gotten is that they cannot do much, and if they would go as far as intubation, you're highly likely to die even with intubation.

Anecdotal evidence seems to be that the doctors are getting better at treating the worst Covid patients. It's still not something you want to get, but it's not quite the death sentence it was.

Apparently, high-flow ventilation is a big improvement over intubation, but until everybody had enough/proper protective equipment it simply wasn't on the table (it aerosolizes the virus).

Which drug cocktails help and how to administer them is also improving.

We're not getting a good treatment until monoclonal antibodies or a vaccine, but were not simply standing still, either.

Re: I'm Married to an ER Doc in NYC

#36

Post by musha68k » Thu, Jun 11, 2020, 3:51 AM UTC

m4rtink wrote: post #32

dr_ wrote: post #3

Not an ER doc, but a doc in long term care facilities which have been hit particularly hard. Fortunately things have slowed down considerably now, but at its peak it was absolutely nerve racking. There’s an element to this pandemic which many people working in healthcare have felt. We see patients fall sick often, and we see them die often, although this was at an near overwhelming scale. But what we don’t see often…

This is what I thin many forget when they speak against lockdown and for "heard immunity" - that this would not only result in a huge ammount of unnecessary deaths, but also pretty much wear out if not outright kill a signifficant part of medical personel. It's basically condemning them to working nonstop for months if not years, watching people die all day long & being in infection danger at all times while at work.…

Completely agree, we have to think of others not ourselves when we diligently put on our masks.

Re: I'm Married to an ER Doc in NYC

#37

Post by bsder » Thu, Jun 11, 2020, 4:01 AM UTC

ketanmaheshwari wrote: post #6

klmadfejno wrote: post #2

The way things are described make the doctors sound powerless. I've been frustrated by the lack the information on the usefulness of hospitals. The impression I've gotten is that they cannot do much, and if they would go as far as intubation, you're highly likely to die even with intubation.

I have never admitted to a hospital in the US but have heard stories of other folks who have been. I just get a feeling that once you are admitted in a hospital nobody has any power including yourself. Everything is taken over by the "system". This is my biggest fear why I would never want to be hospitalized.

> I just get a feeling that once you are admitted in a hospital nobody has any power including yourself. Everything is taken over by the "system". This is my biggest fear why I would never want to be hospitalized.

Well, I was admitted and personally walked out with a gall bladder about to explode. Yeah, I was back in the hospital 24 hours later ... not my finest hour. So, I can absolutely confirm that you can be stubborn and buck the system.

I will absolutely defend your ability to spend time and research your treatment when dealing with doctors normally--especially for chronic conditions. Doctors page fault on every patient and if you are being responsible you may very well be better informed than your general practitioner about what is going on with your body.

However, if you are actually admitted to a hospital with something acute, do you really have the wherewithal to diagnose and manage it? By the time I hit the hospital, I was probably on 72 hours with very little sleep and pain that took hydromorphone to even dent. I guarantee I wasn't thinking clearly by then.

The biggest problem with hospitals is that you need an advocate for you, personally. Without someone in the room with you, you won't know if the nurse missed that medication round, isn't paying attention to your increasing temperature, didn't bring you your lunch, etc.

The problem isn't when the system works. The problem is that without someone else there you don't have someone to watch for if the system hiccups.

Re: I'm Married to an ER Doc in NYC

#38

Post by HarryHirsch » Thu, Jun 11, 2020, 4:01 AM UTC

newacct583 wrote: post #20

joering2 wrote: post #13

Earlier quoted context omitted.

> Fortunately things have slowed down considerably now, I don't get that tho. Supposedly accordingly to all stats, its as bad as its been before. We have 800 to 1,000 death per day and are on record to hit 200k death by September. How come I heard that the pandemic has slowed down yet... according to numbers its been the same.

It's not as bad as it's been. The US new case rate is down to about 65% of peak now. It's not dropping fast, but it's dropping. But a medical professional's subjective experience is local, and the US is a big place. Some regions are still (sigh) growing, and are indeed "as bad as it's been". But New York is now recording new cases at less than 10% of its peak from April. Broadly: much of the country, and all of the w…

It's bad. Try this graph to see how bad it really is: https://ourworldindata.org/grapher/new-covid-cases-per-milli...

New infections per capita in the US are not falling and are an order of magnitude higher than in Western Europe. Israel brought new infections down to a few cases/million until they opened schools back up, now they are in line with Western Europe.

The trouble is that there are superspreading events, someone brings the virus to church or university, and everyone present gets it. There are reports of outbreaks in farmworker accomodation and consequent failures of the vegetable harvest. This isn't over at all and only getting worse when cash-strapped universities insist that their students come back on campus in August.

Re: I'm Married to an ER Doc in NYC

#39

Post by bsder » Thu, Jun 11, 2020, 4:04 AM UTC

nashashmi wrote: post #8

ketanmaheshwari wrote: post #6

Earlier quoted context omitted.

I have never admitted to a hospital in the US but have heard stories of other folks who have been. I just get a feeling that once you are admitted in a hospital nobody has any power including yourself. Everything is taken over by the "system". This is my biggest fear why I would never want to be hospitalized.

It actually benefits you to have a doctor in the family who is there navigating and talking to the doctors. The doctors are more receptive to each other and listen carefully. Otherwise you are just a number. And the doctors won't try so hard on patients who really don't have any understanding of medicine in the first place.

> And the doctors won't try so hard on patients who really don't have any understanding of medicine in the first place.

I have never found this to be the case.

Generally, if I was fighting with a doctor, it was because he was trying to be too aggressive and do too much, not too little.

Re: I'm Married to an ER Doc in NYC

#40

Post by zzzeek » Thu, Jun 11, 2020, 4:11 AM UTC

newacct583 wrote: post #20

joering2 wrote: post #13

Earlier quoted context omitted.

> Fortunately things have slowed down considerably now, I don't get that tho. Supposedly accordingly to all stats, its as bad as its been before. We have 800 to 1,000 death per day and are on record to hit 200k death by September. How come I heard that the pandemic has slowed down yet... according to numbers its been the same.

It's not as bad as it's been. The US new case rate is down to about 65% of peak now. It's not dropping fast, but it's dropping. But a medical professional's subjective experience is local, and the US is a big place. Some regions are still (sigh) growing, and are indeed "as bad as it's been". But New York is now recording new cases at less than 10% of its peak from April. Broadly: much of the country, and all of the w…

this is nowhere near any kind of "home stretch", this is the second inning at best. it is rocketing off in many states now, just not the ones in which it initially took off [1]. it will continue to rocket in various regions of the country, over and over again until a vaccine can be distributed to much of the population or when the government is changed to one that can orchestrate contact tracing, isolation and testing at the national level.

[1] https://www.theguardian.com/world/2020/jun/09/coronavirus-ca...