Health Care Providers are stressed….and it’s not what you think

I would like to thank everyone who has reached out to to health care providers and expressed their gratitude for our work. The sidewalk in front of the hospital is full of chalk messages of encouragement that we see when we walk into work each day. But unless you are a physician in a current “hot spot” such as New York City or New Orleans, the rest of us are spending our time waiting. Waiting for the anticipated surge of patients that most of us have not seen happen as of yet and hope that won’t happen. The anxiety involved in the wait can be worse than being in the battle.

In preparation for the possibility of a marked increase in cases, our clinic doors have been closed to the majority of patient visits. This is not only to decrease the risk to patients of sitting in a crowded waiting room, but also to decrease the risk of transmission to health care providers as well as to conserve the supply of personal protective equipment (PPE).

Although the financial focus has been on the layoffs in the hospitality industry, health care workers are being laid off in unprecedented numbers. Numerous ambulatory clinics have made the difficult decision over the past weeks to furlough a large contingent of their employees. If there are not patients coming in our doors to generate revenue, we cannot continue to pay the majority of employee salaries. Many of the staff that I work with are not only co-workers but also friends. Some have more resources than others. As a small business, we need to make sure that the business is there and viable when this is over, so that we are able to rehire our employees. Hospitals have asked nurses and operating room personnel to take paid time off as operating room schedules have moved to emergency only cases. Physicians are taking enormous pay cuts of 50% or more.

This list of stresses could go on and on but here are just a few more that I have heard over the past few weeks.

  1. Family members that work in health care. The majority of us, physicians, nurses, respiratory therapists, love our jobs and have passed that on to our children. Many of them have followed us into the profession of caring for others. My oldest son is an RN on the Covid rule-out floor in Vegas. My sister is an RN in a cardiac cath lab where emergency procedures are the norm and there is no time to ask a patient questions about Covid symptoms.
  2. As medical professionals, we are often the source of factual knowledge for our friends and family members. Now many of us are being asked questions about hoax-type cures, unproven theories about the origin of the virus and when this will end. My best advice is to follow whatever Dr Fauci says. He has been thru this before with other epidemics and speaks truth to power.
  3. The realization that many of us will probably become infected. Despite best practices, 10-20% of health care providers in China and Italy have been infected. The percentages in Singapore and Hong Kong were much lower as they had better access to PPE and fewer patients. That is why it is so important that Americans follow the simple rules of social distancing, handwashing and keeping your hands away from your face. The less of you that are in need of care, the lower the percentage of health care workers that will be infected. It will also give us time to improve our supply of PPE.
  4. The lack of leadership from the top of our country. Rather than implementing uniform best practices determined by a scientific, medical committee that has access to the latest world-wide information, we are forced to make up our own policies with the information that we can glean from our colleagues in the hardest hit areas. These policies often differ from hospital to hospital and create angst among employees as to what is most correct. While our colleages in Seattle and New York are taxed with caring for massive numbers of patients, they are also trying to disseminate what they have learned so that they rest of us are better armed for the battle.
  5. The realization that Americans will forget what science has tried to teach us. I continue to have pregnant patients refuse the flu vaccine (despite its demonstrable efficacy) so I can imagine that many Americans will refuse the Covid 19 vaccine in the future. This pandemic has demonstrated that co-morbidities such as diabetes, hypertension and obesity, can put a person more at risk than advanced age. Maybe the need to stay at home, go for walks to relieve boredom and cook real food will give Americans an incentive to consider further beneficial lifestyle changes in the future.

Thank you again for your thoughts and words of encouragement. Just realize that our stressors are some of the same as yours…but also different.