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The Difficult Path Ahead: We Hear You and Are Here for You

Frontline workers and healthcare systems around the country are holding their collective breath for what is predicted to be a brutal winter. Escalating COVID-19 positivity rates are likely to be amplified by holiday gatherings and coincide with the influenza season. Recalling that flu season typically strains hospital capacity in a normal year, we understand the burden our members are facing as well as those they anticipate. SCCM released a statement to media imploring the public to rise to the challenge and follow recommended public health measures, such as mask wearing, social distancing, hand hygiene, avoiding large groups, and staying home as much as possible.

Whether your COVID-19 hospitalization rates are surging for the first, second, or third time, stress is part of your daily workflow. As you gird for difficult times, it’s important to celebrate the success you’ve had in managing previous spikes (or your readiness in preparing if you were not previously impacted). The good news is that we now know much more than we did when COVID-19 overwhelmed some of our intensive care units (ICUs) nine months ago. We have a wealth of resources that can help you prepare and refine how you address influxes of patients in existing or novel spaces. Regardless of where you are in the course of preparation or management, please celebrate why you chose a career in healthcare and draw upon that commitment to sustain you through the winter.

Acknowledging Stress

COVID-19 fatigue, the flu, challenged staffing levels, concern about adequate space and equipment, increased work time or burden, self or family infection risk all presage extreme stress during the months ahead. Acknowledge that it will be stressful. But you and your team have weathered this particular storm together months earlier.

In the meantime, we encourage health systems to seriously examine their approach to supporting employees’ mental health. Program offerings such as yoga, meditation, support groups, counseling, and quiet rooms are nice, but health systems must provide necessary support to help people use these services. Even when that support is provided, overworked staff may feel they have no time while engaged at the bedside working to save lives. Advocate for your system to ask staff what they need while at work to lessen the stress and help them do their jobs effectively. It might be dedicated parking, space for coworkers to gather at a social distance to share insights, or additional work stations on wheels. The needs will depend on the system with solutions that are ideally directly solicited from frontline workers.

Clearly, healthcare systems have a lot more work to do to determine how to best care for clinicians and help them avoid burnout. An SCCM presentation, Managing Staff Burnout During a Pandemic, provides some direction and insights for recognizing and mitigating burnout.

Take Advantage of the Resources

Information about COVID-19—including managing staff, equipment, and space—is plentiful. For those experiencing their first wave or who have been through it before but seek updated guidance, SCCM offers numerous COVID-19 resources to address those challenges, including:
  • Resource availability, featuring a tiered staffing strategy that can be employed during the pandemic. Revised slightly based on learnings from the first wave, it appears to work well for most healthcare centers.
  • How to configure the ICU helps address how to enable COVID-19 care in your current ICU as well as how to establish a novel ICU, interface with administrative resources, and care for your newly deployed staff.
  • The self-directed COVID-19: What’s Next course from the first-of-its-kind virtual conference this fall features the latest findings, epidemiologic models, and guidelines from 13 sponsoring societies.
Beyond SCCM’s offerings, explore the many resources available to you online, from your own institution spanning blog posts to social media threads that link clinicians around the globe.

Bring it Back to the Beginning

While you care for others over the coming months, please also care for yourself and those you love. Those same altruistic, selfless, humanitarian motivations that drove you into the field are important to recall and recommit to, now more than ever. And know that SCCM, your coworkers, and many, many members of the public are there for you and grateful for your devotion to our health. While encased in PPE, in the middle of a full ICU, remember that you are not alone. You are part of a global medical community. We are proud of your dedication, courage, and skill. Thank you!

Lewis J. Kaplan, MD, FCCM
SCCM President Lewis J. Kaplan, MD, FACS, FCCP, FCCM, is a general, trauma, and critical care surgeon at the Perelman School of Medicine at the University of Pennsylvania in the Division of Trauma, Surgical Critical Care, and Emergency Surgery and also serves as the section chief of surgical critical care at the Corporal Michael J. Crescenz VA Medical Center. Follow him on Twitter @SCCMPresident


Posted: 11/20/2020 | 0 comments

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