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This week, I joined the front line as a #COVID19-ologist (non-ICU) @NorthwellHealth. Here are a few of my thoughts:
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1. Celebrate the wins.
Yes, there were deaths. But we also successfully discharged home many patients initially admitted with hypoxic respiratory failure, including some in their 70s and 80s with comorbidities.
Yes, there were deaths. But we also successfully discharged home many patients initially admitted with hypoxic respiratory failure, including some in their 70s and 80s with comorbidities.
2. Protocols are evolving on a daily basis.
We’re not sure what meds work, but it does seem like maybe we are getting better at this? I had several patients who participated in clinical trials. Proning (even non-ventilated patients) seems to help, when they can tolerate it.
We’re not sure what meds work, but it does seem like maybe we are getting better at this? I had several patients who participated in clinical trials. Proning (even non-ventilated patients) seems to help, when they can tolerate it.
3. Patients and family members need reassurance that being diagnosed with COVID-19 isn’t a death sentence.
Frequent phone calls with family, and facilitating their calls with their hospitalized loved ones, is a critical part of the job, especially since there is no visitation.
Frequent phone calls with family, and facilitating their calls with their hospitalized loved ones, is a critical part of the job, especially since there is no visitation.
4. It’s fear of the virus, but it’s also fear of the unknown.
My fear subsided a lot once I was busy working and became comfortable with the donning/doffing and my end-of-day decontamination routine. I am fortunate that, unlike many HCWs nationwide, I always had adequate PPE.
My fear subsided a lot once I was busy working and became comfortable with the donning/doffing and my end-of-day decontamination routine. I am fortunate that, unlike many HCWs nationwide, I always had adequate PPE.
5. Working with residents was a highlight of my week.
To say they are rising to the occasion is an understatement. Truly grace (and compassion) under tremendous pressure.
To say they are rising to the occasion is an understatement. Truly grace (and compassion) under tremendous pressure.
6. Watch out for the physical well-being of trainees.
This goes beyond donning/doffing. They need guidance on when it is appropriate to deviate from our norms to mitigate HCW risks, such as by performing more focused PE and not auscultating stable / improving patients.
This goes beyond donning/doffing. They need guidance on when it is appropriate to deviate from our norms to mitigate HCW risks, such as by performing more focused PE and not auscultating stable / improving patients.
7. Watch out for the emotional well-being of trainees.
We started daily rounds with each person sharing how they are feeling and coping (starting with me, to normalize the anxiety). I offered — and later insisted — on taking on tasks to lighten the interns’ loads.
We started daily rounds with each person sharing how they are feeling and coping (starting with me, to normalize the anxiety). I offered — and later insisted — on taking on tasks to lighten the interns’ loads.
