Rebuilding the U.S. health care workforce during and after Covid-19 – Boston, Massachusetts

Boston, Massachusetts 2021-10-18 04:45:12 –

NSI am an emergency medical doctor, responsible for emergency management, and participated in disaster and humanitarian response in areas such as Sri Lanka after the Indian Ocean earthquake and tsunami, and Haiti during the AIDS epidemic. After that, I often experienced a “re-entry” — a disjointed feeling of returning to the places and activities I left behind. I never expected to re-enter my country from working at my hospital in Northern California, but that’s what I feel today.

I know from experience that re-entry often feels like assault. Disaster relief personnel can experience harsh and unpredictable environments, witness horrific sights, and experience personal deprivation. Return home It can be as jarring as relief. Responders often have unforgettable memories, feel significantly changed, and are prone to culture shock and post-traumatic stress.

This is what many have estimated 22 million healthcare workers Currently, the United States has been facing the Covid-19 pandemic for nearly two years. Due to the country’s ongoing pandemic response and long-term health, American healthcare professionals need to urgently work on how effectively they can re-enter what is clearly new and normal.


Emergency managers consider disasters to have four phases: mitigation, preparation, response, and recovery. Mitigation and preparation represent careful planning, established relationships, and guidelines developed before a disaster. The response phase is characterized by quick thinking and action in the event of a disaster.

The recovery phase, which involves normal operations and transitions to normal duties, is very complex, but often a poorly evaluated part of the cycle. Recovery is the process of negotiating short-term needs and long-term goals, balancing the goals of reducing future vulnerabilities with the desire to return to normal.


It is during the recovery phase that individuals and countries begin to truly understand the specific losses of disasters and their hidden costs.

It is a mistake to consider the four phases as linear because even if the response phase is in progress, short-term and long-term recovery must be initiated. Due to the length, breadth, and speed of recovery phase changes, disaster responders tend to recover even in the context of an ongoing response.

The Covid-19 pandemic has brought unprecedented challenges and changes to everyone. For healthcare professionals, it has begun to deploy seemingly endless disaster response. In the early months, doctors, nurses, respiratory therapists, paramedics, hospital food service workers, and others suffered from fear, isolation, and a lack of personal protective equipment and other equipment. They fought the double anxiety of treating this nasty and potentially deadly new illness, worried about taking it home to their families.

The next few months were about physical, mental, and moral fatigue. Patients in tents, patients in corridors, and the whole family were lined up in cars for examinations and sitting in chairs connected to oxygen tubes. One day I spent eight hours under a pop-up tent and treated the patient with an ice pack around my neck when the temperature rose to 108 degrees Celsius. Then it was midwinter and it seemed impossible to treat more patients, but they still came. After that, I often felt empty due to the endless onslaught and experienced the same burnout and compassionate fatigue that so many frontline responders felt during the Covid pandemic.

Relief crew There is a risk of mental health problems After the disaster.. The risk is even higher if the deployment is prolonged, if rescue workers experience the risk of personal harm, and if the responder identifies the victim as a neighbor or community. This is all the factors that healthcare professionals have experienced during the Covid-19 pandemic.

inside that “Tips for Disaster Response Supervisors” Factsheets, the U.S. Substance Abuse and Mental Health Services Department, may experience relentless malaise, sarcasm, dissatisfaction with daily work, easily triggered emotions, and difficulties with colleagues and bosses. Describes a variety of reactions. Some responders get stuck at this stage — they continue to experience terrible stress and may show symptoms of disorientation, anxiety, and despair.

The United States is currently in a complex recovery phase, and Americans are just beginning to fight the moral and psychological fallout of pandemics.Experienced by many exhausted clinicians Subrogation trauma, Anxiety and depression, Moral anger, And even when the country is facing the fourth wave of the surprisingly infectious variant Covid-19, compassionate fatigue, and patients who refuse to prevent illness and save lives.

How do healthcare professionals heal? How do they find the resilience to lean back on? It can begin with Americans acknowledging the exciting work of healthcare professionals and the sacrifices they have suffered from pandemics through this transformational experience. It continues with open conversations between healthcare professionals and their communities about the impact of post-disaster trauma and the creation of safe spaces for clinicians to share, reflect and handle.

Post-disaster social support on the part of the relief team community and employers is essential for successful reintegration. Healthcare organizations can address care barriers by normalizing the need for mental and emotional health support. Evidence-based tools needed for clinicians to rebuild themselves, such as practicing self-compassion, participating in peer support, and deliberately doing sleep, nutrition, movement, and connecting with others. Must be provided. Finally, the country must listen to healthcare professionals and provide the respect, compassion, and support they have provided to patients and communities at this special time in our history.

Most healthcare professionals experience some form of re-entry during the pandemic recovery phase. As a society, we are all responsible for health care workers and their recovery. Because they expect us to take responsibility.

Mary Meyer is an emergency physician and regional medical director for emergency management at the Permanente Medical Group in Kaiser Permanente, Northern California.

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