The Long-Term Effect of the COVID Crisis on the Medical Profession

Damn. Sitting here at around 5 am (as I do most days) reading news stories about hospitals, emergency rooms, ICUs, and clinics around the country, I can’t help but wonder about what this ongoing crisis is doing to the medical personnel who are on the front lines and what the impact on them individually and collectively will be in the long run.

I don’t have to cite examples of the trauma these professionals are facing-- y’all read the stories, too. People dying alone, begging for the vaccine at the last minute when it’s way too late, taking too long to die when someone else needs the bed and the ventilator. Now in New Orleans, having to pump the black bag manually during power outages.

The pandemic has stressed everyone is their own particular way, especially people who have lost loved ones, but dear God, what medical personnel are enduring is like combat surgery in slo-mo but with less hope. In war or natural disaster people need medical care due to circumstances and events largely outside their own control. One does not blame the patient. This is different. Doctors, etc., are swimming upstream against the flood of unvaccinated patients who are pouring into hospitals due to their own stupidity and resistance to science.

How do you even stay in the profession of doctor, nurse, nurse practitioner, PA, EMT, etc., after all this? The trauma and PTSD are going to be with these people forever IMHO. Thoughts?

I was just talking with my son-in-law about this very subject. He’s an MD. For him, the timing of COVID-19 couldn’t have been better.

He worked hard through college, then medical school, then interning and residency. In normal times he would still have tons of supervision, but thanks to the pandemic he’s been forced to do far more than he’d have to sans Covid.

He’s actually happy. He’s young, energetic, at his peak, doing what he’s wanted to do for some time now. Compare him with his wife (my daughter). She’s been a nurse for awhile now, supporting her fiancé/husband. She’s totally sick of people. People suck. Several times she’s come close to quitting. Currently she’s part of a group of nurses threatening to walk off the job unless their coworkers are forced to vaccinate. They’re pissed off!!

I would think that PTSD has to be a bigger and bigger issue in a profession that has increased risk and stress.

Don’t forget there are more than enough doctors, nurses, NPs, PAs, EMTs etc that are also [proudly] unvaccinated due to their own stupidity and resistance to science. We see this every day with hospital workers protesting if their employers are requiring the vaccine. (private/incognito window will get you around the paywall) I’m sure they’re as burned out as the rest, but I have a hard time feeling bad for them when they’re directly contributing to the problem. It’s like being frustrated that you can’t stop scratching a mosquito bite while refusing to use the benadryl that’s right next to you. And more so, I don’t just ‘not feel bad’ for them. I say, fuck em, they can get fired. Yes, they were certainly last year’s heros, but they’re this years super spreaders. There’s plenty of other medical staff that are looking for jobs and will be happy to get vaccinated and take their jobs. Not that it has to be said again, but your freedom of [whatever] doesn’t apply to your continued employment. If your job requires you to get vaccinated you have two choices, neither of which are ‘don’t get vaccinated and keep my job’.
Also, it doesn’t help that that’s my go to hospital. I’ve had surgeries done there, I’ve been to the urgent care there, I have doctors that work out of the pro building there. As a patient, I’m not sure I want to be cut open by someone that might not be vaccinated or have an unnvaccinated urgent care nurse looking at my kid’s sore throat.

There’s a youtuber I love, Annie Onishi, that does a lot of videos for Wired. She’s a doctor in an Los Angeles ICU. Most of her videos had been commenting on how (un)realistic medical portrayals in TV and movies are. Wired actually has a whole series of these types of videos with professionals from a wide variety of fields do this. In any case, a few weeks ago I ran across this video of hers, where she does a video diary of 10 weeks of her life in the hospital dealing with Covid. What’s almost haunting about it is that the 10 weeks starts on March 18th, 2020. Essentially the day when most of the country admitted that we’re kinda fucked, but well before it got really bad.
In her first video, the first stat she puts up is from 3/23/20. LA County has 284 daily cases and 4 deaths. In a follow up video, which I haven’t yet watched, the first stat she puts up from July 8th, 2000 is 3000+ daily cases and 30+ daily deaths.
Even having not yet watched the follow up video, the first one still shows a huge progression from her not really having any cases and offering her services to hospitals in New York to the wave finally starting to roll into the west coast. It’s almost surreal thinking back to 18 months ago when New York was talking about having bodies stacked up in hallways while rest of the country was still dismissing it as ‘the flu’.

That complements what I was saying about how I have no problem getting rid of medical staff that refuses to vaccinate because there are plenty of people ready to take their jobs, enthusiastically so. Plus for them (and most people) getting the shot isn’t something that they’d even think twice about doing.

But yeah, PTSD, or just getting burned out in general, I think is going to be a huge problem. While a lot of people thrive in these situations and are all too happy to be in the middle of it, a lot I think, are going to start evaluating their options for retiring early or, if they’re not old enough yet, maybe getting out of the hospital settings and into private practices, especially specialists where dealing with covid patients isn’t a thing.

I’m pretty burnt out, far far more than I was before covid. I deal with covid stuff every single workday. I plan to retire in 12-15 months. That’s how I’ll cope. I’m fortunate to have that option. And I just have to deal with the covid patients as outpatients. My hospital based colleagues are really fried.

Except that this “mosquito bite” is contagious and potentially fatal.

I think of you often. Saw a headline somewhere recently that predicted that the covid shit (as it were) is really going to hit the fan in prisons very soon.

I included all the medical personnel I could think of in my OP, but now having had coffee, I want to clarify that I didn’t mean to slight anyone by leaving them out. Respiratory techs especially, and other direct patient care people. And those slightly removed (but not much) hospital staff, cleaners, social workers, administrators, even chaplains–they are also drowning in the swamp.

Sadly it already has in many, which is the scary thing. Any additional surges are just piling it higher and deeper as Delta infiltrates facilities that somehow managed to evade the first waves. It’s particularly concerning that as of a month ago less than 50% of prison staff seem to have been vaccinated. Hopefully those numbers are improving, but that’s a little worse than the U.S. population as a whole even back in July. Which ain’t great.

We’re approaching 80% vaccination status for the inmates in my institution, and about 72% for all inmates in our state prison system. I’m hoping that helps blunt the onslaught when it comes. Last summer we got hit so very, very hard, with 80% of my patients testing positive in just over 6 weeks. Some were in the hospital and infirmary for months, miraculously one died (well, 2 but 1 was resuscitated onsite and made a good recovery).

Our state just started offering $100 to individuals getting their first covid vaccination, that helped make over 1/3 of our previous vaccine refusers agree to get their first shot, at least.

But when Delta gets inside the fence (and it will), it’ll spread thru the population readily, I know. Including hitting staff. We still require masks here but it’s hard to enforce 24/7/365.

Don’t get me started on unvaccinated staff.

That’s a good policy which I’d really like to see used more broadly (and to be fair it does seem to be increasing). At least some anti-vaxx resistance seems to be reflexive and not terribly deep. And bribery has a proven track record :expressionless:. The “hell, I’ll do it for 100 bucks” crowd (or $200 or $500) is not to be dismissed.

That’s what my family member the psychiatrist thinks will likely happen. S/he is snowed under now trying to treat his/her share of colleagues from the first waves without going under him/herself, so say nothing of being able to keep up with treating the civilians who still need as much care as ever. It’s a deluge and the aftermath will be even more ugly.

Hey, those numbers are really good. Nice job! Looks like the inmates have more sense than many.

Being inmates, they might not be getting as much freedom to be dumbshits as the unincarcerated public.

My daughter just started her last semester of nursing school. She was told that her clinicals will (not ‘might’) expose her to COVID-19. Fortunately, she is fully vaxxed, and strongly supports the vaccines, but is really concerned about being exposed to vaccine-refusers while doing her job. I worry about the burn-out scenario, but I believe there are many options for new nurses within the different specialties, so hopefully she will land in an area that she likes. We’ll see.

I do know of one person who recently completed nursing school and passed the test to become an RN, but has been very reluctant to pursue jobs in the profession, due to COVID fears. I don’t know what you do with that one.

Or they actually have to sit there and see real suffering first hand 24/7/365 with no time off for stupid behavior. And possibly suffer real time consequences for being perchieved as getting somebody else sick.

They are literally a captive audiance.

Oh, man. I’m picturing one of the early seasons of Walking Dead where they had taken refuge in an abandoned prison. They had to patrol the fence every few hours, patching holes and skewering zombies with a length of sharpened rebar – not that I’m suggesting you follow suit.

One complaint I hear from nurses is that hospitals are willing to pay $100+ an hour for traveling nurses, but they aren’t willing to staff the hospital properly with staff nurses who would make closer to $35/hr.

I don’t know if that’ll change, but hospital administrators seem dead set on understaffing their nurses, which is causing massive burnout, turnover and people leaving the field.

Don’t know if there are any health care administrators on the Dope, but they are some of the most head-up-your-ass people out there. Nursing administration is some of the worst anywhere, and is usually run by people who haven’t worked at the bedside in decades, if they ever did.

The reason they like temps is because they don’t have to worry about health insurance, pensions, and other benefits, and a surprising number are not native English speakers (often Filipina) and can be treated/abused in ways that native-English speaking nurses can’t be. BTW, this isn’t limited to the States, either. I have a FBF who is a hospital nurse in Winnipeg, mostly in the ICU but she sometimes works in med/surg, and her hospital is doing exactly the same thing.

Kind of makes you long for the days before most of the nurses’ unions were busted, doesn’t it?

I would guess if you take a job with a specialist, unrelated to respiratory or acute illnesses, your exposure to covid will be about the same as the general public. That is, if you work in an ER or with a GP or in a pulmonary department, you’re going to end up exposed to people that came there because they have covid and it’s advanced to the point where they need help. If you work for an orthopedic surgeon or eye doctor, the percentage of people you interact with that have it is probably pretty similar to the cashier at the grocery store.

COVID-related issues are part of almost every therapy session I conduct these days. I now take half-hour breaks between most clients and meditate before sessions with the 20% of my caseload that won’t vaccinate.