Working in Healthcare During the Pandemic

I have wanted to be an emergency medicine physician for as long as I can remember. I love working with a team to care for patients, and the associated challenges and unpredictability. Some days are quiet, and other days are filled with action, where I need to think and act quickly to help save a patient’s life.

Over the last five months, nearly every aspect of my personal and professional life has changed because of this pandemic. Although we finally have the ability to quickly and reliably diagnose covid-19 infections, many challenges persist. Patients with shortness of breath are coming into the emergency department and they may have covid-19 infections or other conditions like a heart attack, pulmonary emboli (blood clots in the lungs), or an asthma exacerbation. Although many common treatments like nebulized medications and different forms of ventilation can be used, these treatments put healthcare providers at higher risk for contracting this coronavirus. It is a tricky balance to provide the best and appropriate treatment for patients, while minimizing risk to the healthcare workers providing that care. And when my shift is over, I head home to my husband and two children (ages 3 and 5), all too aware that despite taking extra precautions (always wearing personal protective equipment (PPE), changing into clean scrubs after a shift, keeping all work supplies in my car trunk, showering when I get home), I may have made a small mistake with my PPE or been unlucky, and accidentally brought this infection home.

 

I am very thankful for my thoughtful colleagues and adaptable hospital system, as we've created new workflows that allow us to provide high quality care in a safe environment. We now have cohorted respiratory care areas, one within the emergency department and one utilizing tents in our ambulance bay, where we can diagnose and treat patients, all the while keeping other patients and our staff as safe as possible. Other colleagues have built devices that allow us to intubate patients more safely by reducing the number of aerosolized viral particles in a patient’s room. And when one of our first critically-ill covid-19 patients had recovered after a long hospital admission, we celebrated his discharge together while playing the song “I Will Survive.” Practicing medicine has been and continues to be a team effort.

It is heartwarming and uplifting to feel supported by so many in our community. Students sent cards, meals were provided, and people used their 3-D printers to make PPE. With so many positive efforts directed towards those of us in healthcare, I see how powerful and effective our collective efforts can be. But this pandemic has also highlighted for me some of the injustices and disparities that exist for people of color within medicine. Most of the patients who I have diagnosed and admitted with covid-19 infections are people of color. Most of the patients who are currently in our intensive care unit are people of color. And studies have confirmed this trend: people of color disproportionately become ill with covid-19 infections and disproportionately die. This sad reality is just one example of why we need sustained, systemic, and impactful change within healthcare and within our society at large. It is past time that these racial injustices be addressed, so that we can make real and lasting change. We are all part of the solution and I am committed to learning more, helping to create better, more just systems, and continuing this journey throughout my career and life.

 

And lastly, for advice—find a balance that affords you some socialization with family and/or friends, but minimizes your collective risks. Help your older family members and neighbors with shopping and/or errands. Hand washing, masks, and limiting your social contacts will go a long way towards keeping you and your family safe. This will also minimize the pandemic’s impact on our healthcare system, so resources remain available for all patients when they become ill. Although this is going to be a long haul and it is hard to know what the post-covid world will look like, I am hopeful that we will get there eventually and be a stronger, more resilient, and better community when we do.

Cheryl Lynn Horton CdeP 2000, MD