We have been the last resort for mental health and dental care; we have routinely asked nurses, doctors and techs to work overtime during swells of trauma patients or influenza; we have tolerated threats and violence against our co-workers in the name of providing care. Across the country, emergency departments, intensive care units and ambulance services are overwhelmed. According to data from the Department of Health and Human Services, almost 80 percent of inpatient beds and 83 percent of intensive care unit beds are being used; other data sources suggest that these estimates do not fully account for staffing limitations and that even fewer staffed beds are available. And a couple dozen more patients have been waiting on emergency department stretchers for hours after evaluation, until an intensive care unit, medical or surgical bed becomes available. And they’re big-picture things, like making sure that people can access care when and where they need it, and that our testing infrastructure, telehealth system and home-care network are intact. As our health-care system is pummeled by yet another wave, it’s just too much. But even more, it’s the moral harm from the other cases, the ones that have nothing to do with covid except that they’ve been overtaken by the pandemic.
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But I know there will be another one – probably another coronavirus variant, but possibly something else. So yes, I will celebrate like everyone else when the omicron wave passes. We never recovered from the last wave. At no point have we stopped to take stock of how we survived the last wave, much less what’s needed to withstand another one. 1. Just because an insurance company was too expensive last year, doesn’t mean they will be this year. Of course, a comprehensive policy will be much more expensive, given that all involved, including you, will now be covered. It’s certainly because of the exhaustion of caring for horribly sick covid patients yet again – especially now that the disease is so preventable. Do I jump off now or hope that someone saves us? That patient waits in a bed that could be used for someone with chest pain that might be a blood clot, belly pain that might be appendicitis, or a broken arm that needs pain meds. Instead, I’m scanning the waiting room list to try to find the needle in the haystack – someone with a life-threatening illness that we haven’t identified yet. By the time the patients make it to me, I’m playing catch-up on their pain, their illness and their frustration.
The system sometimes worked against me, most often because a patient lacked the right insurance to get the tests and treatments they needed. Emergency departments and hospitals have worked on a thin edge for a decade. We already have answers on how to fix and rebuild. Two years ago, I hoped the pandemic would help us marshal resources and political will to finally fix this system. At the very least, all those delayed surgeries, postponed preventive-care visits and untreated mental health problems are going to show up, and patients will need care that is simply not there. My colleagues and I will keep showing up for work. I think about what needs to be done today to make sure they’re safe – and what needs to be done tomorrow, or in a month, to keep them from coming back. “I just don’t think I can go back again tomorrow,” one friend texted me after a particularly demoralizing shift.