“In the face of a novel virus threat, China clamped down on its citizens. Academics used faulty information to build faulty models. Leaders relied on these faulty models. Dissenting views were suppressed. The media flamed fears and the world panicked.
The current coronavirus disease has been called a once-in-a-century pandemic. But it may also be a once-in-a-century evidence fiasco.”
Two questions: how did we let it go so far? And what can we do to ensure it doesn’t happen again?
How are you, really? This whole Coronavirus experience has been a bit of a shit storm, wouldn’t you agree? I feel like I’m stuck in a Draconian nightmare and I can’t seem to wake up. There is light at the end of the tunnel, so we’ve been told, but I wonder how getting back to normal is going to actually work. Our government has dug us into a hole, I’m not sure I trust them enough to get us out of it. And the longer we put off opening our country, the harder it’s going to be to dig ourselves out.
My head is spinning with so much data and thoughts about things I’ve heard and watched that I truly don’t know where to start, so I guess I’ll just start at the beginning. Please note, these are my thoughts and opinions. These thoughts in no way reflect how the hospital I work for, nor the people I work with, think or feel. This is my experience, it’s unique to me, everyone has their own unique experiences. You are free to disagree, it’s okay. We can agree to disagree. In return, I will work hard to remain fair and objective about this whole situation as the goal of this post is to record my thoughts and experience and to hopefully give you another perspective, or, to perhaps confirm thoughts you have but are too scared to admit out loud.
And isn’t that a sad state of affairs when you are afraid to voice your thoughts for fear of being attacked and ostracized?
Here’s how it began for me: This nightmare for me began the week the doctor I normally work with was on vacation with his family. He was out-of-the country. Two days into his vacation, shit hit the fan. The COVID-19 scare began and since none of us knew what it was or how severe it would be, we all freaked out, myself included. But still, I’m the sort of person who tends to downplay something, to not panic, until facts present themselves and the situation truly turns dire. THEN I would panic. But I would lying if other people’s fears didn’t affect me. What exactly are we dealing with? How serious was this virus? The fact that no one had ever seen anything like this before, and it was HIGHLY contagious, was … concerning.
The hospital responded the moment it became a pandemic. Most of the entrances were shut down leaving two main entrances and the ER open. We had to stop and have our temperatures taken and elective surgeries were shut down. The hospital also published travel restrictions stating that if you had traveled outside the country you had to be quarantined for 14 days either using ETO (which is estimated time off) or unpaid time, regardless of whether you tested positive for the virus.
When the cases exploded in New York, the hospital put up a tent outside of the ER and patients had to be screened for the virus in the tent first before they were allowed into the tent. (That tent is still up, by the way). A local business donated money to the hospital and they built a COVID wing in preparation of COVID patients. To my knowledge, they’ve only had a few patients use the wing, thank God.
(Update: that wing is about half full now and has been consistently half full for a few weeks now).
We all started worrying that the hospital wouldn’t allow our doctor back to work since he traveled out of the country. We were super worried when the hospital starting furloughing employees – they gave us the option of either working from home, if we could, or staying home using ETO or unpaid time. The hospital’s response to all of this was to try and protect the employees, which was actually pretty great – they worked very hard to put employees in other departments in order to try and avoid sending anyone home because let’s face it, who can afford to stay home without pay?
Oh right, millions of non-essential workers, that’s who.
I don’t know how, and it’s really none of my business on the details, but the hospital allowed my doctor to come back to work. Never one to be idle, he and his mid-level started coming up with a plan B because when he returned, we were essentially shut down and not seeing patients – at all. God bless my team because they come up with a plan to keep people working: They suggested Telemedicine.
I have worked for this clinic for almost nine years and we have never, not once, ever considered offering Telemedicine visits. It couldn’t be done, we were told. Our doctors needed to examine the patients to determine if surgery was a viable option for them. But now, given the option of either trying it or doing nothing, my team started really breaking down the details and asking questions on how we could make it happen. We were willing to try anything at this point, anything to keep the lights on.
We were especially motivated because we were hearing stories of entire departments being shut down simply because we weren’t seeing patients outside an emergent situation and we were scared we would be the next department to get the ax. We hurriedly came up with a plan and started using a program that worked, but was sort of clunky. But again, at least we were moving forward and not sitting idle. We then quickly shifted to using Microsoft Teams since it was a program that the hospital had purchased a license for and if it wasn’t for my lovely nurse and an administrator figuring out the details, how it worked and how it should all come together, we probably would have been told to stay home sooner.
Patients were reluctant at first. And setting up the visits was pretty stressful at first, but we have since figured it out and have come up with enough troubleshooting solutions that we have a pretty good handle on it now. However, it was slow going and instead of seeing 40 patients a week, we were seeing about twelve. And not all of the doctors were on board with this option at first. A few of them fought the option and refused to participate which ultimately led to management calling an emergency meeting letting us know that they were going to have to ask all of us to stay home at least one day of the week – we could use ETO or just not be paid.
It was a sobering meeting and one I will not soon forget. We all gathered in the main lobby, all standing six feet apart, of course, looking serious and crestfallen knowing what was coming but not sure how it would logistically pan out. Our director had tears in her eyes when she told us and though it was shocking to hear it was happening, none of us were surprised. We all saw it coming, and honestly, we were more surprised it hadn’t happened sooner.
When this was asked of us, the providers that weren’t on board with Telemedicine were suddenly on board. I think they felt bad for us, quite frankly. Even though it was in no way their fault, I think they felt a bit responsible for us because let’s face it, our jobs are solely dependent on how many patients and surgeries they do.
Fortunately, this new “normal” only lasted two weeks. Since we were one of the last departments to make any staff changes, it happened shortly before the hospital started allowing elective surgeries again, which was the first part of May. In the meantime, patients started being more receptive to the whole Telemedicine thing and we were “seeing” more patients at one time. In fact, in some ways, it’s been working out better than actually seeing patients in the office because it’s allowed us to really focus on the patients that truly need to be seen for various problems. I know my doctor has been getting quite a few surgeries and he’s been very happy with the process so far. And to be fair, I think the patients have been happy with it as well. My doctor has the ability to share his screen with his patients and he’s able to pull up their images and go over them with the patients so the patients can see what is going on with their spines. Our mid-level has thought of creative ways to do exams over web cam and except for being able to do vitals on the patients, honestly, our process hasn’t changed all that much. I mean, it has, but we have just found a new way to treat patients.
As of this post, the tent is still out in front of ER, we are still only seeing patients via Telemedicine but the city and the hospital are getting ready to implement phase 2 of this process starting June 1st, which means we can see a handful of patients in our clinic but everyone has to wear a mask and we have to space the patients out in the waiting rooms and/or put them in an exam room as soon as possible.
Though we’ve been given the green light to do so, my doctor doesn’t want to see patients in the office yet. He would prefer to only still do Telemedicine which … is fine with me, it means I have a job and it keeps the lights on, but it is a lot of extra work on my part to get it set up because it’s not a quick get them on the schedule and be done with it, a two minute phone call turns into ten minutes, then I have to put them on the Teams schedule, then the normal schedule. Then I’m on the phone with them on the day of their appointment for 15 minutes updating their chart and talking them through establishing a connection. Our doctor doesn’t want to start seeing patients in the office until we have a vaccine, but let’s be honest, that could be 18 months from now, or never, quite frankly. I’m sure he’ll cave once he sees his partners allowing patients back in the office. But who knows, I’ve gotten so good going with the flow lately that I’m sure I’ll deal with whatever new challenge is thrown at me next.
Now on to my thoughts about this mess …