Don't be a hero

I don’t know what it’s like for you, but it’s grim at my shop. A few weeks ago, we had 22 staff sick with COVID-19. We ran short of nurses even pre-pandemic, but now the ones who shouldered the burden during the earlier pandemic were wiped out. Good nurses leave for other sites, stay home on parental leave, or retire and don’t come back. Plus, I hear about nurses who’ve left health care entirely for construction work or trucking, and who can blame them? This outbreak cut through the entire hospital. Housekeeping had at least 40% attrition, so everyone else has to clean more, which burns out the few left standing. Pharmacy got knocked out, so who’s going to check the meds? Someone “off-site,” which means more work for nurses to fax and check those papers, doctors wasting their time manually ordering meds, our EMR protesting, more phone calls for me, etc. Secretaries are now absent or brand-spanking new, which means the phone rings but no one answers, paperwork’s not done, consults aren’t put in, patients get the wrong message (one patient was promised a short wait, which led to the person rushing to the desk and bellowing, “I’m supposed to get my X-ray at 1 o’clock!”) . . . everything grinds to a halt. Read: Feeling burned out, Doctor? Go north and get on the river. And now the sixth wave hit the MDs. On Wednesday, I got this phone call: “Can you come work today? And tomorrow?” I was already working Good Friday. “And we need Sunday day and night.” Our shifts are 10 to 15 hours and sometimes 24-hours-long. They aren’t something you can or should pick up on a whim. Everyone I know is shell-shocked by how much extra work has bludgeoned us. Because it’s not only COVID-19. It’s one doctor getting incapacitated for a different reason, and another one grieving a close family member—on top of a never-ending pandemic. The early waves mostly missed us, but now threaten to swamp our tiny site containing few personnel and scant resources. What’s a doctor “supposed” to do? Pitch in! Never say no! Work to the bone as a doctor-nurse-RT-lab-pharmacist-OT-PT-housekeeping-secretary combo! Sleep when you’re dead! Rah rah rah! But we are all exhausted and overworked already. This is like trying to hide from the zombies for two years, running for the past three months, and just when you think you’ve finally managed to find a spot to breathe, “chomp, chomp, chomp.” Last week I took an extra shift so they wouldn’t have to close the hospital, but this week, I told them the truth: I’m going out of town now. I’m coming back on Tuesday to work 24/7 x 7 days on the inpatient ward. I can’t take any more work on. We came very close to closing our hospital. Read: I'm fed up, and I can't take it anymore! Somehow, the other doctors rallied and managed to patch something together. But I have been told that if we do have to close the emergency department, the hospitalist has to sleep in-house in case any of the inpatients crash or someone drives to the hospital in extremis. That could be me in 72 hours, for the next 168 hours, before I go back for another shift in the ER. It probably won’t be. That would require not filling any ER shifts that week. But if it happens, I’m left holding the bag. If I end up holding that bag, I’m supposed to chant, “It doesn’t matter. It’s a privilege to be a doctor. I’m paid well for this. It’s great! I love it!” Watch out. In my mostly-American EM MD group, they describe how corporations have taken over medicine. Corporations cut hours when ER volumes dipped in early COVID-19 and refuse to staff adequately now that volumes are surging. Doctors have to look after more and more potentially unstable and unobserved patients because it helps the corp’s bottom line. Doctors will be held medically and financially responsible for the resulting death and disability. “Prestige is most dangerous for the ambitious. If you want to make ambitious people waste their time on errands, bait the hook with prestige,” wrote Paul Graham. Right now, if you want to make ambitious people waste their lives, bait the hook with a medical degree. Yes, we all still love the intellectual challenge, the emotional and financial rewards of medicine, but we are allowed to have a life. Don’t be a hero or heroine. Or do it for a while, but don’t do it forever. Live. Read: A broken March Break x 3

Don't be a hero

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The ‘L’ Word

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Blog Author

Dr. Melissa Yuan-Innes

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