Time passed at snail’s pace for most patients in the Intensive Care Unit, accompanied only by the doctors and nurses attempting to spread their care and compassion through as many people as possible in a profession accustomed to providing much more one-to-one emphasis. Some occupied intensive care beds for 50 days or more, which were assisted by mechanical ventilators.
For physicians working in intensive care, the weeks and months since the pandemic began have been relentless and harsh. This remarkable time is a period from which lessons must be learned, and rapidly, for the future of the service, its employees, and patients, particularly in the complexity of this new disease and any possible further peaks.
The first problem at hand is that not only are workers drained, but they may be mourning and feel bereaved that they have experienced a surge of intense trauma during the crisis.
The exhaustion of physicians on the front line after this relentless period is also a major issue, though, especially with potential future waves of COVID-19 hanging in the balance and also the possible increase in demand related to patients staying away from or not being able to receive medical care during the pandemic.
When the pandemic first struck, doctors and all other healthcare workers did their utmost to maintain services while coping with many critically ill patients with COVID-19 and were also exposed to a very unknown level of risk, particularly in the early weeks with all the questions about PPE, the combination of huge workload and very large numbers of very unwell patients.
The most critical thing organizations can and must do is listen to their employees and the associations that represent them because physicians and other healthcare professionals are concerned with many aspects that would be different locally. Flexibility in carrying over annual leave and fair dialogue on how doctors who have done a great deal of shop-floor, hands-on, clinical work are given time to do their SPA work for reassessment and reappraisal.
A big challenge that exists today is sustainability. What is very obvious is that the effort put in is not sustainable and can only be done for brief periods of time, and to do so, it is necessary that protocols are put in place to allow workers to heal.
In a working healthcare system, the pandemic has demonstrated the value of critical care and is a service that often runs at 90% capacity. It’s insufficient to meet demands often in normal times when you operate at that level of capability, let alone when a pandemic fully brings things into a different region.
There may be some real positives to take from the pandemic, but if nothing else, the defining conclusion must certainly be the importance of intensive care unit which is well-resourced, adequately staffed, and valued.