There is no question that the pandemic has stressed our hospitals, doctors, and nurses. Despite it all, our providers have continued to take care of us, sacrificing their own health, time with their families, and all too often, contracting Covid, and even dying.
The COVID pandemic has forced both providers and, therefore, hospitals to focus on the sickest patients, in the beginning of the crisis, typically those with Covid. Lately however, our caregivers have had to make choices to treat a patient with Covid vs. those with cancer complications. And it has caused great anxiety for those caregivers as well as burn-out. There was recently an article in the LA Times written by a physician describing the difference in her mindset when the pandemic began to one year later, after we knew how serious it was, and after immunizations were available. In the beginning, she had great compassion for anyone who developed Covid, and now, all she feels is anger, particularly at having to treat those who refused a vaccine, is now putting others at risk, and continuing to tax the overburdened system as well as expose others to the virus.
Anyone who has fallen ill during this time with an illness other than COVID has known the difficulty and challenges with our medical system. Whether it is waiting for a hospital bed or pushing medical procedure months in the future, many people have experienced such difficulty. While we may never know the exact number, it has been estimated that upwards of millions of elective procedures were cancelled due to Covid, and many people (myself included) postponed or missed screening visits or testing.
As the system has been stressed in so many ways, it’s essential to know how to handle difficult situations. Recently, I was advising a client who has been caring for her elderly Mother. She is suffering from a myriad of health care issues, many severe as well as debilitating pain.
Based on her Mom’s blood work as well as severe shortness of breath it was determined that she would benefit and feel better with a blood transfusion. The home health nurse recommended that she go to the ER, however, they were concerned about the wait, as well as taking up a bed in an already busy ER. We contacted an infusion center affiliated in the hospital, however, she could not be seen there, as she was unable to walk unassisted (one of the caveats for being treated in the out-patient infusion clinic.)
My client also explored an at-home infusion service, but it wasn’t feasible due to the risks of potential complications with a transfusion. In the end, the only option was the ER.
She asked the Nurse Practitioner to call ahead, so the ER knew they were coming. Fortunately, as they were there very early in the morning, and the nurse knew they were coming, so she was taken back almost immediately. Three nurses were getting her Mother into a hospital gown and bed when the ER Doctor came into the room and asked why they were there. My client answered that her Mother needed a blood transfusion, and they didn’t want any other tests done as she was receiving treatment for many different issues at home with a Home Health team. The goal was to get her the needed blood for palliative care and take her home once the transfusion was completed. The doctor immediately became angry and responded “That is NOT emergency medicine. And that is not how I run my Emergency Room. Who told you to come here? She does not belong here! You are going to tie up this room for hours!”
My client left him to speak without interruption and then agreed with him. “You’re right. I wanted to take her to the infusion center at this hospital.”
“That’s where she belongs for a transfusion.”
“They wouldn’t take her unless she could walk in unassisted. Another hospital infusion center had a two-week wait for a chair. Would you like to speak with our Home Health Nurse Practitioner or her boss?”
She said it was at this point that the doctor changed his demeanor and apologized. He noted that COVID had strained the medical system beyond belief. He appreciated the fact she explored other places to take her and said that while her Mom didn’t belong in the ER for the transfusion, he understood that she had no other option. He turned to the nurse and authorized her to provide her Mom with anything that could make her more comfortable—pain meds, food, or drinks. He checked back with them twice while they were there and said he talked to the Home Health NP about how Mom was doing.
Lesson learned: The pandemic has strained our health care system in many ways. Our doctors and nurses are dedicated to keeping us healthy but are bearing the brunt. After all, they never received the mandate to: “shelter at home.” They have worked through the worst of it. If you find yourself at odds with a doctor, nurse, or even a receptionist at a doctor’s office, stay calm, state your problem, do your homework, ask questions, and do your part to get the outcome you need. And always thank them—COVID has tested them in ways most can only imagine.
