Frontline Heroes: The Role of Healthcare Workers During a Pandemic
All Healthcare Workers Deserve Gratitude and Support
Most people recognize the bravery and compassion of healthcare professionals during any medical emergency. But in times of crisis, they deserve our utmost gratitude and support.
In fact, thousands of healthcare workers have been battling COVID-19 with tremendous courage, ingenuity, and determination. This is a remarkable feat when you consider the magnitude of the ongoing outbreak.
At this point, no one can predict the number of casualties that will result from COVID-19. Early estimates put the mortality rate as high as 3 percent for confirmed cases. (As of April 12, 2020, the number of total confirmed cases of COVID-19 was 1.84 million worldwide and total deaths were 114,090.)
Despite the grim statistics and uncertainty, however, frontline healthcare workers—nurses, medical assistants, EMTs, and other first responders—are valiantly working long hours without adequate supplies or personal protection equipment (PPE), and risking their lives to combat this global threat.
Healthcare Heroes and the Roles They Play During a Pandemic
The global healthcare system has lagged in its ability to effectively respond to novel and highly contagious viruses. However, we are learning and updating protocols for diagnosing, treating, containing, and curing these types of global pandemics.
Furthermore, frontline healthcare workers are expanding their roles and assuming greater responsibilities while fighting this viral epidemic.
Here are a few of the critical roles that have been proposed and implemented.
The Role of Nurses During a Pandemic
A nurse’s role in a pandemic is dramatically expanded and increasingly critical.
Nurses become the most important player in the screening, early diagnosis, and ongoing monitoring of infected patients.
Nurses also assume the vital role of documenting a patient’s status and communicating it to other health officials.
Patients require nebulized medications and intubation, both of which increase the risk of airborne infection to the nurse. Because infection increases the patient’s risk of developing wounds, nurses must increase their vigilance for wound prevention.
To reduce the traffic in and out of rooms, nurses may be required to assume duties of other personnel, such as technologists and housekeeping.
Finally, nurses will be needed to inform patients about the importance of regular flu vaccinations in order to reduce the demand on healthcare services during a pandemic.
In 2015, the American Organization of Nurse Executives (AONE) convened to discuss lessons learned from the Ebola virus disease and other emergencies. They identified skills and behaviors nurse leaders need to effectively manage a crisis. These include providing vision and influence to provide strategic decision making and guidance through all phases of a crisis.
The Role of Medical Assistants During a Pandemic
In a pandemic crisis, Medical Assistants (MAs) may be needed to provide greater assistance and increase their clinical responsibilities as doctors and nurses become overloaded.
As the number of patients surge, MAs may need to perform more of the first stage procedures, including patient education, triage, and patient prep.
Medical Assistants may also be utilized for care services, such as remote physiologic monitoring (RPM) under the supervision of the physician or other qualified healthcare professionals.
The Role of Medical Office Administrators During a Pandemic
Perhaps the most valuable role of Medical Office Administrators (MOAs) during a pandemic is communication.
In addition to canceling and postponing non-critical appointments and procedures, MOAs are relied upon to communicate the status of patients who have tested positive to the appropriate officials. Once they have done so, steps can be taken to track and contain the virus.
MOAs can also help secure adequate medical supplies (PPEs in particular) during an outbreak. These supplies may include masks, gloves, eye protection, sanitizers, isolation gowns, testing kits, medications, and other life-saving equipment.
The Role of EMTs During a Pandemic
In addition to their obligations as medical first responders, EMTs will have greater responsibilities for patient assessment (and reporting) of pandemic-related symptoms and early warning signs.
During an epidemic, EMTs will often require on-going education and just-in-time training on the best practices and treatment protocols. They have to adopt modified protocols for pre-hospital treatment, treat and release, and fatality management based on the latest scientific information.
When transporting patients, EMTs must also increase their coordination efforts with hospitals and local authorities to control overcrowding and supply shortages.
Healthcare Providers Face Unique Challenges During an Outbreak
What is clear is that COVID-19 has posed unique and unprecedented challenges to the healthcare community, even when compared to previous outbreaks and epidemics.
Higher Risk of Infection
Evidence from past epidemics suggests that healthcare workers are at a much higher risk of infection than the general public. During the SARS epidemic of the early 2000s, for example, healthcare workers accounted for one-fifth of infections globally. During the Ebola outbreak, healthcare workers were up to 32 times more likely to become infected than the general population.
COVID-19 has been hard to contain because of its ability to spread by people who are asymptomatic. At the same time, COVID-19 has a reproduction rate of about 2.5 (the number of infections generated by each infected person), compared to the influenza virus rate of just 1.5. This means it can spread further and faster than the regular flu virus.
COVID-19 is also “novel,” or new. This means that no one has an immunity, so it can spread faster among the population. It also means that there are no vaccines or approved medications to treat COVID-19. In the U.S., the Centers for Disease Control (CDC) struggled to provide an adequate supply of COVID-19 test kits early on, which has limited the ability of healthcare workers to identify who actually has the disease.
Higher Risk of Mental and Emotional Stress
Healthcare workers are at heightened risk of mental stress and burnout during any contagion, but we are learning a great deal more about this threat through the current pandemic.
recent study in China found that healthcare workers directly involved in the diagnosis, treatment, and care of patients with COVID-19 were at heightened risk of psychological distress and mental health problems. According to the study, frontline COVID-19 healthcare workers were 52.0% more likely to have depression, 57.0% more likely to have anxiety, and 60.0% more likely to experience distress than non-frontline healthcare workers. They were also three times more likely to have insomnia.
The Shortage of Supplies and Manpower
During any international crisis, healthcare workers can expect shortages. This issue has been particularly evident in recent months.
The ongoing shortage of critical supplies during the COVID-19 pandemic has only intensified the calamity. In addition to masks, gowns, and gloves, health officials report the pandemic could result in shortages of other medical supplies, including saline bags and prescription pain relievers.
The Perseverance & Determination of Healthcare Workers During a Pandemic
Despite the challenges of an overwhelmed healthcare system, lack of adequate personal protection equipment (PPE), and the risk of infection to themselves or loved ones, frontline healthcare workers are overcoming the adversity through bravery, determination, and ingenuity.
Below are valuable insights and inspirational thoughts from some of these exceptional individuals.
Kelly Sites, a Disaster Response Nurse in Northern Italy, gave this report: “The hospital is a 600-bed hospital, and currently they have 500 positive Corona patients. We’re set up in the parking lot with our field hospital respiratory care unit which is a 68-bed hospital. I’ve gone to Ebola and cholera and diphtheria in refugee camps. I’ve been doing this for 10 years. But in 19 deployments, I’ve never left a disaster to go to a disaster. I feel very similar right now to how I felt in Liberia, when there was no treatment and there wasn’t anything much we could do except offer supportive care. And that’s not a great feeling. I feel like the United States is just a few weeks behind where Italy is today. It didn’t take long to get here, and it rapidly escalates. So social distancing is not a hype and it’s not a panic thing, it’s a strategy. What we do radically helps others.”
Stephanie Bandyk, an ICU nurse in Seattle, remains positive: “I’ve been working and taking precautions. I think concern is a natural reaction, but I’m not anxious about it. I set up a clean area at the entrance to my home for me to change in and out of scrubs. I change and shower at work as well. I’m making sure to stay as healthy as I can, so that I can continue to care for others. Some of my colleagues are nervous about working with COVID-19 patients, but a lot of people are just kind of happy to be here and to help out. We still have a lot of smiling faces and jokes and chocolate. I feel like people have been working really well together as a team, and help out where they see others who need help. If I can help somebody, I want to. That’s where I’m at.”
Heidi Flores, an Independent ER Nurse in Los Angeles, said: “This is the hardest thing I’ve ever done. When they do come into the ER, they’re coming in very, very sick and they require a lot of resources. I’ll continue as long as I can because it’s not just me. There’s other nurses doing the same thing and I think they give me strength.”
Emily Fawcett, a Float Nurse in New York, shared her creative idea: “These are really scary times. It’s scary to see the patients come in so sick. So, I think if we start to hear the positive outcomes that we are achieving, and if we hear that the patients are getting better, they’re coming off the ventilators and they are getting sent home, that will give us all a little hope and light that we need right now.”
Emily came up with an idea for staff meetings called “Hope Huddles,” where hospital staff can support each other and celebrate good news. As she stated: “Spreading a little hope is everything to the doctors and nurses right now. You know, we’re really desperately trying to see the light at the end of this tunnel.”
Catherine Fogarty, a Senior Director of Patient Care Services and a co-worker of Emily Fawcett, had this positive thought: “We’ll get through this and we’re going to get through it together.”
