Joseph F. Berenato
Medical professionals deal with stress
HAMMONTON—For medical professionals, the holiday season is traditionally a challenging time of year. This year, in the midst of the novel coronavirus (COVID-19) pandemic, this time of year is even more difficult.
“It’s definitely a challenge. We certainly feel the stress. I think a lot of us remember what it was like in the spring, and seeing those really sick patients—a lot of whom were from the nursing homes—come in, and, thank goodness, I personally am not seeing that same degree of critical illness, day in and day out. But, we are seeing definitely an influx of suspected COVID-19 and COVID-19-positive patients come in, so that is a stressor,” said Dr. John Keogh, medical director of AtlantiCare Health Park at Hammonton’s satellite emergency department.
Keogh said that the stress is not limited to work, either.
“We feel the COVID-19 stress at home. Our kids are home from school or working from home. It’s definitely a different time, and we feel it at work, too. Everyone is managing it well, but we’re certainly feeling it. We’re just doing our best,” he said.
Chuck Kinslow, a registered nurse at AtlantiCare Urgent Care Hammonton, agreed with Keogh.
“2020, as everyone knows, has been a rough year. We actually had this thing in check in August and September, and I know for myself—I don’t want to speak for anyone else—people just get tired of it. People are tired ... In my 27-year career of emergency services, I never would have ever thought any of this would ever come to pass,” Kinslow said.
However, Kinslow said, such stress comes with the job.
“The last eight months have been long, but this is what we signed up for. We didn’t expect a pandemic, but it’s part of the deal. We deal with whatever comes down the road when it comes down the road. ... As medical professionals, we all gather together and pull it together, and we need to move forward. We need to keep pressing hard and not stopping, because this is when people need us most and this is where we rise to the occasion and step forward. We support each other. We’re family, and we move forward and try to deliver the best care, safely, that we can,” he said.
One of the difficulties, Keogh said, is the omnipresence of personal protective equipment (PPE) and masks. Keogh noted that he dons his mask while still in his car, and does not remove it—except for small breaks to eat or drink—until his shift is over, which has impacted the way in which he interacts with patients.
“A lot of times there’s a good degree of nonverbal communication with patients and their families, so it’s hard sometimes to really display that empathy. I think it’s really critical. Mostly, you only have a very short amount of time in the emergency department to really form a doctor/patient relationship, and part of that is nonverbal communication. When you’re wearing a mask, they can’t see you frown or smile, so it’s harder to convey the empathy with patients,” he said.
Kinslow said that he has faced similar issues when dealing with patients.
“I usually have to tell people that I’m smiling, and when I tell patients that I’m smiling or joking or laughing, they usually say that they know because they can see it in my eyes. Patients tell me all the time ... We have a totally new format of unexpected communication going on with people’s eyes. It’s a whole different road, but we make do,” he said.
Another challenge, Keogh said, is that patients—with few exceptions—are by themselves when they receive treatment.
“They don’t have their loved ones at the bedside. That sometimes is hard, to call them or talk to them over the phone rather than in person. I think that’s been a little bit of a challenge as well, for both patients and the healthcare team. All this is in the interests of keeping staff safe, and keeping patients safe and keeping their families safe, but that doesn’t mean it’s easy,” he said.
However, Keogh said that the staff has been rising to meet that challenge to the best of their ability.
“We’re pretty used to, now, calling patients’ families, and patients and their families have, for the most part, been very understanding. When we first started with these visitor restrictions, I was expecting a lot more pushback from the community, but I haven’t seen that. The vast majority of times, patients are very appreciative of what we’re doing, so I think we’re handling it pretty well. I always try to go out of my way when there’s a difficult diagnosis or something, where I’m like, ‘we’re all trying to bend over backwards. Can I get you an extra blanket? Can I get you water? What can we do to make your stay in the department better?’” he said.
Kinslow said that community reaction has mostly been in favor of such measures.
“We’ve gotten positive feedback from patients that they feel safe ... We keep each other safe. We keep every patient safe. We treat everyone as an individual case because every case is different. We’re still treating all the regular, standard issues and urgent cases that come in. The waiting room is closed, and now the waiting room is your car, which keeps people safe. They call the number on the door, they’re greeted and registered by the CSR (customer service representative) out front and then the nurse triages them on the phone. The nurse then puts the patient on hold and talks to the physician about each individual patient’s concern and plan of care. We’re doing everything we possibly can,” he said.
Personal experience, Keogh said, helps the medical staff be empathetic and sympathetic to patient needs under such measures.
“We’ve all been there on the other side of things, and we know how hard it is in normal times when you can have a loved one with you at the bedside. Imagine how lonely it must feel now to be a patient without your loved one there. We really do try to bend over backwards as much as we can to attenuate that,” Keogh said.
“The bottom line is that it does not change the level of care that people are going to get. It doesn’t change the level of compassion, empathy or service that people are going to receive from us. It does not change a thing. The format may be different, but it doesn’t change the nurse, it doesn’t change the doctor, it doesn’t change the people out front. The care that we’re giving is totally, 100-percent empathetic and loving,” he said.
Thus far, Keogh said that the volume of patients has remained relatively stable during the course of the past few months. There has been an increase in COVID-19 patients, but it has not been an overwhelming rise. However, what has increased is the amount of time in between patients.
“We have to make sure we’re cleaning the rooms appropriately. The length of stay might be up in the emergency department because we have to wear the appropriate personal protective equipment, we have to clean the rooms, and everyone’s finding this, not just the doctors and nurses but also the X-ray techs—they have their cleaning protocols and they have to wear their PPE—so everything takes a little bit longer. We do feel that a little bit,” Keogh said.
Kinslow noted similar issues, but said that he uses that as an opportunity to reassure patients of their safety within the facility.
“I know, because I cleaned the entire room from head to toe prior to them coming in. I tell them that. I tell them on the phone to grab their mask because they’re safe here. I know, because I’m there for that 12 hours, that I cleaned the room from head to toe between patients. They come in with gloves and masks on, and we make sure they keep the masks on, and I reassure them that they’re safe. I just try to offer reassurance that I have done everything in my power to make sure that you’re safe and I’m safe and my staff is safe,” Kinslow said.
Kinslow said that such safety is a daily battle, but one that must continue to be waged.
“Everybody’s tired. Everybody’s sick of this. Everybody’s had enough. I get it, but the only way to see light at the end of the tunnel is to do your daily routine to continue to try to be safe, continue to follow the guidelines, continue to do your part and we’ll get through this. We should do our daily thing to fight this,” he said.
Keogh echoed Kinslow’s sentiments.
“Wear you mask. Wash your hands. Socially distance. Follow the guidelines of the experts; that’s what we try to do. If you need emergent care, we’re here for you 24/7. We can take care of any patient who walks through our doors. That being said, if you have any coronavirus or flu-like symptoms, we encourage you to call your doctor first,” he said.
Keogh also reiterated the importance of seeking care sooner rather than later for any malady or ailment.
“We don’t want anyone to put off care. We’re open 24/7. We’re here and ready to take care of you. It hasn’t been so bad recently, to be honest—in the spring, it was terrible—but any delay is unnecessary. We don’t want anyone to get sicker at home when we are here to help you,” he said.
Keogh offered words of encouragement that he has been sharing with his family.
“The holidays are here. We’re doing things a little differently. It’s definitely a challenge, but there’s a light at the end of the tunnel. If there’s one good thing about 2020, it’s that we’re learning how much more we’re going to appreciate things, how much more we’re going to appreciate the holiday traditions when we can get back to doing them safely. Hang onto that light at the end of the tunnel,” he said.
Kinslow, too, noted the significance of the season, as well as the importance of family—and of spending time with them in a safe manner.
“Family gatherings at the holidays are going to happen. At this point in time, family is pretty much all people have, and you can’t take that from them. You can’t take away family. But, we have to try to have a middle road where you’re going to do the right thing with your family. If you’re going to see your family, you still have to do the six feet, you still have to have respect for the masks; you’ve just got to do the right thing. If we all do the right thing on a daily basis, one day at a time, I know we’re going to come out of this OK,” Kinslow said.