Temporary entrance in front of New York hospital during COVID-19 pandemic.

Institutional Reforms Needed to Strengthen Health Care Post-Pandemic

By Marissa Wagner Mery

COVID-19 has highlighted that pandemic preparedness and management requires a strong, well-functioning health system.

Shoring up the health system and its workforce should be a national priority post-pandemic. First and foremost, we must recognize that the greatest asset of the health system is its people, and the system must reflect this. Second, our hospital-based, competition-driven health care landscape should be reformed to better meet the needs of our communities.

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DUQUE DE CAXIAS,(BRAZIL),MAY,20,2020: doctors take care of patients with covid-19 and an intensive care unit (ICU) at hospital são josé specialized in the treatment of covid-19.

From Pain to Progress: Nursing After the Pandemic

By Victoria L. Tiase and William M. Sage

America’s nurses are a powerful force for good — four million strong, universally trusted, increasingly diverse, serving every community across the country, with an overall economic impact greater than the total output of the median American state. However, the pain of pandemic nursing is real and widespread. Urgent attention to nursing’s vulnerabilities is required for the profession to help the U.S. emerge from the confluence of the worst public health crisis in over a century and the most severe economic decline since the Great Depression.

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hospital equipment

How COVID-19 Has Widened the Experience-Complexity Gap in Nursing

By Julie Miller

I am a Clinical Practice Specialist for the American Association of Critical Care Nurses (AACN), and I have noticed the experience-complexity gap widening during the pandemic. As increasing numbers of nurses retire due to the stress of serving on the front lines, novice nurses are tasked with complex caseloads.

Hospital-based educators tell me they do not have enough experienced nurses to oversee and mentor the novice nurses due to attrition, as experienced nurses are taking advantage of high paying travel contracts, or are leaving the ICU/PCU specialty due to burnout, moral injury, and post-traumatic stress.

Post-pandemic, the experience-complexity gap for progressive and critical care nurses will continue to widen and affect intensive care unit (ICU) and progressive care unit (PCU) orientation and ongoing education.

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Sisaket,Thailand,09 April 2019;Medical staff wearing face shield and medical mask for protect coronavirus covid-19 virus in CT scan room,Sisaket province,Thailand,ASIA.

The Future of Acute and Critical Care Nursing

By Sarah A. Delgado

We need to change the future for nurses. Even before the pandemic, nurses suffered high rates of burnout and a disproportionate risk of suicide. But the pandemic could be a tipping point that leads many nurses to change careers, leave their jobs, or retire early.

Moral distress, the consequence of feeling constrained from taking ethical action, was well-documented before the pandemic, particularly among critical care nurses providing end-of-life care. Additional research conducted before 2020 demonstrates that nurses were experiencing post-traumatic stress due to the suffering they witnessed and the demands of their work.

During the pandemic, surges in critically ill patients have led to untenable workloads. The distress of end-of-life care is heightened by restrictions on visitation and increased mortality rates. In addition, shortages of basic personal protective equipment contribute to fear and a sense of betrayal.

While the pre-pandemic state of the nursing profession was concerning, the pandemic creates imminent peril.

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DUQUE DE CAXIAS,(BRAZIL),MAY,20,2020: doctors take care of patients with covid-19.

The Future of Medicine Post-COVID: Not a Healthy Outlook for Women

By Laura Dean, Valerie Dobiesz, and Peter Chai

During the COVID-19 pandemic, women health care providers have not only put their health at risk, but also suffered disproportionate professional consequences.

Women comprise 70% of the global and 76% of the US health care workforce, and data from the U.S. Centers for Disease Control (CDC) suggest that nearly three-quarters of the COVID-19 cases among health care workers are women. Additionally, pregnant health care workers suffer greater morbidity and mortality from COVID-19, face uncertain risk from medications and vaccines due to exclusion from clinical trials, and experience significant psychological and medical risk managing pregnancy amidst an uncertain pandemic. Returning to work in an era where limited and ill-fitting personal protective equipment (PPE) is available and risk of infection is uncertain is especially challenging to new and lactating mothers seeking to advance their careers in academic medicine.

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Medical staff work in the Intensive Care Unit (ICU) for COVID-19 patients in University Hospital of Liege in Belgium on May 5th, 2020.

Pandemic Highlights Need for Better Redeployment Planning

By Cory Hoeferlin

In the midst of an unprecedented public health crisis, physicians in all specialties want to assist their frontline colleagues.

Yet after being removed from critical care environments for countless years, many are no longer comfortable when lives hang in the balance.

Putting aside the impending physician-shortage for a moment, a key issue laid bare by the COVID-19 pandemic is not workforce capacity, but capability.

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Doctor Holding Cell Phone. Cell phones and other kinds of mobile devices and communications technologies are of increasing importance in the delivery of health care. Photographer Daniel Sone.

Providing Cancer Care in the Age of COVID-19

By Samyukta Mullangi, Johnetta Blakeley, and Stephen Schleicher

The COVID-19 pandemic has brought many challenges to oncology care; an area of medicine that typically involves frequent, in-person patient visits to complete a course of treatment.

In many ways, COVID-19 has served as a stress test for the specialty, and has catalyzed adaptive changes that we hope will make the oncology care, and the health care system in general, more resilient going forward.

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New York City, New York / USA - May 2 2020: New York City healthcare workers during coronavirus outbreak in America.

Pandemic Threatens Future of Emergency Medical Services

By Benjamin Podsiadlo

The COVID-19 pandemic has posed persistent, wide-ranging existential threats to effective 911 emergency response.

The EMS (Emergency Medical Services) system, which sits at the intersection of emergency medicine and public safety, is the out-of-hospital component of the acute care health care system. The EMS mission is targeted at identifying, responding, assessing, treating, and entering suddenly ill and injured patients in the community into the health care system.

The EMS system’s viability is entirely dependent upon the capacity of its workforce of EMTs, paramedics, and 911 EMS telecommunicators to respond 24/7/365.

The devastating impacts of the COVID-19 pandemic on EMS include: severe damage to workforce sustainability; grossly insufficient logistical resourcing; and further erosion of cohesive system identity.

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Healthcare workers carrying signs protest for improved Covid-19 testing and workplace safety policies outside of UCLA Medical Center in Los Angeles,Dec. 9, 2020.

Beyond 20/20: The Post-COVID Future of Health Care

By Cynthia Orofo

There are two experiences I will never forget as a nurse: the first time I had to withdraw care from a patient and the first day working on a COVID ICU.

Both were unforgiving reminders that the ICU is a demanding place of work that will stress you in every way. But the latter experience was unique for a few particular reasons. Before the end of that first shift, I had overheard several staff members on the floor speak about their fears, thoughts of the unknown, and their version of the “new normal.” As I realized that life would almost certainly not be the same, I developed my own vision of the “new normal” of health care.

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