COVID-19 marks an unprecedented global pandemic that has forever altered how we practice medicine. Medical school did not and could not prepare me for our new emergency room reality amidst coronavirus. Many frontline healthcare workers are unsettled, scared, exhausted and overwhelmed, including myself. Without a doubt, the novel coronavirus pandemic has thrust us into a new, unfamiliar world, making it difficult to focus on anything outside of what will happen to our families, communities, homes, careers and hospitals.
The biggest difference may be in how we are forced to interact with each other—especially in medical situations—as COVID-19 increasingly makes a visit to the emergency room a possibility for many people around the world. How do I, an emergency room physician, build trust when I’m covered from head to toe? Personal Protective Equipment (PPE) is a coat of armor, but it creates a physical barrier between myself and my patient, which can result in patient hostility, suspicion and skepticism.
Lack Of Touch Is An Emergency
Some might argue that humanity is unrecognizable in the absence of touch; yet, in today’s emergency rooms, doctors are expected to create a sensory bond and connection without it. Touch is nonverbal communication that allows us to display empathy in a way that words often struggle to convey. It also contains several health benefits for our physiological and psychological well-being, including reducing stress and increasing a sense of security and trust.
This is why the absence of touch makes it that much more difficult to show empathy for our patients. There is a heightened sense of patient anxiety and distrust when patients are forced to communicate with a doctor or nurse they can barely see.
A visit to the emergency room is generally one that very few ever forget. It stays with patients—etched in their memories as either a really comforting and positive experience in terms of staff care, or a terribly traumatic moment marked by awful bedside manner, slow response times and an overall lack of concern. Through my compassion and patience, I have learned how to engage patients while disarming them to create an opportunity for connection. My goal is to provide quality, meaningful care.
Technology’s Presence In The ER
During a time when COVID-19 has shifted human interaction—touching creates apprehension and hugging is a sin—we’ve become more creative to allow families to stay connected during emergency department visits. Innovative uses of smartphones and tablets not only speaks to the power of technology, but more importantly, the impact of human connectivity. For example, I use my personal cell phone to call a loved one on a patient’s behalf, allowing family to have one last look at the patient before intubation, or being taken to the COVID unit to share lab results. Several hospitals have been crowdsourcing to raise funds to purchase iPads or tablets for patient rooms, so they may say goodbye to their loved ones and not die alone. Often, this is the last moment that families have together before their loved one transitions.
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It’s Not Just COVID
Even though we are in the midst of COVID-19, life continues. People still get sick from other illnesses. I have been faced with many tough decisions over the last two months. For example, we recently had an elderly lady with metastatic breast cancer who had difficulty breathing at home. Enroute to the hospital, she died in her daughter’s car. Due to COVID-19, her daughter was not allowed to come into the ER while we tried to revive her; instead, she had to wait in the car. Imagine the anxiety and pain she must have felt knowing that her mother was just a few yards away clinging to life, and she couldn’t be by her side to hold her hand, talk to her or pray over her. Typically, if a family is present during a code, we would bring them into the room while we are actively working to revive the patient. We suggest that they talk to the patient, rub their feet, or say a prayer for him or her. These seemingly small actions bring closure to a patient’s passing for the family and my hospital staff.
Clinicians are now embracing virtual health, or telehealth, as an integrated delivery approach to replace treating patients in-person. Virtual health is augmenting and supplementing providers to improve the delivery of care—moving from a focus on bedside manner and physical evaluation, to web evaluations where patients are expected to participate in administering their own physical exams under the guidance of a physician. Women are delivering their children alone without their family or partner. Elderly people are forced to attend doctor visits through telehealth if they are able to navigate that process. Patients are scared and they are looking to us, the healthcare professionals, for reassurance, support, clarity, faith and protection.
Who Cares For The Doctors?
There is increasing evidence that suggests that the impact of coronavirus on physicians’ mental health is critically important to monitor and respond to. Undoubtedly, the recent passing of Dr. Lorna Breen, the emergency medicine physician who treated COVID-19 patients in New York, forces us to acknowledge and accept that healthcare providers are not emotionally immune to the virus. Dr. Breen’s family suggests that the highly-trained, seemingly well-balanced doctor committed suicide because she just couldn’t handle the enormity of COVID-related deaths at her hospital. Ultimately, it is our responsibility to care for each other in this work by creating healthy boundaries and standing in the gaps, so we can survive this pandemic and train the next generation of healthcare professionals to be better prepared than we were.
Dr. Safiya Lyn is an Emergency Medicine physician who practices in South Florida. Entrepreneur, author and professor, Lyn is a leading advocate in the medical marijuana industry. Her company Ask Doctor Lyn provides a platform for her to educate patients on the benefits of cannabis treatment. To learn more, visit www.askdoctorlyn.com and follow @askdoctorlyn on Instagram, Facebook and YouTube.