The healthcare crisis that technology can’t solve – too few hands of care
The ongoing COVID pandemic has pushed nurses, doctors and healthcare providers beyond human capacity, and everyone will pay the price for years to come.
As is tradition (and the easy way out), it’s not unusual for editors in late December to pontificate about prognostications for the New Year. Many times, we write upbeat, hopeful soliloquies that make bold, sometimes crazy, predictions about the year ahead.
And while Health Data Management leans to the hopeful side about what technology can accomplish, that will not be this column.
Instead, I want to take a moment to reflect on a crisis that is likely to beset the industry for years, dragging down performance, jeopardizing patient outcomes, patient care, patient safety and, in worst-case scenarios, could result in massive care delivery issues and countless, unnecessary deaths.
It is a problem that no amount of technology can solve; no number of bricks-and-mortar structures will ameliorate. Artificial intelligence can’t help it, nor can any magical efficiency gains.
It’s this – a beaten down, overburdened, overwhelmed workforce facing an overload of death-dealing sickness that doesn’t have an end in sight.
Nurses, doctors, pulmonology staff, ancillary services and others in the nation’s hospitals have fought COVID for two years now. They’ve donned PPE, trudged through wards of patients gasping for breath, wheezing in isolation, held hands and iPads to the faces of dying patients, and done it over and over and over again.
They’ve gone home, taken off their clothes in isolation and feared even touching their children, breathing into the faces of their partners, for fear of passing the killer on. They cry in parking lots outside their workplaces, and overcome all the emotion to do it again the next day.
The impact on healthcare workers has received renewed attention lately, and for good reason. See this recent report from CNN; this Christmas Eve article from the Los Angeles Times; this November article in The Atlantic; and this late December photo essay on the NPR website.
Healthcare doesn’t have professionals to spare. It’s a workforce that is aging and, while dedicated to patient care, may be questioning continued work in direct patient care. Even before the pandemic, nurses were in demand, According to a 2017 survey by the National Forum of State Nursing Workforce Centers, the average age of registered nurses in the country is 51. Nurses are aging out, with not enough coming in to replace them. The U.S. Bureau of Labor Statistics estimates that the healthcare sector has lost nearly 500,000 workers since February 2020.
Other survey data suggest that nearly one in five healthcare workers have quit their jobs since February 2020, according to Morning Consult, a data intelligence company. A survey by the American Association of Critical Care Nurses found that two-thirds of those specialists have considered quitting because of the strain of the pandemic.
Who can blame these nurses and other healthcare workers? While patient mortality is part and parcel of the direct care career, no one goes into the profession expecting the ongoing carnage of COVID, the unable-to-comprehend tragedy of losing more than 800,000 lives … played out one by one, on your unit, day after day. Real patients, final gasps, flat lines on monitors.
It was nice, early on in the crisis, that healthcare workers were hailed as heroes. They were applauded, with heightened awareness and lauded with free food and other acknowledgements. Now, they labor in relative anonymity, a hellish Ground Hog Day of sickness, aloneness and death. And some face questions, reprisals and attacks from those who question whether the pandemic is a fabrication, in a weird twist of illogical blame-shifting, or demanding treatment with worthless, debunked remedies.
It’s no wonder that post-traumatic stress disorder is now associated with healthcare. If troops who served in Vietnam were cycled out after two years of service, and they still now deal with the after-effects of PTSD, it should be no surprise that the early response to the pandemic and the unrelenting severely sick flood of patients could scar a generation of workers.
And there is only so much capacity in the nation’s healthcare system, especially considering outbreaks occur in metropolitan areas or states, and not evenly over the entire nation. Capacity here is not measured in buildings, beds, respirators or field hospitals. It’s dependent on the hands, intellects and psyches of the humans who do the care. No amount of technology can replace that.
And once that human capacity is exhausted, depleted and compromised, COVID not only consumes its victims. It puts at risk any patient who needs emergency care, or any care – already, concerns are rising that people are missing diagnostic interventions that would normally catch cancer or other diseases in early, treatable stages. And in states where COVID has rampaged – or will rampage in the future – the unthinkable rationing of care to those who might otherwise survive (so-called crisis care standards) exemplify the fragility of the care system today.
This is a threat to the country – a potential implosion of healthcare now, and possible traumatic aftereffects for years to come, affecting the system’s most valuable asset – those who actually do the care of health. Not IT, not nifty computerized beds, not smart IV pumps, not EHRs, but the people.
And there is no unified response to this threat. There is a sizable segment of the population that has dismissed the threat of COVID, unwilling to surrender personal freedoms or to believe in science long enough to doing something to support and care for others. With the rise of the Omicron variant, a range of scenarios could swamp the system even more.
This is not how we’ve managed past national threats. In the face of national risks, there’s been a long history of pulling together, unifying in the face of a threat and overcoming it. Without that mindset, that care of the other – that biblically commanded outward focus – we risk dooming current and future patients to suffer, risk disease, long-term effects and death, and run roughshod over caregivers. That is not my understanding of life, liberty and the pursuit of happiness for everyone, not just to serve personal preferences and whims.
This may offend, but I am tired of the wanton self-focus and unwillingness to be minimally uncomfortable by taking a shot or wearing a mask today, without wider concern for others, for the long-term.
I hunker down in the basement of my house eight hours a day, working in front of a computer screen. That is no hardship. But I ache for those giving their all on the front lines of care; I can’t begin to know their trauma, their tears, their stress, the fatalism that creeps in day after day after day.
For God’s sake – for their sake – think of others. Do something for others. Take a step to care for others. It's time to get vaccinated. We must live together or we will die alone.
Supporting clinical workers through technology and other means will be the focus of the upcoming KLASroom Clinician Experience Series, presented by Health Data Management and KLAS Research, featuring guidance on the combination of technology and soft skills needed to help undergird the industry and reduce other factors causing clinician burnout and exhaustion. Register to stay informed about updates to this program.