Dr. Richard E. Besser is president and chief executive of the Robert Wood Johnson Foundation in Princeton, New Jersey, and previously the chief health and medical editor at ABC News. In a recent analysis posted by the network, he applies a career filled with facing numerous health crises in making an important and astute observation: “We enter crises ill-equipped to handle them and we exit crises by quickly forgetting our promises to learn from past mistakes. Two years into this (COVID) scourge, not enough has been done to prevent the next pandemic from playing out like this one or address how — pandemic or not — every day is needlessly a health emergency for far too many people.”
He is not alone in delivering such professional insight. Gerry Wright is a professor of biochemistry and biomedical sciences at McMaster University in Canada. In a post on TheConversation.com in March, he makes a similar observation. “For most of human history, infectious diseases have been the leading cause of death,” he writes. “One thing is certain: COVID-19 will not be the last challenge of our time, and even while we are striving to tame the current pandemic, we need to prepare for the next challenge, using evidence and knowledge … What we should have learned over the last few decades, however, is that our control over infection is illusory and that we remain vulnerable.”
While it may seem now like the worst days are behind us, there is no assurance that a pandemic endpoint looms ahead. Yet spring has sprung, restrictions have eased up and we naturally are looking for some sliver of hope on the horizon. It is natural and important to our mental well-being — but we need help and guidance, and sometimes, professional support in moving past it all. We need our front-line health care providers, maybe as never before. The thing is, as I pointed out last week, they may now need us as never before. Not as patients but as support.
Nancy A. Jones is a neuroscience intensive care unit nurse manager at NYU Langone Health with 36 years of experience. She has worked on the front line of such crises as the terrorist attacks of 9/11 and Hurricane Sandy. “Nothing has been as challenging to the nursing profession as the pandemic,” Jones said in a recent interview with Lisette Hilton of Nurse.com.
As a result, many nurses are experiencing mental health challenges. “During the early months of the pandemic, about 27% of nurses at New York City hospitals reported anxiety, and 17% reported depression, according to a study of nearly 2,500 nurses surveyed from May through July 2020,” Hilton writes.
“Researchers have reported that a lack of preparedness or readiness is a major concern among nurses during times of crisis,” says Christine T. Kovner, a Mathey Mezey professor of geriatric nursing at NYU Rory Meyers College of Nursing.
“Nurses surveyed about their care of Ebola patients in the U.S. listed lack of preparedness/readiness as one of their top concerns,” reports Hilton.
NPR recently reported on one nurse’s death and how it has triggered further alarm by his colleagues about the current mental health crisis within the profession. “Most nurses and other frontline health workers worked relentlessly over the past two years, surge after surge, through countless deaths and severe staffing shortages,” says reporter Rhitu Chatterjee. “And now, a majority are struggling with psychiatric symptoms, research finds. Mental health care providers worry that they will soon see a wave of associated problems, like substance abuse and suicide risk.”
While the investigation into the death of popular 27-year-old nurse Michael Odell is “still ongoing,” NPR reports that “the evidence points to suicide.” This tragic loss of a valued colleague has now galvanized friends and other nurses to call for change in their industry. “They want to see more support for their colleagues dealing with the emotional fallout from the pandemic — people who for two years have put in grueling hours together fighting a brutal virus,” says Chatterjee. Among their demands is for “a less stressful, more supportive work environment with better access to mental health care, and a culture where it’s ok to ask for help.”
“But they’re worried that change won’t come fast enough. So they’re taking things into their own hands by being more open about their own mental health and creating a way for nurses in crisis to get support from their peers,” Chatterjee writes.
Many of the current problems are institutional and started long before the current pandemic.
Gretchen Morgenson is a Pulitzer Prize-winning senior financial reporter for NBC’s News Investigative Unit. In a recent network investigative report, she revealed that regulatory filings and internal documents show that today, “an estimated 40-plus percent of the country’s hospital emergency departments are overseen by for-profit health care staffing companies owned by private equity firms,” which aim “to increase their profits quickly so they can resell them at gains in a few years.”
According to Richard M. Scheffler, a professor of health economics and public policy at the University of California, Berkeley, there’s a reason private equity firms have invested in companies staffing hospital emergency departments. “The money in the hospital is in the ER,” he said. “It is the biggest net generator and a huge profit center for almost all hospitals.” The problem is, “ER doctors are being told how to practice medicine” by financial managers.
“When some doctors have questioned the practices, they have been let go. Physicians who remain employed see that speaking out can put their careers on the line,” reports Morgenson.
Says Dr. Robert McNamara, the chairman of emergency medicine at Temple University’s Lewis Katz School of Medicine in Philadelphia and the chief medical officer of the American Academy of Emergency Medicine Physician Group, “Putting the profit motive in between the patient and the physician can lead to untoward consequences in terms of care.”
While 33 states have laws preventing nonphysicians from influencing clinical decisions, “enforcement of the laws has been spotty in recent years,” says Morgenson.