There's been a lot of talk about us being at war with #COVID19 and that is true in many ways, but it is somewhat unfair to healthcare workers. (thread) 1/
@Docbasia @somedocs @aoglasser @afedwardMD @dr_rajgupta @kari_jerge @karenerrichetti
@Docbasia @somedocs @aoglasser @afedwardMD @dr_rajgupta @kari_jerge @karenerrichetti
Military: there is clear command and control that is ALWAYS present. You walk around with rank on your sleeve.
Hospitals: there are silos, departments, employees, faculty, etc. A pandemic command center pops up with the facility manager and ID Doc as leaders.
Not the same. 2/
Hospitals: there are silos, departments, employees, faculty, etc. A pandemic command center pops up with the facility manager and ID Doc as leaders.
Not the same. 2/
Military: we plan and train for crisis regularly. We actually ALL go into a field and act like we are at war.
Hospital: we plan for efficiency and quality. We do not simulate pandemic regularly hospital-wide.
Not the same. 3/
Hospital: we plan for efficiency and quality. We do not simulate pandemic regularly hospital-wide.
Not the same. 3/
Military: we understand that we may die in war. There is a ton of psychology behind that.
Hospital: we do not expect to die at the hospital.
Not the same. 4/
Hospital: we do not expect to die at the hospital.
Not the same. 4/
Military: we do what we are told to do based upon command structure.
Hospital: we want RCT evidence and doctors tend to do things on their own time. (i.e. get N95 fit tested)
Not the same. 5/
Hospital: we want RCT evidence and doctors tend to do things on their own time. (i.e. get N95 fit tested)
Not the same. 5/
War: we deploy for 6-12 months, with an end date.
Pandemic: we do not have time-frame.
Not the same. 6/
Pandemic: we do not have time-frame.
Not the same. 6/
Military: singular code of conduct and everyone fights.
Hospital/Pandemic: multiple types of ethos. Highest risk providers may decide that its not worth working anymore.
Not the same. 7/
Hospital/Pandemic: multiple types of ethos. Highest risk providers may decide that its not worth working anymore.
Not the same. 7/
Military: I served with the mindset that I was protecting my family.
Hospital: I serve with the mindset that I may infect my family.
Not the same. 8/
Hospital: I serve with the mindset that I may infect my family.
Not the same. 8/
Military: we did not say terrible things about our leaders (in public) because we needed esprit de corps
Civilian: we destroy our leaders publicly and divide our hopes of being able to defeat the enemy together.
Not the same. 9/
Civilian: we destroy our leaders publicly and divide our hopes of being able to defeat the enemy together.
Not the same. 9/
So what can we learn:
1. Leaders must lead. Leaders must ALWAYS have a plan for contingencies. No more hoping things don't happen.
2. Regular hospital wide crisis simulations.
10/
1. Leaders must lead. Leaders must ALWAYS have a plan for contingencies. No more hoping things don't happen.
2. Regular hospital wide crisis simulations.
10/
3. We need unity of purpose at all times. Our purpose is to serve the sick. Patients are our purpose.
4. We need PPE without delay so we can survive.
5. We need strict hospital working policies to make sure we are all ready before the crisis.
11/
4. We need PPE without delay so we can survive.
5. We need strict hospital working policies to make sure we are all ready before the crisis.
11/
6. We need a singular code of conduct that does not separate nurses and doctors.
7. We must at all times understand that opinions can destroy esprit de corps. We must have a mindset that #WeAreAllInThisTogether.
7. We must at all times understand that opinions can destroy esprit de corps. We must have a mindset that #WeAreAllInThisTogether.
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