Dr. Stephanie Benson, Associate Program Director in Family Medicine is currently completing a master’s degree in palliative care. The post below is part of a reflective essay she wrote several weeks ago for one of her classes during a time when COVID-19 cases and hospitalizations were increasing rapidly in our community. She highlights the work she and others in our program are doing to care for patients and for each other in this very difficult time.
The past two weeks I have had trouble focusing on anything else but COVID-19. Our small five-person palliative care team has been extraordinarily busy given the surge of cases we have seen. I have personally witnessed more death in the past two weeks than I have seen probably in the last five years. We now have two refrigerated trucks sitting outside our moderately sized, about 199 bed, hospital to hold the bodies of the deceased because the morgue and local funeral homes are at capacity. It is all difficult to put into words. I have tried to focus on the small wins. Last week we successfully got five patients home with hospice to pass away peacefully with their families despite needing bipap and/or very high flow O2. Our team has been thanked repeatedly by the intensivists, the hospitalists, the ID doc, and the nursing staff throughout the hospital for our help. It is rewarding, humbling, and terrible all at the same time. I am trying to keep things in perspective and work on maintaining my own wellness while looking out for the wellness on my team. As the leader I feel responsible for their wellbeing. This past week I started having individual members of my team rotate away each day and take a break from the hospital. It was beneficial. I hope to set up some sort of schedule to do this consistently every week. Our local daily case numbers continue to rise, and we know that there is a delay between when case numbers rise and when hospitalizations rise. I am trying to pace myself and be attentive to the long game. I know we are just getting started and there is more to come.
One area of impact I did not realize we would have immediately is on the wellbeing of the nursing staff. The first couple of days we were consistently present on the COVID units it struck me how I could almost hear the staff exhale, like soldiers suddenly getting reinforcements. It did not take long to figure out that the simple act of sharing the burden of talking with patients and families, most of which had fallen to the nurses, was a great relief to them. In addition, intentionally and genuinely asking a member of the staff how they’re holding up, genuinely listening to their answers, and then acknowledging with them the madness around us, has been of more benefit to them than I ever would have expected. The moral injury we all feel has been one of the most difficult things to manage. It is contrary to our morality to tell family of a dying person that they cannot see them or touch them one last time. It is demoralizing to see and hear people I know from the community continue to act irresponsibly and dismiss the seriousness of the situation. I told a friend recently that it is like being in a war zone while others outside dance and sing like nothing is wrong while bombs explode all around us. I have used a great deal of what I have learned from this program in the last couple of weeks and I am certainly better for it. I am comforted by the purpose I feel in the work we do and by helping those who have no hope of recovery pass away peacefully according to their wishes. I wish it were not so many.