It’s an odd time to be a new physician. One of the best parts about working at a hospital is the sense of friendship and professional camaraderie that you build with other doctors, nurses, therapists, medical assistants, secretaries, etc.
However, in the COVID-19 era, group events, bonding activities, dinners, conferences, social events, and holiday parties are no longer responsible options. This is for a good reason; according to an email leaked to Becker’s Hospital Review, eighteen anesthesiologists at the University of Florida Health tested positive for COVID-19 in July after attending a private party. While I cherish the friendship that I’ve made with my immediate teammates in the foxhole of medical training, my dream of finding literal and figurative closeness has been deferred for the duration of the pandemic.
However, the self-enforced distance between the trainees is just a tiny example of the fault lines appearing in hospitals, institutions, and medical teams, which grow larger as our collective efforts against the pandemic drag on. While the fraying of individual relationships among hospital workers isn’t as immediately evident or emotion-provoking as, say, ventilation or protective equipment shortages, it may portend negative consequences for patient care.
In psychology, “displacement” refers to an unconscious defense mechanism in which feelings toward an object or individual are transferred to another—usually less threatening—target. As the pandemic continues, the hospital workers’ continuing fear and frustrations over COVID-19 are morphing into anger and disgruntlement toward one another. In one memorable case, a nurse accused the junior resident on my team of shirking her responsibility because she wasn’t entering the rooms of COVID-19 patients. What the nurse didn’t know was that this healthy-appearing resident had a serious lung condition, and the medical team had unanimously agreed that she would not see COVID-19 positive patients unless absolutely necessary. Our senior resident escalated the matter, and we received an uneasy apology from the nurse. This wasn’t the first or the last time that I’d seen the fear of COVID-19 morph in at/from/between nurses, technicians, medical assistants, orderlies, and physicians when it comes to the care and treatment of COVID-19 patients. Our dread over COVID-19 spills over into doubts, poisoning our professional relationships.
Just like the discussions occurring in the general population, there is also growing judgment among hospital workers about our personal decisions—such as dining out, going on vacations, and even sending kids back to school—may impact our exposure to COVID-19. The potential consequences of our decisions are amplified by our proximity to other healthcare workers and patients in the hospital. In one instance, two medical assistants—one with kids and the other without—got into a heated argument. One accused the other of being irresponsible for sending her kids back to an in-person school; the other countered that balancing childcare and supporting her family through work had become untenable.
These small but real misgivings between medical personnel will worsen as our fight against COVID-19 rages on, and as we encounter more and more patients who test positive for COVID-19 but are admitted for other, more mundane reasons that still deserve our full attention. Meanwhile, our collective unease continues to gnaw at the foundations of patient care—the interconnected relationships between services, teams, and individuals.
Our simmering dread will not abate until our country gets a better handle over the pandemic. Care providers and institutions must remember that we are in the same boat that we are trying to manage in a broken system and that a bit of understanding and communication will go a long way in addressing tensions before they flare. Meanwhile, our hospital leaders must continue to assess the wellbeing and health of their employees. We owe it to each other and to our patients to overcome our fears and misgivings and to continue to work together as a team.
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