This has been a very difficult year. COVID-19 has rampaged the country, worked hospitals to their breaking point, torn families apart, and kept families apart. The grief seems never-ending.
At the beginning of 2020, we watched in horror at the destruction in Wuhan, China, and Italy. We could not fathom what was happening over there, with mandatory quarantines, over-filled hospitals, freezer trucks, and body bags because of insurmountable casualties. Global air travel became restricted. Cruise lines came to a halt. And then COVID-19 made its way into the U.S. What we had seen on television, from YouTube videos and news articles from across the world, became a reality — something we thought would never happen here.
Words and phrases like “wear a mask,” “social-distancing,” and “stay at home” became the norm. Perhaps the most tragic of all the consequences of this virus has been the no-visitor policy at hospitals.
Most hospitals have instituted a strict no-visitor inpatient policy, applying to many outpatient clinics as well. The rationale behind these policies is to protect all parties, minimizing person capacity in these enclosed areas; as we know, this virus is mainly person-to-person spread via respiratory droplets. Depending on individual hospital policy, typically, patients in the emergency department can be allowed one visitor. If they were transported via an ambulance, no visitors are allowed if any aerosolizing procedures are being done (i.e., CPR). This is to protect both the health care workers and family members.
Once a patient is admitted to a floor, there is a strict no-visitor policy unless it is a parent/guardian for a patient who is a minor, support for a patient in labor, or end-of-life/goals-of-care meeting. Aside from that, we have Zoom calls, FaceTime, Skype calls, and phone calls if the service is offered. Even when calls are arranged, technical and logistical difficulties can make these calls near impossible.
It is scary enough for a patient to have an urgent condition that requires hospitalization. It is even scarier when you have to go through that process alone in an unfamiliar environment, let alone if a patient has a disability, does not have the means to use a personal cell phone, does not speak English, and on and on. The number of times I have seen patients struggle because they do not have a cell phone, do not know how to operate one, cannot reach an outlet to charge their phone because they are bedridden, cannot speak due to a breathing tube, are innumerable.
Families often wait every second of every day for an update from the medical team regarding their family member in the hospital.
Typically, they should expect a phone call once a day regarding overall updates, but even that can be scarce when hospital staff is stretched then, with staff being sick, on quarantine, or overworked. Whether those additional calls are made between patients and their families depends on their department, staffing available, and local policies on who facilitates those calls. Nurses are often quite busy going from patient-to-patient, taking care of timely nursing orders and all other staff have their own responsibilities.
But everyone has had to lean into their compassion at times, sparing whatever time they may have or not have, to facilitate some of this communication between patients and their families.
My heart hurts for every family who has to go through a family member being hospitalized amidst this pandemic. I can’t imagine how frightening and emotionally taxing it must be to wait for updates on their loved ones, with uncertainty if additional communication can be arranged by way of video or phone calls with staff assistance.
As a medical student, I can attest to the joy of families on the other line when I call regarding patient updates, taking the time to explain a condition, lab finding, or share with the family some progress that their loved one has made.
While delivering bad news is difficult, families still nevertheless appreciate the time spent explaining the situation to easily understand and have a clear picture of what is going on. It has been my privilege as a student-doctor to take care of patients, be present, listen to them, hear their concerns, encourage their spirit, and connect them to their families.
I think it is important to ask the question, “What can I do for you?” to each and every patient, as well as family members, when applicable.
This helps identify pertinent needs and can help prioritize patient care. At times, it may be something completely unrelated to medical care, be it paperwork, nursing services, phone calls, getting a patient water, a warm blanket. However, all of this is encapsulated under “practicing good medicine.”
Medicine is not all about prescribing the right medications and getting to a definitive diagnosis and treatment for a patient. It is about taking care of all of a patient’s needs and connecting them to the right providers and services if you do not have access to the appropriate resources. This is of utter importance with changes that have resulted from COVID-19 precautions.
Before the pandemic, there would always a be a family member by a patient’s side, being the eyes and ears of the patient in terms of listening to all the doctors as they round. They knew what medications have been given and when and keeping track of everything that may be too much to handle for a patient.
Doctors and specialists used to speak to both a patient and family member when in a patient room; now it is just with the patient with maybe a family member on speakerphone, and the family receives a summary of all that has been said and done in a day at a later point in time.
Overall, I believe that this generation of student-doctors is being trained under the most extenuating of circumstances, and we will be better prepared to serve our patients, knowing how the smallest of gestures can shift the paradigm on how we approach patient care.
There are things that I and many others have seen, stark realities, that cannot be unseen. Tears shed for unnecessary sacrifices and dilemmas. What drives me to push forward in the face of this unrelenting virus is for a better day, where families can once again be with one another, laugh and rejoice with one another, and grieve with one another, together.
Until then, we must continue this fight, social distancing with due diligence, wearing masks, and fighting the greater fight for a brighter future.
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