Tuesday 17 November 2020

Moral Injury

The frantic scenes in Bergamo [oasis of calm R] during the First Wave are beginning to fade from front-and-centre. In those first assaults of Covid-19, hospitals and ICUs were overwhelmed by an inrush of sick and very sick people each of whom demanded attention from health-care professionals HCPs. Those doctors and nurses found themselves having to triage time, treatment and equipment because each of those were finite. Now we're in the Second Wave and the health service is better fixed for dealing with it but not sustainably. Time passes fast if you can see the end. The front-line workers can keep calm and carry on if they believe in The Vaccine a miracle. But esprit de corps helps: loyalty to your work-mates. Word on MeFi Street says that HCPs are finding it hard to square the triangle of patient-care, self-care and family-care without systemic support from management. Which requires less busy-work, fewer hours, better sleep, better support, better respect . . . and a lot more money would help too. And really they need applause about as much as they need The Clap. And defo nobody requires a round of compulsory wellness, mindfulness and resilience courses on Zoom.

Here's the voice of experience [7 incandescent mins] reflecting on the disintegration of HCPs as management requirements and lack of appropriate equipment prevented them from, like, caring. Dr Damania refuses the label 'burnout' and insists he and his front-line colleagues are being subjected to moral injury by The Man. It's a thing (the piece-to-camera is dated May 2019) that predates Covid.

Actually it predates the birth of my kids. I've know my pal B for more then 50 years. She is the only person from my teenage years who has kept in touch. She is a year younger than me and has an older sister who caught a devastating tropical encephalopathy as a toddler and needed a lot of care and attention: from parents and siblings. That family cared about and for me insofar as a spotty youth needs that attention - I guess we all do - partly because care was in the air. Anyway, B left school figuring that she was a caring type of gal and enrolled in nursing college where she was trained in a 1970s version of how to be a nurse. B did well in the academic parts of the course - because smart - and did her job effectively on the wards and climbed the career ladder to ward sister. Until she broke. One too many tired, distressed, incontinent, old ladies shouted at her one too many times . . . and she quit. It was a devastating attack on her sense of self. She's an artist now, illustrates children's books. 

So if anyone mentions burnout in a Covid setting, bring them up short and shouty. Burnout is victim blaming. We need to reflect on how much we value healthcare in our society. The answer seems to be not very much when we allocate our tax dollars and a helluva lot when we need it for our own family.

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