May 23, 2022

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If you or someone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

When oculoplastic surgeon Zinaria Williams, MD, began medical school, she made a promise to herself to care for underserved communities. Her parents — both university educators — had instilled within her at a young age a love for learning.

Being a doctor became an important part of who she was early in her life. What she didn’t know when walking through the doors of medical school was that six to nine of her peers would eventually die by suicide (every year in the U.S., it’s estimated that 300 to 400 physicians die by suicide).

Nor did she know that her personal safety – both psychological and physical – would be at risk when she walked through the doors of her workplace.

Williams cared for some of Boston’s most difficult patients during her medical training, and she continues to do the same today in New York City. While never physically assaulted, she said she was regularly manipulated and sometimes physically threatened by incarcerated and psychiatric patients.

That, coupled with extreme sleep deprivation and the responsibilities of being a new resident with little support from mentors who verbally abused house staff, proved to be toxic. She felt anger and resentment brewing within, and began to detach from patient care.

“I knew something wasn’t right,” she said, reflecting back on her training. “My identity was so attached to being a doctor. I had all these student loans and didn’t see any way out. I also couldn’t connect with patients the way I wanted to, and thought it was anger management I needed. It’s shameful even admitting it, but feeling it? I just didn’t want to be this way.”

While driving home from the hospital one evening over the Longfellow bridge crossing the Charles River, Williams found herself wondering if it was high enough.

“I was having suicidal ideation, and sought help through the Employee Assistance Program. With the help of a therapist, I began to see it wasn’t me. It was the environment. I think this is how I was able to get through training, though it was only one level of it.”

Many residents and physicians do not seek help when feeling depressed, burned out, or detached from the self that first sought to heal others because of the stigma associated with asking for help as a medical professional. But recognizing and treating these issues, especially as healthcare workers continue to fight yet another COVID-19 surge, is becoming even more necessary.

Fighting for Healthcare Worker Mental Health

Before Lorna Breen, MD, a New York City emergency medicine physician, died by suicide in April 2020, she was by all accounts a happy person with a wide circle of friends and family. But at the time she was struggling most, she feared she was going to lose her license to practice medicine because she sought mental health assistance after treating COVID-19 patients in the first wave,

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Just before she caught COVID-19 at a wedding ceremony in March 2020, the physician associate invested her times diagnosing and managing folks after she was infected, she turned to her personal colleagues for that exact same treatment. “At very first,” she told me, “I felt a kinship with them.” But when her exams begun coming back destructive, her health professionals began telling her that her symptoms—daily migraines, unrelenting vertigo, tinnitus, significant crashes following moderate activity—were just in her head. (I agreed not to identify her so that she could speak brazenly about persons she still works with.)

When she went to the emergency room simply because 50 % her body experienced absent numb, the ER doctor offered to book her an appointment with a counselor. Another doctor explained to her to try out eliminating her IUD, simply because, she remembers him expressing, “hormones do amusing points to females.” When she questioned her neurologist for a lot more exams, he mentioned that her medical background experienced currently attained her “more screening than I was entitled to,” she told me. Getting element of the health care community manufactured her no different from any other patient with extensive COVID, her eventual prognosis. Even with staying a clinical specialist, she could not convince her own physicians—people who understood her and labored with her—that one thing was seriously wrong.

I’ve interviewed extra than a dozen very similar people—health experts from the United States and the United Kingdom who have extensive COVID. Most explained to me that they were stunned at how quickly they experienced been dismissed by their friends. When Karen Scott, a Black ob-gyn of 19 several years, went to the emergency place with chest discomfort and a coronary heart charge of 140, her physicians checked whether or not she was pregnant and analyzed her for medicines one questioned her if her signs were in her head even though drawing circles at his temple with an index finger. “When I stated I was a physician, they explained, ‘Where?’” Scott said. “Their reaction was She will have to be lying.” Even if she had been considered, it may not have mattered. “The minute I became ill, I was just a affected person in a bed, no extended credible in the eyes of most medical professionals,” Alexis Misko, an occupational therapist, advised me. She and some others hadn’t anticipated specific treatment, but “health-treatment professionals are so employed to currently being considered,” Daria Oller, a physiotherapist, advised me, that they also hadn’t expected their sickness to so entirely shroud their know-how.

A couple of the well being-care personnel I talked with had a lot more constructive ordeals, but for telling causes. Amali Lokugamage, an ob-gyn, had obvious, audible symptoms—hoarseness and slurred speech—so “people considered me,” she explained. By contrast, invisible, subjective symptoms this kind of as suffering and tiredness (which she also had) are normally overlooked. Annette Gillaspie, a nurse, told her health practitioner initial about her cough and quick heart price, and only later on,

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The moment that broke Cassie Alexander came nine months into the pandemic. As an intensive-care-unit nurse of 14 years, Alexander had seen plenty of “Hellraiser stuff,” she told me. But when COVID-19 hit her Bay Area hospital, she witnessed “death on a scale I had never seen before.”

Last December, at the height of the winter surge, she cared for a patient who had caught the coronavirus after being pressured into a Thanksgiving dinner. Their lungs were so ruined that only a hand-pumped ventilation bag could supply enough oxygen. Alexander squeezed the bag every two seconds for 40 minutes straight to give the family time to say goodbye. Her hands cramped and blistered as the family screamed and prayed. When one of them said that a miracle might happen, Alexander found herself thinking, I am the miracle. I’m the only person keeping your loved one alive. (Cassie Alexander is a pseudonym that she has used when writing a book about these experiences. I agreed to use that pseudonym here.)

The senselessness of the death, and her guilt over her own resentment, messed her up. Weeks later, when the same family called to ask if the staff had really done everything they could, “it was like being punched in the gut,” she told me. She had given everything—to that patient, and to the stream of others who had died in the same room. She felt like a stranger to herself, a commodity to her hospital, and an outsider to her own relatives, who downplayed the pandemic despite everything she told them. In April, she texted her friends: “Nothing like feeling strongly suicidal at a job where you’re supposed to be keeping people alive.” Shortly after, she was diagnosed with post-traumatic stress disorder, and she left her job.

Since COVID-19 first pummeled the U.S., Americans have been told to flatten the curve lest hospitals be overwhelmed. But hospitals have been overwhelmed. The nation has avoided the most apocalyptic scenarios, such as ventilators running out by the thousands, but it’s still sleepwalked into repeated surges that have overrun the capacity of many hospitals, killed more than 762,000 people, and traumatized countless health-care workers. “It’s like it takes a piece of you every time you walk in,” says Ashley Harlow, a Virginia-based nurse practitioner who left her ICU after watching her grandmother Nellie die there in December. She and others have gotten through the surges on adrenaline and camaraderie, only to realize, once the ICUs are empty, that so too are they.

Some health-care workers have lost their jobs during the pandemic, while others have been forced to leave because they’ve contracted long COVID and can no longer work. But many choose to leave, including “people whom I thought would nurse patients until the day they died,” Amanda Bettencourt, the president-elect of the American Association of Critical-Care Nurses, told me. The U.S. Bureau of Labor Statistics estimates that the health-care sector has lost nearly half a million workers since February

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WASHINGTON — The Supreme Court declined Friday to block Maine’s requirement for health care workers to receive a Covid-19 vaccine, even though it doesn’t contain a religious exemption.

Justices Clarence Thomas, Samuel Alito and Neil Gorsuch dissented, saying they would have blocked the mandate. Two of the court’s other conservatives, Amy Coney Barrett and Brett Kavanaugh, said they agreed the court should not take the case, because it came on an emergency appeal without benefit of a full briefing.

The state requirement was challenged by health care workers who opposed the Covid-19 vaccination mandate on religious grounds. State officials began enforcing the new rule on Friday.

Maine’s order applies to health workers in hospitals, nursing homes and doctor’s offices. State officials said most of those covered by the order have complied.

Maine allowed religious exemptions in the past for health care workers, daycare employees, school children and college students. But the state eliminated all non-medical vaccination exemptions in 2019. It said falling inoculation rates were causing communicable diseases to spread more rapidly.

A group of health care workers sued when the Covid-19 vaccine was required, saying they objected because the vaccine was developed with the aid of “fetal cell lines that originated in elective abortions.” The rule forced them to decide “what is more important to them — their deeply held religious beliefs or their ability to work anywhere in their state so that they can feed their families.”

None of the Covid-19 vaccines contain fetal cells, according to published data about their composition. During the testing stages for their vaccines, Moderna and Pfizer used cell lines replicated from fetal cells taken 50 years ago. Johnson &Johnson used a different cell line in some of the production phases of its vaccine.

Lawyers for the state told the court that Maine was not engaging in religious discrimination, because the law applies to all healthcare workers and is not intended to restrict any particular religious practice. “The object of the recent amendment to the rule is to prevent the spread of Covid-19 among healthcare workers in high-risk settings, protect patients and individuals from disease and death, and protect Maine’s healthcare system,” the attorneys wrote.

“Most healthcare facility outbreaks in Maine are the result of healthcare workers bringing Covid-19 into the facility,” the state told the Supreme Court.

Writing for the three dissenters, Gorsuch said the state was not treating all healthcare workers equally, because those with a medical objection could refuse to take the vaccine, while those with religious objections cannot.

“Health care workers who have served on the front line of a pandemic for the last 18 months are now being fired and their practices shuttered. All for adhering to their constitutionally protected religious beliefs. Their plight is worthy of our attention,” he said.

https://www.nbcnews.com/politics/supreme-court/supreme-court-declines-block-vaccine-mandate-health-workers-maine-n1282757… Read More...

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