Now You Know How Doctors and Nurses Think

It’s not that I am a worrywart or a pessimist; I just cannot help anticipating what might come next. That’s the way the minds of nurses and doctors work. Spending years in the health field, a good nurse and doctor will always be planning for the next step or considering the “just-in-case.” You have a care plan for your patients, and you make sure all the next measures are in place.

You stock up on equipment for emergencies; you make sure the equipment is ready and the medications have not expired. Would you want to be the patient in cardiac arrest when the batteries in the defibrillator have not been charged? That was my pet peeve. As charge nurse, I was compulsive about my staff performing checks on the emergency equipment.
    
You tend to transfer this same mentality into everyday life. I cannot help but anticipate what we might need: whether it’s for a day trip to NYC, two weeks in Europe or we head out for the mountains on a hiking trail. My family makes fun of me – as I pull out of my purse or backpack exactly what they need. We hiked Mt. Washington years back with several families – sleeping in the huts along the Appalachian Trail. You can only imagine my backpack contents! In addition to my crystal aspirin (in case of a heart attack) and supplies to prevent hypothermia (even though it was July, Mt. Washington’s weather is erratic), I pulled out a water filter when we discovered that the ranger station that we counted on being open was closed. We had planned to fill our water bottles there, along the 10-hour trek on a hot July day, but now we only had untreated water in the bathrooms. We utilized my water filter for the entire group and drank fresh water, and enjoyed the boost in our blood sugar with the chocolate treats that I had stuck in my backpack – just in case.
    
So what does this subject have to do with the pandemic? Everything. The mindset of health professionals (not just nurses and doctors) is different from the rest of the planet – certainly unlike those of politicians or economists. We cannot help but anticipate, and we really become irate when surrounded with unpreparedness for emergencies. What we are experiencing with this pandemic is disrespect for the health profession. The world is paying a price for that. There are so many lessons to learn from this pandemic, but I truly hope this lesson is one of them. I have served in the health profession as a clinical nurse specialist for decades, and so I was driven to write about this subject, given the severity of what we are experiencing.

What has this pandemic revealed?

• I do not understand why disrespect for science has evolved. My intention is not political or religious. To deny science is just plain foolish, and we are experiencing the consequences right now in the management of this pandemic. Instead of a long explanation, as Einstein stated in his 1953 interview, “Science without religion is lame. Religion without science is blind.”
• Numerous cuts were made to health organizations on federal, state, and local levels. That was a big mistake and we are suffering severely. Once again we are experiencing the consequences of this short sightedness. We always have to be prepared for emergencies; it is an invaluable investment. We seem to have a better understanding of this with our fire departments, which is wonderful, but why don’t we apply this to crises preparedness? As I mentioned in the beginning, my pet peeve when I was in charge of my unit was the lax attitude about being prepared for emergencies. This endangers people’s lives. That goes against my grain as a nurse and a fellow human being. My colleagues are feeling this impact across the nation in the numerous health settings including public health departments, emergency rooms, urgent care centers, physician offices, cancer centers and health clinics.
• Why did America decline help, such as not accepting test kits from the World Health Organization (WHO)? We don’t have the answer, but once again we are suffering with the consequences. Not having test kits is like doing surgery blindfolded. We were way behind in starting the testing, which results in being way behind with everything that follows. This includes tracking and treating the disease, which is extremely challenging in a crisis to begin with; health professionals do not need added burdens. By delaying a diagnosis due to lack of testing, we are creating a longer infection chain. It is critical to know who is infected and how many in order to determine the pathway of the spread of the disease and its overall progression.
• Americans seem to struggle with recognizing that we are connected to the rest of the world. We value our independence, but denying that we are linked to others results in exactly what is happening now with this pandemic. We are learning a difficult lesson. It is to our benefit to recognize the patterns of the pandemic in other countries – China and Europe, for example – in order to anticipate what is coming next in America. As the WHO collects data, it provides a global perspective, which is valuable for our plans. If we remain isolationists in this area, we will suffer.
• Americans are not in tune to policies and practices that impact health professionals. Many of us know that there is a shortage of physicians in this country, but do you know why? For decades there has been a scarcity of residency slots for medical schools. Funding has been drastically cut for the training of physicians, and Congress in its “great divide” has been slow to pass legislation to fix this. Unless we change our policies, we will be short 90,000 physicians by 2025. More hospitals will likely close if we don’t make changes in our practices. In the nursing field, many RN programs have two-year waiting lists, and the understaffing of nurses is all too common. Hospitals certainly require business people to help with the operation of the facility, but should CEOs – with less education and not necessarily having medical backgrounds – be making more money than the physicians? Should they be making decisions about your healthcare without the consent of the experts (doctors and nurses) in the field?

To get back to the pandemic, the U.S. has essentially turned its back on our healthcare professionals. Yet now in this crisis, Americans are turning to doctors and nurses and other healthcare professionals to save lives. They are not only risking their own lives, but also their loved ones. Yes, you can say they chose the profession, but they did not choose to face this crisis with inadequate supplies, staffing and protective equipment. They did not choose to carry this out without adequate preparation. We might think that they will “just get sick and recover” but that is not the case. Not only will they be exposing themselves to the vulnerable population who are at risk of dying or getting severely ill, but young doctors and nurses are also dying. They are experiencing exhaustion and over exposure. There are also theories that a genetic factor may come into play with some of these deaths. It is called immune reconstitution inflammatory syndrome and this results in compromised conditions for some individuals (Medscape, March 16, 2020).

• Where are our priorities? Have we put politics and the economy before our health? We know there are those individuals who will sadly take advantage of this pandemic, both politically and economically. Then there are officials who downplayed this pandemic, claiming that we (the healthcare experts) were overreacting. Healthcare professionals were not thinking about political sides when they addressed this months ago; they were thinking about saving lives and how we must protect ourselves. When we get to the other side of this, I hope Americans will understand and respect how nurses and doctors think. We have the ability to anticipate, and maybe America will recognize the value of this skill.
• By the time this article is published, the course of this pandemic will have changed. If we watch what has happened in other countries, we will witness not only the peak and the recovery, but the course of this virus will likely continue on with peaks and valleys. We need to stay connected (at a distance right now) and start thinking about our priorities. We are learning a hard lesson: America did not pay attention to the health experts.

I’ll end with my favorite quote, which is supposedly an old cowboy motto, once used by Winston Churchill: “Speak the truth but ride a fast horse.” (You might see me riding my fast horse out of town!)

Charlotte Michos is a clinical nurse specialist who values personal-centered care and serves as a Healthcare Consultant in helping others make informed decisions. For more information, email her or call (845) 548-5980.