WORCESTER MEDICINE
COVID-19
COVID-19 and a Vision for Wellness Continued that you’re thinking of them and acknowledge the unprecedented experiences of today. Such validation will help normalize the feelings that both you and they are experiencing. Fur-thermore, nonstop media coverage of the pandemic can overshadow the bright spots of your daily work. So talk about the positive things that are occurring in your life, with your family, and with your institution or place of work.
5. seek professional help to cope with moral distress
Symptoms of moral distress may include self-criticism or feelings of shame, guilt, and regret. This moral distress and the anticipatory grief that often co-exists is likely something with which you are unaccustomed. Coping with such novelty may be difficult. Therefore, additional help and support may be needed to address their insidious and harmful effects. Although physicians are generally reluctant to seek help, seeking early help is important to ad-dressing the trauma from moral distress. Peers have been found to be valuable when coping with moral distress. If you have access to an employee assistance program (EAP), you can often receive free and confidential help as well as referrals to help you cope with moral distress. You can also contact your health insurance provider for referrals to mental health professionals who provide telemedicine therapy, or contact the Physician Health Services (http:// www.massmed.org/Physician_Health_Services /About/About_Physician_Health_Services/#. X2O6QJNKhp8). + Steve Bird, MD, is professor of emergency medicine and the Clinician Experience Officer (CXO) at UmassMemorial Healthcare and the University of Massachusetts Medical School. Email: Ste-ven.bird@umassmemorial.org
Part 3
Palliative Care During the COVID-19 Surge Jennifer Reidy, MD, MS, FAAHPM
T
he global pandemic has been described as
a “powerful amplifier of suffering,”(1) and the field of palliative care has mobilized onto the frontlines in emergency rooms, hospital wards, and intensive care units during the COVID-19 crisis. In general, palliative care is focused on providing patients with relief from the symptoms, pain, and stress of a serious illness – whatever the diagnosis. The goal is to improve quality of life for both the patient and the family. Palliative care is appropriate at any age and at any stage in a serious, life-threatening illness and can be provided together with curative treatment. During the pandemic, palliative care providers have faced multiple barriers to their usual hightouch, relationship-based care, including PPE shortages limiting direct patient contact; a no-visitors policy for hospitalized patients which separates loved ones and prevents in-person family meetings; and the moral distress of redeployed clinicians without training in serious illness communication and symptom management. Based on reports from the epicenter in New York City, our palliative care team at UMass Memorial Medical Center quickly developed strategies to plan for the patient surge in central Massachusetts last spring, including: • Expand in-person consults from 5 to 7 days per week at University and Memorial campuses as well as telephone support for outpatient clinicians and the DCU Field Hospital; • Partner with outpatient providers to proactively reach out to their highest-risk patients about their goals and medical wishes if they contracted COVID-19; • Collaborate with local hospices and skilled nursing facilities to anticipate barriers to providing end-of-life care in the community for people dying of COVID-19; and • Promote the use of video technology to connect isolated patients with their loved ones.
NOVEMBER / DECEMBER 2020
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