When caring is lost, who is left standing when we need it the most?
Boston hospital denies heart transplant for unvaccinated patient
Cailey Gleeson (Twitter) – Tuesday, January 25th, 2022″ rel=”nofollow” style=”color: rgb(0, 57, 116); font-size: 1em; word-break: normal; padding-left: 0px; padding-right: 0px;”> Print | Email
Boston-based Brigham and Women’s Hospital will not perform a heart transplant on a patient who refuses to get vaccinated against COVID-19, CBS News reported Jan. 25.
DJ Ferguson, 31, was at the front of the line to receive a transplant, but hospital policy deemed him no longer eligible due to his vaccination status. David Ferguson, his father, told CBS Boston, the vaccination “kind of” goes against his son’s “basic principles.”
“Like many other transplant programs in the United States — the COVID-19 vaccine is one of several vaccines and lifestyle behaviors required for transplant candidates in the Mass General Brigham system in order to create both the best chance for a successful operation and also the patient’s survival after transplantation,” the hospital stated.
Systems across the country began requiring COVID-19 vaccination for organ recipients and donors in October. Arthur Caplan, the head of medical ethics at NYU Grossman School of Medicine, told CBS that vaccinations are necessary for these types of procedures.
“Post any transplant — kidney, heart, whatever — your immune system is shut off,” Dr. Caplan said. “The flu could kill you, a cold could kill you, COVID could kill you. The organs are scarce. We are not going to distribute them to someone who has a poor chance of living when others who are vaccinated have a better chance of postsurgery of surviving.”
If the frontline stops showing up, who will be there to care for the sick?
Stephen J. Motew, MD, MHA, FACS, Chief of Clinical Enterprise at Inova Health System – Thursday, September 9th, 2021″ rel=”nofollow” style=”color: rgb(0, 57, 116); font-size: 1em; word-break: normal; padding-left: 0px; padding-right: 0px;”> Print | Email
We are in the midst of a healthcare crisis that extends beyond COVID-19.
The direct patient care workforce is exhausted, burned out and more-than-ever at risk of becoming permanently disengaged. Nurses, who are consistently ranked as the most trusted professionals and are responsible for the majority of direct patient care, are disproportionally impacted. They are also leaving the workforce. Current estimates of open nurse positions across the U.S. may be as high as 220,000 and a majority of health systems identify clinical staffing as their top concern, putting patient care and safety at risk. This begs the question: if the frontline stops showing up, who will be there to care for the sick?
Nursing shortages have been present for years. Today the problem is particularly dire as we see the continued onslaught of COVID-19, requiring our healthcare heroes to buckle down for each new surge. Over the past 18 months this workforce, which represents the last line of defense for the sick, has had no days off, no remote work-from-home options and increasing workplace violence, all while managing the daily life challenges associated with the pandemic.
The availability of widespread vaccinations provided a tangible glimmer of hope. With an end in sight, this battered workforce buckled down in early 2021, determined to beat the pandemic. But the hope has been stifled as we experience another COVID-19 surge. This surge, however, is different. It is different because it is preventable. Seven in 10 adults in the U.S. are vaccinated, but more than 90% of severe cases leading to emergency department and hospital admissions occur among the unvaccinated. While some adults have legitimate reasons for not being vaccinated, such as for religious beliefs or medical conditions, most unvaccinated are refusing vaccination by questioning the evidence and science. And their reasoning is tied up in partisan ideologies and has nothing to do with the facts, or the science, that has helped them live well up to this point.
Not only is our healthcare workforce at risk by servicing unvaccinated patients, but their day-to-day stress is soaring as emergency rooms, ICUs and hospitals continue to be overwhelmed. It is increasingly difficult for healthcare teams to understand why some of their neighbors aren’t taking this step to protect them by getting vaccinated yet still expect to be cared for with compassion.
We know that by conventional measures, the healthcare workforce is remarkably ‘resilient’. The calling to care, the mission to heal and the privilege to earn the respect of our communities as compassionate dedicated professionals has always kept us going. Working one extra shift away from families, staying late to manage the overflowing ICUs and depleting personal emotional energy for each dying patient is simply “what we do” – without question.
But what will happen if we do see this historically resilient and dedicated workforce question why they keep showing up? What will happen if they question why they continue treating patients who disregard the science or the safety of the very healthcare workers they are asking to care for them? As we see more direct attacks on nurses, hospitals, doctors and science itself, there is increasing withdrawal from the core tenets of compassion and empathy. Fatigue is setting in. If this continues, then the allure of the most noble of career callings will wane. When caring is lost, who is left standing when we need it the most?
The feeling of desperation among U.S. healthcare workers has been pushed to the edge. If the unvaccinated continue to stay that way, America’s hospitals and communities face a bleak future. But perhaps one of the longer-lasting effects of today’s unvaccinated will be the damage to our nursing workforce, risking driving them out of their professions and serving as a warning for those who wish to enter the profession.
This is an existential threat to healthcare in the U.S., and we must issue a call to action to protect our protectors. The solutions aren’t simple, but we must start with facing the problem head-on, recognizing and supporting these heroes and committing to wellbeing and caring as core principles. Foundational changes to training, innovating to create wellness and resilience and holding to account those who impede the progress of the caring industry are necessary. It is critical that as vaccination policies are established and updated, we keep in mind the preservation of both today’s and tomorrow’s nurses. Dr. Jean Watson noted: “Caring is the essence of nursing,” and we have an obligation to assure this remains true.
Stephen J. Motew, MD, MHA, FACS, is Chief of Clinical Enterprise at Inova Health System. He is a fellow with the American College of Surgeons, and a member of the Southern Association of Vascular Surgery and the Society for Vascular Surgery.
Viewpoint: Hospitals should not discriminate against the unvaccinated
Georgina Gonzalez (Twitter) – Thursday, January 20th, 2022″ rel=”nofollow” style=”color: rgb(0, 57, 116); font-size: 1em; word-break: normal; padding-left: 0px; padding-right: 0px;”> Print | Email
As hospitals are again overwhelmed with by COVID-19 patients, opinion pieces in The Washington Post have argued that health systems should prioritize the vaccinated or even consider refusing to treat the unvaccinated. However, that would set a dangerous precedent for ethics and public health, Atlantic science writer Ed Yong wrote Jan. 20.
After interviewing a number of ethicists, he argued that medical care should be offered in line with the severity of a patient’s emergency and should not consider one’s behavior. For example, those who smoke cigarettes or get in car accidents without wearing seatbelts are still treated in hospitals, Yong wrote.
“We don’t use the medical-care system as a way of meting out justice. We don’t use it to punish people for their social choices,” said Matt Wynia, MD, a medical ethicist at the University of Colorado.
The unvaccinated population of the U.S. is also disproportionately poor and those who would consider getting a vaccine outnumber those who say they never would, Mr. Yong wrote. This suggests factors beyond some people’s control are preventing them from getting vaccinated, whether that be a rural location, lack of sick leave or no internet access.
“Blaming or neglecting unvaccinated people won’t save the healthcare system or end the pandemic. It will just be the latest manifestation of America’s instinct to punish individuals for societal failures,” Mr. Yong wrote.
Read the full article here.
Latest articles on strategy:
For Hospitals and Patients, We Need New Medical Device ‘Right to Repair’ Laws
Hospital executives have questions about hospital-at-home
To transform authorizations, health systems can leverage intelligent automation, strategic partnerships
************************Write a brief summary of the contents *************************************
Upload the topic you will be debating for the presentation. Provide a 3-5 sentence summary of the issue and why you have chosen this issue.
Nur 423 Debate Topic Rubric
Nur 423 Debate Topic Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeTopic
Debate topic listed with summary of why this issue was chosen
Debate topic listed with summary briefly explaining why issue was chosen
Debate topic listed or slightly unclear with minimal summary explaining why the issue was chosen.
Debate topic unclear with little to no summary on why it was chosen.
Debate topic not listed or not identified. No summary provided.
Total Points: 50