Commentary Re: Estes, Varghese, Jacques, and Naidu’s “Logistical, Financial, and Psychological Impact of the COVID-19 Pandemic on Cardiac Catheterization Lab Nurses and Technologists: A U.S. National Survey”

The world faced its first modern pandemic scare when the Ebola outbreak occurred in 2014. Outside of West Africa, few were affected. The Centers for Disease Control (CDC) records only 11 cases in the United States with one mortality between 2014-2016. Unlike Ebola, the COVID-19 pandemic has placed a tremendous strain on our country’s (and the world’s) health care system. As cases continue to rise, physicians, nurses, allied health personnel, environmental services, and first responders are willingly placing themselves at risk daily.

The rapid spread of COVID-19 created challenges for which most were poorly prepared. Healthcare workers were forced to contend with clinical and nonclinical stressors daily. As frontline workers, they not only face the physical risk of the virus, but mental consequences as they provide care to patients with COVID-19. Our work and lifestyles have changed quickly and dramatically. Preventing the spread of the illness meant that we as healthcare workers had to wear personal protective equipment (PPE) for prolonged periods for all patient care. Supply chain issues created rationing due to shortages of PPE. The fear of bringing the virus home to family members takes a hefty toll, as healthcare workers directly caring for COVID patients found themselves quarantining themselves in or out of their homes to protect family and loved ones.

Over the last few years, I have worked in interim/contract healthcare leadership positions through B.E. Smith, a division of AMN Healthcare. My last contract, at Mission Health in Asheville, North Carolina, was completed on March 5, 2020. Upon returning home to Ohio, the state began a shutdown the following week. Suddenly, as hospitals across the country began suspending elective cardiac procedures, I was faced with the prospect of not finding a contract position in my area of expertise anytime soon. Interim leadership positions were readily available, albeit in hotbed areas of the country in infectious disease units and the many temporary emergency care facilities. With concern expressed by my family, I did not pursue these opportunities. As the weeks passed on, I heard from friends and colleagues through social media about their working conditions, some of whom who took contract positions in medical ICUs. Being out of work during this period led me to believe that I was not doing my part, and brought on feelings of guilt, inadequacy, and depression.

In late spring, as restrictions in my state began to lift somewhat, I was offered a full-time leadership position at a large community hospital in Canton, Ohio. I had first been contacted about this position in late February 2020. Prior to COVID, the Heart and Vascular Hospital was seeing continuous growth; there were several staff brought on and management promoted into new roles with increasing responsibilities. The Associate Vice President to whom I reported began her position a day before the state announced shutdowns, which included suspensions of elective procedures. Baptism of fire.

In my new role, my greatest struggle was trying to connect with my new staff. How could I learn who my staff was when all I could see were facemasks and eyes behind goggles and shields? I met with my staff one on one, introducing myself and trying to learn a bit about each of them. This proved invaluable, giving me the opportunity to hear their individual stories and concerns. As I began my new role, procedural volumes were on the rise, moving toward “normal.” Several of the staff had been recently hired prior to when the shutdown began. During the shutdown, staff members were floated to other hospital units, and when they were not needed, they took time off, often without pay. Personal protective equipment items became hot commodities, as items were often in short supply. I listened as the team told me of their recent experiences. Some of the “newbies” wondered if they should leave their new roles and go back to work areas where they were more experienced.

Decreased hours, loss of wages, uncertainty about a viral threat: it was clear that individual morale was not at its highest. Yet even through this, everyone understood that patients come first. This is why we all chose to be in healthcare. I am thankful and commend each of my staff for choosing to stay in their positions. I am also thankful for the transparency of the hospital leadership above me, openly sharing and encouraging communication with team members at all levels.

The COVID-19 pandemic has had a considerable effect on society, felt even more so by frontline healthcare workers. In the study, “Logistical, Financial, and Psychological Impact of the Covid-19 Pandemic on Cardiac Catheterization Nurses and Technologists: a U.S. National Survey”, Estes and colleagues are the first to specifically look at the effects on our team members. This is an important piece for all invasive cardiology nurses and technologists to read, and to know that they are not in this alone. For cardiology managers, directors, and all leaders, I encourage you to examine this study, and consider how your team has weathered this storm. 

Ken Gorski, BSN, RN, RCIS, FSICP, can be contacted at kenneth.gorski@aultman.com