Coronavirus: Beyond The Pandemic Response

A View From The Desk Of Ed Marasco

Not Since 9/11

The Coronavirus Pandemic is consuming almost all aspects of our daily life. New information is emerging hourly and access to this information is unprecedented. Our communities are engulfed by information from medical experts about the virus itself, updates regarding actions being taken in communities all over the country and, of course, a great deal of information about those individuals who have been impacted directly. Our nation has not been this immersed in a story since the events of September 11, 2001.

The Second Victim Phenomenon

As the COVID-19 outbreak was declared a pandemic and travel was restricted last week, I found myself at the Association of Critical Care Transport (ACCT) Spring Education Meeting in Louisiana with one of my QMC colleagues and leadership from around the medical transport industry. Ironically one of the featured speakers was Dr. Susan Scott, from the University of Missouri Health Care, talking to the group about The Second Victim Phenomenon. She spent most of her career studying this phenomenon and developing strategies for supporting colleagues after traumatic events. The Second Victim Phenomenon refers to the impact of adverse patient events on caregivers and other public safety responders associated with those patients. While her thesis is more centered around the impact on providers related to medical errors and patient-related injuries, her work is instructive and augments the work done by Jeffrey Mitchell and others who have documented the impact of critical incident stress on first responders. Of course, the emergency medical services profession has acknowledged this impact and many communities have deployed resources to assist emergency responders in this regard. There may be a program to offer real-time diffusing’s after a difficult call, peer check-ins when a team has encountered a high-risk event (e.g. bad assault case, death of a child, etc.) and/or a full CISM Team deployment after a multi-casualty incident. We also know that the effects of difficult events can be additive over time. It may not take a single “landmark event” to trigger the stress response, but the stress response may build over the course of many “smaller incidents”.

At Greater Risk

As I reflect on the events of the last few weeks and anticipate the weeks ahead, it occurred to me that health care workers, including EMS professionals, are at greater risk for the additive impact of all that is going on around the community. Just think about it for a moment… The normal routines of the providers are interrupted as their children are now at home because the schools are closed and child care responsibilities require a new and more creative approach. As is typically the case in our profession, those of us with health care backgrounds often have responsibility for family members with health care needs. In addition to carrying out daily responsibilities, EMS professionals may need to provide food and supplies for high-risk family members in an effort to limit their interaction with the outside world and the COVID-19 risk. As colleagues are required to stay off the job because of potential exposure and/or other responsibilities, those who are still on the schedule may be forced to work extra-long hours to maintain the service. Not to mention the stress associated with caring for high-risk patients on a daily basis and having to constantly think about maintaining the safety and well being of themselves and their colleagues during the daily routine of providing emergency medical services. At a time when EMS professionals are in most need of diversions and outside activities to mitigate the impact of work-related stress, many of those tools (e.g. going to the gym to work out, going to a restaurant for a nice dinner with friends or hitting the bowling lanes) are no longer available. Many EMS professionals turn to their family members for support during stressful times. With the events unfolding the way they are, many family members are also experiencing unusually high-stress levels. We need to be sure that we are taking care of ourselves and both our families at home AND our “work families”.

Six Steps For Mitigating Stress

So, what can we do to maintain our health and wellness and support each other?

Coronavirus: Beyond The Pandemic Response

1. Eat Well
Any mental health professional will tell you that your diet can have a significant impact on stress and the ability to manage it. While shortages at grocery stores and long hours on the job can make eating well a challenge, we should all be more conscious of our eating habits during these difficult times. Plan ahead, pack some healthy snacks in the event you are stuck at work and do your best to stay away from junk food… I’m eating celery sticks in between paragraphs as I write this blog!

2. Exercise
Social isolation doesn’t mean we must lead a sedentary lifestyle for weeks. In fact, we should be striving for just the opposite. Walking, running and bike riding are options that don’t require a trip to the gym and can be done in relative isolation (no shaking hands on the bike trail!). Take advantage of any opportunity to get some exercise during these difficult times.

3. Communication
One of the main stressors in any circumstance is uncertainty. The more information that is available to the key constituents both at work and at home, the lower the stress level is. Take the time to ask questions, share concerns and statuses with your loved ones and hear their concerns. Remember, there is great value in simply listening… a response is not always required… trust me, my wife reminds me of that VERY regularly!

4. Laugh A Little
These are serious times and there are great concerns all around us; however, a little laughter goes a long way toward maintaining a reasonable stress level. Tell a joke, share a funny story or otherwise seek to share a moment of levity with your colleagues. On our afternoon COVID-19 prep call on March 17th, the Chief Technology Officer at QMC joined the Zoom call in a sparkly green fedora and a green “love me I’m Irish” t-shirt. It was a few welcome minutes of fun and laughter before we got down to the serious agenda of reviewing our business continuity plan (BCP).

5. Find Diversions at Home or in a Safe Location
Life comes at us with a fevered pace most days. Some of the pace is generated by necessity and some is self-created. Take an opportunity to turn social distancing into a positive experience by slowing down the pace. Pull out that book you have been anxious to read. Spend a few minutes each day with your family reminiscing about past vacations, telling a story about some experience you had growing up or asking them questions about their hopes desires and aspirations. My Son and Daughter in Law practiced very safe social distancing tactics last weekend… they spent a whole day on a trout stream together!!

6. Limit Your Intake of the “News”
There is such a thing as TOO MUCH INFORMATION. We are all captivated by the evolution of the COVID-19 pandemic. I find myself refreshing the Johns Hopkins tracking map on my screen almost hourly throughout my workday. I could spend all night at home glued to the TV coverage as well. It is important to take steps to limit your exposure and the exposure of your family to the reporting. My children were very young as the events of 9/11 unfolded. I can vividly recall tempering our desire to get the latest news of the aftermath with wanting to limit their exposure to those horrific images and the emotions associated with those events.

What We Are Hearing

We hear some of the same concerns from our team here at QMC as you do from your colleagues in the front lines. The impact on our team members and operations certainly does not have all of the elements faced by you and your colleagues on the front lines; however, we carry the burden of knowing that the work we do for you all is important and it allows your organizations to continue to thrive. We take that responsibility very seriously.

What We Are Doing

At QMC, we have taken great steps to:

1. Address the safety of our team members
2. Support the personal and professional needs of our team members
3. Ensure the ability of our organization to continue to serve our partners who are serving on the front lines
4. Continue to move forward on the many initiatives that we are pursuing to improve our organization over the long term

Our Executive Leadership Team (ELT) is meeting twice each day to discuss the evolution of all things COVID-19, monitor our activities set in motion to address issues and plan additional actions to stay ahead of the curve.

  • QMC leadership is communicating with the teams at our seven (7) offices around the country on a daily basis. We are reinforcing safe COVID-19 avoidance practices for our staff, sharing everything from the evolution of the pandemic to the action steps we are taking throughout the organization.
  • We have placed cleaning materials and hand sanitizer throughout our office locations and encouraged team members to make use of them in support of CDC and local health department recommendations.
  • QMC leadership has arranged for deep cleaning at our sites to augment the existing daily cleaning arrangements at each facility.
  • We are taking steps to expand the number of remote workers during the crisis. While a full 25% of our team members already work at home as a matter of course, we are proceeding in accordance with our business continuity plan (BCP) and expect to have more than 50% of our team members working remotely by the end of this week.

Committed As Your Partner

With respect to the work that QMC is doing on your behalf, we want to be sure that you know that this is one area that you need not let add to your stress. The QMC team is actively engaged in our work and committed as your partner.

We wish you the best in these trying times and remember…

Be Safe Out There!

Ed Marasco is QMC’s Vice-President of Business Development and a veteran healthcare provider and administrator with over 40 years of experience in emergency medical services, reimbursement and consulting. As a member of the QMC Executive Leadership Team, Ed has daily interaction with others to lead QMC through these challenging times.

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