Berks County Medical Society Medical Record Winter 2021 - 11

by Ankit Shah, MD, FACEP, FAAEM
Associate Director of Operations
Department of Emergency Medicine
Reading Hospital-Tower Health
Within your specialty, what secondary ill effects from the
pandemic have you encountered as you care for your patients?
One of the biggest tragedies from a patient perspective has been
the delays in seeking care for non-COVID-19 acute illnesses. ED
volumes across the country have gone down (sometimes by 80% of
pre-COVID numbers), but the patients coming to the ED are sicker
and are being admitted at higher rates than pre-COVID.
In addition, workers are leaving the health care arena in droves.
This has led to a reduction in staffed inpatient beds. As a result,
instead of going " upstairs " to a room, patients are boarded in the ED
due to a lack of inpatient beds. This leads to higher waiting room
volumes and longer wait times for care to be provided.
Mental health admissions have been a struggle as well, due to
increasing numbers of mental health issues, stress and anxiety around
jobs and food, and the need for COVID testing prior to placement
so that the virus is not introduced into settings where it currently
is absent. The need to hold psych patients in the EDs is also
contributing to the waiting room challenges.
Lastly, the toll on the front-line staff has been immeasurably bad.
Morale is low. Stress is high. ED nurses are leaving shifts crying
because of how hard the impact has been on the EDs. The toll of
additional cases resulting from holiday gatherings is going to only
make the situation even more dire than it currently is.
Are your patients generally well-informed about the nature
of this virus and the actions they can take to protect themselves,
or do you frequently encounter problems related to lack of
information or even misinformation about the pandemic and
public health measures?
There is variable knowledge among patients as to the extent,
nature, and prevalence of this virus. There are many deniers, who
will even refuse a COVID swab when being evaluated for admission

due to a refusal to believe in the presence of this infectious agent!
There are other patients who delay presentation to the ED as long
as possible for fear of getting infected while in an ED setting. Most
patients are aware of, but may not know how to best follow, the
guidelines set forth by state and national agencies, especially in light
of changes made to said guidelines.
What strategies have you used to minimize the types of
collateral damage you have encountered with your patients, and
how successful have you been?
Successes and wins have been infrequent due to the virus, the
public health emergency, and measures enacted to increase social
distancing. For example, around the holidays, the ED would
frequently hold raffles to brighten the moods of staff or have buffet
style meals. None of that is allowed due to the need to limit
congregation. So it has been a challenge to help staff out wellnesswise.
Patients should seek care when needed, with or without a public
health emergency. To that end, we have put out advertisements,
both in print and video, urging patients to seek care when needed
and not to delay care. There have also been social media posts
echoing the same message.
I am hopeful that hiring more staff nurses, having surge plans
for higher volumes, and continued public assistance in dampening
down the transmission will help our health care worker staff manage
this pandemic. I would also like to remind people that " front-line
staff " is made up of more people than ambulance staff, nurses, and
doctors. There are front-line workers in environmental services,
security, and medical records departments as well as chaplains,
addiction specialists, telephone operators and many others involved
in the care of acutely ill patients. Please keep all hospital-based
workers in your thoughts and prayers. Stay safe!
continued on next page >

WINTER 2021

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Berks County Medical Society Medical Record Winter 2021

Table of Contents for the Digital Edition of Berks County Medical Society Medical Record Winter 2021

Berks County Medical Society Medical Record Winter 2021 - 1
Berks County Medical Society Medical Record Winter 2021 - 2
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https://www.nxtbook.com/hoffmann/BerksCountyMedicalSociety/BCMS_MedicalRecord_Fall2020
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https://www.nxtbook.com/hoffmann/BerksCountyMedicalSociety/BerksCountyMedicalSociety_MedicalRecord_Fall2018
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https://www.nxtbook.com/hoffmann/BerksCountyMedicalSociety/BerksCountyMedicalSociety_MedicalRecord_Winter2017-18
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