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| Stress in emergency room affect patient care |
The COVID-19 pandemic has added to already high stress levels in emergency- rooms, a social psychologist says.
"ER providers are on the front line of this pandemic, and stress, anxiety and anger - are increasing," said Linda Isbell, a professor of psychology at University of Massachusetts Amherst.
"As we all face anxiety about the fallout of this pandemic, anger about a healthcare system that was already stretched thin and under-resourced is likely to grow," she explained in a university news release.
Isbell's team interviewed 45 doctors and 41 nurses who offered mixed feelings about life in the ER. Persistent issues such as understaffing, overcrowding and limited resources for homeless and mentally ill patients elicited overwhelmingly negative feelings.
"These physicians care deeply about their patients. They're working in a healthcare system that makes it really hard for them to practice the way they envisioned," Isbell said. "They are asked to handle and solve problems that are incredibly trivial or incredibly serious, and some aren't even medical problems. There is awareness that emotions could influence what they do with the patients."
One ER specialist said: "Emotions subconsciously play a role in every single patient and how you work them up, and how you diagnose them, and what you do for them."
Doctors and nurses said that they may spend less time with angry, dimcult or unreasonable patients.
One doctor said: "I do think it is likely that when you have significantly contentious relationships with patients that ....you don't gain as much data and to an) extent that could lead to diagnostic error."
Doctors and nurses said they use various coping strategies. These include suppressing or ignoring their emotions when on duty in the emergency department.
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| Stress in emergency room affect patient care |
"But we know from the emotion literature that's not a good strategy." Isbell said. "It tends to rebound. You may take it out later on your kids or your spouse or dog. It's bad for your body physically and for
your mental health."It may also be bad for patients. The study suggests that more research is needed to learn whether ER providers' efforts to regulate their emotions help reduce the risk to patient safety.
The report was recently published online in the journal BMJ Quality and Safety.
Limited supplies of the anti-malarials chloroquine and hydroxychloroquine could hinder plans to use them to treat COVID-19, experts warned Thursday.
Physicians in Italy, where more than 115.000 people have acquired the virus and nearly 14,000 have died, questioned whether there is enough supply" of the two drugs if they are accepted globally as an
option for coronavirus treatment, according to a letter published in the Annals of Rheumatic Diseases.
The medications are typically used to treat people with malaria, which sickens more than 200 million people per year, according to the World Health Organization.
"If mass prophylaxis was accepted as an option worldwide, this would raise the question of whether there is enough supply of [chloroquine) and (hydroxychloroquine) to support this approach, they write.
As of Thursday, there have been more than 1 million confirmed cases of COVID-19 worldwide. The outbreak started in Wuhan, China, and has since spread rapidly.
Those with severe cases of the virus typically develop pneumonia and require breathing support with a ventilator. Hospitals in the United States have already expressed concerns about shortages of ventilators, as confirmed cases approach 250,000.
Chloroquine and hydroxychloroquine have been used to treat auto-immune diseases like lupus since the 1940s. Over the decades, dozens of studies have shown them to be safe and well tolerated in most cases, the Italian authors noted.
