Friday, March 24, 2023

‘We nearly broke the system’

Photograph for the Sun-Times by Ashlee Rezin

    Dr. Jaime Moreno, head of emergency medicine at Mount Sinai Hospital, was making the rounds Tuesday when he tried to take a quick mid-afternoon break.
     “I haven’t had the chance to sit down yet today,” he said, microwaving a container of beef and vegetables brought from home. “I don’t get a lunch, so I’m going to take my lunch right now.”
     Within minutes. a voice came over the hospital’s public address system: “Code Yellow, Code Yellow, trauma in the emergency room.” A teenager, gunshot wound to the hip. Lunchtime over, Moreno jumped up and hurried to help.
     At the three-year anniversary of the coronavirus shutting down Illinois, the pandemic has ebbed, but Chicago area hospitals are struggling to cope with the vastly altered health care world the plague left behind.   
     “COVID has changed many things,” said Moreno. “We’re still reeling from it.”
     While the public might be trying to forget COVID, that is not a luxury the medical community can indulge in.
     Dr. Ngozi Ezike, who headed up the state COVID response as director of the Illinois Department of Public Health for two years, said while we’re familiar with mass casualty events overwhelming a single hospital or city, COVID is a nationwide mass casualty event — more than a million dead.     ”It was an incredible strain on the system,” she said. “No one living has seen an overwhelming of all hospitals in the entire country at the same time, for a prolonged period of time, literally months at a stretch for each surge. This was unprecedented, and not something any system could fully plan for, prepare for, or endure.”
     “The landscape has changed so completely,” said Kristin Ramsey, senior vice president quality/chief nurse executive at Northwestern Medicine. “Health care providers in all fields are walking away.”
‘Unprecedented’ staff shortage driven by burnout
     Exodus of staff is the No. 1 problem cited by hospital administrators in Chicago and nationwide.
     “A lot of burnout,” said Moreno. Mount Sinai, almost always 10% understaffed, is even lower on “bad days,” with 30%, even 40% fewer personnel on hand than necessary.
     “Unprecedented,” he said. “People are stressed out. A lot of nurses have stepped away, leaving a lot of holes. Not just in my hospital but hospitals around the country.”

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Photograph by Ashlee Rezin


  1. I have been an ER NP for over 20 years. While this has always been a difficult job, the last 3 years have been exhausting. Please be kind to your ER care team—patients never see what all we do to try to keep (a slow) process moving forward.

    1. When someone tells me they think masks were stupid and useless, I just say it was the best way to try to protect those at the front lines, medical staff and their support systems. Plagues come in waves and can recur for years. What will happen next time? Because of the divide and unwillingness to do whatever we can, next time might be much more devastating because people will not comply. We'll all be setting our own broken bones because we've collapsed medical care.

  2. Thanks, Neil, for giving us what it means in human terms for a hospital to be "under staffed" and how it feels for a nurse to be reviled and physically attacked for rendering needed care to deluded and vengeful patients. Implied in the article is the question not of why nurses have been abandoning their jobs out of unmanageable stress and fear, but why anyone persists in going to work every day providing medical care that's unappreciated and even rejected.


  3. Great article. I wonder how much of this is a symptom of our lack of national health care that every other wealthy, industrialized country provides its citizens.

  4. Bravo on another remarkable piece of journalism. As it happens I read it soon after reading Vanity Fair's article on Jared Kushner's leadership as the Trump point man on Covid. The combination of arrogance and incompetence turned my stomach. Tens of thousands of people almost certainly died because of Kushner's astonishing obliviousness and ineptitude.

  5. I trained as a chaplain in hospitals. The stress is beyond imagining - literally staff doesn’t have time to ask for help for themselves. My experience is they care a good deal, and their commitments don’t generally waver - rather the role stress becomes unbearable in a context where errors become a matter of life, death, litigation. A very harsh reality.”Heroes” don’t begin to describe those who stay and give their all every day. Many consistently deal with the effects of post-traumatic stress. I worry about their families and the long-term health of those staying.

  6. My 25 year old daughter is a nurse. Do the math and you can see that she essentially "graduated into a Pandemic." Her first two years were on a COVID floor. In some ways, it was easier on her than older nurses since it was all she ever knew and she did not have a family she was living with to worry about. She was also less isolated than many of her peers. So, she (and we) try to look on the positive side of things. She learned SO MUCH

  7. How about some retention bonuses? That could help medical professionals pay of their education expenses. And why aren't more nurses in unions? Answer: Because hospitals and nursing homes are notorious union-busters.

  8. I retired from nursing before the pandemic and thanked God every day I was not working because I know how broken things were before the pandemic. Hospitals cut corners constantly and staffing is always not adequate. CFOs make decisions and leave bedside nurses ( and their patients) in jeopardy every day. The median age for RNs in this country is 52. This country is in real danger. Try to stay out of the hospital!


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