COVID Fatigue

Anesthesia alert! This overhead call alerting pending intubation can be heard bellowing throughout the hallways of my medical center several times throughout the day and is seemingly the soundtrack of COVID-19. My typical routine is to pause, make sure it’s not sounding the alarm to my patient’s room, and then continue with my workday.

It has been 304 days since the WHO has declared COVID-19 a pandemic. COVID numbers at my medical center continue to rise, and although the vaccine is widely available to hospital staff, we are continuing to see some of our highest numbers since the beginning of the pandemic.

As a general cardiology fellow on the advanced heart failure service at a high volume mechanical circulatory support and transplant center, we really get to know our patients while taking care of them during their index hospitalizations. For the past two weeks, I’ve gotten to know one patient in particular. She presented in cardiogenic shock, was stabilized on inotropes and a balloon pump, with plans for upcoming destination therapy LVAD implantation.

Every day when we come to her bedside, she is on FaceTime with her partner. Today, the day before her LVAD implantation, we walked to her bedside, and once again she was on FaceTime with her devoted partner. She is obviously loved. Considering that she was going for LVAD the following day, we spent a bit more time explaining the procedure in-depth to the patient and her partner. After discussing all of the technical details, she timidly asked “Do you think my partner could come to spend the night with me tonight? I just need to see my love and it’s been so long.” You could see the tears begin to drop from her face and her partners.

Donning and doffing, wearing the N95, not knowing what anyone looks like without their mask; things have become routine. Health-care workers have adapted so well to the ever-demanding challenges of practicing medicine in the era of COVID-19. We’ve made guidelines, adjusted our practice, established routines, and found ways to provide quality medical care in the darkest of times. We’ve become oddly accustomed to these necessary rituals in order to protect ourselves, our loved ones, and the patients that we care for.

But none of this is normal.

At that moment, when we told our patient that the person who loved her the most in this world could not sit with her the night before a life-altering surgery, it became dramatically apparent to me that all of this is abnormal. The weight of 304 days of pandemic sat heavy in my heart and the sounds of endless anesthesia alerts echoed in my head.

Depression and burnout were prevalent in the healthcare field even before the pandemic. COVID-19 has undoubtedly placed an added burden on all healthcare providers. I implore people to take time off if you can, spend time with family if able, and be thoughtful of your mental well being because this past year has been anything but normal.

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Nursing Poster Sessions

Next to the great talks, there are also great posters at the American Heart Association. Some of these posters I would like to highlight in this blog.
Muna Hammash presented that interventions such as psychoeducational before and after ICD insertion may improve perceived control and, in turn, quality of life.

Muna Hammash  
Dr. Misook Chung had an interesting poster on diet quality in patients with heart failure. She found that diet quality was similar in patients with heart failure regardless of their adherence to sodium restriction diet.

Dr. Missook Chung in front of her poster at Scientific Sessions

Missook Chung poster

Solim Lee presented why patients with heart failure don’t respond to early symptoms.

Solim Lee in front of her poster at Scientific Sessions

Solim Lee conclusion

Dr. Jennifer Miller showed that living in a socio economically austere area imparts greater risk for death or hospitalization for ICD recipients.

Dr. Jennifer Miller in front of he rposter at Scientific Sessions

Hiroko Ishida presented a poster on dyad research. She found that health literacy of patients with heart failure and their caregivers was independently associated with caregivers burden. 

Hiroko Ishida in front of her poster at Scientific Sessions

Umama Gorsi had an abstract accepted about cardiac rehabilitation. She found that early outpatient cardiac rehabilitation is associated with reduced total mortality rates after myectomy for treatment of hypertrophic cardiomyopathy.

Umama Gorsi Poster

There were great presentation on self-care in patients with heart failure. Foster Osei Baah found in his research that self-care confidence moderates the relationship between marginalization and self-care maintenance in patients with heart failure.

Foster Osei Baah in front of his poster at Scientific Sessions

In another research on self-care, Miyuki Tsuchihashi-Makeya found that health literacy was associated with poor self-care. Furthermore, she found that perceived control mediated the association between health literacy and self-care behaviors in patients with heart failure.

Miyuki Tsuchihashi-Makeya Poster

I would like to thank all the researchers in this blog for their enthusiasm to discuss their work with me!

Leonie Klompstra Headshot
Leonie Klompstra is a Nurse Scientist at the Linköping University in Sweden. Her primary focus is on heart failure and rehabilitations.