ARTICLE: Mitigating Health-Care Worker Distress From Scarce Medical Resource Allocation During a Public Health Crisis
AUTHORS: Lauren E Benishek, Allen Kachalia, Lee Daugherty Biddison, Albert W Wu
JOURNAL: Chest. 2020 Aug 6;158(6):2285-2287. doi: 10.1016/j.chest.2020.07.073. Online ahead of print.
The coronavirus disease 2019 (COVID-19) pandemic has exposed a significant vulnerability of the US health-care system: the limited supply of life-saving medical resources, such as ventilators and dialysis machines. Shortages have sparked considerable anxiety among patients, the public, and health-care providers alike. Fair and ethical protocols are needed to manage these situations. In parallel, organizations must recognize that providing care when resources are scarce can be highly stressful, particularly when typical job demands are amplified.1 Frontline health-care providers may be psychologically traumatized from triaging life-saving treatments and bearing witness to the consequences of those decisions. Organizations must be prepared to implement strategies that will mitigate the resulting grief, anger, shame, guilt, anxiety, and moral distress providers may experience. Neglecting to do so fails these essential workers and further compromises patient safety and care quality.2 We recommend that health-care organizations consider adopting three sets of strategies to reduce provider stress. These strategies that ideally would be executed well in advance of a crisis include creating clear scarce resource allocation criteria and protocols, separating triage and frontline care providers while endorsing a rapid triage appeal process, and establishing essential programming to provide emotional support and adequate recovery.
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