From Triage to Trial

Healthcare professionals working the front lines are faced with difficult decisions every day. Compound that with the COVID-19 pandemic, working around the clock, and worrying about their own health and safety. Basic triage decisions have evolved into heartbreaking shifts, with hardly any respite for those facing the onslaught day after day.

As is the norm in our litigious culture, what will follow is a wave of potential malpractice suits(1), some due to the triage decisioning process, and others because healthcare facilities lack basic supplies, such as face masks and ventilators. While it seems unthinkable to accuse a medical professional of making the wrong decision when they are putting themselves at great personal risk to treat so many others, it will happen.

The key to triaging patients during a global pandemic is consistency. It is paramount to determine – and stick with – clear, concise, specific policies that do not discriminate based on subjective criteria. A healthcare professional cannot simply decide if a patient is too old or too sick (based on other comorbid conditions) every time they triage a new patient. The clearer the guidance, the more objective employees can be. Follow up these decisions with proper documentation to ensure that guidelines were followed, and the documentation can serve as the collective memory, even once this pandemic has past.

There’s also the question of how to determine what a pandemic triage policy should be, when (hopefully), each of us will only go through something so impactful once in our lifetimes. For example, the next outbreak might not require such a large demand for ventilators, so how do we determine (and who decides) what is normal or expected?

In terms of prevention, healthcare facilities can support their personnel by addressing the anxiety and confidence dips that are normal during a global health crisis. Health care workers cannot calm and reassure the public when they aren’t being reassured themselves. The concerns of health care professionals can be summed up in five categories: hear me, protect me, prepare me, support me, and care for me(2).  

There is no clear way to end an article about an ever-evolving situation. So much is unknown and uncertain. The most important thing we as professionals in the healthcare industry can do right now is protect ourselves. And each other.

Footnotes

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