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  • Compassion Fatigue

    Jeffrey G. Chipman, MD, FACS
    Compassion Fatigue

    I recently cared for several ICU patients with COVID-19 who required significant life support, including advanced ventilator techniques.  The majority were unvaccinated. I had to confront my feelings of frustration and irritation as much of it could and should have been avoided.  The evidence that the vaccines are safe and effective is incontrovertible, especially when viewed with a public health lens. The toll of the last 18 months on critical care providers has been relentless, and I am not alone in feeling some compassion fatigue, particularly for the unvaccinated.   I recently liberated a patient suffering from COVID-19 who was on the ventilator for over a week.  When I reported the success to the spouse and that the patient was now considered “recovered” and therefore could have visitors, the spouse shared being unvaccinated.  “Inconceivable,” was all I could think. I wanted to free my frontal lobe and yell, “your spouse has been in the hospital for three weeks and just spent over a week on a ventilator and nearly died?” I asked why and gave my pro-vaccine spiel, but it was a voice to a vacuum. Nothing is going to change some people’s minds, no matter how much evidence there is or the suffering they experience. I acknowledge that for the person who does experience the rare, severe vaccine complication, the risk is 100%, and the public health lens becomes opaque. Even so, one’s perception of risk is often illogical, as I have addressed previously.  It seems impossible to dissuade fear with data. 

    This shared sense of frustration is amplified by the fact that many of us were hoping and planning that the worst of the virus was in the past but are now seeing increased numbers of patients straining already full hospitals - a situation made worse by staffing shortages, partly as a fall out from the last 18 pandemic months. So, to see numbers start climbing again due, in part, to ignorance, obliviousness, or obstinance is salt in the wound. 

    In a way, the hospital systems are in a more significant predicament than when the pandemic began, and supply shortages were severe.  At least then we had plenty of people who could solve the problem, even if it was with baling wire and twine or whatever else was available. The same is not true now. We don’t even have enough people for the non-COVID work. I don’t claim to understand the myriad of reasons for the personnel shortage. However, the strain of the last 18 months on the healthcare workforce cannot be underestimated.  In a recent survey of over 27,000 employees of an academic healthcare institution, of the more than 5000 participants who completed the entire survey, 1 out of 5 are considering leaving their professions due to the strains of the COVID-19 pandemic.  It’s clear that for many, it’s just not worth it anymore.  And with low national and local unemployment rates, there are plenty of available jobs outside of healthcare.  

    Hmmm…I’ve always wanted to be a cowboy.

    Jeffrey G. Chipman, MD, FACS

    Frank B. Cerra Professor of Critical Care Surgery
    Division Head, Critical Care, and Acute Care Surgery, 
    University of Minnesota
    Executive Medical Director, Critical Care Domain, M Health Fairview