Doctor: Corporate medicine causes unhappy Thanksgiving in emergency room | Commentary

Please be kind to a nurse.

Please be kind to the emergency techs, respiratory therapists, ultrasound and radiology techs, registration personnel, emergency security personnel and hospital housekeeping.

The physicians, physician assistants, and nurse practitioners in the emergency departments cannot do efficient, proficient, or even safe medicine without them.

We in emergency medicine understand how hard it is when people are in pain and afraid. And we also understand well that misbehavior is often the language of the wounded.

We are professionals in the care of the homeless, mentally ill, inebriated, abused, traumatized, bleeding, anxious, depressed, suicidal, homicidal, sick, and the dying.

We signed up to help those who are the most helpless and the most in pain. This is our work that we have done honorably in Wichita for decades. But we are in a new, and much worse place than we have ever experienced before. Emergency medical care is worse, much worse now, than during COVID.

And it is not just COVID and the lack of material resources that have plagued emergency medicine. It is not just the uptick in unkindness, the recent hostile attitudes and unscientific Facebook opinions that patients want to go to war with staff over. It is the fatigue, lack of personnel with increasing numbers of patients, and the moral injury that the people you work for do not have your back.

This must not be blamed only on the COVID aftermath. The corporations who have taken over healthcare are the most demoralizing that believe, preach, and behave that “medicine is a business.” They staff not for proficiency, but for profit.

We have a lack of critical staff today because of financial decisions in the Spring of 2020 when emergency department volumes fell. COVID was demolishing the East Coast, and everyone in medicine knew it would be just a matter of time before the deadly coronavirus came to the heartland. But the corporations, though they had been given hundreds of millions of dollars for COVID preparation from the U.S. government, slashed staff, cut contracts without notice, got rid of as-needed nursing, and sent home as many nurses as possible on slower days, although they needed the money.

And then COVID killed Wichita in the winter of 2020-21. In the Emergency Department, we daily had 30-40 sick admitted patients, many of them on breathing assistance, with another 20-30 waiting in the waiting room just as ill and scared, with not enough staff to take care of them.

We are not Denver or Dallas. When you snub the few that have committed to your hospital in Wichita, there are no others to take their place. So, we just put our heads down inside our masks, prayed, and worked harder with less people until we could find our way to the end of devastating shifts.

When the sun started to come up from this dark night, key people started quitting. Some of it was the sheer combat trauma for so long; but a lot of it was the lack of financial and resource support from healthcare corporations that profited over a billion dollars during the same year of a national pandemic.

None of this money during that year or the next made it to nursing salaries. Staffing was never beefed up to take a little emotional pressure off of the constant grind. Administrators at hospitals expanded their business staffs and received increased bonuses while the workers in the emergency departments grew hopeless and quit.

Now, most evenings at many of the busiest ERs in Kansas, we are without a respiratory therapist. Can you imagine heading into croup and RSV without a professional respiratory therapist? You cannot teach any nurse to do this highly skilled job in a week or two.

Ultrasound techs at night in Wichita might take many hours to get studies done that could make a difference in whether a couple can have children or not. Housekeeping that keeps us safe with infection control and cleaning are a hit and miss. Unarmed security with tasers they are told not to use are often not present with nurses walking out to darkened parking lots, while patients carry guns and knives.

Some of this might have been inevitable, but had hospitals put personnel and patients before maximal profit, a good portion of this would have been preventable.

Now we pay salary and a half to fly in nurses (when available) who we do not know, who are trained by our own faithful nurses paid a fraction of their salary. Can you imagine how emotionally defeating this is?

If someone tries to give you the party line that “we can’t hire people that are not there” or “we are having the exact same kind of problems as other businesses, even in healthcare,” this is half-truth misdirection.

Other companies did not profit a billion dollars in 2020-2021. Other companies were not given hundreds of millions of dollars from the government specifically to make COVID medical care better.

But most importantly, your emergency care is not, and should not be treated like a business. We are the healthy delivery of your baby. We are the cardiac resuscitation of your dad. We are the life and limb-saving trauma care of your teen in a motor vehicle accident. We are the suctioning and respiratory care of your young child and grandchild with RSV. We are the safe return of your grandparents to their homes.

There may not be much that the average Wichitan can do about the dangerous capitalization of healthcare in America that makes your emergency care more about profit than medical proficiency. Perhaps our local and national medical societies can exert a louder voice and stronger arm against the current financial powers that are making us broke and sicker.

But as we slide into the icy winter of RSV, influenza, and broken bones with understaffed, tired, and demoralized healthcare providers — often without respiratory therapists and now without a single 24-hour pharmacy in Wichita — consider this Thanksgiving being kinder to a nurse and all essential medical staff you encounter.

Consider the miracle of the health you have in spite of a changing environment of good money over good medicine.

Give an “emergency Thanksgiving” this holiday to the people who still find it an honor to bring healing to you and those you love.

Dr. Mark Mosley is a medical doctor and has a master’s degree in public health.