Vote in Support of OHSU's Missions
--guest post by Roger Clark, Local 328 executive-board member--
As a pharmacist in the OHSU’s Emergency Department, I have witnessed first-hand how the Trump administration has affected the day-to-day operations of providing direct patient care. The majority of these effects have to do with the administration’s poor response to the COVID-19 pandemic. I’ve also seen many patients come through the ED as a result of clashes between opposing groups of protesters or between protesters and heavy-handed police.
Patient Care and Students
As a consequence of the administration’s poor response to the COVID-19 pandemic, my workflow has changed dramatically. First of all, OHSU had an almost immediate shortage of personal protective equipment. Pharmacists have been asked to stay out of the rooms of patients confirmed or suspected to be infected with COVID-19, in order to preserve valuable PPE. In the early days of the pandemic, we were asked to make our procedure masks last for days. Trump’s refusal to invoke the Defense Production Act to increase production of PPE unnecessarily prolonged the shortage of PPE.
Not being able to enter the room of COVID-19 patients inhibits my ability to interact with patients and ask them important questions about allergies, height/weight, contact information, preferred pharmacy, etc., and I am unable to interview patients to perform an accurate medication reconciliation. Traditionally, I enter the room when traumas arrive, when we have a code blue, and when code-3 ambulances (very medically ill patients — sepsis, heart attack, stroke, etc.) arrive, to name a few situations. Not being able to enter the room inhibits my ability to make timely interventions and participate in the care of the patient. Not being able to hear providers in the room because they’re wearing an N95 or P100 mask, or because the door is closed because they are performing an aerosol-generating procedure, means that interventions are delayed and information is typically exchanged second- or third-hand.
Not only have patients needlessly died secondary to COVID-19 infection, but the care of other patients has been compromised due to the changes we’ve had to make. Early in the pandemic, our patient load was reduced significantly. This wasn’t because people were no longer getting sick — it was because they were taking their chances at home to avoid coming to the hospital and getting infected with COVID-19. Many of our patients have comorbidities that put them at higher risk for poor outcomes from COVID-19, and many immunocompromised patients come through the ED. My fear during this time was that patients were sitting at home with symptoms of a heart attack or stroke, preferring not to interact with the health-care system.
Teaching the next generation of health-care providers has become difficult. In the early days of the pandemic, students were told to stay at home because of the PPE shortage and the desire to avoid unnecessary exposures to the virus. Like myself, students of all disciplines are not allowed to enter the rooms of COVID-19 patients or when trauma/code-blue/code-3 patients are present. Interacting with students has become difficult due to the need to social distance. Students are often expected to work on their own in a distant location, when they would learn much more if they were in the presence of their preceptors. Classroom learning has transitioned from in-person instruction where students form relationships with their professors and fellow students to remote online learning.
Protesters and Politicization
I attribute any injuries or deaths from the Portland protests to be a result of the Trump administration’s refusal to acknowledge that systemic racism is just as prevalent as it always has been, Trump’s insistence on courting and rallying hate groups to counter peaceful protesters and the administration’s deployment of federal police officers into OUR city. Have all the protesters conducted themselves peacefully? Absolutely not, but it doesn’t help to continually throw gas on the fire.
We’ve had protesters on both sides come to the ED after being assaulted with fists and feet, after being stabbed and after being hit with “non-lethal” rounds. These are unnecessary injuries secondary to a toxic environment fueled by rhetoric, hate and a desire by some to create chaos.
Under President Trump, everything has become politicized. Interacting with patients can be tricky, because some insist on making their political beliefs known without any provocation. Anything you say or do can be interpreted — or misinterpreted — as being affiliated with one political belief or another. One patient’s father refused to wear a mask because he “knows his rights” — instead of following the rules so that he could be at his child’s bedside, he argued with staff and Public Safety about why he wouldn’t wear a mask. He wasn’t concerned about his actions putting other patients or staff at risk; he was only concerned about his constitutional right to not have to wear a mask. He finally decided to wear a mask just as Public Safety was getting set to arrest him for trespassing.
If the Trump administration is successful in dismantling the Affordable Care Act in the courtroom (after the GOP’s many unsuccessful attempts to do so in the legislature), what will become of the millions of COVID-19 survivors? In addition to millions of Americans losing their health-care coverage, those experiencing long-term complications from COVID-19 infection may have coverage for their care denied due to their pre-existing condition.
We need new federal leadership that will acknowledge that COVID-19 is still an immediate threat — that adherence to mask-wearing and social-distancing is the only way to get through this pandemic without extensive loss of life. Ignoring the virus and allowing for herd immunity will lead to hundreds of thousands more deaths. We can focus on vaccine and therapeutics development and production without losing focus on containment efforts. Our country looks weak and foolish in our pandemic response, and any effort to convince other nations that we are a leader in anything other than the spreading of misinformation and chest puffing is nearly impossible. We need leadership that will help us restore our place in the world and unify Americans toward common causes.
I won’t tell you who to vote for, but if you care about OHSU’s missions, it shouldn’t be Donald J. Trump.