How 7 Clinicians Prep for a Day on the Front Lines

What your doctor is reading on Medscape.com:

MAY 09, 2020 — On even the best of days, clinicians have to make difficult decisions, sometimes life-or-death decisions. But these are not the best of days. They are arguably the hardest days some clinicians might face, as COVID-19 pushes them to their limits, again and again.

How do frontline doctors, nurses, physician assistants, and others steady themselves to spend yet another day fighting COVID-19? How do they get ready for the emotional and physical onslaught they may be about to face?

Medscape Medical News asked seven healthcare professionals to share how they prepare for work each day — and for returning the next.

Joshua D. Miller, MD, 40, assistant dean, Renaissance School of Medicine, Stony Brook University and medical director of diabetes care, Stony Brook Medicine, Long Island, NY. He splits his time between overseeing COVID-19 testing and caring for patients:

“I have to put to rest, or at least triage, the anxiety-provoking thoughts we all have, and I have, about the risk for family, parents, and someone with diabetes. I have type 1 diabetes. I acknowledge the anxiety. I think it’s important to acknowledge that fear, to acknowledge that I am, like every single one of us, fearful of bringing the virus home.

“When I get home, I take off all my clothes. My kids are not allowed in my car these days — not that we are going anywhere. I try to allay the fear by telling myself, the same way I do in the hospital, that if I do things that way [with hygiene practices and PPE] I will lower my risk to myself and my wife and my kids.

“There’s an ebb and flow to the anxiety. On the days when I am not as successful at triaging those emotions, those are the days when I look around and realize, this is the new normal and we are finding it is really scary, Orwellian and disconcerting.

“The moments that get me most are when I am out on the testing site and I see kids in the cars. I love kids and I am always able to get them to smile. Now, I wave and they don’t wave back. I realize I’m wearing a mask and they are surrounded by military personnel. Those are the moments when it has been really, really difficult. When I see a 1-year-old in a car getting swabbed, it gets more challenging to table the emotions.