What differentiates those who emerge from hard times better and stronger from those who do not?

I am always shocked by where the inspiration to share content comes from.  For instance, I was thumbing through my emails this morning and the following headline from Medscape caught my eye: The Four Attitudes of Resilient Medical Families.

It was an article by Wayne M. Sotile, PhD that described what attitudes separate those that grow and develop during a crisis from those who do not.  I had been deployed to regions of this country during the COVID-19 pandemic and I saw many folks who were coping very well (like water off a duck's back), and others who were having emotional breakdowns over what seemed (to me) to be the most minor inconveniences.

To summarize, Dr. Sotile lists meaning, wonderment, incorporation, and realistic optimism as vital attitudes to have to come out of a crisis with resilience and strength.  He was speaking specifically to medical families, but I think that it is safe to apply these attitudes to responders and those in leadership roles.

Please take the time to venture over to Dr. Sotile's article at Medscape:

https://www.medscape.com/viewarticle/951494?src=WNL_dne_210524_mscpedit&uac=315598HK&impID=3394055&faf=1

Or his website:

https://www.sotile.com/

This article contains a wealth of knowledge in a small package.  Worth the time to read.  Thank you Dr. Sotile for sharing!

Reading List for Public Health, Biosecurity, and Disaster Preparedness

Over the last year, I created a reading list for my niece who was starting her undergraduate degree program in public health at Saint Louis University.  It covers several resources for COVID-19, biosecurity, public health, infection control, behavioral economics, and disaster preparedness/response.  I share this as a resource for my readers as well.

Here are a list of links that may be of interest to you regarding public health and COVID-19:

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

https://govstatus.egov.com/kycovid19

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

https://www.osha.gov/SLTC/covid-19/controlprevention.html

https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/coronavirus-disease-2019-covid-19

 

Here is a list of books that may interest you:

A Planet of Viruses: Second Edition 2nd ed. Edition

by Carl Zimmer 

Deadliest Enemy: Our War Against Killer Germs 1st Edition

by Michael T. Osterholm PhD MPH (Author), Mark Olshaker (Author)

Spillover: Animal Infections and the Next Human Pandemic 1st Edition

by David Quammen  (Author)

The Tangled Tree: A Radical New History of Life Paperback – August 6, 2019

by David Quammen  (Author)

Reimagining Global Health: An Introduction (Volume 26) (California Series in Public Anthropology) First Edition

by Paul Farmer  (Editor), Arthur Kleinman (Editor), Jim Yong Kim (Editor), Matthew Basilico (Editor)

What the Eyes Don't See: A Story of Crisis, Resistance, and Hope in an American City Hardcover – June 19, 2018

by Mona Hanna-Attisha  (Author)

The Fatal Strain: On the Trail of Avian Flu and the Coming Pandemic Hardcover – November 12, 2009

by Alan Sipress  (Author)

And the Band Played on: Politics, People, And the AIDS Epidemic Hardcover – November 1, 1987

by Randy Shilts  (Author)

The Great Influenza: The Epic Story of the Deadliest Plague in History 1st Edition

by John M. Barry  (Author)

Crisis Emergency Risk Communication Paperback – January 19, 2016

by U.S. Government (Author), Penny Hill Press Inc (Editor)

What Were They Thinking?: Crisis Communication: The Good, the Bad, and the Totally Clueless

by Steve Adubato  | Aug 27, 2008

Crisis Communications: The Definitive Guide to Managing the Message Hardcover – March 5, 2013

by Steven Fink  (Author)

Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (ALA Notable Books for Adults) 1st Edition

by Sheri Fink  (Author)

Heat Wave: A Social Autopsy of Disaster in Chicago 1st Edition

by Eric Klinenberg  (Author)

The Ghost Map: The Story of London's Most Terrifying Epidemic and How It Changed Science, Cities, and the Modern World Hardcover – October 19, 2006

by Steven Johnson  (Author)

The CDC Field Epidemiology Manual 1st Edition

by Sonja A. Rasmussen (Editor), Richard A. Goodman (Editor)

Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service 1st Edition

by Mark Pendergrast  (Author)

Biosecurity Dilemmas: Dreaded Diseases, Ethical Responses, and the Health of Nations

by Christian Enemark

FORUM ON MICROBIAL THREATS: The Impact of Globalization on Infectious Disease Emergence and Control: Exploring the Consequences and Opportunities (Workshop Summary)

by Institute of Medicine of the National Academies

The Perils of Partnership: Industry Influence, Institutional Integrity, and Public Health

https://www.amazon.com/dp/0190

Public Health Law: Power, Duty, Restraint, 3rd Edition

by Lawrence O. Gostin and Lindsay F. Wiley

Advocacy for Public Health Policy Change: An Urgent Imperative

by Harry M. Snyder, JD and Anthony B. Iron, MD, JD, MPH

Selling Public Health

by Rick Reynolds

Health Care Emergency Management: Principles and Practice

by Michael J. Reilly and David S. Markenson

Essentials of the U.S. Health Care System, 5th Edition

by Leiyu Shi and Douglas Singh

Neighborhoods and Health, 2nd Edition

by Dustin T. Duncan and Ichiro Kawachi (Editors)

Racism: Science and Tools for the Public Health Professional

by Chandra L. Ford, PhD, MPH, MLIS, Derek M. Griffith, PhD, Marino A. Bruce, PhD, MSRC, MDiv, & Keon L. Gilbert, DrPH, MPA, MA (Editors)

Milestones in Public Health: Accomplishments in Public Health Over the Last 100 Years

Published by Pfizer Global Pharmaceuticals, Pfizer, Inc. (2006)

Nebraska Isolation & Quarantine Manual

by Theodore J. Cieslak, Mark G. Kortepeter, Christopher J. Kratochvil, James V. Lawler (Editors)

Rethinking Readiness: A Brief Guide to Twenty-First Century Megadisasters

by Jeff Schlegelmilch

Advanced Disaster Medical Response Manual for Providers, 2nd Edition

by Susan Miller Briggs, MD, MPH, FACS (Editor)

Quick Bio-Agents: USAMRIID’s Pocket Reference Guide to Biological Select Agents & Toxins

by Jaspal Ahluwalia, MD, MPH, Matthew Chambers, MD, MPH, Janice Rusnak, MD, & Mark Withers, MD, MPH

Criminal and Epidemiological Investigation Handbook, 2011 Edition

by US Department of Justice, Federal Bureau of investigation

Sometimes Brilliant: The Impossible Adventure of a Spiritual Seeker and Visionary Physician Who Helped Conquer the Worst Disease in History

by Larry Brilliant

The Rules of Contagion: Why Things Spread - and Why They Stop

By Adam Kucharski

The Politics of Crisis Management: Public Leadership under Pressure, 2nd Edition

by Arjen Boin, Paul ’t Hart, Eric Stern & Bengt Sundelius

Epidemiology by Design: A Causal Approach to the Health Sciences

by Daniel Westreich

Landesman’s Public Health Management of Disasters: The Practice Guide, 4th Edition

by Linda Young Landesman, DrPH, MSW and Rita V. Burke, PhD, MPH

Urban Planning & Public Health: A Critical Partnership

by Michael R. Greenberg, PhD and Dona Schneider, PhD, MPH

Urban Health: Combating Disparities with Local Data

by Steven Whitman, PhD, Ami Shah, MPH, & Maureen R. Benjamins, PhD

The Only Grant-Writing Book You’ll Ever Need, 5th Edition

by Ellen Karsh and Arlen Sue Fox

Great American City: Chicago and the Enduring Neighborhood Effect

by Robert J. Sampson

The World: A Brief Introduction

by Richard Haass 

Critical Thinking (The MIT Press Essential Knowledge Series)

by Jonathan Haber

Nudge: Improving Decisions About Health, Wealth, and Happiness

by Richard H. Thaler and Cass R. Sunstein

Evicted: Poverty and Profit in the American City

by Matthew Desmond

This is a video of a CDC Epidemiological Investigative Service (EIS) Officer’s TED Talk presentation about an investigation that I was involved with at the state health department:

https://www.youtube.com/watch?v=zVlzAQkz5eE

Robust Preparedness Plan for US Hospitals and for the Nation's Healthcare System Needed

Greg Burel, the former Director of the Strategic National Stockpile (SNS), shared an article on LinkedIn that the SNS needs to be more than just supplies on shelves (https://www.linkedin.com/feed/update/urn:li:activity:6742802262206246914/).  To further this point, much of the supplies contained within SNS that was distributed to states early in the COVID-19 pandemic were beyond their use-by date and in many cases unusable.  The system needs to have a robust supply chain with regional manufacturing available in order to answer the call when the healthcare system is challenged.

Frontline had a scathing documentary on the state of the US supply chain for PPE that was released on October 6, 2020 (https://www.pbs.org/wgbh/frontline/film/americas-medical-supply-crisis/).  Part of the documentary covered the loss of domestic manufacturing of PPE.  This is a national security problem.  If the manufacture and supply chain is inadequate to support frontline healthcare workers, there will be a catastrophic impact on our delivery of healthcare services.  This fact was made abundantly clear during the first half of the response to the COVID-19 Pandemic in the United States.  Facilities across the country had to depend of crisis contingencies for PPE use, that in other times would be unheard of to put into practice.

Because of shortfalls in PPE supplies through all aspects of healthcare delivery in the US, critical healthcare workers were exposed to higher than acceptable levels of transmission risk from the SARS-CoV-2 virus.  The US needs to close these infection control gaps caused by inadequate PPE supplies in order to get our country to the downward slope of the daily case counts, and begin to get to a new normal in our society.

Looking forward to discussions on this topic.  Please follow my blog and contribute comments to my posts.  I don't have all of the answers.  However, open and honest discussions will bring us closer to answers to these challenges.  Thank you for stopping by.

Sorry for my absence!

There have been several of you who have continued to visit my blog, even though I have not provided new content in a very long time.  The last several years have been very challenging for me personally.  I would ask for your continued patience.  I will be returning very soon with content that will pick up where I left off in February 2018 (I cannot believe it has been that long since I last published).

In the meantime, I will share that I have made some changes career-wise to be more aligned with my career goals.  In November of 2018, I took a job as an Infection Control Nurse within the Healthcare-Associated Infection Prevention and Antibiotic Resistance Reduction Program at the Kentucky Department for Public Health.  That's a mouthful, I know.

It has been a challenging, exciting, and rewarding experience over the last 2 years.  I have been pushed outside of my comfort zone and asked to do public speaking and work collaboratively with others from different disciplines.  Often, I felt like I was the novice, but the professionals at the facilities with whom I talked to were looking for guidance.  And, I worked with some very talented individuals who helped me provide answers to their questions.

This Fall, I started a Masters in Public Health with a concentration in Biosecurity and Disaster Preparedness through Saint Louis University.  With everything going on this year, the timing felt right to start such a venture.

I know this post is brief, but mostly I wanted to say thank you to those who visit my blog and to ask for your further patience.  I will provide additional content very soon.  I look forward to sharing more.

Talk to you soon!

Hospital Emergency Management: The Anatomy of Growth

The following link was from the most recent Domestic Preparedness Journal Weekly Brief.  It is amazing how much has changed, and how much has not changed.

I could be wrong, but I would be willing to bet that a lot of our hospitals out there have someone who has hospital emergency management as one of many responsibilities.  We need to focus the energies of those who fulfill that responsibility to just hospital EM, for the protection of the patients, their families, the staff, and the community.

I welcome the thoughts of those who follow me.



Hospital Emergency Management: The Anatomy of Growth: Prior to 11 September 2001 the term "emergency management" was more an abstract theory than an operational mandate. Today it is a full fledged…

Hospital Emergency Management exercises

Communication

One of the keys to an effective response to an internal or external emergency is communication.  The healthcare staff must be aware of the altered expectations that will be in place in the event of a major incident.

What contingency plan is in place to accommodate staff that must remain at the facility beyond their regularly scheduled shift?  What understanding does the staff have regarding mandatory callbacks?  When might mandatory callbacks be implemented?  Which staff members will be required to make every possible effort to report to duty on a scheduled day off?  Is the staff even aware that a major emergency might trigger such extraordinary callbacks?

When is the last time that the employee's contact information had been updated in the system?  A simple exercise might involve a simulation where staff are asked to respond back when a "callback order" is given.  This should involve minimal time and minimal interruption of one's day.  However, the lessons learned from this simple exercise could be a good foundation upon which to build.

Altered Standards of Care

The occurrence of an emergency alters the context in which care is given.  Contextual changes may include shortages of staff or supplies, provision of care in settings other than the usual patient care rooms, or numbers of patients far in excess of the usual capacity.  Expected standards of care that can be followed during usual times may not be possible, requiring the facility to clarify expectations within the existing situation.  This is another area in which management during the disasterous event requires thoughful anticipation and planning.  A key to the change is the shift from what is typical in any United States care setting, that of providing maximum care possible to each presenting patient before moving on to the next one, to an approach that ensures the greatest good for the largest possible number of patients (Veenema, 2012, p 195).

Emergency standards of care would involve a massive contextual shift in the minds of those who respond.  Much of our "normal" environment at work might be altered in a major event.  Staff must be prepared to adapt quickly to this altered environment in order to effectively provide care.  To achieve this goal, staff must practice under simulated conditions.

The goal here is not to act like a bunch of robots.  The goal is for staff to anticipate restrictions and limitations and be able to respond accordingly.  The anticipation of the possible conditions is the key.  To achieve this, the staff must be provided with possible context.

References

American College of Emergency Physicians. "Guidelines for Crisis Standards of Care during Disasters." ACEP Disaster Preparedness and Response Committee; 2013.

Veenema, T. Disaster Nursing and Emergency Preparedness for Chemical, Biological, and Radiological Terrorism and other Hazards. 3rd. Ed. New York, NY: Springer Publishing Co. 2012

Call to Action

I had just received the January issue of American Nurse Today this week.  Within it was an article authored by David Benton titled "Is nursing prepared for the next disaster?  Are we?

Do we have a plan B in place to cover other systems that will be affected by the disaster (schools, child-care, elder-care, transportation, etc.)?  Do we have a game plan in place for our families so that we can effectively respond to the disaster?  Have we read after-action reports from previous disasters that dramatically affected the delivery of healthcare to learn the lessons learned?  Or are we doomed to repeat the same mistakes and shortcomings that occurred in previous events?

Are we becoming advocates for increased availability for disaster training in our workplace or advanced degree programs?  Are we prepared for the realities of a major incident?

How many of our workplaces offer disaster training through simulation, community disaster exercises, hospital exercises, or tabletop exercises?  How many of us are ready for the mental health challenges that we will face during a disaster; in our patients and ourselves?  What resources are available to our patients and us?  Is our behavioral health
or employee health resources actively involved in the planning phase?

How many of us truly understand that when we talk about triage during a disaster we are talking about the fact that we will not be able to save everyone?  Inherent in a disaster is an event that so totally overwhelms the healthcare system that simple issues become major hurdles.  This will be mentally taxing for many of us.  How many of us are so self-aware of our triggers and are okay to ask for help?

These and many more questions need to be asked.  If you identify a gap or shortcoming, are you willing to take action no matter your role in your institution?

Thank you David Benton for your timely article.

References

Benton, D. (2018). Is nursing prepared for the next disaster? American Nurse Today. 13(1), 32-33.

Veenema, T. G., Lavin, R. P., Griffin, A., Gable, A. R., Couig, M. P., & Dobalian, A. (2017). Call to Action: The Case for Advancing Disaster Nursing Education in the United States. Journal of Nursing Scholarship. 49(6), 688-696.