First, Do No Harm

The following article is about personal and professional obligations to prevent harm to patients. 

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"First, do no harm" is the primary directive for all healthcare practitioners. Achieving this goal at this time certainly requires vigilance, both personal and professional, on the part of all practitioners. Some commentators have suggested anecdotally that healthcare practitioners may be a significant vector of transmission of the coronavirus.
In an article in The New York Times on February 26, 2020, entitled "Shaved Heads, Adult Diapers: Life as a Nurse in the Coronavirus Outbreak," Nurse Zhang Wendan reported that she and her colleagues were required to live in the hospital where they worked for thirty consecutive days. They then quarantined for an additional fourteen days before returning home.
Likewise, Italian physicians raised the question in early reports about whether patients should be kept at home when diagnosed with coronavirus with intensive remote monitoring. They suggested that in-person care at home should be provided by a mobile team dedicated to the care of coronavirus patients and that only the most severely ill patients should be hospitalized.
In "Bringing the Hospital Home to Patients," by Gurvinder Kaur, MD, published on June 18, by Vituity, Dr. Kaur recommends that COVID-19 patients be kept at home whenever possible. The article provides details about how the "hospital at home" model has worked in a health system in California.
The questions of whether practitioners are a significant vector of transmission and if so, how to disrupt transmission will undoubtedly be resolved at some point in the future. In the meanwhile, practitioners must be vigilant about their conduct both on and off the job to help ensure that patients are not harmed. It's "all hands on deck" all of the time!
The importance of vigilance, both at work and in personal life, is underscored by a recent article in The Boston Herald on July 29, 2020. The article reported that thirteen patients and twenty-three employees at a Massachusetts hospital, Baystate Medical Center, tested positive for the coronavirus after an employee recently traveled to an out-of-state virus "hot spot." The situation was almost certainly exacerbated by the fact that hospital staff members gathered in break rooms without wearing masks or observing social distancing protocols.
Practitioners must be vigilant about their behavior at all times until more is known about how the coronavirus is transmitted, or until there is an available vaccine or treatment or both. In other words, it's not enough to wear personal protective equipment (PPE) and to adhere to infectious disease protocols at work in order to prevent harm to patients and colleagues. The current pandemic calls for more. Practitioners' conduct on and off the job may now cause harm to both patients and others. Be vigilant everywhere!
©2020 Elizabeth E. Hogue, Esq.  All rights reserved.


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