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Writer's pictureThe Communiqués

Clinical Communiqué Volume 7 Issue 3 September 2020


In this edition

  • Editorial

  • Our safety is our patients’ safety

  • Flattening the hiearchy to keep health care workers safe

  • Health care leadership in COVID-19; Getting better at getting better, together

  • Risk, moral injury, and decision-making in the time of COVID-19

Editorial


Welcome to the September 2020 edition of the Clinical Communiqué.


2020 has been a year of firsts in so many respects for the professional and personal lives of almost everyone on the planet. In health care, we have had to rethink our systems, redefine our teams, and reflect on our individual practices. The words ‘R number’, ‘unprecedented’, and ‘furloughed’ have become as commonplace as the personal protective equipment (PPE) we now reach for on a daily basis.


The Clinical Communiqués have always been about patient safety, but we have also focussed on health care worker (HCW) safety. Now more than ever, we need to talk about HCW safety. Vital discussions are taking place about the long-term mental health effects of the pandemic on the community, and the acute effects of PPE failure on HCWs. Rightly so, but what about the long-term effects of working in health care during the COVID-19 pandemic? The insidious, cumulative, psychological harm of working in a constantly evolving environment that is not what many of us chose for ourselves? Those discussions are emerging, but many of us are too busy, too tired, too focussed on other matters right now, to stop and pay attention to our own health.


It will be many years before we fully understand the consequences of the pandemic on HCWs – but we should be proactive and prevent harm today so that the incident reviews and coronial investigations do not ensue. So, in yet another first, this edition of the Clinical Communiqué dispenses with our standard format and presents four expert commentaries that offer guidance to HCWs on establishing and maintaining psychological safety during the pandemic. Dr Jesse Zanker writes a compelling piece about self-care and recognising vicarious trauma during COVID-19, and Dr Michelle Ananda-Rajah astutely outlines the importance of framing PPE and HCW safety within an occupational health and safety lens. Dr Mya Cubitt shares her humanising perspective on leading a profession at the frontline, and Dr Neil Cunningham discusses risk and moral injury with insightful tips on creating a safe environment at work. Each of these experts is working tirelessly in their roles to improve the safety of their teams as well as their patients and the broader HCW community, and they bring a wealth of knowledge and their own personal accounts of the pandemic to their commentaries.


There are immeasurable emotions that this pandemic raises for HCWs. Emotions that are conflicting, skewed, accentuated by the changes taking place around us. We have all seen, or had, those fleeting moments of doubt where, as HCWs, we have wanted to close the door, stay inside, and not face another day of working in a COVID-19 environment. We have watched colleagues wrestle with a sense of guilt of not being able to continue face-to-face care – to stand alongside their team at the frontline.


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