Attrition: the process of gradually reducing strength or effectiveness of someone or something through sustained pressure.
It is mid-November 2020, the year of the Coronavirus pandemic. I never thought I would use a word like attrition when associated with the medical world. It would seem to fit when talking about a military conflict like World War I. However, 2020, has been unique and challenging and the word attrition seems to fit the reality of everyday life in the hospital.
Let me explain; I work in a hospital in Columbus, Ohio that is a part of a hospital system. This means we have several hospitals and healthcare facilities located throughout the city. Further, this vantage point seems to be reflected throughout the United States and the world. Currently, in the hospital I work in, we have more COVID+ patients admitted in the hospital than at any other time. This number has been consistently rising on a weekly basis and no one knows when this trend might stop. Further, there is less staff available to care for the patients that come our way.
This has occurred for several reasons. First, several departments (including the Spiritual Care department) have had their staff reduced due to the financial struggles medical institutions are experiencing during the pandemic. Second, we have had COVID+ patients for nearly eight months in our hospital. Some staff have gotten tired or overwhelmed and chosen to step away. Many have left due to health concerns for those they love and a knowledge that working in this environment places family and loved ones at a potentially greater risk. Currently, there are 135 staff members within the system who are either quarantined or are COVID+. Many staff members have already had COVID-19 and are trying to work through some of the residual symptoms of the illness; most notably fatigue. Finally, and this is a detail we often try and look away from, more nurses worldwide have died from COVID-19 during the 2020 pandemic than during World War I.
The hospital system I work in has had all the material including PPE (Personal Protective Equipment), ventilators and beds to take care of patients. However, finding enough nurses, PCAs (Patient Care Assistants) and those heroic house cleaners who continually enter COVID rooms is proving to be extremely difficult.
Attrition. As a world community we are approaching 1.3 million lives lost. What can a chaplain do during such times? What positive impact might we make?
First, and for me this is the most difficult part, we need to admit that we can not be everywhere for everyone. As difficult as it might be the reality is many if not most of the coronavirus patients who die will die alone. This is devastating for families and very hard on staff; including myself. Stating truth with grace and simply being with families and staff in the truth of the moment can be reassuring and healing.
We are approaching one hundred deaths due to COVID in the hospital I work at and I have personally been with twenty-nine families at or near the death of their loved one. It’s a lot. It is a lot for staff who have worked on the units for nearly eight months and have no clear vision of an end in sight.
Second, it remains important for the chaplain to model healthy living. This might sound strange; however, the reality is even during hardship, struggle and death there continues to be enormous beauty in the world. In a previous meditation, I mentioned the reality of sacrificial love that can be seen every day. Fall in central Ohio has been especially beautiful with vibrant colored leaves and many days a crisp blue sky. Life continues and life is good!
It is not a time to model a stoic, machismo or even martyr-like demeanor. To confront such tendencies, I have made a conscious practice of encouraging staff to take time away to recharge and enjoy life. During Halloween, I made a habit of asking young parents the costumes and creatures their little ones dressed up as and seeing pictures as often as possible. I am taking the week after Thanksgiving for a time of rest and renewal and I am telling everyone that will listen about my plans. Encouraging them to think about a similar time away.
Finally, when at work and at all times model endurance and hope. This is consistent with my faith tradition. Romans 5:1-5 reads, “Therefore, since we have been justified by faith, we have peace with God through Jesus Christ. Through him we have also obtained access by faith into this grace in which we stand, and we rejoice in hope at the glory of God. Not only that, but we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not put us to shame because God’s love has been poured into our hearts through the Holy Spirit who has been given to us.”