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Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.

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COVID 19: Looking back on the past year’s challenges

The challenges faced by health care professionals during the peak of COVID-19, including rapidly evolving guidelines and patient surges, are summarized.

Lenworth M. Jacobs, Jr., MD, MPH, DSc(HON), FACS, FWACS(Hon)

May 4, 2021

The month of March marked a full year since most states began lockdowns and restrictions to protect the public from the spread of the coronavirus 2019 (COVID-19). The past year has brought many challenges to health care professionals as they dealt with rapidly changing guidelines and patient surges as COVID-19 cases increased across the country.

COVID-19 takes a toll on health care personnel

To not only reflect the difficult circumstances that health care workers have been working under, but also to give voice to the hurdles they have observed while doing so, The Joint Commission issued a special edition of its Sentinel Event Alert newsletter to share the concerns that health care workers have expressed during the pandemic.* The issue—the first in a new series—provided education and examples that may be helpful to other health care professionals as institutions continue to respond and prepare for future challenges that will require safe, healthy, and engaged health care workers.

“Voices from the pandemic: Health care workers in the midst of crisis” examines how the continuing onslaught of COVID-19 cases pushed health care facilities to their limits and workers beyond physical exhaustion. These kinds of traumatic experiences underscore the critical importance of supporting health care personnel who bear the burden of crisis situations along with patients and families.*

As a sounding board and source of information for U.S. health care institutions, The Joint Commission is in a unique position to understand and shed light on their collective experience during the pandemic, which is expected to continue with high rates of infection and mortality despite the rollout of vaccines that started in December.

The alert states that according to the feedback received by The Joint Commission’s Office of Quality and Patient Safety, health care personnel shared three main concerns or fears in the early months of the pandemic. They were as follows:*

  • Fear of the unknown, in part because of unclear, confusing, or contradictory guidance from leading sources on the appropriate precautions and procedures for containing the spread of the disease
  • Fear of getting sick, particularly for professionals who were more likely to suffer more serious complications from COVID-19, such as individuals with preexisting conditions or in a high-risk age group
  • Fear of bringing the virus home, especially among personnel who lived with older adults or children

Health care facilities can help

The alert also cited an online survey from September 2020 that was conducted by The Joint Commission to learn about the needs of health care institutions in the current and evolving pandemic environment. The questionnaire had a total of 735 respondents, representing a variety of health care settings.

The study found staffing issues was one of the greatest challenges facing health care facilities across all settings during the pandemic.

The issue also listed five key ways institutions can support health care personnel. They are as follows:*

  • Foster open and transparent communication to build trust, reduce fears, build morale, and sustain an effective workforce.
  • Remove barriers to health care personnel seeking mental health services and develop systems that support institutional as well as individual resilience.
  • Protect workers’ safety using the National Institute of Occupational Health and Safety hierarchy of controls framework.
  • Develop a flexible workforce; evaluate the work being performed and determine if it can be performed remotely.
  • Provide clinicians and others with opportunities to collaborate, lead, and innovate.

Call to action

These are challenging times. However, the advent of vaccines that are effective against COVID-19 is very positive. In December 2020 and January 2021, the euphoria that resulted from the vaccine being produced and delivered to the public was mitigated by the realization that there were too few vaccinations for everyone who wanted to be vaccinated. With the advent of a third vaccination produced by Johnson & Johnson and the production of vaccinations being enhanced by other companies, it became clear that in the spring 2021, the U.S. would have an abundance of vaccines but too few vaccinators.

Volunteers from all walks of the health care system have stepped up to assist the government and private sector in vaccinating all members of the public. An example of volunteerism and the desire to be altruistic is the emergency medical technicians, paramedics, nurses, and physicians who have been trained as STOP THE BLEED® instructors. Many of these professionals have given their time to assist in the national vaccination initiative.

Volunteers are essential to turbocharge the vaccination process, as nurses and other personnel from the hospital environment are increasingly required to perform their normal activities in the hospital.

The American College of Surgeons issued a call to action to all health care professionals who want to be part of the vaccination team. The government and other health care agencies that are performing vaccinations are welcoming this new volunteer workforce, which will be able to inject the increasing supply of vaccinations into the arms of the entire U.S. population.


The thoughts and opinions expressed in this column are solely those of Dr. Jacobs and do not necessarily reflect those of The Joint Commission or the American College of Surgeons.

*The Joint Commission. Sentinel Event Alert, Issue 62: Voices from the pandemic: Health care workers in the midst of crisis. Available at: www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea-62-hcws-and-pandemic-final-1-28-21.pdf. Accessed March 26, 2021.

Newman L, Campbell A. Surgeons: Take an active role promoting COVID-19 vaccination programs, especially in minority communities. Bulletin Brief. Available at: facs.org/publications/bulletin-brief/011921/clinical#vaccine. Accessed March 26, 2021.