他们建造野战医院，将手术室改造成重症监护室，并巧妙地打造了自己的医院呼吸机和口罩。现在他们被绑在组成一个危重护理人员。
乔治华盛顿大学米尔肯研究所公共卫生学院的研究人员发现，大多数州现在都面临着2010年食品短缺的风险医护人员需要治疗危重病人，包括COVID-19。本周的报道显示了在过去的一周中令人担忧的预计短缺医生、护士、呼吸治疗师和药剂师。
最近的更新发现，26个州将很快面临重症监护室医生短缺，而上周只有5个。十个州面临着重症护理护士短缺的风险。七个国家面临着在医院工作的医生短缺。九个州将没有足够的呼吸治疗师，上周是零。六个州将面临药剂师短缺。这一严峻的预测让人们想起了2008年劳动力短缺的记忆纽约市当...的时候卫生保健全国各地的工人响应号召采取行动。
米尔肯研究所菲茨休·穆兰卫生人力平等研究所所长帕特里夏·皮特曼博士说:“这些训练有素的医生、护士、呼吸治疗师和药剂师共同努力，为COVID-19和其他重病患者提供可能挽救生命的护理。”“当COVID-19在美国继续激增她补充说，“我们目前的分析表明，大多数州都面临着这些关键指标的不足健康护理人员。"
皮特曼的团队创造了一种叫做州立医院劳动力赤字估计为了帮助各州和联邦政府衡量对医疗保健专业人员的需求，给出了COVID-19的不同情景和工人的正常流失率。劳动力估算器允许决策者计划COVID-19案例中的潜在峰值，并开始配备人员以帮助满足需求。
尽管追踪劳动力短缺趋势的能力有所提高，但考虑到医学和药理学学生在重症监护室工作需要多长时间，这个问题更难解决。重症监护室医生在医学院毕业后接受了近六年的培训，获得了理事会认证，重症监护室药剂师在药学院毕业四年后完成了两年的住院医师培训。
重症监护室医护人员短缺的问题并不新鲜，但在大流行的背景下，这无疑是一个更紧迫的问题。2019年，危重病医学学会(SCCM)发布了一份关于预计劳动力短缺和可能解决方案的声明。SSCM的基础重症护理支持计划，针对农村和其他重症护理服务不足的地区，为非重症监护室医师、护士、执业护士和医师助理提供一个较短的认证计划，这些人通常缺乏重症护理培训。
远程医疗服务可能是在特定情况下满足需求的另一种缓解战略。高级实践提供者，如执业护士和医师助理，可能更容易被拉上队伍，组成一个多学科团队。
重症监护是医疗团队运动的主要例子，如果医院没有派出足够的团队，即使有最先进的设备，他们也不能指望帮助他们的病人赢得对抗冠状病毒。
26 states will soon face shortage of ICU doctors
They built field hospitals, transformed operating rooms into ICUs, and ingeniously crafted their ownventilators and masks. And now they're strapped for the people who make up acritical care workforce.
Researchers at George Washington University's Milken Institute School of Public Health found that the majority of states are now at risk for shortages inhealthcare workers needed to treat critically ill patients, including those with COVID-19.This week’s reportshows alarming projected shortages over last week indoctors, nurses, respiratory therapists and pharmacists.
The most recent update finds that 26 states will soon face shortages in ICU doctors, up from only five last week. Ten states are at risk of running low on critical care nurses. Seven face shortages in doctors trained to work in hospitals. Nine states will not have enough respiratory therapists, up from zero last week. Six states will face shortages in pharmacists. This stark prediction brings back recent memories of workforce shortages inNew York Citywhenhealth careworkers from all over the country answered the call to action.
“These highly trained doctors, nurses, respiratory therapists and pharmacists all work together to provide potentially life-saving care to COVID-19 and other seriously ill patients,” said Patricia Pittman, PhD, director of the Fitzhugh Mullan Institute for Health Workforce Equity at the Milken Institute. “At a time when COVID-19continues to surge in the United States," she added, "our current analysis shows that most states are at risk of running low on these criticalhealthcare workers.”
Pittman’s team created a tool called theState Hospital Workforce Deficit Estimatorto help states and the federal government gauge the demand for healthcare professionals given different scenarios of COVID-19 and the normal attrition rates for workers. The Workforce Estimator allows policymakers to plan for looming spikes in COVID-19 cases and begin staffing up to help meet the demand.
Despite an increased ability to track trends in workforce shortages, the problem is a more challenging one to address given how long it takes medical and pharmacology students to be trained to work in an ICU. ICU doctors have nearly six years of training after medical school to become board certified, and ICU pharmacists complete two years of residency after four years of pharmacy school.
The problem of a shortage of healthcare workers in ICU is not new, but it is certainly a more pressing one in the context of a pandemic. In 2019, the Society for Critical Care Medicine (SCCM) released a statement on the projected workforce shortage and possible solutions. The SSCM's Fundamental Critical Care Support program, aimed toward rural and other areas underserved in critical care, offers a shorter, certificate program to non-ICU physicians, nurses, nurse practitioners and physicians assistants who often lack critical care training.
Telemedicine services may pose another mitigation strategy in specific circumstances to address the need. Advanced practice providers, such as nurse practitioners and physician assistants may be more easily pulled up the ranks to round out a multidisciplinary team.
Intensive care is primary example of a team sport in medicine, and if hospitals are not fielding adequate teams, even with state-of-the-art equipment, they cannot expect to help their patients win the battle against thecoronavirus.
