Trainee doctors overwhelmed by public hospitals detail exhausting working conditions in pandemic

Officials at the public hospital admitted on Friday that the system is ill-equipped to respond to staff suicides following at least two incidents in which medical residents committed suicide during the pandemic.

The admission came at a hearing, board member Carlina Rivera (D-Manhattan) called in following three deaths since last summer among medical residents-in-training at Lincoln Hospital in the Bronx, after THE CITY and Daily News reports in July.

Rivera toasted executives at Health + Hospitals Corporation over a statement by Dr Eric Wei, director of equality at H + H, made to THE CITY in July, in which he said that a mental health program and existing wellness center called Helping Healers Heal is “not intended to combat suicide.” . “

Dr Omar Fattal, deputy medical director of H + H in the Office of Behavioral Health, asserted that the program “per se does not deal with suicide,” noting that the peer support model “is not an encounter clinic ”.

The agency is in the process of hiring “a crisis response education officer” who can be deployed “if and when a tragedy occurs,” said Jeremy Segall, assistant vice president and director of welfare. be at H + H.

Two dozen residents and trainees then testified at the surveillance hearing, which focused on the mental health issues of medical trainees in the city’s public hospitals as well as the harassment allegations against them. .

Dr. Omar Fattal, behavioral health specialist at NYC Health and Hospitals and Clinical Associate Professor at NYU Grossman School of Medicine, testified at the City Council Hospitals Committee meeting on interns and residents of New York and health.
Screenshot / New York City Council

The speakers, who work in Bellevue, the Metropolitan, Kings County and other public hospitals, implored city officials and lawmakers to increase funding for the H + H system. They cited critical staff and equipment shortages and major factors contributing to their stress and mental health issues, often to the detriment of the patients they care for.

“It’s sad to see that my patients are not satisfied with the care they are receiving and that their concerns are valid,” said one resident who testified anonymously. “When my patient tells me that she refused her pill against the water because there is no nurse to help her urinate and she has to stay in her urine for hours, it makes me sad and I feel like I failed with my patients. “

“Bad equipment and lack of personnel”

Hospital-based residency programs, where graduates of medical schools receive training and prepare for specialties, are notoriously difficult, with interns working long hours.

The working conditions of residents have long been targets for reform. Thanks to past changes, residents cannot work more than 80 hours per week, on average over four weeks, and no more than 24 hours on duty at a time, with a few exceptions.

The Interns and Residents Committee, a union representing state medical trainees, is pushing for a hard limit of 80 hours of work per week, “not on average and including non-clinical duties.”

Dr Oluyemi Omotoso, emergency medicine resident in Lincoln and CIR-SEIU secretary-treasurer, said ahead of the hearing he was hoping to hear responses from city officials on Friday about how they plan to address those concerns as the union begins contract negotiations with Health + Hospitals next year.

Dr Oluyemi

Dr Oluyemi Omotoso, emergency physician and chief resident of Lincoln Medical & Mental Health Center, testified at the City Council Hospitals Committee meeting about New York interns and residents and their health.
Screenshot / New York City Council

At the hearing, a Kings County resident, testifying anonymously, said the shortages were so severe at the facility that clinicians created a WhatsApp group called “Where’s the ultrasound?” »The internal medicine departments of the hospital.

“We loudly bemoan how terrible it is that black people are disproportionately affected by death and disease, we denounce the racism of Donald Trump and his supporters, and then in a city as wealthy as New York, we allow l hospital that takes care of them. become dilapidated, poorly equipped and with few staff, ”said the resident.

Double duty

Kings County internal medicine resident Dr. Dina Jaber testified that due to understaffing, residents often have to perform phlebotomy tasks usually reserved for nurses, taking time to treat patients. .

“I have the impression that nurses and technicians are totally understaffed,” she said.

The mix of tasks “doesn’t create a good culture between nurses and residents, which is an additional stressor for us, for nurses, and clearly not good for our patients,” Jaber added.

Omotoso told THE TOWN that part of his “untitled” job at Lincoln includes transferring patients to other rooms and wards and changing their linens – tasks also typically reserved for support staff, a- he declared.

“All of these little things take time, and it takes time for patient care,” he said.

During the hearing, Rivera pleaded with city hospital officials to ensure that “wellness programs are accessible to residents and are safe spaces.”

Even with existing wellness programs, many residents say they’re afraid to speak up after seeing or experiencing what they considered bullying behavior. This includes a former Lincoln intern who told THE TOWN in July that program officials and even some other residents berated her for being too gentle for the job after saying she was having emotional difficulties.

Residents alleged harassment and retaliation from Lincoln Hospital management, with current and former hospital interns claiming that a harsh culture took its toll before three residents died in eight months, including two by suicide. In an editorial, Lincoln Medical Director Dr Vihren Dimitrov and Internal Medicine Director Dr Nehad Shabarek categorically denied claims of a “toxic” work culture.

Dr Ernesto Blanco, a former resident at Coney Island Hospital, said on Friday his schedule was “very unfriendly” when he requested leave to deal with the crisis his family faced in 2019 when his country of origin, Venezuela, has collapsed.

“I had to fight for free time and I was finally told I could take four days off. On the second day I started getting called and asking when I was coming back, ”he said. “My program director said to me, ‘You have to come back, that’s not the way to do it.’ “

“When we dare to speak out about the struggles we face, it seems we are not being listened to,” he said.

Rivera said during the hearing that “all residents should feel safe and provide feedback on their programs without fear of reprisal.”

Health + Hospitals spokesperson Stephanie Guzman made a statement to THE TOWN in response to Friday’s testimony.

“NYC Health + Hospitals interns and residents are vital members of our healthcare teams and have heroically served New Yorkers during the COVID-19 pandemic. We are proud of their contributions and recognize the challenges they faced during this devastating pandemic, ”she wrote.

“All allegations of unsanitary, unsafe or unfair working conditions are taken seriously and investigated by the system. We respect and invite our residents to be a part of the public process and are committed to working with them to address these complaints appropriately.

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