Masking & Professionalism | Excerpt From The VPZD Show Ep. 32

[owlofathens]

I used to get sick once every 2 months on residency. Since the pandemic I have only gotten sick twice in 4 years, and not from work. Im keeping masks on forever.

[MNP]

We've gone back to pre pandemic phase - wearing masks when patients are coughing. I still want that choice. Also, an actively vomiting patient in a small exam room when vomitus can aerosolize. You'd better believe I'm wearing a N95! We have window masks for our HOH patients.

[splashesin]

What if the isolation and reverse isolation process comes from way further back than the recent pandemic to the bone marrow transplant situations. Laminar airflow units, or patients sometimes wearing masks in the outside world depending on blood counts, and what other things "opportunistic infections" are circulating. The ocd had to be learned, and the patient had to show they could use sterile surgical procedure to change the dressings around their central lines, before getting let loose back home or into the world at large, often without any other caregivers. No one wants to be ocd, or single themselves out wearing masks, but if you repeatedly deal with the consequences that all to often happen, and start weighing how many days of incapacitation regularly happen compared to how many days for the types of friends who want to feel offended no matter how you explain it's not them, it's just that their friend is, more susceptible to everything. The one person that needs to be ocd once in awhile shouldn't have to be scapegoated either.

[TheReligiousLeft]

So sometimes my patients ask me to take my mask off. I let them know that I wear it because I have a 2 year old at home. Then they ask me to keep it on haha.

[garyvecellio]

I don't care about how my doctor dresses as long as they do their job. Unfortunately I can't find one that does. In the last 3 years I have tracked mine, my mother's and wifes blood tests, ordered by doctors. They came back with odd results which the doctors said not to worry about. I pushed for months for further tests and found cancer twice and a liver condition. Then they all got excited suddenly to do their jobs. Wear crocs for all I care. Just do your jobs.

[berneetkaur]

My work place won’t let us use sick leave if we get a cold, flu, or COVID. We have to use vacation. I’m not worried about dying when I wear a mask at work - my patients are the people I have the closest contact with except my spouse who doesn’t go anywhere bc he works at home. I am most likely to get a URI from work. I have to lose vacation time. I’m wearing a mask at work. I’ll let up when they let us use sick leave again.

[catsladder]

Here is another thought. Why is it important to convey a sense of professionalism? Is some patient’s population and environmental context, it can backfire. What constitutes professionalism evolve over time (e.g tie). Depending on the definition of professionalism, it could also mean distant and cold. What would better for a patient— a doctor who is professionally cold without mask or a doctor who is warm, empathetic, but with a mask on? Probably the relationship between masking and professionalism requires wisdom as it may be different in different situations.

[alfanzoblanco]

Coming from EMS and then now going into medicine, I don’t like touching pt’s without gloves not only for myself but I want to make sure the contact I’m making is fully perceived as procedural. I think pt’s can compartmentalize the feeling of that contact differently from direct contact with skin.

[thatswhatisaidCA]

I am not in the profession, but I found this hilarious and fun, and a little insightful. :)

[catsladder]

Here is an idea for research. In a hospital or SNF where a patient need diaper changes and bath assist, in another word, intimate procedures. Would a patient feel more comfortable with a nurse or CNA doing these tasks with a mask on or not a mask on. This idea is inspired by an old article I read where in Japan, they find elderly patients prefer a robot to assist in these intimate tasks rather than a person.

[ebellyfish]

Interesting discussion. As usual, either extreme is probably best avoided, as under normal circumstances (i.e. not in a pandemic or epidemic) extremism rarely serves us well.

[chrisdavis]

We’re still required to wear them in the CLC (community living center)@ the VA

[HayseedHick]

I just read "Tell Me When Its Over" by Paul Offit. I got the strong impression that Offit is a mask advocate....what am I to believe now?
( I strongly recommend the book. Clear/concise as I expect from Paul Offit. Basically a summary of the complex history of the pandemic and other related stuff.)

[catsladder]

If we really want to be patient centric, then find out what our patients are more comfortable in terms of masking, and we do what is comfortable for them. So if a patient comes in with a mask on, I am going to to put one on, if a patient not comfortable with me having a mask, then I am not going to put one on. Also are we tracking staff calling in sick in the context of a mask wearing environment vs a nonmasking environment as that affects patient care indirectly ( basically low staffing which affect not just patient care quality and also staff moral).

[wchphoto]

Excellent topic! I love listening to your podcasts and I get a lot from them. Here is one of my mask experiences...I teach self-defense at a community college and in my first semester coming out of the pandemic, everyone had to wear a mask. It was terrible, for me anyway. All I saw was eyes and hair, making it harder to learn everyone's name. And, I'm in my 70s so my hearing has diminished a bit and I realized that I had been relying on lip reading. The mask mandate made that impossible. I was always saying, "What?" Halfway through the semester, I told my dean I would retire if we had to wear masks in the future. I was a microbiologist for 36 years so I know just enough to have an educated opinion. So, it was good to watch these videos, not only for up-to-date info but a lot aligned with my way of thinking, as well Thanks, VPZD!

[catsladder]

It depends on the working culture. Where I work, it is not mandatory but highly encouraged. So as a result, roughly 25-30% of the staff wear masks. The thing is, people in this work place don't make an issue with it. If you wear a mask, fine. If you don't, fine. In terms of patient care, I notice there is a small tendency for older Asian patients to wear mask and they do feel more comfortable if the provider wear one, probably a cultural thing. Also a health care provider wearing a mask may have family members at home that are at risk. In emergency room, it is probably safer to wear a N95 as we don't know what is coming in and when the next pandemic hits and find out too late. It is really based on risk perception which has multiple variables.

[marymakesmandalas]

A doctor who wears a suit is trying to intimidate me as a patient, especially if I am in a paper vest. Horrible. Let’s both wear normal clothes.

[AdamJones]

How you do anything is how you do everythng

[paulaisaac]

If someone is wearing a mask, I can't see what they are saying. I've had my hearing tested and it's all good.

[owlofathens]

People who get triggered by masks, it says more about them than anyone wearing a mask. I found that professor to be extremely unprofessional by demonstrating such an extreme stance and controlling obsessive behaviour