The physicians and nurses facing the onslaught of this pandemic are undoubtedly heroes. We salute them for leaving their homes and families every day to face the risk of personal illness and death. Their bravery is an inspiration. That bravery is a product of the oath that each swears upon entering this profession. There are others in this struggle, however. Others who never swore an oath to use their skills to care for the sick and injured. Others who are every bit as critical to these efforts, but who are not receiving accolades and applause as they make their way to hospitals every day, to work another shift at great personal risk. I am speaking of the janitors and housemen and women who work in our hospitals all day, every day.
These brave individuals serve an indispensable role in caring for patients and keeping the medical system working. They transport the patients to the ICU’s, and in so doing, are exposed to the same risks as the treating physicians and nurses. During the painful learning process of caring for the sickest of the COVID-19 patients, it was discovered that the technique of prone ventilation, in which the patient is positioned on their belly while on a ventilator periodically every day, is the only consistently effective therapeutic intervention so far. But this treatment requires the careful repositioning of a sedated patient in critical condition, a process that requires a team of nurses, physicians, and other health care workers to effect safely. Those other health care workers are often Physician Assistants, or Surgical Techs displaced from the now-idle operating suite, and Housemen and women. This oft-repeated therapeutic maneuver puts all members at an equal risk of infection. And while nurses and physicians, PA’s and NP’s are carefully trained and experienced in how to minimize their risks, these other critical team members have–until this moment–not prepared professionally for this effort. Nonetheless, we expect this, and much more, of them. They have stepped into the battle without hesitation.
Janitors also are unsung heroes in this crisis. They are required, just as the physicians and nurses, to don PPE and masks to perform the critical duties of cleaning the rooms and care spaces of the contagion which is pervasive in their work. Our janitors are no less courageous in their efforts. Indeed, maybe more so, as the physicians and nurses are almost always working as a team, with particular monitoring for the proper removal of protective garb and other concerns to minimize risk. Janitors, however, are often working on their own, with no such assistance. Every ICU room, every ventilator, every ER bay, must be cleansed and prepared, else risk injury of the next patient. Without the critical services of the janitors, the system cannot provide care.
These brave health care professionals, the janitors and housemen and women in every hospital, are working just as hard and at just as great a risk, as our physicians and nurses. They never swore an oath. They don’t get the same benefits, or the same pay, or the same accolades. But they deserve at least as much of our gratitude.