Policies have been introduced in many places: the frontline of the anti-epidemic has been promoted exceptionally, what do the medical staff in the rear think?

On July 28, the Beijing Municipal Health and Health Commission issued the “Notice on the Qualification Evaluation of Beijing Municipal Health Series Senior Professional and Technical Positions in 2022”, which clearly stated: Participate in epidemic prevention and control The first-line medical staff who are qualified can apply for the evaluation of the higher-level health technology series professional title or qualification examination one year in advance, and priority is recommended for application and evaluation.

Medical staff who have outstanding performance in front-line work in epidemic prevention and who have received commendations such as merit can be directly hired for professional and technical positions up to the first level, and are not subject to the restriction of the position structure ratio of the unit. “Front-line medical staff” who support or participate in epidemic prevention and control during the period of supporting or participating in epidemic prevention and control can directly participate in the review without a defense.

Image source: Beijing Municipal Health Commission

Two days later, the Gansu Human Resources and Social Security Department also issued a document stating that the front-line medical staff in the fight against the epidemic will be given priority to apply for professional titles, and clinical treatment, medical records, and diagnosis and treatment plans can all be used as performance results. When applying for a senior professional title, they will no longer participate in the professional practice ability assessment, and will be directly identified as qualified.

Incentive policies for frontline medical care are introduced in many places

Actually, it is not the first time that relevant policies directly link the “frontline of epidemic prevention and control” with “professional title review”. Starting from 2020, Hubei, Jiangsu, and Anhui provinces have successively introduced relevant policies. similar regulations.

For example, in the early stage of the epidemic, the Hubei Provincial People’s Government issued a document: Make outstanding contributions to the front line of epidemic prevention and control, and won the city (state) level party committee government or provincial work department commendation, or credit The rewarded professional and technical personnel in medical, inspection and quarantine, and epidemic prevention scientific research can apply for a higher-level professional title one year in advance after review.

Source: Hubei Provincial People’s Government

In addition to promotions, provinces have also introduced a variety of incentive mechanisms for front-line medical care in the fight against the epidemic. For example, add points for the high school entrance examination for children of anti-epidemic medical care: Hubei Province will add 10 points to the high school entrance examination for the children of front-line medical staff in 2020, and those who take the college entrance examination will be given priority to adjust their majors in the same batch; Henan will also provide front-line medical staff 10 points will be added to the children’s high school entrance examination; Shanxi Datong will add 30 points to the senior high school entrance examination scores of the children of medical and nursing aid in Hubei, and so on.

There are also some areas where frontline healthcare workers are motivated by staffing. On April 6 this year, the Jilin Provincial Department of Human Resources and Social Security issued the “Several Policies and Measures to Fully Support the Fight against the New Coronary Epidemic in the Human and Social Field of Jilin Province”, which mentioned “anti-epidemic inclusion”.

“The non-staffing staff who have made outstanding contributions to the public institutions that directly participated in this round of epidemic prevention and control can be based on the actual employment needs of their own units, under the premise of empty posts and empty posts, according to the national Relevant regulations and relevant requirements, directly go through the employment procedures after reporting to the Human Resources and Social Security Department.”

Photo source: Jilin Provincial Department of Human Resources and Social Security

The favorable policies of the front-line medical staff are also one of the motivations for them to fight the epidemic on the front line. However, in the three years that various policies have been implemented one after another, some doctors and nurses have also begun to worry.

Some caregivers have concerns about incentives

Taking the “Priority Review of Frontline Medical Staff” as an example, some doctors’ concerns about this policy are understandable: “Can promotion be linked to anti-epidemic?” p>

For medical care, promotion is a common demand, and the rules for promotion are not unfamiliar. Take the evaluation criteria of attending physicians published by a tertiary hospital as an example: the hospital will quantify factors such as the number of outpatient clinics, the number of inpatients, the number of consultations, patient satisfaction scores, and teaching, etc., according to different weights.

Image source: The hospital’s assessment standard document

These quantifiable factors result in a total score that represents the nurse’s comprehensive ability at the level of their professional discipline. Among them, the weight of the medical quantity index and the work quality index is the highest, that is to say, according to the previous promotion assessment standards, the clinical diagnosis and treatment level is the decisive factor for promotion.

But when the doctors goOn the front line of the fight against the epidemic, the content of work will undergo a major change. Take the situation of the people admitted to the square cabin of the Shanghai National Convention and Exhibition Center in April as an example: the proportion of asymptomatic infections is about 95%, and about 10% of them will develop mild symptoms. As of the end of April, among the 65,000 discharged people, 20 were converted into severe cases, accounting for about 0.03%, most of which were aggravated by their own underlying diseases, mainly common diseases.

Facing such a patient population, it is difficult for doctors from different departments to exert their expertise. Therefore, some doctors and nurses have raised questions: Can the accumulated anti-epidemic experience and the professional ability relied on for promotion in peacetime are equal?

Image source: Figure Worm Creative

Another question is that the policy encourages promotion of “frontline healthcare workers”, how should “frontline healthcare workers” be defined?

According to the document published by the Beijing Municipal Health Commission: “Front-line medical staff” refers to, during the epidemic prevention and control period, according to the unified deployment of the government, dispatched by the health department or the requirements of medical and health institutions, Directly participating in the front-line work of COVID-19 prevention and treatment and having direct contact with confirmed or suspected cases of admission, screening, inspection, testing, transfer, treatment, nursing, epidemiological investigation, medical observation, and direct Medical and health technicians in case specimen collection, pathogen detection, pathological examination, and pathological anatomy.

That is, only healthcare workers who have had direct contact with a confirmed or suspected case (virus) are considered “frontline healthcare workers.” Doctors who stay behind because they assist the frontline to complete tasks cannot be included in this range.

However, doctors in the “big rear” also face high work pressures. Ping Zi (pseudonym), a doctor from a tertiary hospital in an eastern province, is like this, “The original schedule for weekend rounds was one day per person, and during the epidemic period, only one person can be used for two days. Usually, it is possible to write a medical order for discharge and bring medicine. It will take half a day.”

Before the selection, the routine medical team configuration in the hospital consisted of “one senior doctor + one attending doctor + one resident doctor + two regular trainees”, but due to the large number of resident doctors supporting the epidemic situation in other places, they The pressure of work has increased sharply: “A medical team is equivalent to a quarter of the staff less than the director, leaving three people, forty patients, and most of them are patients who need fast turnaround.”

“During the epidemic, some groups were still in a state of “crazy admission of patients”, surgical inpatients and surgical arrangements did not decrease, and the emergency department was short of people due to the epidemic, and our department also needed to arrange manpower support .” Recalling the turnaround at that time, Pingzi still felt very tired.

However, according to the definition of “frontline personnel”, Pingzi, who has a lot more work than usual, does not belong to this scope.

The Great Rear, also worth seeing

In 2020, according to the Hubei Provincial Health and Health Commission’s proposal to “strengthen the policy preference for front-line medical staff”, the reason is that “the epidemic prevention and control in our province has entered a critical stage, and the front-line medical staff of epidemic prevention and control has entered a critical stage. Taking on more arduous tasks of prevention, control and treatment… In order to further care for the front-line medical staff in the province and encourage them to devote themselves to epidemic prevention and control with firmer confidence and stronger combat effectiveness.”

Faced with the unknown situation of the epidemic, the medical staff on the front line of the fight against the epidemic need to be cared for and motivated. However, in order to assist the front line, the medical staff who have been silently supporting the rear are also facing similar arduous tasks. They’re not just adding to their previous workload, they may also add new tasks.

Dr. Pingzi mentioned that due to the spillover of the epidemic from other provinces in the urban area, the whole city urgently carried out the general nucleic acid collection, and the sampling work also fell on the left-behind medical staff. “But whether it’s to reinforce other provinces or to support the city, the result is that there are fewer and fewer medical care left behind.”

Image source: Provided by Pingzi

Ding Shuai (pseudonym), a nurse in a hospital in Anhui, is in a similar situation. During the epidemic, he often had to work multiple night shifts in a row, and his department’s schedule was completely out of order. “We dispatched two people to help with the pre-check shift. The original “two or three day shifts for night shifts” became ” Three night shifts and two days off.” On the first day off, you had to prepare for shifts, and then after two days of work, the night shift started again. The remaining medical staff will also be dispatched to the city at any time.”

Dr. Ping Zi also said, “Our medical work in the rear must be overloaded.” These non-“front-line” doctors are also fighting against Great efforts have been made during the epidemic, and their efforts are also worth seeing.

Planning: yxtlavi

Producer: gyouza

Image source: Visual China