Working in the Emergency Department During a Virus Outbreak : Lessons from the Ebola Crisis

As the COVID-19 pandemic stretches public health systems around the world, the role of hospital emergency departments has never been more important. Whether people are acutely ill with symptoms from coronavirus or from other illnesses and injuries – such as heart attacks, strokes, or trauma accidents – citizens expect that the emergency department will be open and offer care. In this way, emergency departments function both as a place of medicine and as an institution that society has entrusted to accomplish normative values of ensuring citizens have access to essential services. Emergency doctors and nurses can be conceptualized as institutional custodians because they are the caretakers whose job it is to preserve this institution of healthcare. They help protect the human welfare, order, and stability of society through their everyday work in local emergency departments. As the coronavirus pandemic accelerates, the work of these institutional custodians becomes increasingly difficult as demand threatens to outstrip health system resources, and as more patients pose infection risks to frontline responders. How can institutional custodians in emergency departments stay the course during the coronavirus pandemic?