Now, more than ever, the health and wellbeing of North Country residents and visitors is of concern, as
is the immense burden on our incredible team of providers, nurses and support staff. For the past
several weeks, North Country Healthcare hospitals (Androscoggin Valley Hospital, Upper Connecticut
Valley Hospital, Weeks Medical Center), have seen increasing numbers of patients requiring an
inpatient bed due to their extreme sickness or deteriorating condition. NCH officials warned of this
“second wave” of patients over a year ago, citing the fact that many patients were opting to forgo routine
or preventative health during the pandemic. Although our facilities always stand ready to serve
everyone, the ability for us to transfer patients who require more critical care has become compromised,
as hospitals within and beyond Coos County many times lack the capacity to accept patients.
The proverbial “elephants in the room” that few are willing to discuss are the moral injuries we, as a
society, are inflicting on our healthcare workforce, lauded as heroes by all just one year ago. Moral
injury can occur when someone engages in, fails to prevent, or witnesses acts that conflict with their
values or beliefs. Examples of events that may lead to moral injury include:
• Having to make decisions that affect the survival of others or where all options will lead to a
• Doing something that goes against your beliefs (referred to as an act of commission)
• Failing to do something in line with your beliefs (referred to as an act of omission)
• Witnessing or learning about such an act
• Experiencing betrayal by trusted others
Although healthcare workers are prepared to see patients suffer or even die, witnessing a great deal more
suffering and death than what is expected may create moral distress, especially with the scientific
education and knowledge base to be aware that this situation was, and is, preventable. Our healthcare
workforce is operating daily in an environment largely absent human touch, or the ability to translate
non-verbal cues as simple as a smile. When situations arise that do not allow healthcare workers to
deliver care in the way they’ve been trained, moral and ethical dissonance results. This is critically
important in that moral strength represents the very foundation of the capacity for healthcare workers to
use compassion in their practice.
New Hampshire should not be the national leader in COVID-19 infection rate. We are the least
vaccinated State within New England. Even more concerning, for the past several days, we have set
new records in terms of the number of patients requiring hospitalization from COVID-19, passing 460
yesterday. It doesn’t have to be this way. Our community members should not have to battle a disease
which has long-lasting and, unfortunately oftentimes, fatal, effects; our nurses, who continue to provide
each patient with the highest level of dignity and care, should not have to give everything that they have,
only to experience the trauma of losing yet another friend or loved one to a merciless disease; our
residents shouldn’t have to worry about getting ill or suffering an injury, concerned that there will not be
an inpatient bed available at our or other facilities. We should not be forced to have repeated
conversations with families explaining why we cannot transfer their critical ill loved one because our
tertiary partners are besieged with COVID inpatients, the overwhelming majority of whom are not
vaccinated. We should not have to read on a daily basis about the actions of our elected representatives
who introduce legislation directly in opposition of established public health actions to appease
misinformed voters. Despite the COVID-19 vaccine being clinically proven as the most effective way
to reduce transmission and prevent getting the disease, and easily available throughout the North
Country, we are nowhere near where we need to be to best ensure everyone’s safety.
Approaching two years into the pandemic, our providers and nurses, many of whom are understandably
experiencing high levels of burnout, are left to struggle with the unnecessary and alarming reality that,
by most recent accounts, 85% of intensive care patients throughout New Hampshire with COVID-19 are
unvaccinated. This isn’t a political issue; this is a safety issue. The literal call to arms has never been
more necessary, or more urgent, as these hospitalizations, which impact us all, could largely have been
preventable. We have the tools (vaccines, masks, social distancing). It is critical that they be used.
The current condition is so dire, that states within the Northeast, including New Hampshire, are calling
upon the Federal Emergency Management Agency and National Guard to help healthcare facilities
battle the crush of patients. These are unprecedented times. Again, it doesn’t have to be this way. It’s
imperative that we all do our part. On behalf of the nearly 1,000 dedicated, NCH, healthcare workers
who have worked tirelessly to support our communities – we urge you, please, do the right thing.
In addition to the sites listed at https://northcountryhealth.org/SleeveUpNH/, COVID-19 vaccines are
currently available at the White Mountain Chalet and Walgreen’s in Berlin, at Walgreen’s in Colebrook,
at Walgreen’s in Lancaster, and Walmart in Gorham.
About North Country Healthcare
Named a 2020 Best Place to Work by Modern Healthcare, North Country Healthcare (NCH) is a nonprofit affiliation of four medical facilities in the White Mountains Region of New Hampshire. NCH
includes numerous physicians and medical providers at multiple locations. This leading comprehensive
healthcare network, which employs hundreds of highly-trained individuals, delivers integrated patient
care through three community hospitals, medical laboratories, and home health and hospice services.
NCH remains committed to the health and well-being of the communities it serves.
For more information about NCH, please call (603) 389-2205 or visit www.northcountryhealth.org.