In April we shared the stories of Certified PAs across the country who were working on the front lines of the fight against COVID-19. Following the publication of those stories we received dozens of additional stories from PAs who are also working tirelessly to address this pandemic.
As many states begin to open up, we share these stories as a reminder that the battle wages on.
Michael Trueba, PA-C
As this pandemic has picked up momentum in the United States, our urgent care policies and the way we practice general medicine transitioned as well. Our priority is treating our patients safely while keeping our staff out of harm’s way. However, this becomes exceedingly demanding as the personal protective equipment (PPE) continues to dwindle, the number of tests available were initially not enough, and the overall sentiment of fear continues to rise. We are no strangers to this at our urgent care clinic.
Our clinic has shifted more towards a triage model, where patients are screened and the decision is made based on Centers for Disease Control (CDC) guidelines whether or not they qualify for testing. Urgent cares and other outpatient clinics of the sort have also had to adapt to the stay-at-home orders which forced us to seek other alternatives to patient care. As a response, we have adopted telemedicine in an attempt to continue serving our community.
Personally, the pandemic is stirring change at home as well. My wife is eight months pregnant with our first child. She’s a therapist and continues to work as well. I fear for her health, while she fears for our child’s, as there is not an exact answer to the effects of COVID-19 to infants. Pre-pandemic, I would get home and greet my wife, my hyperactive dogs and make my way into our bedroom to change out of my scrubs. Now, I come in through the garage, get undressed there, make sure I do not touch any surrounding walls, and open the door with one hand while the other is carrying my things. My wife and dogs get a wave, and I skirt off to shower. Meanwhile, she then retraces my steps and cleans all surfaces I’ve touched, including door handles, light switches, as well as my keys, wallet, phone, and glasses. Then, I can finally relax with my family, but our conversations are different.
“Anything interesting today?”
So far the answer has been no. Metaphorically speaking, I take my work home, but this virus is not going to be one of them.
I heard a saying once, “If it doesn’t challenge you, it doesn’t change you” and indeed what a challenge this has been. Despite growing concerns, I am grateful every day for the ability to continue practicing medicine during this pandemic and provide the best care possible as a physician assistant.
Kyle McMahon, PA-C
April 22, 2020
Beginning in March, COVID-19 flipped the country upside down. It made New York City the epicenter of the world with the surrounding states falling close behind. As a full-time cardiac surgery PA in Central New Jersey, I pivoted my critical care skills to help in the medical ICUs that quickly became inundated. Now I bounce back and forth between two major hospitals in North and Central New Jersey to help in any way that I can. At the time of writing this New Jersey has 95,865 cases statewide with 5,063 deaths. Our ground zero hospital here has approximately 460 COVID positive patients, a little over 100 patients on ventilators, with 10 operating ICUs including the cafeteria.
Stepping onto my unit for the first time was overwhelming. An oncology floor converted into an ICU. 23 patients, all COVID positive. Two patients to each room. All were on ventilators. Most were proned. 4:1 nursing. We wrote the plans for the day in marker on the glass door windows. Many of my patients were young and didn’t have any significant past medical history. Patients were dying alone. Last month a 40-year-old COVID positive mother in her 26th week required an emergency C-section. Just last week I held the hand of a friend’s father as he passed of COVID related complications under my care.
Nothing prepares you for experiences like these. But through the darkness there has been some light. From extubating mom and seeing her FaceTime with her recovered newborn, to being there for a friend’s family member so they didn’t die alone, to our 800 discharges and 49 patients off ventilators as of this week.
We’re all exhausted but the support from the community and sense of purpose keeps us pushing forward. At 7 p.m. every night the streets here in Jersey City erupt with cheers for medical professionals while you hear echoes across the Hudson River as the same is being done in NYC. The Empire State Building glows red and beats like a heart to honor the fight for COVID-19 and its emergency workers. It’s truly inspiring.
Recently I was at the store in my scrubs when someone approached me and said, “Thank you for your service.” He was right, we are at war with this virus and the ones in scrubs are the soldiers on the front lines. Our profession was founded on these grounds – during times of war when medical providers were desperately needed. I believe once again we are rising to the occasion as everyday I see PAs making sacrifices to help get this country through one of its most difficult times. For that I could not be more proud to be a Certified PA.
To my colleagues, I want to say that I’m proud of you. Hang in there and keep fighting. We’re all in this together.
Tracey Piparo, PA-C
April 30, 2020
➔ the imparting or exchanging of information or news.
➔ means of sending or receiving information, such as telephone lines or computers.
As someone who practices medicine, I always thought of communication: with patients, families, friends, nurses, colleagues, consultants as a sort of art form, a dance that we all
participated in. It’s complete with body language, facial expressions and linguistic nuances. My ability to perform this dance well was something I was proud of, something that I counted as a
strength – it helped me not only care for my patients but learn from colleagues and earn respect from others.
The act of simply talking to a person, especially a patient and their significant family and/or friends, can be empowering and humbling at the same time. We often are the bearers of news
that will forever alter someone’s existence – good or bad. With my 18+ years of experience, I am still learning and developing these skills with every interaction. It is that quest for constant
improvement that had me thinking about how much has changed since the world has been dealing with this pandemic, a mere five weeks ago.
Not only is everyone wearing masks that cover a significant portion of their faces, but most communication with families and patients are now taking place via telephone or FaceTime. It
did not take me long to realize how much I missed simply seeing a person’s face and having them see mine. I realize the value of that mutuality – me watching their body language and them seeing mine. The importance of observing patient interactions is another component. How much I wonder- do they really understand what I am saying? Can they sense the urgency in my voice? Can they feel the empathy in my words? Do they know that my hand would be on their shoulder if I could? Do they know I am holding their loved ones hand not just for me, but now in their physical absence, it is for them? I wonder if the last 20 minutes I took to explain their care was enough.
What have I changed? What am I trying to change? I realize that an even tone of voice works on the phone. I need to speak slowly and enunciate, but choose carefully the words I emphasize. I find myself making facial expressions under my mask and remember that no one can see them.
I have tried to make my eyes more expressive, to use more direct eye contact – an awkward, long direct contact with patients. Like any good Brooklynite :), I talk with my hands more and
strangely feel as though they encourage engagement and familiarity with the patient, even though I am avoiding touching them. My conversations often end with a friendly shaka or
thumbs up, since shaking hands is now frowned upon. I’m learning to communicate with the same level of empathy I always strived for with a whole new level of restrictions.
FaceTime has proved interesting. Families are excited to speak to their loved one and to me also, however the lack of facial/body language clues leads to speaking over one another until
everyone is at a good comfort level. It definitely wins over the phone since I enjoy seeing their faces and have some abbreviated glimpse into their physical language. My covered face still
doesn’t help and those eyes – I feel their importance again, and I remember – LOOK at the camera, open your eyes, SPEAK with your eyes. Ask repeatedly, almost feeling silly – are there
any questions for me? Are there any concerns? I try to change the phrasing to prompt any thoughts and alleviate any fears of seeming inconsequential or bothersome. I realize the value
of not just a yes or no question, but one with meaning to communicate my care and genuineness for their well-being.
Families and patients are grateful. I had felt they were always grateful for my focus on communication but now it just seems different, more genuine, more comforting. Like the hug or hand on the shoulder I am currently unable to provide to them – they are sharing it with me. We are learning this new road of medicine, together.
Colleagues, nurses, consultants – some days I think we are simply happy to be at work and have the pleasure of speaking to those other than our immediate household members. But, gone are the days of a high five, handshake, fist bump, or shoulder hug. I miss sharing our gratitude as well as sharing our pain and fear. That interaction is replaced by awkward adjustments of masks – without hands – nose movements a la I Dream of Jeannie and “air” hugs that get us through the day. Moments of humor to remind us, we’re all in this together.
This is an adjustment for everyone involved in patient care but I believe we are all learning and growing together. It is in those efforts we can keep communicating with that familiar empathy.