Provider Practice Essentials registered nurse continuing education

The Pandemic PA in New York

What’s it like being a traveling PA during a pandemic? It’s an experience most of us are probably at least a little curious about–especially the events during the early days of the outbreak. We’ve caught up with traveling Physician Assistant David Hendry to get some insight on what it’s like to work in a pandemic hot spot. We’ll hear about his experiences on assignment in hospitals across the country in this “Pandemic PA” series.

Introducing the “Pandemic PA” and the New York Assignment

My name is David and I’m a Physician Assistant with 18 years experience in the field. My first assignment as a traveling PA was this year in Midtown New York City–I’m proud to say I lived and worked there for 2 months.

With bags in hand and airline tickets purchased, I made my way to NYC not knowing if my travel assignment was a scam or something tangible. The staffing company I signed up with rented a hotel room for me just 2 blocks from Times Square and 1 block from Central Park. I was told to show up at this hotel for my assignment. To my delight (and great relief) the hotel was full of like minded nurses, Nurse Practitioners and Physician Assistants when I arrived. It looked like the job was real.

All the nurses and providers already at the hotel came to answer the call of the New York governor asking for help just days after learning of this deadly virus. Many had left families, children, spouses and jobs and bravely traveled to meet this medical crisis head on.

On my first morning, we all gathered in the hotel basement where our leader gave a heartfelt speech about the important things in life and making a life worth living. A prayer was offered up for us to continue to be brave and for the safety of everyone and their families. We boarded buses solemnly and took our seats not knowing what was to come.

Working in Harlem Hospital

I was assigned to Harlem Hospital–one of the hardest hit hospitals in the pandemic, also one with the fewest resources. When we arrived, a fellow from the hospital residency program was there to greet us and show us the ropes: the computers, ordering modules etc. We were assigned to a physician and rounds would start in an hour, so we immediately had to gown up and get to work.

Gowning for safety was a daily process. First, there were booties to cover shoes; those were left on throughout the day. Then we put on a surgical gown and a plastic gown over the surgical gown. We always wore two pairs of gloves and a N95 face mask. For those of us that were fortunate enough to bring our own supplies or had some shipped in, we wore splash resistant coveralls over our scrubs and a plastic face mask to protect against spit particles.

Donning and Doffing our personal protective equipment (PPE) was crucially important; we had to be meticulous, as any mistake could lead to overlooking one of the microscopic viral particles we were battling.

As the days wore on, there was a shortage of supplies, masks, gowns and foot coverings. We were instructed to keep our N95 masks in brown paper bags for 5 days as there were not enough available to issue a new one daily to every staff member. Often times, we had to visit multiple floors at the start of a shift to piece together an outfit. Floor 15 for shoe covers, check. Floor 6 for a gown.  

I remember even going into the dark dungeon of a basement one morning in search of PPE. I opened multiple boxes stacked along corridors to find a gown and some shoe covers as all the floors had run out. We were resourceful and what we didn’t have we made up for in the willingness to help.

Developing COVID Protocols in Real Time

Originally my hospital had sequestered all the COVID patients to floor 14, which was my assigned floor. However, as the stages of the pandemic worsened, like a creeping eruption, all the floors became COVID floors.

During a debriefing on one of my shifts, my co-workers and I were informed that of the 35 residents at the hospital, 18 had contracted COVID and were out sick. Over half. At this stage I’m not going to lie, I got scared. Scared that I would get it, scared that we didn’t know anything about it, and scared that I had made the biggest mistake of my life coming to New York City. Hit with the fact that I had a 50/50 chance of catching this bug I had a choice to make. Stay and continue the fight or leave.

I noticed a few people stand and make their way to the back during the meeting, but the majority of the staff stayed. The 4th year resident giving the debriefing broke down the ordering set and treatment modalities for COVID. Things like Sed Rates, Serum Ferritin, coagulation screening, LDH, CK, Neutrophil count, PCT levels–all things I had rarely or never ordered were being ordered on the regular. In fact, these tests were being used as a screening tool for COVID because at that moment in time, a COVID test result could take 5-7 days. Time we didn’t necessarily have to wait.

The residents and doctors I worked with at Harlem were by far some of the smartest and adept clinicians I had ever seen. The doctors early on developed a strategy that they collaborated on, and from that collaboration, protocols were made. Everyone was on the same page and knew “this is what we are doing, and this is why we are doing it.” A solid front was critical to our mission.

The strategy, however, was not set in stone. If new information came out, changes were made. Everyone had to adapt on the fly during the crisis in every aspect of medical practice, so all ideas and suggestions were always considered. We developed new strategies as we discovered better ways to do things; treating and containing this particular virus was new territory for everyone.

We were fighting an unknown–and our plan was to win, and to keep winning for every single person and every single family. Safe to say, my first travel assignment was gratifying. The challenges, watching medical history being made, and being part of a fight that made such a profound impact on the community made the risk and the fear worth it.

It wasn’t my last pandemic traveling assignment. Stay tuned for the next hotspot!

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