What It’s Like to Work in an ER During a Pandemic
by : Wing Sze Tang- Apr 2nd, 2020
The COVID-19 pandemic has swiftly and dramatically changed our daily lives. We’re speaking to Canadian women about how coronavirus has affected how they work, parent, run their businesses and more. For information on where to find the latest updates on the evolving COVID-19 situation in Canada, go here. Below, Danielle Lucky, a physician assistant at Scarborough Health Network, discusses her experience on the frontlines as the COVID-19 pandemic unfolds.
I’ve been working as a physician assistant for just over five years. When a patient comes into the ER, they’ll go through triage, and once they’re put in a room, someone like me or a doctor will go in. I can see my own patients, take histories, do physical exams, and come up with a patient plan, which I normally discuss with one of the ER doctors.
Right now, we’re in the calm before the storm. It’s hard to know when everything’s going to get bad – if it’s going to be one week or two weeks or what. Every shift I walk in and it’s like, Is today the day we’re going to be inundated with sick patients? We’re planning as much as we can, to be prepared for when that does happen. We have measures in place, like backup doctors who can come in and help.
We’re also doing simulations in full protective gear. This is the first time I’ve had to do simulations like this. It’s good to practice because there are little things that are easy to forget, like reaching up and touching your face.
It doesn’t take that long to put all the gear on – maybe a minute or so, depending on the patient we’re seeing. For the majority of patients, we’re using something called droplet contact protection. That includes a gown, long gloves that go above the sleeves, a hair cover that looks like a bonnet, and a procedure mask with a visor for eye, nose and mouth protection.
Wearing all this for a minimum of 10 hours is not fun. It’s quite hot. My glasses will fog up sometimes, or they’ll slide down – and I can’t touch them. Sometimes you feel like your face gets really itchy or irritated, and again, you can’t touch your face. You can’t touch anything. It’s challenging. Getting used to working long hours in that gear is new for me.
In terms of the supply of personal protective equipment and masks available, I think all hospitals are in kind of a similar situation. We’ve set up a donation drive, similar to other hospitals in the GTA. So if you want to donate to Scarborough Health Network, you can send an email to [email protected]
So far, the symptoms I’ve seen have been quite a range. Sometimes people come in when they’re quite ill. Others come in with a bit of a sore throat or a bit of a cough. So it really varies.
Our federal government released a statement saying if you have mild symptoms, stay away from the hospital. Stay home, isolate, follow public health guidelines. Of course, in the emergency department, we can’t ever turn people away or deny care. That’s not what we do. But coming to emerg, you’re putting yourself at an increased risk, just because we could have people who are very sick with this disease.
We would love to test everyone with symptoms, but we just can’t, due to resources. Right now, we’re trying to test as much as we can. We’re testing high-risk populations and people with severe symptoms. But if you’re 20 and otherwise pretty healthy and have some mild symptoms, we can just presume you have it – a test isn’t going to change how I treat you.
It’s not like I have a medication I can give you for COVID-19 – it’s going to be treated the same way. So most of the time, if you have some mild symptoms, you don’t need a test. What you need to do is stay home, isolate from others, including family members or people you live with, wash your hands, and you should be fine on your own. We also explain when people need to come back to the ER: if they can’t breathe, can’t keep things down, or are vomiting a lot.
For those who come in with more significant symptoms, often what we do is supportive care, like providing oxygen and fluids. There are drugs being tried in other countries, but there’s nothing actually proven to help. We don’t have anything concrete.
There is a certain level of stress. I worry more about coming home. I can’t see my parents or grandparents because I’m worried about infecting them. There are sacrifices a lot of healthcare providers make during this time. I know doctors who have moved into their basement, so they don’t potentially infect their family members. So they’re living in separate quarters, which takes a huge toll on you as a person, especially when you’re going through this and then you have to be even more isolated.
I try to stay positive. If you let yourself think about things too much, I find you get more anxious or worried. Every day I’m off, I go for a nice, long walk with my dog. I get outside, get some fresh air, get some exercise, all while following the guideline of staying two metres away from others. I leave my phone at home. Another big thing I do is limit the amount of news time I get. I’ll watch updates from Justin Trudeau, and then turn off the TV, silence my emails and chat, and kind of go off the grid for a bit. If you’re surrounded by [news] all day, it’s not helping.
We have a wellness program at the hospital and they’ve come down to emerg, saying, “We have counsellors ready if anybody needs to talk about anything.” It’s been really nice to get support from people I work with every day – it’s like a family we’ve created in this emergency department. A lot of our doctors have been through SARS, which hit our hospital hard, so they’ve been very supportive of those who haven’t gone through a pandemic outbreak. We’ve had strangers sending us coffee, and it’s just so nice to know your community is also out there, thinking of you. That’s been very surprising. I’ve never experienced anything like that before.
The biggest thing for Canadians to know is to just listen to Health Canada. This is a serious issue, and it could get worse as we’ve been seeing from New York, Italy and China. Try to manage your stress as best you can. Eat right, get sleep, maybe unplug from the TV or social media or whatever increases your anxiety. Try to stay inside and flatten the curve. That’s the best way you can support your frontline healthcare workers.
– As told to Wing Sze Tang
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