Caring for pandemic patients: Medical residents learning valuable lessons
Medical residents at WellSpan Health are learning valuable lessons during the current Coronavirus pandemic.
Sonam Sherpa, D.O., has seen medicine evolve in real time, as physicians discovered what worked and what didn’t in the treatment of COVID-19 patients, quickly adapting their practices along the way.
Cassandra Black, D.O., has learned both practical skills, such as placing central intravenous lines, and bedside skills, such as having difficult, empathetic conversations with the families of dying patients.
Maggie Ahrens, M.D., has had a closeup view of the toll COVID-19 has taken on our communities, through the lens of an intensive care unit.
All three are WellSpan resident physicians who have been redeployed to help care for critically ill COVID-19 patients. It has meant rearranging their residency rotations to work in the intensive care units of WellSpan Good Samaritan and WellSpan York hospitals during the pandemic.
“The residents have excellent skills that allowed them to rapidly transition to working in the ICUs,” said Michael Bohrn, M.D., vice president and chief academic officer at WellSpan Health. “They have readily accepted the challenge of helping us work though this difficult time.”
WellSpan has 171 residents, or physicians completing specialty training in eight different programs based at the two hospitals. It didn’t matter their specialty. The residents are helping staff in traditional hospital inpatient and ICU services, as well as specialized COVID-19 ICUs.
Dental program residents were the only exception.
Part of an emergency exemption
This is part of an emergency exemption by the national residency accreditation organization. The residents work with full supervision from attending physician faculty. They help staff in traditional hospital inpatient and ICU services, as well as specialized COVID-19 ICUs.
It has actually turned out to be an educational experience that no one was expecting.
“It was definitely a shock,” Sherpa said. “I was a new doctor.”
It helped to have “a phenomenal team” of attending physicians and others who helped, he said.
Sherpa is a second-year family medicine resident at WellSpan Good Samaritan Hospital.
The entire internal medicine residency team redeployed at York; shifting to either the academic hospitalist service, the traditional ICU service, or one of the COVID-19 ICUs. Residents from emergency medicine, family medicine, obstetrics and gynecology, orthopedic surgery and surgery also are all redeploying for additional shifts in the ICU.
Black, third-year chief resident in internal medicine at WellSpan York Hospital, said the experience has been both challenging and enriching.
“You have to remind yourself to see the good in these unpredictable situations,” she said. “COVID-19 can be very unpredictable. Patients in the ICU are the sickest of the sick. Some we feel are going to recover and improve. The next day you come in they are crashing, and they don’t make it. You can be giving them your very best and, despite your best efforts, they are not going to get better. You have to try to be flexible and adaptable and encourage yourself and your colleagues to keep working hard.”
An eye opening view of pandemic
For Ahrens, a fifth-year surgery resident, the experience has temporarily shifted her main focus from the operating room to patient rooms, giving her an eye-opening view of the pandemic.
“You see how critically ill these patients are; and what a terrible disease this is,” she said. “It’s something you hear about but until you experience working with these patients firsthand, you don’t really get a grasp of it. The gravity of it was very surprising to me.
“I admire everyone who has been working at this almost exclusively for the greater part of the year. They should be applauded more than people like myself, who were recently deployed.”
The residents will never forget their front-row seat to this historic time in medicine, nor will they forget the lessons they learned.
Black was considering a fellowship in infectious disease before the pandemic. Her experiences cemented that path.
“My experiences with COVID-19 have confirmed that I’m supposed to be doing work in infectious disease,” she said. “It’s an important time in history and I get to be an active participant in that. It confirmed what I should do with my life.”
Central role of physician
Ahrens said her experiences with patients have cemented the central role of a physician.
“Helping patients get though this is definitely part of doing my job,” she said. “I am a physician; and I believe we are called to care for patients, wherever the need is and wherever we are able to help.”
Sherpa said he hopes some parts of his experiences continue after the pandemic is over.
“What I hope continues is the sense of camaraderie in the health care community at large,” he said. “Nursing staff, case workers, intensivists and other physicians – we got to know each other well. There was that sense of camaraderie with patients and family and the community as well. I hope that moves forward. People say that COVID-19 brought the worst out in people, but I would argue that it also brought the best out of people too.”