Aisha and Stacey, Internal Medicine PAs on the frontlines of COVID-19

Aisha and Stacey are McMaster PA Program graduates who now work in General Internal Medicine.

The last few weeks have tested our community in ways we never could have imagined.

While overall patient volumes are down, anxiety, and the complexity of our remaining inpatients runs at an all-time high.

Our hospital has seen the highest number of admissions for COVID-19 in all of York Region, with many of those cases requiring ICU care. As a result, our organization has been very involved in the development and early implementation of protective policies for our patients and staff.

With hospital policies and clinical guidance being updated daily, more time is now dedicated to staying informed. Frequent email communications, daily huddles, education sessions, simulations, and virtual COVID-19 planning meetings have become the new normal.

Clinical assessments now take much longer. Many of our new admissions require use of PPE, given evidence of sustained, local community spread. As well, with a strict no visitors policy, we must make time to connect with families by phone to provide frequent medical updates as well as reassurance. People rely on our staff, now more than ever, to be proxies for their loved ones.

“Working in Internal Medicine, we have been integral to providing continuity of care on our respective wards. While COVID-19 patients often require an enhanced level of vigilance, we must ensure that all of our patients receive the same standard of care.”

We have transferred many of our chronic, complex patients to other institutions, and must remain mindful of who no longer requires hospitalization. Contingency planning is underway to accommodate increasing patient volumes, level of acuity, and to cover absences should any of our staff fall ill.

It has been especially challenging to arrange for optimal follow up post-discharge, with many offices and outpatient clinics closed or running on reduced hours.

Virtual assessments and telephone follow-up have become commonplace to minimize risk.

Discharge planning has become more complicated for those who may be in need of increased support or reside in congregate settings – especially when COVID-19 test results are outstanding or when transportation is required for positive cases.

Despite these challenges, we feel fortunate to be working alongside a team of such dedicated and compassionate individuals.

To have some semblance of a normal life, a daily routine, and to have friends by our side, has made these difficult times all the more bearable.