Carolle, Malignant Haematology PA on the frontlines of COVID-19

Carolle is a Canadian Certified Physician Assistant practicing in Malignant Haematology at the Ottawa General. She is a McMaster PA graduate.

April 2020 - My name is Carolle Domen and I work as a Physician Assistant in Malignant Hematology at the Ottawa General. COVID-19 has significantly changed the way we practice medicine in hematology.

Most of our outpatient appointments have been transitioned to telephone encounters and in-person appointments are mostly limited to new consults and patients requiring physical assessments prior to regularly scheduled chemo appointments.

As a result, the 4 PAs in malignant heme have primarily been supporting the teams on the in-patient wards.

We continue to admit patients with febrile neutropenia or other complications from their malignancies, in addition to patients newly diagnosed with leukemia requiring induction chemotherapy.

Many of these patients are initially swabbed for COVID as the symptoms can be quite non-specific.

Given their immunosuppression, malignant hematology patients are one of the most vulnerable populations susceptible to COVID-19.

However, we have been very fortunate that we have had a minimal number of patients positive with COVID-19. That is not to say that we have been spared the impacts of this pandemic.

On March 13th the Ottawa Hospital began limiting visitors to 1 per patient and on March 21st a complete ban on visitors was implemented, with exceptions being made for compassionate reasons. This was perhaps the biggest way that we would see COVID affect our patient population.

Restrictions on visitors has meant greater challenges helping our patients cope with new diagnoses of cancer, without the benefit of their loved ones at their side.

We have depended on technology daily to reach out to families and give them medical updates.

Our patients depend on their devices to keep in touch with the outside world and receive emotional support that otherwise would have come from someone physically present at the bedside.

The COVID-19 pandemic has brought its fair share of challenges, but in it we have seen the resiliency of the human spirit and it has brought members of the healthcare team closer together. We will get through this.