Linda, Alberta Rural Medicine PA on the Frontlines of COVID-19

Linda Parrish is a Canadian Physician Assistant working in a small community in rural Alberta on the frontlines of COVID-19. She completed her training with the Canadian Forces, including working as a PA with the HMCS Calgary and Fleet Diving Unit (Pacific).

She now works in Alberta Health Services first as part of the PA Demonstration Project providing clinical support in family medicine in a rural hospital, and is now a full time member of the Bassano Health Care Team.

April 2020 - As a rural PA, I have a very broad scope of practice. I’m truly the epitome of a generalist – I live a small, community hospital, in Bassano Alberta, with a community population of 1200, with a catchment area of about 3000.

A Day in the Life of a Rural PA during the COVID-19 Pandemic

On a daily basis, I would usually complete rounds on hospitalized patients, followed by outpatient clinic appointments. Throughout the day, I would be called to assess patients presenting to the ER.

Our usual staff compliment consists of 2 physicians, 1 Physician Assistant, 1 RN, 1 LPN, 1 HCA, and 2 lab/X-ray technicians.

We have a 2 bed ER, 4 acute care beds and 8 LTC beds.

Over the past few weeks, Alberta Health Services has implemented procedures and protocols to protect our inpatients and manage intake of potential COVID-19 patients.

While our inpatient care and morning rounds remain unchanged, there is an added level of ‘decontamination’, reflecting the serious nature of the current threat.

Every shift, staff are screened and they’d temperatures taken to ensure we are all in good health, prior to accessing the facility.

For the most part, outpatient appointments have been restricted to essential visits only, the remainder to be managed as much as possible via telephone consults. So far, this has been working reasonably well, given the circumstances.

Visitors to our hospital have been restricted to essential visitors only, and only one visitor at a time. All visitors are screened for potential exposure.

As for ER visits, all patients are funnelled through a single entrance to control access and are screened for COVID-19 exposure. We have a separate room secured for potential ‘positives’, and all assessments are conducted with appropriate PPE in place. We rate every precaution to protect our staff and inpatients from exposure.

We have been fortunate so far, our small community has no positive cases at this time, the citizens have been doing well with physical distancing and contributing to our overall security.

As the only PA, I am an essential part of our emergency response team. We work as a well-integrated team, monitoring each other’s PPE donning/doffing to reduce risk of exposure. My presence provides the physician with an added ACLS-trained clinician, to assist with intubation and interventions as needed.