Abbey Ruland

Stanley

National Physician Assistant Week kicks off on October 6th this year. Every year I put together a press release that explains what the PA profession is all about, and mostly it doesn’t get published, as it is boring and reads more like a vocabulary lesson rather than a story. This year, though, is different. It is different for everyone that is reading this article, and it is most definitely different for the wonderful PAs working in our great state.

PAs are medical professionals that see patients, make diagnoses and write prescriptions. We help you when you need us. And through the time of COVID-19 we have done what we do best. However, we too are vulnerable to the problems of the current times; uncertainty, frustration, and fear.

Denise Fried has been a PA for 26 years and has spent time practicing in rural medicine, family practice, pain management and most recently in long term care. She has never feared illness. She has had influenza in the past, and even though it was not fun, she was fine. When the outbreak occurred, she was most fearful for her patients, residents of long-term nursing care units. She wore all of the appropriate protective equipment and took every precaution to make sure her patients were safe. Which is why, on July 17th, when she found out a family member had been exposed and has tested positive to the novel coronavirus, she called into work and had a test performed immediately, even though she had no symptoms. She tested positive and was to be home for 10 days to ensure she did not endanger her patients. She thought it would be a vacation of sorts, she felt fine and planned to sew and relax in her pool. However, 3 days later she began to feel ill, she had body aches, which were severe, fever and extreme fatigue. She had a cough. But, after 3-4 days she was feeling better and spent a few days at home outside, getting ready to return to work in a short time. The virus has other plans. 24 hours later she was so ill, she felt disoriented. She could not manage to take a shower. Her husband came in to check on her and she was breathing so slowly and shallowly that for a few moments he thought she was not breathing at all. He took her to the ER, even though thought it unnecessary.

When arriving in the ER she had labs and was told her oxygen level was severely and dangerously low. They discussed intubation. Denise was fearful and did not want to be intubated if possible. If she was not sleeping and wearing oxygen mask at full force, she could keep her oxygen levels at a point that is still considered to be low but is tolerable. So, for the next 24 hours she kept herself awake. She would begin to dose off and would hear the alarm ring, alerting her of dangerously low oxygen levels. She would shake her head and take deep breaths, desperate to avoid intubation. “I remember laying in the hospital and wondering what everyone would do if I died” Denise recalls. She was alone, no visitors and very little contact with the nurses and hospital providers, to avoid unnecessary exposure. “I was so scared”

Denise did improve some and was able to go home after 6 days in the hospital, but the recovery was far from over. She continues to have trouble with her breathing to this day. She does not know if it will ever go back to normal.

She now has more respect and some fear regarding the virus. She sees the toll daily in her work. Long term care facilities have been hit hard by COVID-19, not just with the deaths and infections, but also with regulations, in order to protect the residents. Denise noted “people are dying because they are lonesome.” It is heartbreaking for the staff in the COVID wing of the long-term care facilities. Families are not allowed to visit, if the resident has COVID-19, which means the nurses are holding phones to resident’s ears while their loved ones say their goodbyes. This is a devastating situation.

This is one PA’s COVID-19 experience. Physician assistants are here and working hard in North Dakota to bring you the best healthcare possible. I would encourage you to thank a PA this week for their dedication and perseverance in this difficult time. I would encourage everyone to share hope, love and wisdom as we all aim to move forward.

Abbey Ruland is a PA in Stanley and the co-chair of the public relations committee for the North Dakota Association of Physician Assistants.