NOCHS Frontline Workers: ER & UCC

This is the final article in NOCHS’ frontline workers series. 

It’s been a long time since the healthcare system has encountered a wildly contagious yet completely unknown disease. That’s what made COVID so challenging at the beginning. “We know how to deal with strep throat, pneumonia and other contagious diseases,” says Julie Gortsema, physician assistant in Urgent Care. “We know how they spread and how long people are contagious. COVID was a whole new ballgame. It was an unknown and that made it challenging.”

Urgent Care and the Emergency Department are two places where the precautions of COVID slammed up against the need for immediate care. Although routine visits and elective care can be delayed, things like chest pain or broken bones cannot. Both of these departments inside our health system had to reinvent how they did their work to accommodate a COVID reality.

“I loved the fact that our hospital administration immediately jumped into action when the news of COVID hit,” says Julie. “They were proactive in obtaining accurate, up-to-date information. So although this was new, and we were learning as we went, we had the best available information every day. That meant all of us as providers were on the same page as we designed medically safe approaches to our work.”

Julie says the unknown was the biggest challenge. “We were working from CDC guidelines to safely get people in the door and treat them. We created a new patient flow. People came in to register, then waited in their cars unless they were in immediate medical need…then they went directly into a room. We cleaned rooms with specific cleaners, and then had to wait the appropriate amount of time before we could admit another patient. We got an air filtration system installed, which was vital because it cut down that wait time and allowed us to perform breathing treatments safely. We just kept adapting our processes based on what we learned each day.”

The Emergency Room experienced many of the same challenges. Asking family members to wait outside, wearing full protective gear and moving people right into rooms were just a few of the many new processes that were developed. “It got tough when we had husbands and wives come in together,” observes Michele Laurino, Emergency Room manager. “Who takes care of them when they’re both sick and their families are far away? We had to stand in for family when family could not be there.”

A year into COVID, things have changed a bit. “We’re still seeing COVID-positive patients in the ER, but they are not as sick,” says Michele. “We still have safety precautions in place, and we know more about the disease process now than we did a year ago. I feel like we’ve reached a new normal.”

Julie agrees. “I think we all know COVID is a serious illness, but it’s no longer perceived as this terrifying plague, or an immediate death sentence. This is our new reality. Urgent Care is a place where things are going to be thrown at you. People who work here already have a coping mindset. COVID upped the ante quite a bit, but we all just keep adapting.”

Both Julie and Michele are pleased to see that the caseload is starting to feel more normal, too. Covid numbers are going down in both places. “The vaccine has definitely felt like a light at the end of the tunnel,” Michele says. “We’re still taking precautions, but we’re seeing more of the routine stuff now, like dog bites, lacerations and injuries. We can also allow someone to come in with most patients, which feels a lot better to everyone.”

Through it all, community support has meant everything to the staff. “I want to thank the community for the cards, food, and expressions of support that we received,” Julie says. “I never doubted for a minute that our community stood behind us. Now we’re hoping that you will come see us when you need care. That ongoing support is just as important to us. Our facilities are clean. It’s safe to come in.”


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