Portraits in Healthcare: Providence ED doc says 'I want people to know it’s safe to come to the hospital'

This is part of our occasional series called PortraiPortraits in Healthcare logots in Healthcare to capture the changes happening in healthcare due to COVID-19 as experienced by providers. 

Providence Regional Medical Center Everett, just north of Seattle, was the first U.S. hospital to report a COVID-19 case in late January. At the medical center, emergency department physician Sarah Hansen, M.D., and her colleagues were prepared for an outbreak as far as equipment and protocols—they had run through regular drills for a mass casualty situation. But they didn’t know what to expect as information about COVID-19 continued to evolve. By the end of February, the Seattle Washington area had emerged as an early epicenter of the coronavirus outbreak. Emergency department clinicians are used to working in a highly dynamic, stressful environment, but the pandemic brought on new challenges for Hansen and her ED colleagues. This her story as told to FierceHealthcare and edited for length and clarity.

​I don’t think we really got a sense of the scope of where it was going until the Life Care incident in Kirkland and that specific weekend where several patients came in critically ill.

For me, that was the moment when the impact of it really hit home.  

Shortly thereafter, there was a regional emergency provider, one of our colleagues, who became critically ill from COVID. That was a big moment for a lot of us, and certainly for me, about the serious nature of this. It became close to home at that point. My husband is also an ER physician and he called me as I was going to work that evening and said, ‘This is happening, wear your PPE and be very careful.’

There is always a level of understanding that any pathogen can happen at any point. That hasn’t changed. But the amount of equipment that we have to use now, that experience is different because it just takes longer. There is a lot more thought that has to go into donning and doffing PPE.

The communication also is different. We try to go into the room less often. We are not having patients’ families present, so communication with them has changed and that’s stressful for patients and providers as well. That is what has changed the most.

That’s always this baseline level of anxiety working in the ED and that has increased just a tick beyond what it normally is. There’s an overall level of concern for the safety of the staff and patients and trying to provide the high-quality healthcare that we’ve been used to doing with all of this in the background. This anxiety has calmed down as it has become more normalized, and easier to don and doff all the PPE and it becomes more routine. It’s reassuring that the infection rate among our providers is very low. That’s a good sign that what we are doing is appropriate and effective.

Dr. Sarah Hansen (Providence)

I think back on what was going on in the ED and volumes were down, which was a big surprise. I will say, however, the folks that are coming in are more ill. To me, that’s an indication that they are waiting longer to come in because they are concerned about something. Part of me considers this an act of love on their part—this is what they are doing to flatten the curve, to keep their neighbors safe, keep themselves safe, and keep healthcare providers safe.

But it is very concerning that the people who are coming in are more critically ill, and they are coming in late for things that are time-sensitive, things like heart attacks, strokes, and even traumas.

I want people to know it’s safe to come to the hospital. If they need to come, they should come. They shouldn’t delay if they are having weakness on one side, if they are having chest pain, or if they are having the worst headache of their life or they’re having trauma. We are taking tons of precautions. We’re doing a good job protecting ourselves and therefore protecting the patients. It’s safe…

The biggest thing I’ve learned is that we are well prepared. Sometimes doing emergency drills feels silly and a little bit false but they are really important.

When you have something like this, it looks like a tsunami—you get a little bit of warning, but you don’t know how big it’s going to be or how hard it’s going to hit. But if you have good habits at baseline, it’s manageable. What we have in place in our hospital and in our department is effective and it works. It's safe…

It looks like the numbers are coming down. I would anticipate as things open up a little bit, we’ll get little spikes here and there. I do think this is going to fundamentally change the way people interact with each other at baseline, so I wouldn’t expect a huge spike.

Are you a provider with a story about COVID-19 you'd like to share for our Portraits in Healthcare series, we'd love to hear it. Please email [email protected]. Please include a photo that can be used with your story and a telephone number where you can be reached if your story is selected.