Family Doctors – the COVID Patient’s Greatest Ally
When the world started seeing signs of a pandemic, the public was lavish with praise, calling doctors and nurses heroes. But as the saying goes – today’s exceptions become tomorrow’s expectations – and people grew to expect the Herculean efforts by frontline workers.
Two CRPCN doctors, Dr. Stratton Steed of Pinnacle Medical Westmount and Dr. Andrea Wilson of Mokala Medical, worked tirelessly and without ceremony to help manage a devastating six-week outbreak in a Calgary supportive living facility.
As COVID spread in its expected and deadly fashion, more and more residents became ill but so too did frontline staff who cared for them. Despite precautions, nurses and healthcare aids became ill, and so did their families. Fewer people were well enough to battle the disease and protect the vulnerable.
Everyone was working their absolute hardest despite fear for their patients and families. It was into this environment that Dr. Wilson charged. She was designated as a first-wave “dirty doc.” [A number of physicians are held in reserve to replace those expected to become sick and unable to work.]
As a family doctor and expert in palliative care, Dr. Wilson’s knowledge, and ability to assess patients and manage symptoms were invaluable at a time when care was put to the test. She was pulled between her family, her duties at her regular practice, and worked long shifts and weekends to support the facility and team.
Dr. Cassandra Hoggard said, “It got so crazy. At one point, all you could hear was oxygen machines going. We were administering saline to so many people that we ran out of stands. We started taking pictures off the wall and using the hooks to hang the saline bags. It was a makeshift hospital.”
With so many regular staff not able to work, assistance was requested from Alberta Health Services and temporary workers. “For a while doctors as well as allied health were helping feed patients because there just wasn’t anyone else there to do it. There were so few regular staff that often the family doctors became the last line of defense for continuity of care and link to the family.”
Dr. Steed and Dr. Wilson took 24/7 call detail. Dr. Steed attends two supportive living sites and so was designated as a second wave “dirty doc” and was required to provide critical care remotely. He worked behind the scenes to ensure the onsite docs were aware of the ever-changing current best practice recommendations for managing COVID-19.
He frequently received calls in the middle of the night. The CRPCN doctors at long-term care facilities “opted to take our own calls because we know our patients and families, and we knew that our knowledge of their history was going to be critical,” said Dr. Hoggard, adding, “Dr. Steed was a total champ in the virtual world. One particularly tough situation was a 40-minute goals of care conversation on the phone with a patient with language issues. Thank goodness Dr. Steed knew his patient and could understand what they were trying to communicate! There is no doubt in my mind that he was the only one that could have done that.”
The upside to the outbreak was the unprecedented collaboration between healthcare providers. All the doctors would discuss nightly treatment plans for patients and there was constant communication between all staff on site. Families were not allowed to visit, and staff were busy and frequently not a member of the usual care team. It often came down to the family doctors to be the trusted voice on the other side of the phone to answer questions and calm anxious families. Dr. Hoggard says, “Our doctors were there. Every. Single. Day. And accessible 24 hours of every single day. Mortality was lower than average, and we can credit that to our nurses, health care aids, and doctors going above and beyond.”
If everyone could see our family doctors in action, they’d agree with Dr. Hoggard’s assessment that they were “glorious.”
We couldn’t be more proud.