Inside the front lines of the Covid-19 fight at PRMC

In the battle against Covid-19, an elite few are on the front lines at Peninsula Regional Medical Center.

“This is a warship – only essential, multifunctional, cross-trained personnel are on board,” said Dr. Yashvir Sangwan, an interventional pulmonologist and Medical Director of the Covid-19 unit.

The Covid-19 unit is a designated area where providers treat patients confirmed to have Covid-19, and those under investigation whose tests have not yet come back. This method of isolating patients keeps the community safer by keeping these patients where the virus can’t reach others who aren’t infected. It also keeps the staff safer, as those dealing with Covid-19 patients have special gear to keep the virus out.

“The well-trained team comes through a special door,” Sangwan explained. “You never see them in the normal hospital. We then go into a special room and wear our ‘space suits’ in the proper way. Then we enter the unit and never take our hoods off. We will not get Covid from our patients, and our patients and coworkers will never get Covid from us. We change all gloves and gowns between patients and observe commando-style protocols – no mistakes.”

The “space suits” Sangwan mentions might not be NASA-style, but they are high-tech. PAPR systems – powered air-purifying respirators – cover and shield the staff’s faces. Purified air is supplied through a facepiece to ensure that the tiniest Covid-containing droplet cannot reach the bedside caregivers.

All rooms in the Covid-19 areas are negative-pressure rooms. Negative-pressure rooms are ventilated in a way that allow air to flow into the room, but not out of it, to contain all airborne contaminants. Right now, the CDC says negative pressure is not required for the treatment of Covid-19 patients, but it is a step that Peninsula Regional Medical Center is able to take above recommended guidelines to enhance infection control measures.

The planning was swift by necessity, but intense, said Registered Nurse Tom Jones, Director of the Covid-19 Unit.

“There is no way to adequately express the amount of work nor the astonishing team work it has taken to make this happen. This involved virtually every single department in our organization.  However, in regards to nursing, I would be remiss if I did not single out Erin Tobat and Ann Turner. They have been involved at every level, in every way in the Station One/Covid unit effort. They put themselves right alongside our staff, on the frontlines, caring for patients, providing on-the-spot training, and figuring out many unforeseen needs of the unit on the fly.” 

The staff on the unit is all-volunteer by design. “You need only the most motivated and trained people,” Sangwan said.

“I wanted to be part of the solution,” said Registered Nurse Shannon Flood, a unit volunteer. “It’s like M*A*S*H – very challenging, and team nursing is a must.” Fortunately, she said, that teamwork has been there. “All the skills and skill sets work together to make a perfect care team.”

Dr. Yashvir Sangwan.

That’s why the unit doesn’t take every volunteer – just the most highly trained. “If you are a respiratory therapist who can use a glidescope and be a nurse when you are called to – or if you are a nurse who can do critical care and place PICCs – come on in,” Sangwan said. “It takes time to practice and get to the level of threat awareness and strict protocol. Therefore anyone who works here – we want them to stay on the team until this is over, or until they tell us they need to be replaced.”

However, everyone who has asked to volunteer is being kept in mind, Jones said. “In the coming weeks, we will need all of those who have volunteered and most likely many more.  This is undoubtedly the greatest healthcare emergency most of us have ever faced, but we have a solid plan to absorb the surge, and the best staff anywhere.”

The learning curve is steep as new information comes out almost daily. “The unit is new and ever-changing as we learn how to manage patients and a potentially deadly virus,” Flood said.

Her colleague, Registered Nurse Amy White, said, “It’s a big change of pace for me, but it’s a great opportunity to grow as a nurse and at the same time fight this war.”

It’s a physical challenge as well, said Registered Nurse Linda Tuthil – because of those space suits. “It’s difficult – hearing in the PAPR is challenging, it’s hot, you’re always thirsty. You have to get completely undressed to drink. But we have a great team.”

The dedication of the staff has been remarkable, Jones said. “They came to us and volunteered with full knowledge of how contagious Covid-19 is and how difficult it will be to work 12 hour shifts in full PPE.  This is such a testament to the commitment our nurses have to caring for our friends, our families, and our community.”

The Covid-19 team is all-in, working 12-hour shifts at a time; Sangwan makes himself available 24 hours a day, seven days a week and spends at least seven hours a day on the unit every day.

“It has often been said that heroes are ordinary people thrown into extraordinary situations where they do extraordinary things.  We do not have to look far for heroes – here, we are surrounded by them,” Jones said.

Helpful Coronavirus links

Maryland Department of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage

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