The laughter and smiles show kids at camp enjoying themselves. But this camp, now in its 18th year, serves important therapeutic and educational purposes.
Valerie David never imagined there would be a time in her career when she would have to decide which patients would receive clinical care ventilators. Yet, because of the COVID-19 pandemic, she and her team are now facing those difficult decisions.
Valerie David, MHA, RRT-NPS, AE-C, is a second-year student in the College of Health Profession's Doctor of Health Administration (DHA) program. She has been working as a health care professional for 30 years and currently serves as the director of Respiratory Care Services, Pulmonary Diagnostics, Neurophysiology, and Sleep departments at Piedmont Atlanta Hospital in Atlanta, GA. As part of her role, she has operational responsibilities in each department and oversees a diverse group of employees.
Her team ranges in experience from those in their first year of service to lifelong health care workers nearing retirement. It makes for a well-rounded team but also poses a unique set of challenges.
The more senior among the team are more adaptable and flexible due to their years of experience working through similar crises. They've gone through the HIV crisis of the '80s, MERS, and SARS. But this virus is like none that they've seen before. According to David, "it's most similar to HIV in the fact that we are dealing with something so new and mysterious that we don't have much information about it yet." Adaptability hasn't come as easy to the younger and less experienced members of her team. For newer employees, without years of experience to draw from, it's a lot to process at once. What all her team members have in common is their worry about the virus' spread and if they will get sick too.
Each day, David designates, which team members will handle each patient type. Her goal is to keep the virus contained and minimize cross-contamination between patients with and without COVID-19. While Piedmont does have hospital staff that is explicitly treating non-COVID-19 patients, it is increasingly difficult to cohort patients. Space is limited, and each day more patients with COVID-19 are coming into the hospital.
To make matters more challenging, David and her team are now facing difficult decisions. They must decide who among those patients with COVID-19 will receive clinical care ventilators and who will receive transport ventilators. Transport ventilators, mainly designed for patient transport inside the hospital, are not typically used in this capacity. However, it is necessary for the current situation. "Thankfully," David said, "we haven't had to decide who gets a ventilator at all."
That scenario keeps her up at night. And if they stay on the same trajectory that they have been in the past two weeks, tough decisions will need to be made. But David is hopeful it will not get to that point.
Although the situation has been stressful, David has found that her naturally adaptive personality has helped to keep her outlook positive. She is working hard to help her team maintain their mental health and stay calm so they can process, focus, and recover quickly. David shared that "overall, morale in her team is good. They try to keep positive, share workloads, and be supportive of one another." The team is meditating, practicing breathing exercises, and connecting with their families virtually for added support. Additionally, David partnered with a lavender farm in north Georgia to give satchels of calming lavender to each of her team members.
David credits the DHA program with helping her become the leader that she is today. Although she worked as a clinician for the first 20 years of her career, David felt she lacked some fundamental organizational leadership knowledge she needed. The first course she took in the program, Foundational Leadership, was particularly helpful in this area. It gave her a foundation in organizational structure, hierarchies, and perhaps most importantly, in the current situation, change management. David tells her team that how they respond in this crisis will be remembered ten years from now and tries to act accordingly as a leader. To demonstrate, she has taken on clerical tasks for her team so they can focus on patient care. "Pulling together shows our sense of community and humanity," said David. That includes the outpouring of support from members of the Atlanta community. David expressed gratitude for those doing “wonderfully nice things” to show their support for health care workers.
When posting about her experience online, she uses the hashtag #BuiltForThis in each post. She truly feels this is her calling and believes it's true of others working in the health care field right now.
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Keywords: Health Administration