March 6, 2020: I knew that what had happened was big but, how it would come to change my world and the world around me, I had no idea. Up until this date, the coronavirus was just something happening elsewhere, something affecting China and other countries, something that had entered the US but had not gotten close enough to change my world. Until March 6, 2020, I wasn’t scared. That day, I was working with a nurse practitioner student in my family medicine clinic. We were just wrapping up the day and I was excit
Nebraska PA, Emily Struebing is dressing in personal protective equipment as she prepares for a full day of assessing and testing patients for COVID-19.
ed to get out of town to visit my boyfriend in Hastings, NE. Sarah, the NP student, was reading through the news and saw that the first case of c
oronavirus had recently been confirmed in Nebraska. My jitters relating to this news quickly dissipated and I drove to Hastings. After a fairly uneventful Saturday, I was sitting in church on Sunday morning and my phone began to light up with calls and text messages. Once able to read and respond to them, I started to come to the realization that my world was about to change drastically. A clinic in our system was going to be converted to testing for COVID-19. Because of this, these doctors needed a new place to work out of and my home clinic was just the location.
March 9, 2020: Monday morning. In preparation for the new doctors, I got to work early, cleaned out space in my office and began discussing the changes with my coworkers. It was quickly becoming evident to me that I could best be utilized outside of this clinic. I reached out to my manager and director volunteering to move to the testing site and help out where I could. I received a call around noon on March 10, 2020 and, by early that afternoon, I was on my way to corporate to help with the hotline.
Being a part of this new challenge was both fascinating and overwhelming. In the beginning, whenever we suspected COVID-19 in a patient, we would call Douglas County Health and discuss the patient. They would then decide if a test was warranted. We fielded many phone calls from concerned patients: some with symptoms, many with questions, all with fear. The information we had at our disposal changed daily and sometimes hourly. We would keep a large white board with the locations of known positives to try and track if a patient had an exposure. I spent many hours trying to calm patient concerns but, truthfully, I didn’t know much more than they did. We were all making this up as we went along.
March 13, 2020: Friday the 13th. I was moved again, this time from corporate back to the clinic. Only, it wasn’t back to my clinic. I was moved to our current one and only COVID-19 testing facility. We had a very small but very resilient staff. Myself, a couple of medical assistants and a receptionist formed a very tight alliance and learned to work with each other and adapt. And boy did we adapt! What started as only a few tests per day quickly exploded to 30 tests, 50 tests and 100 tests per day. In the beginning, I was making decisions on every patient that came through. Would they get a COVID-19 test? Influenza? Respiratory panel? I was deciding based on limited information written in a chart note and my growing but still small knowledge base of COVID-19 infection. As the year marched on, we transitioned from a walkin testing site to a drive-up testing site to a very smooth drive-through testing site. We did most of our work outside, enduring cold and rain as well as scorching heat, all while wearing our full PPE.
Eventually, I was asked to work in the respiratory clinic as well. These patients with respiratory concerns cannot yet be seen in our regular clinics due to concern of spreading the virus. But, they must be cared for. Again, I get to see a range of complaints. Many patients with a sinus infection or bronchitis, easily cared for as outpatients. Many others with COVID-19 positive diagnoses who are becoming increasingly short of breath or fatigued. With every patient, I am tasked with the job of keeping them out of the hospital. Our hospitals are overflowing and for every patient I can keep from going to the ER that means a room can be open for someone else. I was recently moved to a new location. I now have different staff to train, a new process to iron out and many more patients to care for. Every day brings a new challenge and a new lesson to learn about COVID-19. We are ever-changing and ever-adapting. I feel fortunate that my training as a physician assistant led me to a point that I could be an integral part of this, hopefully, once-in-a-lifetime season.