By Rohit Uppal, Chief Clinical Officer, Hospitalist Services
Even in the best of times, the role of the hospitalist is one of the most challenging and valuable occupations. The work hospitalists do every day is heroic. We care for the most vulnerable and sickest patients. We work to improve the system of care in our hospitals and communities. We support the work of nurses and specialists through our teamwork and leadership. The everyday heroics of hospitalists is only amplified during pandemics and disasters.
As clinicians, we work every day to improve the lives of others, and when disasters come, it intensifies our duty to serve our neighbors and communities. In December 2021, our team responded to disaster in the midst of the pandemic.
Dec. 10 at 9 p.m. CT, a tornado entered western Kentucky from Tennessee. Its path would grow to be more than 160 miles. A tornado with this long of a track is rare, especially in December. And as the night progressed, it was clear that the storm was not only rare but also creating a historic amount of devastation in western Kentucky. The hardest-hit areas included Mayfield and Dawson Springs.
In the early morning hours before the sun came up, our teams across the South were mobilizing to respond.
Dr. Kellie Taylor is the Hospital Medicine Facility Medical Director at Jackson Purchase Medical Center in Mayfield, and Baptist Health Deaconess Madisonville, which serves Dawson Springs. Dr. Taylor wanted to care for all her patients and teams but knew she could best respond in one location. To prevent Dr. Taylor from feeling torn as a leader to be two places at once, Dr. Hunter Housman, the Regional Medical Director who oversees Jackson Purchase, headed to Mayfield from Lexington. At the same time, Dr. Taylor was en route to Madisonville.
Locking arms in Madisonville and Mayfield
It became evident very quickly that the volume of patients at Madisonville – one of a small handful of regional trauma centers – was going to be tremendous in a very short time span. National- and state-level emergency management was on the ground triaging and distributing patients from the scene, and emergency departments were also distributing patients to regional trauma centers.
By 5 a.m., the team had come together. Luckily, the members of the team who were scheduled to be working that morning live farther away from the hospital, and those who live locally were able to come to the hospital quickly to join them. They all started rounding, visiting the inpatients at the hospital that morning. Since the hospital was coming off of the Delta surge at this time, it was quite busy. By 8 a.m. when the morning shift usually starts, the team had seen 90 patients and discharged the appropriate patients to allow room for the incoming trauma patients.
At that point, the emergency department was starting to get an influx of injuries from Dawson Springs. With the inpatient discharges in motion, Dr. Taylor and her hospitalist team headed to the ED. They worked hand-in-hand with the emergency clinicians. As soon as an emergency clinician saw a patient they knew needed to be admitted, they released them from the ED, and a hospitalist took them directly.
Hospitalist clinicians worked as both triage and covered ED volume, and then worked in their more typical role as admitting providers.
With the amount of trauma, the hospitalists also worked hand-in-hand with surgeons to identify who needed to get to the OR first and get the patients fluids, antibiotics and blood as soon as possible. The peak ED volume that morning was triple a high volume day.
In the days to come, on their days off, despite the very high degree of stress they had endured, the team members went to Dawson Springs to help with cleanup efforts. They were there, ready to help with no questions asked.
Dr. Housman and the Jackson Purchase team in Mayfield were managing through the complexities of treating patients in a hospital with no running water. They only had generator power and the networks were down, which makes it challenging to refer patients.
If patients were able to be discharged, many had no home to return to due to the storm. At both Madisonville and Jackson Purchase, the teams supported patients through tremendous loss. Patients lost loved ones in the storm. They lost homes and livelihoods. The team was there, at bedsides, offering any comfort they could to those who had lost so much.
Managing through crisis
When you quickly put immense stress and strain, on any process or system, including a medical system, imperfections, cracks and breaking points are made evident. But, TeamHealth Hospitalists showed their fortitude. They made heroic efforts to ensure staffing was appropriate despite environmental pressures. And, TeamHealth Hospital Medicine and Emergency Medicine colleagues locked arms together for a common cause. They united to take care of patients that had their lives turned upside-down.
The support and resources that the teams received from TeamHealth leadership, spanning from facility medical directors to executive leadership, were immediate, robust and continued to be predictable. Blood banks supported shortages. Food and water were brought in to the hospitals to support the clinicians during long shifts. If a clinician needed shelter, it was provided – sometimes for a clinician who lives far from the hospital to travel in to help. All the pieces, like a puzzle, were coordinated quickly.
“It’s not like we’re just feeling around in the dark,” said Dr. Housman. “We have a script. We’ve got a process. We’ve got applicable resources, and we go to work and get this done. And take care of our people.”
We are TeamHealth. The words team and health embody the response to the tornadoes in western Kentucky. A team of hospitalists locked arms with emergency colleagues and did whatever needed to be done to take care of patients in a moment of crisis.
Happy National Hospitalist Day
We have been through so much. It is with a heavy heart that I acknowledge that hospitalists have been on the front line of the ongoing pandemic for two years. It is with an immense sense of thankfulness and gratitude that I wish all hospitalists a happy National Hospitalist Day. I am so proud of our specialty. Thank you for the work that you have been doing, especially on the front lines of the pandemic, and thank you to the teams that responded to the natural disaster in Kentucky during this extremely challenging time.
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