WHO: SHAWN FEIRER, 49, PROGRAM MANAGER OF RESPIRATORY CARE, MILWAUKEE VA MEDICAL CENTER (ZABLOCKI)
Respiratory therapists are called to a patient’s bedside to provide a number of different therapies: simple oxygen, nebulizer treatments and variations of chest physiotherapy (for example, pounding to loosen secretions). More advanced therapies include using machines such as BiPAP (bi-level positive airway pressure), CPAP (continuous positive airway pressure) and Vapotherm , which is a nasal cannula that delivers high flows of heated and humidified oxygen that take away the work of breathing.
Fortunately, we were ahead of the curve in preparing for COVID-19. When Ebola hit a few years back, even though there were no cases in Wisconsin, our administrative team took it very seriously and had enough PPE in place.
This year in February, we began following closely what was happening in Asia and Europe. Dr Andreea Anton, the leader of our physician leadership group, gave me a challenge: “Please don’t tell me we are not going to provide care. Tell me how we are going to provide the same level of therapy to these patients by different means.” Our team proactively researched what was working in Asia, Europe and Canada; looked at best practices being reported by the WHO and the CDC; and put together guidelines for treating this patient population.
We had these guidelines in place three weeks before the first COVID patient even presented, and we have been seeing good results. Dr. Anton and I shared the guidelines at a national webinar for all hospitals, not just VA hospitals. It was very well received.
These are just guidelines, though. We don’t have all the answers for every patient, because each one has a specially tailored treatment plan that requires an integrated, multidisciplinary team effort by physicians, nurses and respiratory therapists. It’s a very collaborative process.
In addition to already having enough PPE on hand, we put together a contingency staffing plan. As COVID became more widespread in the area and outpatient procedures were canceled except for emergencies, we were able to transfer seven respiratory therapists to the inpatient side. We are prepared to handle a surge if it happens.
So within the hospitals, we’re managing. My concern now is what I see outside of them. Some people in the community feel this [COVID-19] isn’t as significant as it is. I agree with Dr. Fauci: If we rush back to a “state of normalcy,” we’re going to see much more significant effects of the disease in the fall and winter.
I am also a veteran. I served for eight-and-a-half years with the 440th Airlift Wing until it relocated to Georgia. This population is one of the most rewarding I’ve ever worked with. We’re here to help them feel better, but more often than not, when we greet someone, their first concern is how we’re doing. It’s very humbling.
– As told to Carolyn Kott Washburne
The sky is not falling
Shawn is being modest. Back in February, when COVID was just ramping up, there was a lot of fear in hospitals about how to handle it. Instead of running around panicky — “The sky is falling!” — Shawn and his team calmly made plans to have enough equipment and staff in place even if there was a surge. We were one of the first hospitals in the area to have a screening process for people coming through the front door. We were ahead of the curve.
– Gary Kunich, Milwaukee VA Public Relations Director