An orthopedic hospital turns itself into a transition hospital for patients recovering from an unsettling virus that poses new challenges for everyone.
Last weekend on the COVID-19 wards at NYU Langone Orthopedic Hospital, it was the new business as usual. Namely, helping patients wean off oxygen, treating their anxiety and blood clots in their legs, and overcoming overall fatigue and deconditioning. I participated and learned a lot about the twists and turns of recovery. The virus and its aftermath can ravage the body, badly damaging the lungs, heart, kidneys and brain. Rehabilitation can be difficult, not to mention the problems of when and where to send the patients when they are medically ready to leave.
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At the heart of the battle against the virus in New York City is NYU Langone Health. Its orthopedic hospital takes COVID transfers from Tisch Hospital and the Kimmel Pavilion, NYU Winthrop and NYU Brooklyn while at the same time, according to the chair of orthopedic surgery, Dr. Joseph Zuckerman, it has accepted transfers for orthopedic emergencies from Bellevue, Tisch, and other hospitals that are beset by COVID patients.
Teams of experts teaching each other
Langone Orthopedic Hospital itself has four COVID wards, filled with patients in various stages of recovery. The hospital has temporarily pivoted and changed its overall purpose to perform as a transition hospital for COVID-19 patients.
According to Nurse Practitioner AB Brody, just coming off an overnight shift, there is an unsettling amount of unpredictability to the virus. He described to me the plight of a 93- year-old woman who had multiple medical problems, and was turning blue with very low oxygen levels in the middle of the night. They turned her over (proning) and she stabilized, the team gave her extra oxygen, which she responded to, and within four days she turned around and went home. Brody added that there are other patients, including some younger ones, who have not done nearly as well, and some have died.
Dr. James Slover, in charge of the surgical service at the hospital, talked to me about how the teams came together, sharing skills, a hospitalist and nurse practitioners and physicians assistants working together with orthopedists who usually inhabited these halls. Slover indicated that they were all learning from each other, that a surgical nurse practitioner with expertise in Personal Protective Equipment quickly shared this information while at the same time learning standard medical practices from his or her medical cohorts.
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I joined group rounds, experiencing and participating in the congeniality and effective exchange of information. There was no ranking or pyramid, just everyone pitching in, professionals doing their new jobs. The skills of the two critical care specialists I met with were clearly valued, especially when it came to the issues of low oxygen and blood clots. They readily lent their expertise to others on the team.
On the wards to do God’s work
Michelle Meneses, Manager of Advanced Practice Providers at the hospital but now managing COVID Medicine, talked to me about the challenges of treating both mental as well as physical disabilities as COVID patients recover. The anxiety that stems from this illness, the isolation and the fear, compounds pre-existing psychiatric conditions and makes adjustment and placement that much harder.
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Recovery from COVID 19 is a long game. It requires not just retooling but constant commitment and devotion. As I walked through the wards clothed in PPE, I couldn’t get out of my head the image of Dr. Adam Karp, a highly regarded longtime geriatrician, clearly in a high risk group because of his weight and being over 60 years old, carefully donning PPE to enter the room of a recovering COVID patient, bringing good cheer while performing an important decannulation procedure — removing the breathing tube from the patient’s trachea — which demonstrated that the patient was on the road to recovery.
Dr. Karp was wearing a kippah, and I didn’t have to ask him to know that he was on the wards to do God’s work. He and everyone else there appeared unafraid and performed their assignments at a high level. This jewel of a hospital will not be defeated by this powerful virus.
Dr. Marc Siegel, a member of USA TODAY’s Board of Contributors and a Fox News medical correspondent, is a clinical professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center. Follow him on Twitter: @DrMarcSiegel.
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