Providing Emergency Care in a Hard-Hit Area

Physician assistant Kendra Moore ’13 sees a steady stream of COVID-19 patients in a northern New Jersey ER.

By: A.C. Shilton  Tuesday, April 28, 2020 08:45 AM

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Physician assistant Kendra Moore ’13 in protective gear at work

Kendra Moore ’13, a physician assistant at St. Mary's General Hospital in New Jersey, began thinking seriously about COVID-19 months ago. While most Americans still thought it a far-away problem, Moore was researching what we did and didn't know about the virus and how it might affect the emergency room where she worked. And yet, when the first suspected COVID-19 patient presented at St. Mary's, Moore realized that research, while helpful, didn't answer all the questions about the virus. 

"This is a brand-new disease, and we're learning as fast as we can, but it is scary to go into this with so many unknowns," says Moore, who was a biology major and public health minor at Muhlenberg.

The hospital’s first suspected COVID-19 patient arrived around mid-March. Soon after, the emergency room began to fill up with others who likely had the illness. Passaic County, New Jersey—where Moore works—borders Bergen County, one of the nation's most significant coronavirus hotspots. Models show that perhaps this region has hit the peak of infections, but Moore is awaiting the moment when that translates to fewer patients coming through the ER.

What makes COVID-19 so scary is how low on oxygen patients are when they arrive. A blood oxygen level of 98 to 99 percent is normal, but COVID-19 patients can be in the 70s or 80s, even with just mild shortness of breath. “That's very unusual; we've never seen that before," she says. 

A real challenge for Moore is figuring out which patients need to go to the ICU and which she can stabilize in the ER. She does feel lucky, however, that she doesn't have to witness the devastating progression of the worst cases like her colleagues in the ICU do. Still, most patients (besides minors) cannot come in with family, and it's scary for many of them to not know when—or if—they'll see their loved ones again.   

Also tricky is that regular emergencies haven't stopped. "We still see people for lacerations or abdominal pain. Appendicitis is still happening," she says. During most of her shifts the ER is packed. In some regards, COVID-19 has forced emergency rooms to become more efficient. The patients she can quickly treat and release get moved along to open up bed space. That's something she hopes continues once this is all over. 

Like many American healthcare workers, Moore worries about running out of personal protective equipment, but she says that so far, her hospital has had enough to keep her and her colleagues safe. She does worry about getting sick, but she's quick to add, "This is our work; we signed up for this."

Moore decided to become a physician assistant during a job shadowing program at Muhlenberg. As part of the program, she watched physician assistants at work at St. Luke's Hospital’s Bethlehem campus. "They were amazing and doing all kinds of jobs," she says, adding that she was impressed by how much autonomy they had. Emergency medicine—with its never-ending stream of different challenges—has been a perfect fit. She loves that no two days are the same.

These days, however, the shifts feel long and hard. Moore tries to make it through an entire shift (typically 10 to 12 hours, but shifts can be longer if volume necessitates it) without taking off her mask. Her ears ache from the elastic by the end of the day. Still, she says there are some bright spots, all things considered. "We've had more than 100 discharges of COVID patients. When the 100th was discharged, all the staff were clapping," she says. 

But her biggest morale boost comes from knowing she's doing work that matters. And while she loves that folks around the country are clapping for healthcare workers each night, that's not what she really wants. Everyone can help lift Moore’s spirits by doing something far simpler: Staying home.