Texas NP Deployed in NYC, Reports from the Front Lines of COVID-19
Monday, April 27, 2020
Posted by: Erin Cusack
Q&A with Ashley Hughes
Meet NP Ashley Hughes from Temple, Texas. Hughes was recently deployed with the 301st medical squadron and began working at Jacobi Medical Center in the Bronx but is now working at Queens Hospital Center in Queens. Learn more about Hughes and how she is caring for patients in the epicenter of the COVID-19 pandemic.
Q: Tell us about your current nurse practitioner role. Where do you work and what patient population do you serve?
A: Currently in my role as a nurse practitioner, I work for the Department of Veterans Affairs (VA) at the Central Texas Veterans Health Care System. I work in Home Based Primary Care (HBPC), a program where an integrated healthcare team goes into the Veteran’s home and provides primary care services. HBPC targets the sickest and most vulnerable of our Veteran populations to include patients who are home bound, receiving end-of-life/palliative care and with chronic debilitating comorbidities for whom routine clinic care is not effective.
Q: How are you helping to serve on the front lines of COVID-19 right now?
A: I am part of a 17-member group made up of nurses and nurse practitioners, physician assistants, and physicians from the 301st MDS (medical squadron). Our unit is located at the Naval Air Station Joint Reserve Base in Fort Worth, Texas. I began working at Jacobi Medical Center and due to my extensive background working with pulmonary disease processes was identified by joint operations to go to Queens Hospital Center. Both medical centers are a part of the NYC Health + Hospitals system.
Even though I’m a nurse practitioner, my background in Critical and Medical Surgical Nursing is what is most needed. This is not uncommon, as we have seen Certified Registered Nurse Anesthetists, surgeons and other clinicians shifting to a more intensivist role to fully meet the overwhelming capacity required to care for patients during this pandemic.
Q: How has this pandemic changed the way you work and interact with patients?
A: Regardless of my title and degree, patient care and compassion come first. Many of these individuals at Jacobi and Queens are susceptible populations and may not have the support system required to meet even basic healthcare needs. This problem is further magnified by the inability to have visitors for the patients during this time. As a nurse practitioner, I am able to apply not only my previous experience, but also my advanced practice knowledge as I am able to more fully understand and comprehend the complexities of this virus and rapidly intervene with other healthcare team members to ensure the safety, healing and wellbeing of these patients.
Q: As a health care provider volunteering during this pandemic, what has been the biggest challenge or barrier you’ve experienced?
A: Jacobi and Queens are both City hospitals and suffered major staffing losses due to quarantine protocols, as many frontline providers have contracted the virus and can no longer come to work. This left a tremendous void for which NYC hospitals did not have contingency plan and required rapid onboarding of staff and training.
Q: What message would you share with other nurse practitioners and health care providers as they continue to navigate COVID-19? What message do you have for our policymakers/leaders?
A: I have been in the nursing field for 12 years and have never seen anything like the COVID-19 pandemic. I know back home in Texas this pandemic has not spread like it has here in New York City and it might be hard to fathom if it really is as bad as what the news is reporting. But the simple answer is yes, and it might even be worse. Since I began working in the hospitals here in New York, I have only encountered COVID-19 positive patients. I cannot stress enough the importance of following the national guidelines, as recommended by the Centers for Disease Control and Prevention, such as wearing a mask, social distancing and handwashing. Before being deployed, we were just beginning to implement telehealth and telemedicine visits in my role as a nurse practitioner in the VA. The message I have for our policymakers/leaders is that telemedicine appears to be the way of the future for many of the lower-complexity patient needs and should be utilized to its fullest extent. Telemedicine deserves our investment and attention now and as we move forward in healthcare. Additionally, the most vital point, if nothing else is learned during this pandemic, is that each discipline be allowed to practice to the fullest extent of their education and training as well as increasing the use of nonphysician providers such as nurse practitioners and physician assistants in practice.
Q: Why did you become an NP? And how has your DNP program prepared you to be a better leader/policy expert/clinician?
A: I became a nurse practitioner in order to have an expanded knowledge of disease processes, wellness and illness and to have the ability to reach patients whom I would not be able to without an advanced practice license. My DNP and military training and education have prepared me to succeed in high-stress environments while remaining focused on accomplishing the mission at hand without feeling overwhelmed and manage the stress that comes with the job. The amazing thing about working with nurses, even those you do not know, is that we are all trained with like-mindedness and are a family that pulls from each other’s strengths in order to achieve the best patient outcomes.
Q: What do you do to practice self-care during this time?
A: Self-care during this pandemic includes going for runs, playing cards/board games, watching movies, reading books, and Face Timing with family back home!