A tick before 7 p.m. on November 25 – the day before Thanksgiving – Dr. Shanta Zimmer pushed the “send” button on an email that sounded a call to arms against an enemy that was gathering strength.
The foe was the novel coronavirus, which was rapidly spreading throughout Colorado and sending fresh waves of patients sickened with COVID-19 to hospital beds. Zimmer, an infectious disease specialist at UCHealth Colorado Hospital on the Anschutz Medical Campus, saw the strain on staff with her own eyes. The number of patients hospitalized with COVID-19 had climbed rapidly at UCH and other UCHealth hospitals since September. She also knew that Colorado Governor Jared Polis wanted to stem the tide. Two weeks previously, he had told UCH and hospitals across the state to submit plans to increase their capacity by 50%.
Zimmer was in position to call on some fresh troops to meet that call. As senior associate dean for education at the University of Colorado School of Medicine, she oversees the studies and development of more than 700 medical students. Her email went out to fourth-year students preparing for and scheduling residency interviews. Zimmer requested volunteers to take on two consecutive 10- to 12-hour shifts, either on medical/surgical floors or the surge ICUs, from Nov. 30 to Dec. 5.
Urgent COVID-19 need answered by medical students
Attending physicians, residents, hospital medicine specialists and advanced practice providers (APPs) at UCH badly needed assistance with patient care, Zimmer wrote, mincing no words. “We are entering the ‘all hands on deck’ phase of the crisis here in the Denver area,” Zimmer wrote.
She attached two documents to the email describing the support students would be asked to provide on floors and ICUs: placing orders, contacting family members, documenting care, tracking lab results and more. In short, they would function as clinical team members under the supervision of faculty and residents. She emphasized that they were under no obligation to volunteer.
Zimmer awoke Thanksgiving morning to find that the students had filled all the available shifts for the week. The surge continued that week – without any sign of abating – so on Friday, Dec, 4, Zimmer asked again for volunteers, this time to fill shifts for the rest of December and all of January. By the following Monday, the students had filled all of those shifts, including Christmas Eve and Christmas Day.
The students had taken the “all hands on deck” call seriously.
“People say a lot of things about the next generation and are they going to be committed and are they altruistic – all those kinds of things,” Zimmer said. “I want people to know they are. You can count on the next generation of physicians who are coming out.”
A desire to pitch in
Katie Havranek is among that generation and one of the volunteers who answered Zimmer’s email request. Now preparing for her residency interviews, Havranek plans to specialize in internal medicine. She said she welcomed the chance to volunteer – particularly because the capacity pressures created by the first wave of the COVID-19 pandemic in March and April had forced the hospital to set aside teaching temporarily. That forced Havranek and her fellow students out of their clinical rotations and away from patient care – a difficult situation for people training to serve others.
“Going into medicine, most of us are compelled to help people,” Havranek said. “In our fourth year, we feel a sense of belonging and responsibility to our communities, our patients and other physicians.”
Not that she and many of her fellow students sat by idly during their direct patient care hiatus. For example, after being sidelined from her clinical training, she helped gather personal protective equipment for the hospital and worked with others to distribute cards thanking Environmental Services staff for their service. (Watch this video to see how a sense of teamwork among UCHealth care givers has never been stronger.)
After the first surge subsided in the summer, Havranek got back to direct patient care, completing a clinical rotation caring for COVID-19 patients in intensive care units.
Medical students help COVID-19 patients
As with all her fellow fourth-year student volunteers, she was thus prepared to add much-needed clinical support in November and December as the latest patient surge intensified at UCH. For her initial ICU shifts, she prepared by reading the documents Zimmer sent describing the help clinical teams needed; watching videos on proper donning and doffing of PPE; and reviewing the hospital’s protocols for caring for COVID-19 patients.
Havranek joined teams that included an attending physician, an intern and two residents. For each shift, she was assigned a patient, read their chart, medical history and course of care, and presented the case to the attending physician during rounds. She then wrote notes that a resident edited for review by the attending.
Havranek also helps to manage volunteer shifts and field feedback from other volunteer students about their experiences on the units. The insights have helped to make assignments more flexible – volunteers might switch from one unit to another that needs more help on a particular shift – and bolstered documentation about how to call families of COVID-19 patients and respond to the questions they frequently ask.
Benefits of volunteering in medical school
The volunteer experience has been valuable on many levels, Havranek said. The most obvious is that she’s gotten a rare opportunity to gain clinical experience working with faculty, residents and nurses.
She acknowledged feeling that she “didn’t want to encumber the team.” But that hasn’t been an issue, she added. “They are always very generous teachers,” she said. Despite the mounting stress of the pandemic, “I’ve never encountered anyone not excited to teach.”
Among other insights, the experience has taught her the importance of being flexible in the unpredictable world of COVID-19 patient care.
“I try to be present and react to any tasks the team may need,” Havranek said.
Her bonds with her fellow students are stronger because of volunteering, she added.
“I feel a sense of camaraderie with other students,” Havranek said. “I’m lucky to be part of a community that works so hard and feels such a calling to help patients.”
The physical and emotional toll exacted by COVID-19 is real, and Havranek said she has felt it keenly while working on the units.
“The hardest part is seeing the devastation of COVID for patients and families,” she acknowledged. But that has only strengthened her resolve to work on their behalf.
“The pandemic really leaves me committed to start work,” she said. “It’s been a relief to be helpful, and I feel we can do even more as time goes on. I feel very positive about that.”
The students’ contributions have not gone unnoticed. In his “Weekly Message” Dec. 7, School of Medicine Dean Dr. John Reilly took notice of their spirit of selflessness in combatting the surge.
“We and our hospital partners are striving to avoid the extremes that we faced in the spring,” Reilly wrote. “I want to commend our fourth-year medical students for responding to a call to serve in team-support roles in critical care and floor units at UCHealth University of Colorado Hospital.”
Dr. Jean Kutner, chief medical officer for UCH, added a note of praise and gratitude for the students’ commitment to relieving stress on hard-pressed providers, patients and families.
“We got a great response from the fourth-year medical students, who have become members of teams and provided support,” Kutner said. “It shows the strength of an academic medical center.”
These days, Zimmer said she occasionally encounters one of the student volunteers when she sees a patient in her role as an infectious disease specialist. She’s gratified to see them working as an integral member of a clinical team.
“I see these students of mine as colleagues, and I let them know that I see them that way,” Zimmer said. “There is an understanding that they are now part of the profession of medicine. That gives me an immense sense of pride.”