What Orthopaedic Redeployment Looks Like in NYC

If you are wondering how orthopaedic residents and attendings are being redeployed in the so-called epicenter of the worldwide COVID-19 pandemic, check out the latest JBJS “What’s Important” article by Sarpong et al. The voices therein come from 3 orthopaedists at Manhattan’s Columbia University Irving Medical Center.

To ease the anticipated burden on the ER from a COVID-related surge, Columbia’s orthopaedic department early on created a Musculoskeletal Urgent Care Center. But everyone realized they could do more, and ever since April 5, 2020, every available practitioner in the orthopaedic department—including attending surgeons, fellows, residents, nurse practitioners, nurses, physician assistants, medical assistants, and support staff—has been redeployed to areas of the hospital with unmet needs, particularly the ER and ICU.

The two resident authors, Nana O. Sarpong, MD, MBA and Lynn Ann Forrester, MD, say that when they reported to the ER, the pace there was as fast as ever, but it was eerily quiet because the majority of patients were intubated. Amid a feeling of “both palpable fear and determination in the room,” Drs. Sarpong and Forrester rounded as members of a newly formed ER-ICU Triage Team to help take care of COVID-19 patients who had been admitted to the ICU but had not yet been physically moved from the ER. After rounds, they obtained arterial blood gases from intubated and sedated patients, obtained chest radiographs, and helped transport patients when ICU beds became available.

Acknowledging that all health-care workers are now practicing near the edges or beyond the scope of their training to provide compassionate, high-quality care to patients, Drs. Sarpong and Forrester say their redeployment so far has emphasized that “we are a part of the broader medical community, and thus are inextricably linked to our colleagues on the front lines of this pandemic.”

A similar message comes from orthopaedic department chair William N. Levine, MD. He describes the early formation of a departmental Redeployment Committee, which reviewed the goals and needs of the hospital as well as the assets among among the orthopaedic faculty, taking into consideration their age and comorbidities, family health concerns, and other relevant information. Soon thereafter, to broaden the provider pool and minimize overall virus exposure, redeployed faculty from orthopaedic surgery joined forces with those from urology, otolaryngology, and ophthalmology.

Noting that most every physician cites a “calling to help people” in their personal statements for medical school, residency, or fellowship, Dr. Levine says, “Now we all have the opportunity to do just that.” Despite the emotional roller-coaster redeployment has engendered, Dr. Levine says, “The visceral gratitude demonstrated by our ER nurses, respiratory therapists, ward clerks, and physicians will likely have the longest-lasting positive impact on me from this pandemic.”

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