To See or Not to See: An Orphan Program Student’s Perspective on Seeing Suspected COVID and COVID Positive Patients

Opinion

Kellan Etter, OMSIV, Des Moines University College of Osteopathic Medicine
EMRA MSC Great Plains Representative

“Hey, why don’t you go see the new patient that just came into 18?”

“Sure thing!” I reply, eager to show my excitement and enthusiasm. As a student from an orphan program I have been travelling from hospital to hospital throughout the year. Each month, I need to be on my A-game to impress a new set of attendings, each with different likes, dislikes, structure, and culture, all while figuring out a new city and living situation. I peek at the board to see a common chief complaint that these days tends to stop me in my tracks: Cough, Shortness of Breath.

“Uhh…” I’ll start unintentionally, trying to figure out based on the limited information if this patient may or may not be a COVID rule-out.
My attending will realize, “Oh, you’re not allowed to see potential COVID patients, are you?” And pause before continuing, “Well, you know, it’s your education.”

Well, it’s your education.

It’s never meant with any malicious or leading intent, the phrase conveys the inherent message of EM—this is the job. However, as a visiting student on an audition rotation, I feel the need to impress at every turn, and turning down the opportunity to see a patient may be seen as a negative. The truth is, I want to see these patients and connect to those fighting in the trenches during this unprecedented time. I want to be a part of the team, and help the department the best I can. But I have explicit instructions not to. Liability issues aside, everyone wants to make sure we are protected, and can continue our education (relatively) uninterrupted. Even during a global pandemic, there are still plenty of patients to learn from and ways to contribute to the team. Regardless, when faced with the opportunity, I still feel torn. I know that I should not see COVID patients, but when presented with the idea that it’s my education, I tend to get pulled in the other direction.

It has been a tough year as an EM-bound medical student. I’ve tried to express genuine enthusiasm to see any patient, while walking the thin line between excitement to help and necessary restraint to keep myself safe. For me, the scariest aspect of this year has been losing the opportunity to shine and prove to myself and our prospective residency program that I have what it takes, that I can put patients first. Any concern about the virus itself has been secondary. I need to remind myself that programs and potential residency homes are not holding my decisions to err on the side of safety against me. It is my education. And no matter how I approach seeing COVID patients in the ED, I’m going to be just fine come July, and I know you will be too.