This week’s honorable mention: Israeli PA Natalia Wolfson

Written by: Yahli Uzan
Published at: Beer-Sheva Net, July 3, 2020
Translated to English by: Roi Ozer

She works around the clock 24/7 together with her colleagues to save lives, during regular times and especially during these COVID-19 times. This week honorable mention goes to Natalia Wolfson, a Physician Assistant at the respiratory emergency department and to the teams of the Soroka Medical Center in the southern city of Beer-Sheva Israel.

The medical teams are working during these last months around the clock to help all of us with routine everyday medical issues and with the battle against the corona virus. This week Honorable Mention goes to the medical teams at the Soroka Medical Center that are doing all they can to save lives 24/7, and especially to Natalia Wolfson, a Physician Assistant at the respiratory emergency department at the Soroka Medical Center at the southern region of Israel, located at the city of Beer-Sheva. We heard from her about the challenges and hardships during the COVID-19 period (“We had to say goodbye to our daughters and were called to the flag”), the coping with pressures of the job (“Balancing between the medical needs of the patients to protection from exposure to the SARS-CoV2 is a huge challenge”), emotionally touching moments of her job (“Every patient leaves an impression on me and builds me as a person and as a caregiver”).

Natalia Wolfson is 37 years old, is married to Alex and has two daughters aged 8 and 5 years old. Natalia is a veteran paramedic and has being working as a physician assistant at the department of emergency medicine in Soroka Medical Center for the last four years. “I made Aliyah to Israel in 1991 when I was 9 years old. I grew up in Beer Sheva and studied emergency medicine in the Ben-Gurion University,” Natalia explains to Beer-Sheva Net. After 12 years of working as a paramedic in Magen David Adom, the National Israeli EMS organization, Natalia underwent a one year training course by the Israeli ministry of health to become one of the pioneers in a new profession recently introduced to the Israeli healthcare system – physician assistants working in emergency departments and oriented to emergency medicine.

Fighting COVID-19

“The COVID-19 period is challenging in every aspect. A couple of days before the closure of the educational institutions and the general lockdown, my husband was among the first ones that was drafted to a COVID-19 sampling team as part of the reserve unit of Magen David Adom and in the ED they already started to talk about a transition to working shifts of 12 hours”, Natalia recalls, “We understood that we need to create a complete separation between us and our parents in order to protect them. We had to say goodbye to our daughters for two months and we were called to the flag, and began working long and non-routine working hours”.

Natalia recalls that during those times their daughters were with their grandparents, and saw their parents only by video conversations. “It was very hard emotionally to us and to our daughters due to the physical distancing, but they understood that their Mom and Dad are fighting this epidemic. It was very challenging to manage and operate from a distance online school lessons, meetings with teachers and extracurricular activities”.

Professionally speaking, during the COVID-19 period, many changes and adaptations were done “during movement” at the medical center. For example, conducting daily follow up of innovations, changes and updates in treatment of COVID-19 patients, regular changes in the working method and even in the infrastructure of the ED itself, according to a constantly changing situation report. Natalia adds: “It is a huge challenge. On the one hand, it is very important to give the best and most appropriate treatment to COVID-19 patients, but on the other side, you can’t abandon the “regular” or “routine” patients, while protecting susceptible and weakened patients from exposure to the virus”.

Natalia adds that the job was done on the best side thanks to a unified and targeted ED team composed of: doctors, nurses, auxiliary staff, receptionists, technicians and other ED staff. “We succeed in conquering the challenges we face by the leadership of Dr. Dan Shwartzfox, Deputy Director of the Soroka Medical Center and Director of the emergency department, and of Mrs. Drori Rahel, the Director and Head of Nursing in the ED”, says Natalia, “in the respiratory ED, there is a specific, designated site for suspected COVID-19 patients. Natalia who works at this site, says it encompasses a very big challenge. This specific zone of the ED, receives a very diverse and large patient population, and part of my job is to inquire, locate and identify patients who need expert consultation and imaging. Trying to balance between the medical needs of the patient and the need to protect other patients and the medical team from COVID-19 exposure is a big challenge”.

As a Physician Assistant in the respiratory ED did you feel that the public is afraid of coming to the hospital because of the virus?

“During the lockdown period there we felt that people were afraid to come to the hospital because of the virus, but after the lockdown was opened, the numbers of people requesting treatment in the ED returned to what it was before. It is important that the public understands that in emergency and life-threatening cases they should not be afraid and they need to come to the ED to get treated. We are doing everything required to protect you and that you feel safe at Sororka”.

What is the most challenging case you had to deal with during COVID-19?

“A mother and small child with special needs, both of them tested positive to COVID-19, and the child needed hospitalization. It was a big challenge for the whole medical center, from the initial phase of testing with a pediatrician in an isolated room in the ED and through all preparations made to hospitalize the child together with her mom in isolated conditions, so that the daughter, who has special needs, wouldn’t need to be separated from her mom. Everybody in the hospital committed himself to this mission, in favor of the well being of the patient and family”.

Prepared to Treat Emergency Situations

Besides dealing with COVID-19, the teams at Soroka need to cope with considerable pressure from patients, who need to wait during long hours in the ED. Consequently, many of them decide not to seek treatment even when they are in need of emergent and urgent care. Natalia explains the importance of medical treatment and of the work done in the ED, “the department of emergency medicine is ready to treat medical emergencies effectively also during COVID-19. We can spot a medical emergency already in the triage stage done by the triage nurse and can offer rapid treatment if needed, while maintaining continuous and bidirectional communication between the medical and the nursing staff”. She adds: “I think that it is important that the public understands that the ED is not a big clinic that you come to and you are seen by a doctor according to the time you came in and in a linear or queue based method. On the contrary, in the ED, medical treatment is given according to medical acuity and the level of the patients’ medical urgency and triage level. The medical team is constantly examining and treating many patients in a parallel fashion, with ever-changing environment conditions and while constantly prioritizing emergency cases to get treated first”.

“In some cases, a more thorough and comprehensive medical inquiry is needed, and usually the patient will undergo a series of tests such as: imaging, blood tests, expert consultation, etc. which will require additional stay in the ED”, Natalia explains. She adds and says that according to the annual survey that Israeli ministry of health conducts, the Soroka ED is leading in its short wait times in relation to other large EDs in Israel, and is improving from year to year. “The team of the Soroka ED is committed to succeed also in this parameter, without lowering of treatment quality and safety, for the sake of the wellbeing of the Negev (Israel’s’ southern region) population”, she says.

The emergency department teams have to cope with a lot of pressure during their shifts and need to deal with complex cases that require emergent and urgent care. Do you think that a doctor or a team member in the ED needs to have specific character traits in order to succeed in his job?

“I think that everyone that works in emergency medicine has to be able to think clearly and respond rapidly to emergency situation. You need to put aside your feelings until the end of the event or case, in order to work with a clear mind. You also need to know how to work in a team. An emergency requires well-coordinated and synchronized actions, the ability to input information, analyze it and to give rapid, precise and clear orders. Self- criticism, introspection and an ability to draw conclusions for the future are also very important for a caregiver. And last but not least – having empathy. We need to remember that when we are treating someone, we are also taking care of his environment and his family. We need to understand the needs of the patient and his family. Giving an appropriate answer to the needs of the patient soul and spirit are important just at least, if not more, than any medicine”.

“Every Patient is a Whole World”

During the many years Natalia has been working as a paramedic and as a physician assistant she encountered more than once, heart moving stories and events, involving patients she treated. These stories and events accompany her until today, touch her soul and go with her everywhere. “After many years working day by day in emergency medicine i can recall more than one event that touches you deeply and that you take everywhere you go. Every patient is a whole world”, Natalia says, “when the ED is not crowded, I like to stop a little bit and talk with the patient about more than just the medical problem that brought him to the ED in the first place, to listen a little bit to his life story. Some patients really need that. Every patient leaves some kind of imprint or mark within me and builds me as a person and as a caregiver”.

Tells us about a case you had recently that was emotionally touching?

“There was a patient that came to the ED and told me how her daughter, that was in advanced pregnancy had died suddenly, and despite prolonged resuscitation efforts done in the field, she could not be saved. I felt like I was hit in my chest. I was the paramedic in the team that conducted those resuscitation efforts. The images of that event came back to me, I remembered how we fought and the efforts we took to save her life, and I apologized to her, that we couldn’t save her daughter. She hugged me and said quietly ‘I know, thank you for trying’ “.

What would you like to say to all your colleagues at Soroka or to the people of Beer-Sheva reading this article?

“To my colleagues, I am proud to work with you each day. I feel part of a large family, and I am thankful for the opportunity that I got to work with all of you. I hope that we will return to a normal work routine soon. To the people of Beer-Sheva and its surroundings, I want to wish good health and wellbeing. Please follow the simple rules of wearing a face mask, of social distancing and hand hygiene so that this epidemic can be eradicated, and on the meanwhile you have us to count on, the Soroka Medical Center emergency department team, that comes every day to work for the sake of all of you, willingly and with a lot of love to what we do. I hope you won’t need our services, but if you do, please don’t hesitate. We are here for you”.

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