A View from the Trenches

By Eric Cipcic, CRNA, PHRN, MSN
From the Bloomsburg Municipal Airport April Newsletter

Newsletter coordinated by BJ Teichman, Airport Coordinator & Dave Ruckle, Pilot
Emails: airportcoordinator@bloomsburgpa.org; ruckleds@yahoo.com
“Dave and I have always encouraged pilots to participate in the N13 newsletter. In the spirit of that we share the article below submitted by Eric Cipcic.

Eric Cipcic, CRNA

Greetings fellow pilots and aviation enthusiasts! Well, here we are going into mid-April and now is the time that I really start to get antsy to do some serious flying; The weather is gorgeous, Sun n Fun is here, Oshkosh is around the corner, and there’s lots of pancake breakfasts & fly ins rip-roaring and ready to go. But whoaaaa!! Hold the phone. This spring a pandemic has pulled the reins back on all adventures big & small, affecting nearly every single thing we do. Yet, in these unprecedented, tumultuous times, we are coming together as communities; we are sacrificing in ways that we never imagined would happen in our time; we are proving that we are stronger collectively and will fight as such to persevere through this dark period. To each of you I say “thank you.”

But with so much going on, I can’t help to daydream a little. Think back to that windy, somewhat gusty day, when the sun was beaming and you decided to go over to Selinsgrove to practice some crosswind landings. As you plotted your way over to the neighborhood 4700’ strip, the usual planning, pilotage, and persistence took hold: today is gonna be great because it’s going to be a challenge! The CTAF is quiet and the pattern is clear (probably because no one wants to fly in this windy crap) and you enter downwind for 35, turning base, and then final, ultimately crabbing or weathervaning your way to the threshold. As you glide through your ground effect and gently grease the upwind tire onto the runway, followed by the other tire, and finally let the nose tire rest down upon the runway, you feel a tidal wave of emotion cascade over you. THAT WAS GREAT!! And a big ‘ole smile ensues. Now let me ask you a question: Did that just happen by chance or accident? No! It happened because you were prepared. It happened because you were trained, you were vigilant, and you were prepared. I am an advanced practice, critical care, CRNA (certified registered nurse anesthetist) for UPMC Susquehanna in Williamsport. I write to you in a time when we have all been inundated with news and pictures of the horrific images encompassing New York and surrounding areas that depict unimaginable conditions, shortages, fatigue, and death. I wanted to convey a brief message to you and describe what’s going on within the critical care units in the hospitals among our local communities. This is a view from the trenches where many of us are spending 12–16 hours a day, and although we are not living in other regions where infection rates and death tolls continue to rise, we are not immune to SARS-CoV-2 (the new coronavirus causing Covid-19). Here’s the truth: We are prepared….both as hospitals and healthcare providers, and most importantly, as a community.

Is Covid-19 coronavirus here? Yes, you bet it is. It is an infectious disease caused by a new virus that spreads primarily through an infected person who breathes, coughs, or sneezes on someone else; it can also spread by contact (touching) a contaminated surface. I have intubated patients in our ICU and have performed invasive procedures on infected patients, such as arterial catheters (a-lines). We wear full PPE equipment to protect ourselves and maintain strict isolation protocols.

Under black light, you can see what a cough and sneeze can splatter on a face shield.

Fortunately, the medical community has borrowed its best tricks from us in aviation! Before I enter a negative pressure isolation room, there are a host of people akin to dispatchers, co-pilots, and ATC to guide everyone collectively through this critical procedure of intubating the patient. There is two-way comm between the isolation room and the outside command area. But of utmost importance, there is a detailed 40 point checklist that is systematically followed, read-back by a charge nurse next to you, and no one moves on to the next step until CRM (crew resource management) is met, and everyone agrees and repeats aloud the confirmation of the task. Makes you proud to be a pilot. The isolation is taken very seriously, as you can imagine. You enter the room in a 2 by 2 fashion, always having a buddy to watch your back (and you watch theirs). Even within the room, there are contaminated, and partially contaminated sections, clearly marked and taped off on the floor. All the while you have an immediate support group just outside the glass doors to assist you, in case of an emergency, or if you just need further supplies. It is a grueling choreography and somewhat surreal in nature. You’ve seen the images in the news and can imagine the complexity not to contaminate yourself, your colleague, the ICU, and ultimately take coronavirus home and infect your family and the community. What you don’t hear about is how incredibly HOT all of those layers of gowns, and gloves, and shields, and booties get to be. There is limited access in & out of an isolation room, and you could be stuck sweating in there for a couple hours. Remember to pee first before putting your PPE gear on, and take just a little sip of water!

My hospital has been ready for a storm for quite a long while, and I know that other major facilities in the region are as well. We all talk with each other, communicate, and help each other out in this time of need. We have daily briefings so that everyone is up to speed and on point. We have floors that are locked up, sterile, stocked, and ready to accommodate an overwhelming influx of sick patients. “So why isn’t Covid-19 widespread in my community…I’m not sick and I feel fine?” Because you are doing exactly what needs to be done, admirably and with flying colors! As a community, we are staying home, we are social distancing, we are wiping everything down and cleaning surfaces that could (and are) contaminated….and we are washing our hands, washing our hands, and washing our hands until it feels like the skin is gonna peel off! Right?! Trust me…follow me around a 16-hour shift in critical care and you wouldn’t believe that you could scrub yourself so much in one day.

A randomized study in Italy last week (one of the hardest hit regions on the planet) took 60 asymptomatic people, who stated they hadn’t been sick, and tested them for coronavirus: 40 of the people tested positive, and were essentially infecting the population without knowing it. On behalf of all the healthcare workers in your community, we thank you for your continued vigilance and now more than ever, we must continue these simple, life-saving efforts. You are prepared. Finally, just a few notes about your healthcare providers: your doctors, nurses, techs, and everyone that cares for you. We’re scared. Yep…there it is. Cat’s outta the bag. We won’t show you; we will never lead on that we are, but there’s not a moment that goes by when we don’t want to see another person suffering, or another patient of ours die.

An isolation room ready to be used.

We are terrified that we will bring this home to our babies, our spouses, our family, and our friends. Combine that with mental, emotional, and physical work exhaustion and one would wonder why we don’t crumble. Yet the answer is simple: we love what we do. We thrive to help others at the expense of our own well being. There is nothing more gratifying than compassion and caring for someone in need, and nothing more beautiful than to hear a patient say, “thank you so much…without you I don’t know what I would have done!” And yet, somehow, the most uncomfortable feeling is to be called a hero. Although I say with the utmost gratitude, thank you, it simply doesn’t feel right to have that label for doing something that you absolutely love. You are the reason that we’ll walk thru hell and back, and keep coming back for more. I walked into work the other day and neighborhood kids had drawn pictures on every sidewalk near the employee entrance, thanking us, and reminding us to be strong, because we need you, you are our heroes…..I was so taken back by this simple gesture; my heart rang out with joy, and the tears I was trying to hold back would make one think I had just gotten pepper-sprayed!

So again, I want to thank you for your efforts, your kind words, and your love in keeping us going. You are keeping us safe, so that we can keep you safe.

So, as I finish off another fruitful 16-hour shift and take my tired bones home, I think I’m gonna bring the flaps up….push the throttle forward….ease back on the yolk….and come around for one more of those beautiful crosswind landings! This one will be full stop. Please stay safe, be healthy, and I look forward to seeing you in the skies again very soon.

Best regards, Eric