MCPHS Responds: Julie Hurley, Assistant Professor of Physician Assistant Studies
Throughout the coronavirus pandemic, healthcare workers all over the world have been called upon to face new risks and unprecedented challenges. They have continued to do their jobs—and more—in the most trying of circumstances. As a healthcare education university, MCPHS has seen students, alumni, faculty, and staff perform bravely on the front lines in a variety of healthcare roles. We want to shine a light on some of these individuals and their work in the time of coronavirus. We encourage you, members of the MCPHS community, to share your front-line stories using the hashtag #MCPHSResponds.Even in ordinary times, Julie Hurley’s job as a physician assistant on an oncology floor at a South Shore community hospital can be difficult; it takes a certain kind of strength and commitment to provide end-of-life care. Hurley, Assistant Professor in the School of Physician Assistant Studies at MCPHS in Boston, says the work is a calling, and that “patients deserve the same kind of dignity and respect when they leave this earth as when they are born.”
This devotion to patient quality of life is something that’s found its way into Hurley’s teaching in the PA curriculum at MCPHS. "I teach the difficult conversations and how to deliver difficult messages with empathy,” she says. “I also discuss the definition of hope. Hope for each person is different. And to be a good PA, you need to understand what a patient's hope is. It's not what your hope is." It’s the sort of compassionate care mindset espoused in books like Being Mortal by Atul Gawande and The Definition of Hope by Jerome Groopman. And it’s the mindset Hurley brought to work when her oncology floor began to be flooded with COVID-19 patients.
“There's a floor dedicated to all the oncology patients. They were trying to keep it strictly the oncology patients. But because of the number of patients admitted with the virus, there was some overflow,” Hurley says. “They were there because they were getting compassionate end-of-life care.” Hurley decided to take on weekend shifts as the number of COVID-19 patients rose; she says she felt capable of working and therefore called to use her training to help during the pandemic. She found one thing in particular the most challenging, but not for the reasons you might think.
Hurley is extremely grateful for personal protection equipment (PPE) like masks, face shields, and gloves. It works, she says, and if used according to guidelines, it stops the spread of the virus. It allows her some sanity when coming home to her family from work. And though it can be unwieldly and less than comfortable, that doesn’t bother her. It’s something less obvious about PPE that Hurley finds difficult: the obstacles it can present to spending time with and giving human touch to patients. She says she and her team struggle emotionally with not spending “the time with the patients that we want to because we have to completely gown up, glove up, mask up.” In a world where technology is king and safety is paramount, that human element can often go overlooked.
She continues, “The warmth in someone's smile was just taken away from us because we are covered with an N95 mask. Some of the staff, we were putting photos of ourselves on our chest or on the outside so that [the patients] would actually know what our faces look like...there's the power of human touch and healing with human touch, and giving that compassionate care we're trained to give. But now we’re divided by this level of PPE.”
The change from ordinary routine to new safety protocols happened quite suddenly, without a ton of time to train and adjust—just like Hurley says, “there wasn't much time to take everything that we've been doing at professors and then bring it to a virtual-only environment.”
But teaching her students, even remotely, has been one of the brightest spots for Hurley during the pandemic:
What I found most rewarding was being able to share my experiences with the students. Our third-year students who haven't yet been able to start rotations because of SARS-COVID-2 virus got a glimpse of pandemic care through my experiences. I was able to talk about the uplifting aspects, the patients that did get better, and to recount poignant moments.... I was able to revisit the importance of end-of-life care and how compassion flooded the wards. Some of the students deservedly felt sidelined by the virus, but when I think about the flip side, they will be entering their rotations in the aftermath of a pandemic and armed with the most vital medical instrument known: empathy.
In this age of necessary sterility and distance, Hurley believes it’s vital to the success of medical care that healthcare providers still find ways to deliver empathy and personal touch—particularly for those receiving end-of-life care. To be able to emphasize the importance of humanity in healthcare to students at MCPHS, and during such a pivotal time, is fulfilling. Says Hurley, “I feel very humbled.”