2019 Wayne State physical therapy graduate steps up to COVID-19 front lines
Kristen Robertson, PT, DPT graduated from Wayne State’s Doctor of Physical Therapy program in December 2019 and her career has taken some unexpected turns in the short time since then.
Everything started out according to plan in January, when Dr. Robertson took a physical therapist position at a Detroit-area outpatient clinic. The job was what she had hoped and trained for while studying at the Eugene Applebaum College of Pharmacy and Health Sciences, having completed a clinical experience at that very clinic prior to graduation.
“I worked with orthopaedic patients to educate them on their diagnosis, train and improve movement ability, reduce pain, and restore function. It was a welcoming environment — I wasn’t afraid to ask questions and received great mentorship,” Dr. Robertson said, adding that she enjoyed working with patients with Parkinson’s disease, as well as helping those who’d had hip and knee replacements in the morning get up and walk by the afternoon.
She remembers March 11 as the day the World Health Organization declared the novel coronavirus outbreak a pandemic. And she remembers March 23 as the day her clinic closed.
In the less than two weeks between those two dates, the clinic discharged patients nearing the end of therapy and put plans in place for those still needing treatment. “We were given adequate time to personally call each patient,” said Dr. Robertson, who reviewed home exercise programs with everyone and gave them her email address so they could reach out if they had questions even after she was officially off the job. “On March 23, I saw the last few acute post-op patients, and the general mood was uncertain but hopeful.”
Then Dr. Robertson was redeployed to the hospital’s ER, going from post-op physical therapy to assisting with screening incoming patients and employees for COVID-19.
She was unfazed: “I am a health care professional. I will always help however I can.”
And so she did, greeting everyone warmly as she reviewed symptoms and took temperatures. “Tests were very scarce at the time, and since we didn’t know as much then, they wouldn’t test without a 103-degree fever,” she recalled. “It was an opportunity to see symptomatic COVID-19 patients firsthand as I worked alongside nurses. I didn’t treat patients, but I could offer a kind face for them to see.”
Dr. Robertson was soon redeployed again, this time as a mobility aid on an inpatient non-COVID unit, put in place to help reduce strain on the hospital. “My job was to provide help with ambulation, ensuring patient safety while on the unit,” she said.
And then she was redeployed again — this time to work with the hospital’s most critically ill COVID-19 patients. As a member of a 4- to 6-person proning team, Dr. Robertson worked with medical professionals including occupational therapists, RNs, nurse anesthesiologists and respiratory therapists to place sedated, intubated patients on ventilators on their stomachs to improve ventilation.
Prior to beginning her acute care assignment, Dr. Robertson studied up on best practices, reviewing webinars, articles and other COVID-19 resources offered by the Michigan Physical Therapy Association and the American Physical Therapy Association.
Everyone in the room had a specific job, from administering sedation to keeping lines tangle-free. “As PTs, we were in charge of patient positioning to minimize pressure injuries and neuromusculoskeletal impairments,” Dr. Robertson said. “Patients stayed proned for 16 hours at a time — imagine how uncomfortable you’d be if you sat still in a chair for just 20 minutes! So we needed to place them so their skin didn’t break down, and make sure their body position was correct without pressure on their shoulders, hips or knees, for example. Combining collaboration and communication was critical to care for these patients.”
The proning process took 15- to 45-minutes depending on factors such as blood oxygen levels, and it always started with suiting up in full PPE: a P100 respirator mask, face shield, gown and a double layer of gloves. “We always had enough PPE,” Dr. Robertson said. But that didn’t keep her from feeling uneasy at times.
“The longer you’re in there, the more exposed you are,” she said. “I just focused on getting the job done and trying to make the patient as comfortable as they could be. They’re all alone in there, and they’re sedated, so we can’t have a conversation with them, but we can send them healing thoughts and feelings.”
At first, Dr. Robertson helped prone as many as 12 patients during a 12-hour shift. As Detroit’s curve began to flatten, that pace began to slow. During her last day on the proning team, Dr. Robertson worked with just one patient. She was furloughed on May 3.
“I see that as a good sign,” she said. “I think it means things are getting better.”
And that was her perspective when she shared her experience with Assistant Clinical Professor Martha Schiller’s PT 8800 class two days later. Speaking to students who are scheduled to go out on their terminal clinical experiences at the end of May, Dr. Robertson offered tips and brought students up to speed on the clinical environment they’re about to enter.
“Kristen went through a lot of change in a short time for a recent graduate,” said Dr. Schiller. “It required flexibility, adaptability, use of evidence-based practice skills, interprofessional collaboration — all goals of our DPT program.”
Dr. Robertson agreed that her WSU education — including clinical rotations in a range of settings and taking part in interprofessional activities — gave her confidence and taught her that “communication and collaboration are key in providing the best care.”
During her time off, Dr. Robertson is attending webinars and participating in continuing education as she eagerly awaits the day that she can resume treating patients in the clinic.
“I think everything I’ve experienced will help me and my colleagues as we start to care for recovering COVID-19 patients,” she said. “They’ve been lying in bed for so long that they’ve lost the strength needed to stand up straight and even breathe properly. I’m looking forward to helping these patients build back that endurance and start to improve their mobility and function. I’m just so glad I can contribute.”