LocumLife - June 2008 - (Page 12)

BASIC NECESSITIES Her first opportunity to go to Antarctica came in August 2003. In total so far, she has completed four seasons at the McMurdo Station on the Ross Sea, and filled in just briefly at the South Pole Station when someone was ill. That station is more constrained from flying personnel in and out because the severe weather can freeze the plane’s hydraulics. There is also Palmer Station, which is a very small community closer to South America. Basically, there are two seasons in Antarctica, the austral summer and winter. The latter runs from February to late October. And, for the most part, people arrive during what is known as the Wind Fly, a brief period between winter and summer. In the summertime, McMurdo reaches its maximum population of about 1,100 to 1,200. Often, people stop over before going onto the South Pole. McMurdo also receives ships a couple of times a year to bring in supplies, so the community may blossom with another 100 to 200 people. In the winter, BARBIE BRITTELL, PA-C in front of however, the census the Dome at the old South Pole Station. drops to approximately 200 people, just enough to maintain the station. Ms. Brittell explains,“The McMurdo clinic is an old military building that was constructed when the station opened more than 50 years ago. It has a trauma area with two beds and one private room that is generally used for counseling and gynecological or private exams. Another area, that we call the ward, is considered an inpatient unit that holds three beds.” She adds, “The clinic is pretty well equipped with a crash cart, defibrillator, and ventilator. However, we are not prepared to provide long-term care. That said, we may be required to hold onto a patient for a few weeks while we arrange a Medivac transport. In the summer, weather permitting, we normally have access to military planes to fly patients out, but even then, the process could take hours to initiate. For example, on a good day with good weather, it will take a 12 LocumLife JUNE 2008 minimum of 8 to 10 hours to evacuate trauma cases or critical patients to definitive care in New Zealand. Approximately two or three times a year, someone will become seriously ill or sustain a substantial injury and will require an urgent Medivac. Still, the medical staff has the ability to practice very good trauma and emergency care.” KEEPING THE COMMUNITY SAFE Beyond the facility, says Ms. Brittell, the biggest challenge is the limited staffing. In the winter, staff consists primarily of a PA, doctor, and sometimes a physical therapist. On the other hand, in the summer, there are usually one or two physicians, a military flight surgeon, and one mid-level provider—a PA or nurse practitioner. And the complex is also staffed with a lab tech and an x-ray tech, as well as a physical therapist and a dentist. Additionally, every Medivac crew has a flight nurse who is trained in trauma. A second nurse acts as an administrator at the station, but can be pulled into a clinical role if needed. “I must emphasize how important it is for physicians to be comfortable with mid-level providers in this setting,” says Ms. Brittell.“We all take call, rotating about every third night, which removes some of the stress off of the doctors, particularly in the winter. If the doctor is not comfortable with releasing some of that authority or responsibility, then the physician will feel like he or she is on call 24/7 for the entire time. We all work together to support each other. Regardless of the season, we all conduct practice runs for mass casualties. Technically, a mass casualty is defined as an event that overwhelms the medical resources, which, in this setting could constitute two or three very sick people.” Remember Jerri Nielsen, MD, the physician who diagnosed herself with breast cancer while she was stationed at the South Pole back in 1999? The USAP administrators learned a lot from her case, like expanding medical services to include both a PA and a physician, so there is always a healthcare provider able to take care of the other if one falls sick. Plus, they have stocked the clinic with even more equipment. “We have the ability to run labs including cardiac enzymes, cholesterol and comprehensive metabolic panels, blood counts, and sed rates,” remarks this mobile adventurer. “There is a microscope that has the ability to photograph slides and send the images via computer to specialists for evaluation. The digital x-ray machine is also quite useful. If there is no tech at the station, the other medical personnel can run it and send the x-rays electronically to a radiologist for reading. In fact, through telemedicine, we have access to many services that help us care for our www.LocumLife.com http://www.LocumLife.com

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LocumLife - June 2008 Editorial Contents From Nalto Survey Says Last Minute Luxury Residency Corner Antarctica Bound 2008 Locum Tenens of the Year Awards Career Center Opportunities Direct Advertisers' Index Recruiters of the Year Showcase Contest Rules Destinations La Vita Locum

LocumLife - June 2008

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