An Oncology Nursing Team's Rapid Response to COVID-19

May 19, 2020

On Monday, March 2nd, the first confirmed COVID-19 patient in New York arrived at NewYork-Presbyterian Hospital/Columbia University Irving Medical Center. That afternoon, Maura Abbott, PhD, CPNP, and a team of oncology nurses and staff sprung to action, working around-the-clock to set up what is known now as the HIP COVID-19 Fever Clinic. For the past two months, the  clinic has been responsible for keeping the Herbert Irving Pavilion (HIP)—where the bulk of cancer patients are seen—a COVID-19 secure zone.

“I was actually in the clinic that day as the daily NP and my phone started ringing off the hook and text messages were flying in,” says Abbott, director of the Oncology Sub-Specialty Program in the Division of Hematology/Oncology at Columbia and assistant professor in the School of Nursing. “We met with [division chief] Dr. Gary Schwartz, and minutes later, I started putting together the initial screening and isolation plan that would expand to the HIP COVID-19 Fever clinic.”

In full operation by March 16, the HIP COVID-19 Fever Clinic has been instrumental in  the medical center’s rapid response to the global pandemic. In the first few days of COVID-19, before positive cases in New York City bombarded hospitals in every borough, Abbott and her team quickly began to screen all patients who arrived in the lobby of the building, carefully isolating and triaging patients and visitors who may be positive for the virus. People who were deemed “unstable” were immediately sent to the emergency room, and those with fever and who presented mild symptoms were sent home and asked to reschedule their appointments. For their safety, visitors were required to remain in the lobby or wait elsewhere.

Maintaining a COVID-19 secure zone

On March 25, just three weeks after COVID-19 hit NewYork-Presbyterian/Columbia, the HIP Fever Clinic expanded to serve as an official coronavirus testing site. On a daily basis, the clinic tests some 40 people and triages and surveys about 300.

“We’ve grown rapidly. We’re testing anyone eligible for testing,” says Abbott. “We’re seeing all patients—symptomatic and asymptomatic. At first, we wanted to just quickly make sure our cancer patients were not exposed, and now our mission and goal is to keep all of HIP a COVID-19 secure zone.”

For Abbott, jumping into the COVID-19 fray was a non-discussion; she immediately led the charge. Just a week into prepping and planning for the clinic, however, Abbott tested positive for the virus.

“I knew I had prolonged exposure to a COVID patient,” she says. “We didn’t know much then about COVID-19. By that first weekend in the clinic, I was sick, and stayed sick the following 10 days.”

Abbott turned to her co-pilot, Claire Brieva, an oncology nurse practitioner in the Division of Hematology/Oncology and a 2018 graduate of the School of Nursing. Together, the pair has led the operational end of the Fever Clinic, with partners from obstetrics, cardiology, and cancer leadership to Columbia facilities, NewYork-Presbyterian, and public safety. Since NewYork-Presbyterian/Columbia began its “re-open” in mid-May to patients with elective surgeries scheduled, the clinic has tripled their staff of nurses, nurse technicians, and nursing graduate students.

“We’ve had to coordinate care with every single provider in this building and we are making sure that patient care is first and foremost,” says Brieva. “There is an enormous amount of pressure to make sure HIP remains a COVID-19 secure and safe zone, but at the same time, I have amazing people working with me. It is a collaborative effort, and I feel empowered by this experience.”

The HIP Fever Clinic will continue to operate for as long as the pandemic lasts and holds appointments Mondays through Fridays, from 7:00 a.m. to 5:00 p.m. Undoubtedly, this pandemic has forced many across Columbia, NewYork-Presbyterian Hospital and the Herbert Irving Comprehensive Cancer Center into action. Many people have also been thrown into a new daily routine—working from home, sheltering-in-place, and social distancing. For the nurses of the HIP Fever Clinic, this pandemic has proved to be a high-anxiety and also high-rewarding time.

“I feel so proud that we’re doing this,” says Brieva. “We’ve really taken steps to make sure our patients are as safe as possible.”

“In many ways, I feel lucky,” adds Abbott. “Yes, there’s a lot of fear and anxiety in what we’re doing, but there are also real live patients, and I can help take care of them. To me, that’s the most rewarding thing of all.”