Scott Darrah is an advanced practice nurse at the University of Virginia Medical Center, where he tends to COVID-19 patients in an acute care setting. And he is a leader in developing three acute care units to handle coronavirus patients as special pathogens units, or SPUs.

Several acute care units and intensive care units at the hospital have become designated as special pathogens units, so as to separate COVID-19 patients from non-COVID-19 patients and prevent the spread of the virus.

“When you have a volume that’s too many for that area, you, kind of, like a light switch, turn on the next unit to become just that unit as well,” Darrah explained. “And so, we will fluctuate to having just single-digit amounts of patients to being constantly full. It just depends on what the need is. And I think the trick is to keep the next unit able and ready enough to be able to flip that switch, and we tend to overflow into that area. And so it’s always playing that kind of mental chess to stay ahead for beds.”

What distinguishes acute care units and intensive care units is the level of care, Darrah said.

“So if I need any invasive life-prolonging things like intubation or a breathing tube or medicines to keep my blood pressure up, I will need the critical care unit,” he said. “But if I need some close monitoring and nursing specialized care, but not necessarily need help breathing, I would be in an acute care setting. So we deal with the same population, just different layers of illness.”

As the future of personal protective equipment supplies around the country remains uncertain, Darrah said one of the hardest things right now is balancing transparency with avoiding causing fear or distress.

Although things may be relatively stable now, and the curve flattened for the most part, among health professionals, the feeling that everything could change swiftly and devastatingly remains.

“In our acute care setting, we’re seeing the majority of our patients do relatively well,” he said. “So that’s been good. I can’t say the same for my ICU colleagues who see a lot of these patients not do as well, especially when they need mechanical ventilation. And so it’s kind of what we all signed up for in a lot of ways, but we didn’t sign up for the support system that’s not guaranteed.”

He added in an email that the hospital “rose to the challenge of balancing transparency, front-line safety and supply issues” and certified that health-care workers have stayed safe at UVa.

Through it all, Darrah remains optimistic that when Charlottesville and America as a whole emerge from the crisis, they will have grown from it.

“I think we’re learning so much about each other at work going through this together that I think there’s gonna be some really good things that’ll happen — at UVa specifically, but I think in healthcare in general in this country, it is really going to change for the better,” Darrah said. “I’m very optimistic about that because I think this crisis has highlighted some of the gaps in terms of being ready for large scale things but also, what do we really value out of people in this country when push comes to shove?”

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